S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7467
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               May 24, 2023
                                ___________
 
 Introduced by M. of A. PAULIN, SAYEGH, STECK, SIMON, COOK, GLICK, VANEL,
   LUNSFORD,   L. ROSENTHAL,   BRONSON,   ZEBROWSKI,   THIELE,  WILLIAMS,
   BICHOTTE HERMELYN, CARROLL, FALL, GALLAGHER,  FORREST,  CRUZ,  STIRPE,
   CLARK, COLTON, SANTABARBARA, HUNTER, JACKSON, ZINERMAN, KELLES, JACOB-
   SON,  OTIS,  WALLACE, MEEKS, SILLITTI -- read once and referred to the
   Committee on Health
 
 AN ACT to amend the public health law, in relation to the use of psycho-
   tropic medications in nursing homes and adult care facilities
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The  public health law is amended by adding a new section
 280-d to read as follows:
   § 280-D. USE OF PSYCHOTROPIC MEDICATIONS IN NURSING  HOMES  AND  ADULT
 CARE FACILITIES. 1. AS USED IN THIS SECTION:
   (A)  "PSYCHOTROPIC  MEDICATION" MEANS A DRUG THAT AFFECTS BRAIN ACTIV-
 ITIES ASSOCIATED WITH MENTAL PROCESSES AND BEHAVIOR, INCLUDING, BUT  NOT
 LIMITED TO, ANTIPSYCHOTICS, ANTIDEPRESSANTS, ANTIANXIETY DRUGS OR ANXIO-
 LYTICS, AND HYPNOTICS;
   (B)  "LAWFUL  REPRESENTATIVE" MEANS, WHERE A PATIENT LACKS CAPACITY TO
 CONSENT TO HEALTH CARE, A PERSON AUTHORIZED TO CONSENT ON BEHALF OF  THE
 PATIENT,  INCLUDING,  BUT NOT LIMITED TO, A HEALTH CARE AGENT AUTHORIZED
 BY A HEALTH CARE PROXY UNDER ARTICLE TWENTY-NINE-C OF THIS CHAPTER OR  A
 SURROGATE UNDER ARTICLE TWENTY-NINE-CC OF THIS CHAPTER;
   (C)  "INCREASE"  WHEN  USED IN RELATION TO AN ORDER FOR A PSYCHOTROPIC
 MEDICATION, MEANS AN INCREASE OF THE DOSAGE OR DURATION OF  THE  MEDICA-
 TION  ABOVE  THE  DOSAGE  OR  DURATION  COVERED  BY THE CURRENTLY ACTIVE
 CONSENT;
   (D) "HEALTH CARE  PROFESSIONAL"  MEANS  A  HEALTH  CARE  PROFESSIONAL,
 LICENSED,  CERTIFIED  OR AUTHORIZED TO PRACTICE UNDER TITLE EIGHT OF THE
 EDUCATION LAW, ACTING WITHIN HIS OR HER LAWFUL SCOPE  OF  PRACTICE,  WHO
 HAS AUTHORITY TO ORDER A PSYCHOTROPIC MEDICATION; AND
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01548-01-3
              

