TOPEKA, Kan. — A bill that would require nursing facilities to get written permission from residents or their guardians before administering antipsychotic drugs faced stiff opposition from groups representing doctors, hospitals and skilled nursing homes during debate in the Kansas Legislature.
The U.S. Food and Drug Administration has warned that antipsychotics increase the risk of falls, stroke and other potentially fatal side effects for people suffering from dementia. Since the federal government started tracking off-label use of such medications in nursing homes in 2011, Kansas has been at or near the top in percentage of medicated residents, The Kansas City Star reported .
Rachel Monger, a lobbyist for LeadingAge Kansas, told legislators recently that the law “would be by far the broadest and most restrictive law on antipsychotics in the country” and would penalize nursing homes for funding and staffing shortages they can’t control.
“What this will really do is offer more penalties and lawsuits,” said Monger, whose group represents faith-based and nonprofit nursing facilities. “That’s what providers are scared of.”
The federal government recently enacted similar informed consent rules that will help reduce improper antipsychotic use, Monger said. The regulations won’t impose penalties for 18 months.
Mitzi McFatrich, the executive director of Kansas Advocates for Better Care, said her group doesn’t think the federal regulations are adequate and wants state laws to protect nursing home residents.
“We have people who are currently in harm’s way,” McFatrich said.
Monger said the industry is hampered by cuts to Medicaid and problems with Kansas’ Medicaid eligibility determination system. Medicaid covers about half of Kansas residents who are in nursing homes.
“The drivers behind anti-psychotic use are funding, workforce and training,” Monger said. “We’ve done the training… (but) we don’t have a lot of control over the funding and the workforce, and it is a serious problem.”
Kansas also leads the nation in the percentage of skilled nursing facilities cited by the federal government for several medication-related violations, some of which relate to antipsychotics. The state was highlighted in a Human Rights Watch report last month.
The Kansas Hospital Association and the Kansas Medical Society, which represents doctors, also oppose the bill. Rachelle Columbo, a lobbyist for the medical society, said the use of antipsychotics in nursing homes is a “complex problem” that would be better addressed with conversations that include nursing homes’ physician medical directors, rather than new regulations and penalties.
The law includes and exemption for use of antipsychotics in emergency situations.
Chad Austin, a lobbyist for the hospital association, said it wasn’t clear whether the bill would apply to hospitals that treat nursing home residents. If it does, he said, it should explicitly say that the exemption also applies to hospitals.
But Rocky Nichols, the executive director of the Kansas Disability Rights Center, said the exemption is too broad and could be used to get around informed consent regulations.
Information from: The Kansas City Star, http://www.kcstar.com