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
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 Agenda 2
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 New Public Guardian and Trustee Act Adult Guardianship Legislation 3
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. Boot Cam p for Quarterbacks 4
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PGT Health Authority Investigate Determ ining the Need
I nform al Pension Enduring RA7 CoE SPG Options Trustee POA Voluntary: Yes – Yes – None: None Yes - Yes – Test of Supreme Assessment Presumed Involuntarily: Medical & Medical & I ncapability Court under Part capable ISP Certificate Legal Legal Affidavits 2.1 of AGA of Incapability Canada Rep. Patients Adult Pension Plan Power of Statute None Agreement Property Guardianship or Old Age Attorney Act Act Act Act Pension Plan • Access • Manage • Manage • Manage • Manage financial and bank Federal ISP financial routine legal affairs account Benefits and legal financial • Set- up (OAS, GIS, affairs and • Manage property Authorized direct CPP) • Manage legal Actions debits property affairs 7
Court as a Last Resort Right to Self Just Enough Determination Support Presumption of Capability Guiding Principles
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. Green Light 9
PGT Statutory makes Committee Property financial of Estate Guardian and legal decisions W hat is a SPG/ Com m ittee of Estate?
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 Snapshot: Assessm ent and I nvestigation Services ( AI S) 11
No Other Person Risk to Assets Adult May be Incapable 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 able to Informal Adult is make EPOA or supports are capable RA7 sufficient Adult is referred to SDM now Someone else appropriate complying able to assist services Certificate of Incapability is warranted I nvestigation Outcom es
The purpose of an incapability assessment under Part 2.1 of 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 Medical Functional Component 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 of 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 Assessment Any time after Within 40 days of PGT and health the second notice that the authority consult assessment PGT is statutory property guardian Assessment Reassessment Second Assessm ent and Reassessm ent
Court orders a reassessment PGT informs health Reassessment authority that a must occur if: reassessment is needed Adult requests reassessment and has not been reassessed in previous 12 months Reassessm ent
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. Second Assessm ent or Reassessm ent – Best Practices
∗ 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
http: / / www.trustee.bc.ca/ reports-and-publications/ Pages/ certificate- of-incapability-guidelines.aspx Resources
Thank you & Questions? 27
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