In December 2009, CANHR met with the California Department of Public Health (CDPH) to renew a longstanding call to enforce informed consent requirements related to nursing home use of antipsychotic drugs and other types of psychoactive drugs. Although California law prohibits nursing homes and doctors from using these drugs without residents’ informed consent, the law is widely ignored by CDPH, nursing homes and doctors.
On January 7, 2010, CANHR followed up by writing CDPH to summarize concerns about drugging and to make specific recommendations on improving inspections and enforcement for informed consent requirements. In part, the letter states:
The rampant misuse of psychoactive drugs in California nursing homes is a leading cause of avoidable death, abuse and neglect for elderly residents with dementia. Each day, almost 25,000 California nursing home residents are given powerful antipsychotic drugs despite FDA black box warnings that these drugs are likely to cause their deaths. Nursing homes, doctors, pharmacies and drug companies pay no heed to these warnings or their duties to carefully inform residents and their representatives about dangers associated with these drugs.
As the Governor noted in his veto message on SB 303 (Alquist, 2009), more than half of the residents receiving antipsychotic drugs are being drugged outside of federal guidelines.
DPH is greatly contributing to this problem. Its failure to enforce the informed consent requirements is allowing skilled nursing facilities to drug residents with impunity. According to DPH citation records, it has issued less than 10 citations to skilled nursing facilities during the last decade for giving residents psychoactive drugs without informed consent.
Additionally, CANHR attached a proposed investigative protocol that describes how to conduct meaningful inspections on informed consent.
A CDPH official acknowledged the letter in March 2010, promised that procedures and inspector trainings were in the planning stage, and assured us that an official response was forthcoming. However, the official response hasn’t arrived, inspectors remain very poorly informed on informed consent, and nursing homes continue to drug residents into submission without the least concern that CDPH will force them to stop.
CANHR will continue to pursue inspection and enforcement reforms and will post updates here.