A bill concerning informed consent for nursing facility residents was discussed in a hearing held by the Assembly Health Committee on Tuesday. The bill passed in a unanimous vote and was re-referred to the Assembly Judiciary Committee.
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Assembly Bill 1809, or the Nursing Facility Resident Informed Consent Protection Act of 2022, was introduced by Asm. Cecilia Aguiar-Curry (D – Davis). This bill would establish the right of every resident in a skilled nursing facility or intermediate care facility to receive all relevant information to an individual’s decision about any proposed treatment or procedure, including the administration of psychotherapeutic drugs.
The bill would give residents the right to refuse psychotherapeutic drugs used for the purpose of resident discipline, convenience, or chemical restraint, except in an emergency situation. The bill would also make the resident’s physician responsible for disclosing this information and obtaining their informed consent. The prescription or administration of psychotherapeutic drugs without informed consent would become a state-mandated crime.
The bill would also require the California Department of Public Health (CDPH) to inspect for compliance with this requirement.
Aguiar-Curry said this bill would help remedy an ongoing problem in the state’s nursing homes of giving antipsychotic drugs to residents with dementia to control their behavior.
“These chemical restraints are being prescribed to sedate and subdue residents who often use behavior to communicate their pain, discomfort, or distress,” she said.
She added that these antipsychotic drugs can be dangerous for individuals with dementia, and that this bill is intended to protect them from chemical restraints that go against their consent.
“When the drugs are administered without informed consent, patients and their families are not making the choices to take such a risk,” she emphasized.
Tony Chicotel, representing California Advocates for Nursing Home Reform, spoke in favor of the bill.
“We really need some help from our legislators … to bring informed consent back to the forefront of everybody’s minds when it comes to using these drugs, and making sure that the very best people to prevent misuse are given the chance to do that, and that’s the residents and their loved ones,” he said.
Jennifer Snyder, representing the California Association of Health Facilities and the California Hospital Association, spoke in opposition to the bill as it is currently written. However, she emphasized her organizations’ openness to work with the bill creators to make amendments.
She cited concerns about providers receiving criminal penalties for prescribing these medications.
“We’re really trying to find a balance between making sure that patients are protected, but also making sure that those prescribers and physicians that provide the care are not put in situations where they are required to put together cumbersome, onerous, and very broad-written consent requirements that then are coupled with criminal and civil liabilities that are attached to an informed consent error,” she said. “Our concern from nursing facilities’ perspective is we will have prescribers that won’t want to care for our patients, and we will have patients that will lose access to psychotherapeutic drugs that really need it.”
Asm. Chad Mayes (I – Yucca Valley) shared these concerns, as well as Asm. Marie Waldron (R – Escondido), who wanted to ensure that providers who made paperwork errors or honest mistakes would not be criminalized.