S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1461
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              January 9, 2025
                                ___________
 
 Introduced by M. of A. PAULIN, SAYEGH, STECK, SIMON, COOK, GLICK, VANEL,
   LUNSFORD, ROSENTHAL, BRONSON, WILLIAMS, BICHOTTE HERMELYN, R. CARROLL,
   FALL,  GALLAGHER,  FORREST, CRUZ, STIRPE, CLARK, COLTON, SANTABARBARA,
   HUNTER, JACKSON, ZINERMAN, KELLES, JACOBSON, OTIS, MEEKS, WEPRIN, RAGA
   -- 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 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-
 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;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02250-01-5
 A. 1461                             2
              

 
   (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.
   (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
 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.
 A. 1461                             3
 
   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.