Assisted living communities no longer are included in legislation tightening controls on the use of psychotropic medications in long-term care facilities.
Assembly Bill A7467B / Senate Bill S466A is written to require healthcare providers to obtain written consent by a resident or their legal representative prior to the initial order or dosage modifications of psychotropic medications. It also would limit all medication orders to 14 days.
Initially, the bill applied to both assisted living communities (adult care facilities) and nursing homes, but assisted living communities were removed as covered entities in an amendment following opposition from the senior living industry in the state.
Outside scope
In a memorandum in opposition of the bill, the Empire State Association of Assisted Living, or ESAAL, said that if the bill was applied to adult care facilities, then it would place those operators in a “precarious position” and potentially subject them to liability if a healthcare professional failed to comply with the consent requirements.
ESAAL noted that prescriptions and consent traditionally are obtained outside the scope of practice for assisted living communities and would be “impracticable” to implement. Assisted living communities have a case management obligation to help residents receive services from sources not directly provided communities, the association said. When it comes to medications, providers are solely responsible for ensuring that a resident receives or takes his or her medications or potentially helping a resident in taking medication, ESAAL noted.
Primary care physicians unaffiliated with a senior living community often make house calls and provide services, ESAAL said. The legislation, according to the organization, had the potential to discourage healthcare providers from offering such services, “making it more onerous for adult care facility residents to access care.”
The bill also would have placed operators in a position to require staff members to review prescriptions to ensure informed consent, ESAAL said, and in addition, staff members would have been prevented from assisting with a resident’s prescription until copies of the informed consent were received and included in the resident’s medical record.
“This could result in residents not receiving their medication at the prescribed time, and the NYS Department of Health could impose penalties on the adult care facility provider for something beyond their control,” the letter read.
Bill is ‘dated’
New York State Health Care Facilities Association / New York State Center for Assisted Living President and CEO Stephen Hanse told McKnight’s Senior Living that the bill simply “didn’t make sense for assisted living.” He called it a “dated” bill, having been first introduced in 2015, and said that it doesn’t reflect the federal and state safeguards now in place regarding the use of antipsychotic medications in long-term care.
“Gradually, there is a recognition that the bill really doesn’t reflect where providers are currently in 2024, and doesn’t reflect all of the strides providers have made in decreasing utilization of antipsychotics and ensuring they are used appropriately,” Hanse said. It has been an ongoing effort to educate policymakers on the strides the industry has taken to reduce the use of antipsychotic medications, he added.
LeadingAge New York also submitted a memorandum of opposition on the bill, saying that although the organization supported the goal of the legislation to reduce the inappropriate use of antipsychotic medications, the bill’s requirements “will disrupt medication regimens and lead to adverse outcomes.”
Organizations such as The Joint Commission use the off-label use of antipsychotic drugs as a performance measure for their assisted living accreditation and recognition programs.
Source: McKnights Seniorliving