Im plem entation of the Mental Capacity Act in Singapore 3 r d W o - - PDF document

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Im plem entation of the Mental Capacity Act in Singapore 3 r d W o - - PDF document

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NNI Talk 23 November 2013 25/4/2014 Im plem entation of the Mental Capacity Act in Singapore 3 r d W o r l d C o n g r e s s o n A d u l t G u a r d i a n s h i p 3 0 M a y 2 0 14 1 Singapore New York City (786 sq km) is

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Im plem entation of the Mental Capacity Act in Singapore

3 r d W o r l d C o n g r e s s o n A d u l t G u a r d i a n s h i p 3 0 M a y 2 0 14 1

Singapore

 New York City (786 sq km) is slightly larger than

Singapore

 Tokyo (2,187 sq km) is three times bigger. –

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Sources: (1) http://www.sla.gov.sg (2) http://app.singapore.sg/about- singapore/map-of-singapore

Demographic Trends: Singapore

Resident Elderly 65+

300,000 400,000 500,000 600,000 700,000 800,000 900,000 1,000,000

Rise in No. of Resident Elderly 65+ with Dementia

50000 60000 70000 80000 90000

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200,000 2013 2020 2030 Source: DOS, NPTD (2011) 20000 40000 60000 80000 100000 2013 2020 2030

Resident Elderly 85+

Observation: increasing number of individuals would need deputies and donees

Source: MOH, DOS, NPTD (2011) 10000 20000 30000 40000 2013 2020 2030

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Singapore law

1952

  • Mental Disorder Ordinance 38
  • f 1952

4

1970

  • Mental Disorders and

Treatment Act 1970 (“MDTA”)

2010

  • Mental Capacity Act (“MCA”)

Government’s role enhanced by MCA

MDTA:

Judicial arm confined to “archaic concept of unsound mind”

MCA

framework adequate to deal with the problems suffered by the mentally incapacitated

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Framework of Mental Capacity Act

The 5 Principles ardian Person who Lacks Mental Capacity Lasting Power of Attorney Court Appointed Deputies Care Givers Office of the Public Gua Code of Practice Excluded Decisions Ill-Treatment 6

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NNI Talk ‐ 23 November 2013 25/4/2014 3 Functions of the Office of Public Guardian

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4 Functions of OPG

Registry

Public Guardian

Public Education Investigation Supervision

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Registry Supervision

Establish and maintain a registry of:

  • Lasting Power of Attorney

(LPAs)

  • Court orders appointing

Supervise deputies Manage & direct Board of Visitors Reporting to court

4 Functions of OPG at a glance

I nvestigation Public Education

  • Court orders appointing

deputies

Reporting to court

Create awareness of MCA / LPA Stakeholder outreach and education Public information

Investigate into alleged ill- treatment of a person without mental capacity

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Key Components of Registry Functions

  • Establish and maintain a register of LPAs
  • Verify information on LPAs before registration
  • Review draft LPAs for ineffective clauses
  • Update list of revoked LPAs for third parties’

verification

LPA

  • Establish and maintain a register of Court
  • rders
  • Facilitate 3rd parties’ searches on OPG’s

register

Deputy

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Key Components of Supervision Functions

  • Allocate appropriate level of monitoring to new

cases

  • Write to deputies to request for due reports

Supervise deputies Write to deputies to request for due reports Manage & direct Board of Visitors to conduct home visits Reporting to court where directed to do so

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Key Components of Investigation Functions Receive complaints of alleged ill- treatment of a person without mental capacity Investigate into complaints by exercising statutory powers Take follow up action to protect P’s personal welfare or property

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Key Components of Public Education Functions

  • Publish information about MCA and LPA
  • Reach out to target audience through

booths at exhibitions

Create awareness

H ld di l i h k k h ld

S k h ld

  • Hold dialogues with key stakeholders

regularly

  • Meetings with individual stakeholders

Stakeholder Engagement

  • Give talks on LPA and deputyship
  • Publish guides for donees, deputies and

caregivers

Public Information

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No of LPA applications received No of court

  • rders

appointing deputies FY2010 (March 2010 – March 2011) 655 171

Registry of LPAs and court orders

FY2011 (April 2011 – March 2012) 977 223 FY2012 (April 2012 – March 2013) 1,930 229 FY2013 (April 2013 – till date) 2,241 220

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NB: Persons appointed as Com m ittee of Persons and/ or Estate under repealed Mental Disorder and Treatm ent Act are considered deem ed deputies. 4,528 deem ed deputies from 3,195 court orders w ere absorbed by OPG on 1 March 2010. LPA as pre-planning instrument to protect one’s interests. LPA as key component of holistic planning for life’s eventualities. LPA provides for personal autonomy & upholds one’s dignity.

Life unpredictable. One can lose mental capacity unexpectedly because of accidents d i l i i i f i l i

Public Education’s key messages and target audience

Positioning LPA protects an individual in event he loses mental capacity and becomes vulnerable. Making LPA offers certainty and peace of mind to individual, his family and loved

  • nes in life’s uncertainties.

even as dementia also rising in fast ageing population. Active Agers ‘Influencers’

lawyers, doctors, financial planners, social workers

Working/ affluent adults Elderly Heartlanders Youth

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Target Audience Key Messages

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Varied tactics to reach out to the target audience

Public Awareness Cam paign TV/ radio campaign, print ads, local media engagement,

  • utdoor bus shelters, bus wrap ads etc.