 A. 7467                             2
 
   (E)  "PATIENT"  MEANS AN INDIVIDUAL WHO IS A RESIDENT OF A RESIDENTIAL
 HEALTH CARE FACILITY AS DEFINED IN ARTICLE TWENTY-EIGHT OF THIS CHAPTER,
 OR AN ADULT CARE FACILITY CERTIFIED UNDER SECTION  FOUR  HUNDRED  SIXTY-
 ONE-B OF THE SOCIAL SERVICES LAW.
   2.  (A) AN ORDER FOR A PSYCHOTROPIC MEDICATION IN A NURSING HOME SHALL
 INCLUDE THE DOSAGE, FREQUENCY, AND DURATION OF THE ORDER WHICH SHALL NOT
 EXCEED FOURTEEN DAYS. A HEALTH CARE PROFESSIONAL, WHO IS EMPLOYED BY  OR
 CONTRACTED  WITH  A  NURSING  HOME  OR  ADULT  CARE  FACILITY TO PROVIDE
 SERVICES TO FACILITY RESIDENTS,  OR WHO PROVIDES SERVICES ON SITE  IN  A
 NURSING  HOME  OR  ADULT  CARE FACILITY, MAY NOT PRESCRIBE OR INCREASE A
 PRESCRIPTION FOR A PSYCHOTROPIC MEDICATION FOR A PATIENT IN SUCH FACILI-
 TY UNLESS THE HEALTH CARE PROFESSIONAL HAS OBTAINED THE WRITTEN INFORMED
 CONSENT OF THE PATIENT OR THE PATIENT'S  LAWFUL  REPRESENTATIVE,  OR  IS
 ACTING  PURSUANT  TO  AN  ORDER  UNDER  THIS SECTION, OR IS ACTING UNDER
 SUBDIVISION THREE OF THIS SECTION. WHERE A  PATIENT  LACKS  CAPACITY  TO
 CONSENT TO HEALTH CARE AND LACKS A LAWFUL REPRESENTATIVE, A PRESCRIPTION
 OR  INCREASE  OF  A  PRESCRIPTION UNDER THIS SECTION SHALL BE SUBJECT TO
 SUBDIVISION FOUR OF SECTION TWENTY-NINE HUNDRED  NINETY-FOUR-G  OF  THIS
 CHAPTER  AS  IF  THE PATIENT WERE AN INPATIENT OF A GENERAL HOSPITAL. TO
 CONSTITUTE INFORMED CONSENT, THE FOLLOWING DISCLOSURE SHALL BE GIVEN  TO
 THE  PATIENT  OR,  WHERE THE PATIENT LACKS CAPACITY TO CONSENT TO HEALTH
 CARE, THE PATIENT'S LAWFUL  REPRESENTATIVE,  IN  A  CLEAR  AND  EXPLICIT
 MANNER:
   (I)  THE  REASON FOR THE MEDICATION, INCLUDING THE NATURE AND SERIOUS-
 NESS OF THE PATIENT'S ILLNESS, DISORDER OR CONDITION THAT THE MEDICATION
 IS INTENDED TO TREAT;
   (II) THE ANTICIPATED BENEFIT FROM  THE  MEDICATION,  AND  THE  DOSAGE,
 FREQUENCY, AND DURATION OF THE ORDER;
   (III)  THE  PROBABILITY  OF  SIDE EFFECTS AND SIGNIFICANT RISKS OF THE
 MEDICATION, INCLUDING THE NATURE, DEGREE, AND DURATION OF  SUCH  EFFECTS
 AND REASONABLY KNOWN RISKS;
   (IV)  THE REASONABLE ALTERNATIVE TREATMENTS TO THE PROPOSED MEDICATION
 AND THE REASON THAT THE HEALTH CARE PROFESSIONAL  PREFERS  THE  PROPOSED
 MEDICATION IN THIS INSTANCE; AND
   (V) THAT THE PATIENT OR LAWFUL REPRESENTATIVE HAS THE RIGHT TO CONSENT
 OR  REFUSE  CONSENT TO USE OF THE PROPOSED MEDICATION, AND THAT IF HE OR
 SHE CONSENTS, HE OR SHE HAS THE RIGHT TO REVOKE HIS OR HER  CONSENT  FOR
 ANY  REASON,  AT  ANY  TIME,  INCLUDING A DESCRIPTION OF HOW THE CONSENT
 SHALL BE REVOKED.
   (B) THE HEALTH CARE  PROFESSIONAL  SHALL  DOCUMENT  IN  THE  PATIENT'S
 MEDICAL  RECORD  THE  DATE AND TIME THAT THE INFORMED CONSENT DISCLOSURE
 WAS PROVIDED, AND TO WHOM AND BY WHOM IT WAS PROVIDED, AND  INCLUDE  THE
 WRITTEN CONSENT.
   (C)  WHERE THE PATIENT'S MEDICAL RECORD NOTES THAT A FAMILY MEMBER HAS
 REQUESTED NOTIFICATION OF MEDICATION ORDERS OR PRESCRIPTIONS,  AND  SUCH
 NOTIFICATION  IS  OTHERWISE  LAWFUL,  THE HEALTH CARE PROFESSIONAL SHALL
 CAUSE  NOTICE  TO  BE  PROVIDED  WITHIN   FORTY-EIGHT   HOURS   OF   THE
 PRESCRIPTION,  ORDER, OR INCREASE OF AN ORDER OR PRESCRIPTION UNDER THIS
 SECTION. SUCH NOTICE SHALL NOT BE PROVIDED IF THE  PATIENT  SPECIFICALLY
 REQUESTS THAT THE FAMILY MEMBER NOT BE GIVEN NOTIFICATION.
   3.  A HEALTH CARE PROFESSIONAL IS NOT REQUIRED TO OBTAIN CONSENT UNDER
 THIS SECTION TO ISSUE AN ORDER FOR USE OF A PSYCHOTROPIC MEDICATION  FOR
 A  PATIENT  IN  A  NURSING HOME WHERE IT IS NECESSARY IN AN EMERGENCY TO
 PROTECT AGAINST AN IMMEDIATE THREAT TO THE LIFE, HEALTH OR SAFETY OF THE
 PATIENT OR ANOTHER PERSON.  THE MEDICATION MUST BE THE MOST  APPROPRIATE
 AVAILABLE  MEANS  OF  REDUCING  THAT THREAT, WITH THE LEAST RISK OF HARM
 A. 7467                             3
 
