Informed consent for psychotropic medications in nursing homes and community-based residential facilities. (FE)

Current law prescribes the situations and procedures under which a guardian may consent to the voluntary or involuntary administration of psychotropic medications to his or her ward. Current law also requires that a nursing home obtain written informed consent before administering a psychotropic medication that contains a boxed warning to any resident who has degenerative brain disorder. A psychotropic medication is an antipsychotic, an antidepressant, lithium carbonate, or a tranquilizer. A boxed warning is a warning, described in federal regulations, the text of which is contained in a black outlined box on the drug's label and in the full prescribing information. Either the resident, or, if the resident is incapacitated, a person acting on behalf of the resident, may provide written informed consent. A nursing home is not required under current law to obtain written informed consent if there is an emergency in which the resident, who is not under a court order for administration of psychotropic medication, is at significant risk of physical or emotional harm or puts others at significant risk of physical harm; if time and distance preclude obtaining written informed consent; and if a physician has determined that the resident or others will be harmed if treatment is not initiated.

In such an emergency situation, the nursing home must obtain oral consent and must obtain written consent within ten days. If the nursing home is unable to contact a person acting on behalf of an incapacitated resident to obtain oral consent but has made a good faith effort to do so, the nursing home may administer the psychotropic medication to the resident for up to 24 hours before it must obtain oral consent from the resident or a person acting on behalf of the resident. The bill imposes those same requirements on community-based residential facilities, except instead of written informed consent the bill requires a signed acknowledgment form from a resident of a community-based residential facility. The bill requires that the acknowledgment form acknowledges receipt of an informational form indicating that the resident has been prescribed a medication that has a boxed warning and information from the federal Food and Drug Administration for the specific psychotropic medication the resident has been prescribed. The acknowledgment form also notifies the resident, or person acting on behalf of the resident, that if he or she seeks more information that he or she should contact the prescriber of the medication. The community-based residential facility is required to include contact information for the prescriber on the acknowledgment form.

Under current law, a nursing home is not required to obtain written informed consent before administering a psychotropic medication to a resident if the prescription for the psychotropic medication is written or reauthorized while the resident is off of the nursing home's premises. Under the bill, if the prescription for the psychotropic medication is written or reauthorized while a resident of a community-based residential facility is off of the premises of the community-based residential facility and if the community-based residential facility has not previously obtained a signed acknowledgment form for administration of that psychotropic medication to that resident, the community-based residential facility must obtain written informed consent or a signed acknowledgment form within 72 hours after first administering that psychotropic medication to that resident before continuing to administer that psychotropic medication to that resident. The bill maintains current law for nursing homes when a prescription for a psychotropic medication for a nursing home resident is written or reauthorized while the resident is off of the nursing home's premises.