Talks

  • Corporate lunch time talks
  • Community Centre/ VWO/ Healthcare

Events outreach participation

  • C3A: 50Plus Expo, religious
  • rganisations

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Community Centre/ VWO/ Healthcare institution talks

  • Big scale public talks like HDB’s

retirement seminars

  • Industry specific seminars e.g. NNI’s

Neurocognitive Symposium Outreach to ‘influencers’ Training social intermediaries (pro bono lawyers, social workers at FSCs) to conduct talks & assist elderly with form-filling Workshops Regular LPA & Deputy workshops Collaboration with partners POSB , C3A, PA

  • rganisations
  • CEL: LivEnabled roadshow
  • NTUC U Live: U Live Symposium for

the 50+

  • ADA, HPB, TTSH: World Alzheimer’s

Day related events

Tactics

Out-of-home ads

OPG’s inaugural awareness campaign

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OPG in the news

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Increasing awareness of LPA, MCA and increased uptake of LPA

Source: Public surveys conducted in 2010 and 2012

Almost 50%

5-year workplan (FY2013 – FY2017)

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STRATEGI C THRUSTS Them e : Staying Relevant; Review & Refine

Strategic Thrusts – Next 5 years

ENSURE PUBLI C CONFI DENCE SHARPEN PROTECTI ON FRAMEWORK

ENSURE ACCESSI BI LI I TY, EASE AND CONVENI ENCE

Relevance

Review & refine

Changing Mindsets

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The Roadmap – Next 5 years

Review legislation Review legislation T t d d /

ENSURE PUBLI C CONFI DENCE

T t d d /

ENSURE PUBLI C CONFI DENCE ENSURE ACCESSI BI LI I TY, EASE AND CONVENI ENCE SHARPEN PROTECTI ON FRAMEWORK SHARPEN PROTECTI ON FRAMEWORK

STRATEGI C THRUSTS STRATEGI C THRUSTS

Refine Refine ce ce

Review legislation Review legislation Review Code of Practice Review Code of Practice Online accreditation Online accreditation

Continuing education and outreach Continuing education and outreach Generate conversations Generate conversations Advocacy Advocacy Ongoing engagements Ongoing engagements

LPA Review Committee LPA Review Committee Targeted donor / donee engagements Targeted third party engagements Promote & encourage best practices Targeted donor / donee engagements Targeted third party engagements Promote & encourage best practices

Framework for professional deputies Develop risk-based supervision framework Framework for professional deputies Develop risk-based supervision framework

Review modes of LPA submission Review modes of LPA submission

Review & R Review & R Relevan Relevan Changing Mindsets Changing Mindsets

Feasibility of tribunal system Feasibility of tribunal system

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Simplification of LPA form

ENSURE ACCESSI BI LI I TY, EASE AND CONVENI ENCE ENSURE PUBLI C CONFI DENCE SHARPEN PROTECTI ON FRAMEWORK Mid-Jan 2014

  • Testing of revised

forms

Feb 2014

  • Comments by

Chairman, PGB

  • 7th LPA Review
  • Comm. mtg

Mar - Apr 2014

  • Senior mgmt’s

clearance

  • AGC clearance
  • Minister’s

approval

Apr – May 2014

  • Public comms.

Plan & training

1 Jun 2014

  • Launch of

simplified forms

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See Appendix for full tim eline

New initiatives to increase efficiency

Pilot postal mode of LPA submissions

ENSURE ACCESSI BI LI I TY, EASE AND CONVENI ENCE ENSURE PUBLI C CONFI DENCE SHARPEN PROTECTI ON FRAMEWORK  To reduce waiting time for public and

staff pressure during processing of application

submissions Additional manpower for LPA registry Tapping on technology

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application

 Exploring with RSVP to tap on

volunteers to carry out back-end processing of LPA applications

 Online search module  Online LPA form maker  Self-help kiosk

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Continual public engagement

ENSURE ACCESSI BI LI I TY, EASE AND CONVENI ENCE ENSURE PUBLI C CONFI DENCE SHARPEN PROTECTI ON FRAMEWORK Mar 13: Review of outreach, identification of i d Mar 14 : OPG-Financial

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issues and development of strategies Apr 13: Proposed engagement plan to Sub Board OPG-Financial Sector Dialogue Session Dec 14 : Public confidence survey

Engaging financial sector through dialogue and exchange of ideas

ENSURE ACCESSI BI LI I TY, EASE AND CONVENI ENCE ENSURE PUBLI C CONFI DENCE SHARPEN PROTECTI ON FRAMEWORK

  • Ongoing enga gem ent to achieve greater buy-in to MCA and its planning

instrument LPA

Objectives

26 instrument, LPA

  • Dia logue with banks to share and understand ground issues faced by banks

as well as proxy decision makers to ensure public confidence in LPA

  • Share and promote best p ra ctices in industry
  • A good understanding and appreciation of MCA / LPA
  • Buy-in and support from banks
  • Consistent approaches in facilitating LPA transactions
  • Awareness of best practices in industry in facilitating banking transactions on

behalf of Ps

Desired Outcomes

See Appendix: OPG-Financial Sector Dialogue Session

Panel deputyship for Ps without NOK

 Proposal for appointment of

Panel Deputies via service level agreement

ENSURE ACCESSI BI LI I TY, EASE AND CONVENI ENCE ENSURE PUBLI C CONFI DENCE SHARPEN PROTECTI ON FRAMEWORK

level agreement

 Accept cases referred by AIC  Deputies – lawyer and

social worker to be jointly appointed

 Deputyship for limited

duration and power

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D liquidates P’s assets D transfers P’s money into SNTC trust D works out P’s care plan with SNTC D submits report to PG & discharges himself

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1186 private clinics distributed across Singapore

183 285

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Source: SingHealth, “ Find a GP or Fam ily Clinic Near You” , <https:/ / w w w .singhealth.com .sg/ PatientCare/ GP/ Pages/ Hom e.aspx>

256 257 205