 CONSIDERING THE PATIENT'S CONDITION OR DISORDER. THE  ORDER  SHALL  ONLY
 APPLY,  IN  THE ABSENCE OF CONSENT, DURING THE EMERGENCY. WHERE AN ORDER
 IS MADE UNDER THIS SUBDIVISION, THE HEALTH CARE PROFESSIONAL SHALL IMME-
 DIATELY  RECORD  THE  USE OF THE PSYCHOTROPIC MEDICATION, THE REASON FOR
 THE USE, AND THE DOSAGE, IN THE  PATIENT'S  MEDICAL  RECORD;  AND  SHALL
 PROMPTLY  NOTIFY  THE PATIENT OR THE PATIENT'S LAWFUL REPRESENTATIVE WHO
 WOULD HAVE HAD THE AUTHORITY TO CONSENT, AND ANY FAMILY MEMBER  REQUIRED
 TO  BE  NOTIFIED UNDER THIS SECTION AND RECORD SUCH NOTIFICATIONS IN THE
 PATIENT'S MEDICAL RECORD.
   4. THIS SECTION DOES NOT INCREASE THE LAWFUL SCOPE OF PRACTICE OF  ANY
 HEALTH CARE PROFESSIONAL AND DOES NOT DIMINISH OR IMPAIR ANY REQUIREMENT
 FOR OR REGULATION OF CONSENT TO HEALTH CARE TREATMENT.
   5. THE COMMISSIONER MAY MAKE REGULATIONS TO IMPLEMENT THIS SECTION.
   § 2. This act shall take effect on the one hundred eightieth day after
 it  shall have become a law. Effective immediately, the addition, amend-
 ment and/or repeal of any rule or regulation necessary for the implemen-
 tation of this act on its effective date are authorized to be  made  and
 completed on or before such effective date.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7467--A
                                                         Cal. No. 409
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               May 24, 2023
                                ___________
 
 Introduced by M. of A. PAULIN, SAYEGH, STECK, SIMON, COOK, GLICK, VANEL,
   LUNSFORD,   L. ROSENTHAL,   BRONSON,   ZEBROWSKI,   THIELE,  WILLIAMS,
   BICHOTTE HERMELYN, CARROLL, FALL, GALLAGHER,  FORREST,  CRUZ,  STIRPE,
   CLARK, COLTON, SANTABARBARA, HUNTER, JACKSON, ZINERMAN, KELLES, JACOB-
   SON,  OTIS, WALLACE, MEEKS, SILLITTI, GUNTHER, WEPRIN -- read once and
   referred to the Committee on Health -- reported and  referred  to  the
   Committee  on  Codes  --  reported from committee, advanced to a third
   reading, amended and ordered reprinted, retaining  its  place  on  the
   order of third reading
 
