S T A T E O F N E W Y O R K
________________________________________________________________________
4380
2025-2026 Regular Sessions
I N S E N A T E
February 4, 2025
___________
Introduced by Sen. COMRIE -- read twice and ordered printed, and when
printed to be committed to the Committee on Health
AN ACT to amend the public health law, in relation to limiting the off
label use of antipsychotic drugs with black box warnings on elderly
patients with dementia; and to amend the education law, in relation to
professional medical misconduct
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 DRUGS ON ELDERLY PATIENTS WITH DEMENTIA.
1. AS USED IN THIS SECTION:
(A) "OFF LABEL" MEANS A MEDICAL PRACTICE IN WHICH A PHYSICIAN
PRESCRIBES A DRUG FOR A DIFFERENT MEDICAL PURPOSE THAN THE ONE FOR WHICH
SUCH DRUG IS APPROVED FOR;
(B) "BLACK BOX WARNING" MEANS A WARNING ISSUED BY THE FEDERAL FOOD AND
DRUG ADMINISTRATION AND PLACED ON THE PACKAGE INSERT OF A PRESCRIPTION
DRUG THAT MAY BE FATAL OR CAUSE SERVER SIDE EFFECTS;
(C) "CHEMICAL RESTRAINT" MEANS WHEN AN ANTIPSYCHOTIC DRUG THAT
PROVIDES NO MEDICAL BENEFIT TO A PATIENT WITH DEMENTIA AND IS USED TO
SEDATE SUCH PATIENT, CONTROL SUCH PATIENT'S BEHAVIOR OR RESTRICT SUCH
PATIENT'S MOVEMENT;
(D) "ANTIPSYCHOTIC DRUG" MEANS ANY TYPICAL OR ATYPICAL ANTIPSYCHOTIC
DRUG THAT IS INTENDED TO BE USED ON PATIENTS WITH MENTAL ILLNESS THAT
REQUIRE A BLACK BOX WARNING AND SHALL INCLUDE BUT NOT BE LIMITED TO THE
FOLLOWING:
(I) TYPICAL ANTIPSYCHOTIC DRUGS: HALOPERIDOL, LOXAPINE, THIORIDAZINE,
MOLINDONE, THIOTHIXENE, FLUPHENAZINE, TRIFLUOPERAZINE, CHLORPROMAZINE,
PERPHENAZINE, OR PROMOZIDE; OR
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05835-01-5
S. 4380 2
(II) ATYPICAL ANTIPSYCHOTIC DRUGS: ARIPIPRAZOLE, LUMAPETERONE, CLOZAR-
IL, ILOPERIDONE, ZIPRASIDONE, PALIPERIDONE, LURASIDONE, BREXIPIPRAZOLE,
RISPERIDONE, ASENAPINE, QUETIAPINE, CARIPRAZINE, OR OLANZAPINE; AND
(E) "PATIENT" MEANS AN ELDERLY INDIVIDUAL WITH DEMENTIA WHO IS:
(I) A RESIDENT OF A RESIDENTIAL HEALTH CARE FACILITY AS DEFINED IN
ARTICLE TWENTY-EIGHT OF THIS CHAPTER OR AN ADULT CARE FACILITY CERTIFIED
UNDER SECTION FOUR HUNDRED SIXTY-ONE-B OF THE SOCIAL SERVICES LAW; OR
(II) IN THE CARE OF A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF
THIS CHAPTER, A FACILITY AS DEFINED IN ARTICLE TWENTY OF THIS CHAPTER OR
ANY OTHER HEALTH CARE FACILITY WHO CARE FOR INDIVIDUALS WITH DEMENTIA.
2. NO ANTIPSYCHOTIC DRUG THAT CONTAINS A BLACK BOX WARNING SHALL BE
USED FOR AN OFF LABEL PURPOSE ON A PATIENT KNOWN TO HAVE DEMENTIA OR TO
CHEMICALLY RESTRAIN A PATIENT KNOWN TO HAVE DEMENTIA. AN ORDER FOR AN
ANTIPSYCHOTIC DRUG MAY ONLY BE ISSUED IN AN EMERGENCY SITUATION AND BY A
HEALTH CARE PROFESSIONAL WHO SPECIALIZES IN DEMENTIA OR IS SPECIFICALLY
TRAINED IN THE TREATMENT OF DEMENTIA PATIENTS IF SUCH A PATIENT IS
AGITATED AND WHERE IT IS REASONABLY NECESSARY TO PROTECT THE LIFE,
HEALTH OR SAFETY OF THE PATIENT OR ANOTHER PERSON. WHERE AN ORDER IS
MADE UNDER THIS SUBDIVISION, THE HEALTH CARE PROFESSIONAL SHALL IMME-
DIATELY RECORD THE USE OF THE ANTIPSYCHOTIC DRUG, THE REASON FOR THE
USE, AND THE DOSAGE, IN THE PATIENT'S MEDICAL RECORD; AND SHALL PROMPTLY
NOTIFY THE PATIENT OR THE PATIENT'S LAWFUL REPRESENTATIVE WHO WOULD HAVE
HAD THE AUTHORITY TO CONSENT THAT SUCH DRUG WITH A BLACK BOX WARNING WAS
USED AND ANY FAMILY MEMBER REQUIRED TO BE NOTIFIED UNDER THIS SECTION
AND RECORD SUCH NOTIFICATIONS IN THE PATIENT'S MEDICAL RECORD.
3. 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. A HEALTH CARE
PROFESSIONAL WHO FAILS TO COMPLY WITH THE PROVISIONS OF THIS SECTION MAY
BE FOUND GUILTY OF PROFESSIONAL MISCONDUCT PURSUANT TO ARTICLE ONE
HUNDRED THIRTY-ONE-A OF THE EDUCATION LAW.
4. THE COMMISSIONER MAY MAKE RULES OR REGULATIONS TO IMPLEMENT THE
PROVISIONS OF THIS SECTION.
§ 2. Section 6530 of the education law is amended by adding a new
subdivision 51 to read as follows:
51. FAILING TO COMPLY WITH THE PROVISIONS OF SECTION TWO HUNDRED
EIGHTY-D OF THE PUBLIC HEALTH LAW.
§ 3. This act shall take effect on the thirtieth day 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.