Incapability Process Presentation to BC Cancer Agency Psychosocial - - PowerPoint PPT Presentation

Adult Guardianship Act (AGA) 2.1: Changes to the Certificate of Incapability Process

Presentation to BC Cancer Agency – Psychosocial Oncology February 19, 2015 Amanda Brown, React Adult Protection Program Kevin Coughlin, Public Guardian and Trustee

Agenda

 Adult Guardianship in British Columbia  Getting to Statutory Property Guardian (SPG)  Assessing for Incapability under Part 2.1 of

the Adult Guardianship Act

 Rights Advice and Notifications  Impact on BC Cancer Agency

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Adult Guardianship Legislation

 Representation Agreement Act  Health Care (Consent) and Care Facility

(Admission) Act

 Adult Guardianship Act

• Part 3 – Abuse & Neglect Provisions
• Part 2.1- Statutory Property Guardianship

 Public Guardian and Trustee Act

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New

Boot Cam p for Quarterbacks

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Overview of the Statutory Property Guardianship Process

• Case Managers, Social Workers, Mental Health Clinicians,

Designated Responders and any staff who may be involved in determining need, consulting with PGT, stewarding the process, coordinating assessments and providing rights notifications to adults and their families.

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Determ ining the Need

Investigate Health Authority PGT

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I nform al Options Pension Trustee Enduring POA RA7 CoE SPG Test of I ncapability None: Presumed capable Voluntary: None Involuntarily: ISP Certificate

• f Incapability

Yes - Medical & Legal Yes – Medical & Legal Yes – Supreme Court Affidavits Yes – Assessment under Part 2.1 of AGA Statute None Canada Pension Plan

• r Old Age

Pension Plan Power of Attorney Act Rep. Agreement Act Patients Property Act Adult Guardianship Act Authorized Actions

• Access

bank account

• Set- up

direct debits

• Manage

Federal ISP Benefits (OAS, GIS, CPP)

• Manage

financial and legal affairs

• Manage

property

• Manage

routine financial and legal affairs

• Manage financial and

legal affairs

• Manage property

Guiding Principles

Presumption

• f Capability

Right to Self Determination Court as a Last Resort Just Enough Support

Green Light

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Prior to conducting a formal assessment, the PGT and Health Authority have determined that there are no other appropriate alternatives and the green light is given to go ahead. Following this point in time all assessments must be completed to a standard by duly qualified assessors.

W hat is a SPG/ Com m ittee of Estate?

PGT makes financial and legal decisions Committee

• f Estate

Statutory Property Guardian

Snapshot: Assessm ent and I nvestigation Services ( AI S)

11 Regional Consultants Centralized admin services 1400 referrals per year – PGT

becomes Committee of Estate for approximately 350

Investigate allegations of abuse,

neglect or self neglect

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Adult May be Incapable Risk to Assets No Other Person

Public Guardian and Trustee I nvestigation

The PGT (under the PGT Act) and/or health authority (under the Adult Guardianship Act, Part 3) may:

• Interview the adult, their spouse, family, friends, care facility

staff, health authority staff

• Obtain reports about an adult’s health, personal, legal or

financial affairs

• Gather information from the adult’s bank, doctor, landlord,

lawyer The PGT has broader authority to obtain financial records including:

• Asking a substitute decision maker (POA, RA, Trustee) to

provide a financial accounting

• Obtaining reports about the adult’s financial situation from the

adult’s bank, credit union or investment advisor

W hat happens during an investigation?

Adult is capable Adult is able to make EPOA or RA7 Informal supports are sufficient Adult is referred to appropriate services SDM now complying Someone else able to assist Certificate of Incapability is warranted

I nvestigation Outcom es

The purpose of an incapability assessment under Part 2.1

• f the Adult Guardianship Act is to determine whether an

adult is incapable of managing his or her financial affairs.

Purpose of the Assessm ent

One Assessment Functional Component Medical Component Assessm ent of Financial I ncapability

Only medical practitioners (physicians) can conduct the medical component of the assessment. Physicians are the only ones who can conduct both the medical and functional components of the assessment. A qualified health care provider can conduct the functional component of the assessment. To be considered qualified for this purpose a health care provider must:

 be a registered social worker, registered nurse, registered psychiatric

nurse, registered occupational therapist or registered psychologist, and

 meet the standards, limits and conditions established by their college

to act as qualified health care provider

 complete MOH course  Support from Health Authority

W ho Can Conduct the Assessm ent?

An adult is incapable of managing their financial affairs if, in the opinion

• f a qualified health care provider, any of the following apply:

The adult cannot:

 understand the nature of their financial affairs  understand the decisions that must be made or the actions that must

be taken to manage their financial affairs

 understand the risks and benefits of making or failing to make

particular decisions

 understand that the information referred to in this subsection applies

to the adult

 demonstrate that he or she is able to implement, or to direct others to

implement, the decisions or actions about their financial affairs

Test of I ncapability – AGA 2 .1

The qualified health care provider is required to inform the adult of the results of the assessment. They must

• Advise the adult of the details and the results of the assessment including

the determination

• Offer the adult a copy of the report and attachments

The qualified health care provider informs the adult of the results of the assessment unless they have reason to believe that providing the information may result in

• serious physical or mental harm to the adult or
• significant damage or loss to the adult’s property.

I nform the Adult of the Results

The Health Authority Designate is responsible for making a decision about whether or not to issue a certificate of incapability. This is not a decision that should be made lightly. Once a certificate of incapability is issued the adult loses their ability to make financial decisions which means a loss of independence and autonomy. Role of the Health Authority Designate

Second Assessm ent and Reassessm ent

Assessment Second Assessment Reassessment

Within 40 days of notice that the PGT is statutory property guardian Any time after the second assessment PGT and health authority consult

Reassessment must occur if: Court orders a reassessment PGT informs health authority that a reassessment is needed Adult requests reassessment and has not been reassessed in previous 12 months

Reassessm ent

Second Assessm ent or Reassessm ent – Best Practices

• Generally, the health authority that will assist in facilitating

the assessment is the health authority in the area where the adult is living.

• PGT and health authority staff will consult with one another to

determine the best manner to proceed in facilitating the assessment.

• A second assessment is similar to obtaining a second opinion.
• The QHCP(s) conducting the second assessment or

reassessment should review the prior assessment information.

∗ Legislated notification and rights to review ∗ Standardized assessments by QHCPs ∗ All Committees now obliged to follow same

set of principles – duty to foster independence and include adult in decisions that affect them

Benefits of Changes to AGA 2 .1

∗ No expected increase of referrals ∗ Consider involvement of other designated

agencies

∗ PHSA Health Authority Designates:

∗ Dr. Johann Brink ∗ Barbara Lohmann

∗ Contact Dr. Tristin Wayte for more

information

∗ (604) 524-7700 ext. 336012

I m pact on BC Cancer Agency

Resources

http: / / www.trustee.bc.ca/ reports-and-publications/ Pages/ certificate-

• f-incapability-guidelines.aspx

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Thank you & Questions?