 AN  ACT  to amend the public health law, in relation to the use of anti-
   psychotic medications in nursing homes
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The  public health law is amended by adding a new section
 280-d to read as follows:
   § 280-D. USE OF ANTIPSYCHOTIC MEDICATIONS IN NURSING  HOMES.    1.  AS
 USED IN THIS SECTION:
   (A)  "LAWFUL REPRESENTATIVE" MEANS, WHERE A RESIDENT LACKS CAPACITY TO
 CONSENT TO HEALTH CARE, A PERSON AUTHORIZED TO CONSENT ON BEHALF OF  THE
 RESIDENT,  INCLUDING, BUT NOT LIMITED TO, A HEALTH CARE AGENT AUTHORIZED
 BY A HEALTH CARE PROXY UNDER ARTICLE TWENTY-NINE-C OF THIS CHAPTER OR  A
 SURROGATE UNDER ARTICLE TWENTY-NINE-CC OF THIS CHAPTER; AND
   (B)  "HEALTH  CARE  PROFESSIONAL"  MEANS  A  HEALTH CARE PROFESSIONAL,
 LICENSED, CERTIFIED OR AUTHORIZED TO PRACTICE UNDER TITLE EIGHT  OF  THE
 EDUCATION  LAW,  ACTING  WITHIN  SUCH  HEALTH CARE PROFESSIONAL'S LAWFUL
 SCOPE OF PRACTICE, WHO HAS AUTHORITY TO ORDER AN  ANTIPSYCHOTIC  MEDICA-
 TION.
   2.  (A)  A NURSING HOME OR A HEALTH CARE PROFESSIONAL SHALL OBTAIN THE
 INFORMED CONSENT OF THE RESIDENT  OR  THE  RESIDENT'S  LAWFUL  REPRESEN-
 TATIVE, BEFORE INITIATING THE ADMINISTRATION OF AN ANTIPSYCHOTIC MEDICA-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01548-06-4
              

 A. 7467--A                          2
 
 TION  FOR  A  RESIDENT,  PROVIDED  THAT  INFORMED  CONSENT  SHALL NOT BE
 REQUIRED IN THE CASE OF:
   (I)  A  RESIDENT  WHO  HAS BEEN PRESCRIBED AN ANTIPSYCHOTIC MEDICATION
 PRIOR TO AN ADMISSION OR READMISSION TO THE NURSING HOME;
   (II) A RESIDENT WHO HAS PREVIOUSLY PROVIDED  INFORMED  CONSENT  WITHIN
 THE LAST TWELVE MONTHS;
   (III) A RESIDENT RECEIVING HOSPICE CARE;
   (IV) A RESIDENT OF A NURSING HOME'S CERTIFIED BEHAVIORAL UNIT;
   (V) A RESIDENT WITH A PRIMARY DIAGNOSIS OF HUNTINGTON'S DISEASE; OR
   (VI) AN EMERGENCY AS DEFINED IN SUBDIVISION THREE OF THIS SECTION.
   (B)  WHERE  A  RESIDENT  LACKS  CAPACITY TO CONSENT TO HEALTH CARE AND
 LACKS A LAWFUL REPRESENTATIVE, A PRESCRIPTION UNDER THIS  SECTION  SHALL
 BE  SUBJECT  TO  SUBDIVISION FOUR OF SECTION TWENTY-NINE HUNDRED NINETY-
 FOUR-G OF THIS CHAPTER AS IF THE RESIDENT WERE AN INPATIENT OF A GENERAL
 HOSPITAL. TO CONSTITUTE INFORMED CONSENT, THE FOLLOWING DISCLOSURE SHALL
 BE GIVEN TO THE RESIDENT  OR,  WHERE  THE  RESIDENT  LACKS  CAPACITY  TO
 CONSENT TO HEALTH CARE, THE RESIDENT'S LAWFUL REPRESENTATIVE, IN A CLEAR
 AND EXPLICIT MANNER:
   (I)  THE  REASON FOR THE MEDICATION, INCLUDING THE NATURE AND SERIOUS-
 NESS OF THE RESIDENT'S ILLNESS, DISORDER OR CONDITION THAT  THE  MEDICA-
 TION IS INTENDED TO TREAT;
   (II)  THE  ANTICIPATED  BENEFIT  FROM  THE MEDICATION, AND THE DOSAGE,
 FREQUENCY, AND DURATION OF THE ORDER;
   (III) THE PROBABILITY OF SIDE EFFECTS AND  SIGNIFICANT  RISKS  OF  THE
 MEDICATION,  INCLUDING  THE NATURE, DEGREE, AND DURATION OF SUCH EFFECTS
 AND REASONABLY KNOWN RISKS;
