[citation needed] On the Council, Perkins served as Deputy Majority Leader, and championed the lead paint laws that required New York City residences to be tested for hazardous conditions.

He was quoted as saying, “We recognize that in the person of Nicolás Maduro, the president of Venezuela, we have an exceptional leader!”[9] Perkins was one of the few New York lawmakers who endorsed Bernie Sanders and not Hillary Clinton, in the 2016 Democratic Party presidential primaries.

[13] On January 31, 2019, Perkins was transported to a hospital by authorities "after neighbors called the police on him for acting erratically in his Manhattan home".

At the time, the Daily News reported that Perkins was receiving treatment for colon cancer and that various constituents and colleagues had expressed concern about his health and his continued fitness to hold public office.

[14] In June 2021, Gothamist published a piece on Perkins entitled "As Worries Persist Over Harlem Lawmaker's Health, Elected Leaders Stay Mum".

[15] On August 9, 2021, Perkins conceded the primary election to Kristin Richardson Jordan, a democratic socialist, and announced that he would retire at the end of the year.