   (IV) THE REASONABLE ALTERNATIVE TREATMENTS TO THE PROPOSED  MEDICATION
 AND THE REASON THAT THE PRESCRIBING HEALTH CARE PROFESSIONAL PREFERS THE
 PROPOSED MEDICATION IN THIS INSTANCE; AND
   (V)  THAT  THE  RESIDENT  OR  LAWFUL  REPRESENTATIVE  HAS THE RIGHT TO
 CONSENT OR REFUSE CONSENT TO USE OF THE PROPOSED MEDICATION, AND THAT IF
 SUCH RESIDENT OR LAWFUL REPRESENTATIVE CONSENTS, SUCH RESIDENT OR LAWFUL
 REPRESENTATIVE HAS THE RIGHT TO REVOKE SUCH RESIDENT'S OR LAWFUL  REPRE-
 SENTATIVE'S CONSENT FOR ANY REASON, AT ANY TIME, INCLUDING A DESCRIPTION
 OF HOW THE CONSENT SHALL BE REVOKED.
   (C)  THE  HEALTH  CARE  PROFESSIONAL  SHALL DOCUMENT IN THE RESIDENT'S
 MEDICAL RECORD THE DATE AND TIME THAT THE  INFORMED  CONSENT  DISCLOSURE
 WAS  PROVIDED,  AND TO WHOM AND BY WHOM IT WAS PROVIDED, AND INCLUDE THE
 WRITTEN CONSENT.
   (D) WHERE THE RESIDENT'S MEDICAL RECORD NOTES THAT A FAMILY MEMBER HAS
 REQUESTED NOTIFICATION OF MEDICATION ORDERS OR PRESCRIPTIONS,  AND  SUCH
 NOTIFICATION  IS  OTHERWISE  LAWFUL,  THE HEALTH CARE PROFESSIONAL SHALL
 CAUSE NOTICE TO BE PROVIDED WITHIN FORTY-EIGHT HOURS OF THE ORDER  UNDER
 THIS  SECTION. SUCH NOTICE SHALL NOT BE PROVIDED IF THE RESIDENT SPECIF-
 ICALLY REQUESTS THAT THE FAMILY MEMBER NOT BE GIVEN NOTIFICATION.
   3. A NURSING HOME AND A HEALTH CARE PROFESSIONAL SHALL NOT BE REQUIRED
 TO OBTAIN CONSENT UNDER THIS SECTION TO ISSUE AN ORDER  FOR  USE  OF  AN
 ANTIPSYCHOTIC  MEDICATION  FOR  A RESIDENT IN A NURSING HOME WHERE IT IS
 NECESSARY IN AN EMERGENCY TO PROTECT AGAINST AN IMMEDIATE THREAT TO  THE
 LIFE,  HEALTH  OR SAFETY OF THE RESIDENT OR ANOTHER PERSON.  THE MEDICA-
 TION MUST BE THE MOST  APPROPRIATE  AVAILABLE  MEANS  OF  REDUCING  THAT
 THREAT, WITH THE LEAST RISK OF HARM CONSIDERING THE RESIDENT'S CONDITION
 OR  DISORDER.  THE  ORDER  SHALL  ONLY APPLY, IN THE ABSENCE OF CONSENT,
 DURING THE EMERGENCY. WHERE AN ORDER IS MADE UNDER THIS SUBDIVISION, THE
 HEALTH CARE PROFESSIONAL SHALL IMMEDIATELY RECORD THE USE OF  THE  ANTI-
 PSYCHOTIC  MEDICATION,  THE  REASON  FOR THE USE, AND THE DOSAGE, IN THE
 A. 7467--A                          3
 
 RESIDENT'S MEDICAL RECORD; AND SHALL PROMPTLY NOTIFY THE RESIDENT OR THE
 RESIDENT'S LAWFUL REPRESENTATIVE WHO WOULD HAVE  HAD  THE  AUTHORITY  TO
 CONSENT,  AND  ANY  FAMILY  MEMBER  REQUIRED  TO  BE NOTIFIED UNDER THIS
 SECTION AND RECORD SUCH NOTIFICATIONS IN THE RESIDENT'S MEDICAL RECORD.
   4.  THIS SECTION DOES NOT INCREASE THE LAWFUL SCOPE OF PRACTICE OF ANY
 HEALTH CARE PROFESSIONAL AND DOES NOT DIMINISH OR IMPAIR ANY REQUIREMENT
 FOR OR REGULATION OF CONSENT TO HEALTH CARE TREATMENT.
   5. THE COMMISSIONER MAY MAKE REGULATIONS TO IMPLEMENT THIS SECTION.
   § 2. This act shall take effect one year after it shall have become  a
 law. Effective immediately, the addition, amendment and/or repeal of any
 rule  or  regulation necessary for the implementation of this act on its
 effective date are authorized to be made and completed on or before such
 effective date.