For incapacity, end-of-life, the future. Who is Nidus? What is Personal Planning? What legal...
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Transcript of For incapacity, end-of-life, the future. Who is Nidus? What is Personal Planning? What legal...
Personal Planning in BCFor incapacity, end-of-life, the future
• Who is Nidus?
• What is Personal Planning? What legal documents can I make?> This presentation is about planning. It does not discuss details
of the ‘default scheme’ – such as TSDM, Committeeship or PGT – when there is no plan or gaps.
• Where do I get more information and the legal forms?
• Where can I register the completed documents?
This presentation provides a very basic overview. It is not legal advice.
Agenda
Who is Nidus?
• BC non-profit, charitable organization (1995) established as a result of a grass-roots law reform.
• Hub for expertise on Representation Agreements.
• Resource to the public, community organizations, and professionals.
• Centre for excellence on personal planning and best practices – training and collaboration.
• Provides a Registry service to connect information and documents to the right people at the right time.
Nidus…
Nidus is the Latin term for nest: a symbol of support and safety.
Personal Planning – what is it?
• Personal planning is about making arrangements in the event you need assistance during your lifetime.*> The law divides our life into four general areas or
categories. See chart after next. We don’t live in separate categories – the areas are
interrelated and we need to address them all in our planning.
* The health system uses the term ‘advance care planning’ to encourage planning for health care. Personal planning covers all life areas. (Estate planning is about making arrangements for after death.)
Personal planning and life areas
Putting the spotlight on personal planning
Personal planning covers 4 life areas
• There are two paths in personal planning.> Future path
For adults who are capable of making decisions and managing their own affairs and who want to plan for the future in case they need assistance. They understand what the planning documents cover and their effect.
OR> Need help today path
For adults whose mental capability is currently in question – due to illness, injury or disability.o These adults may need help for a temporary period (while recover
from a stroke) or on an ongoing basis (due to advanced dementia).
Personal planning has two paths
• Let’s look at the FUTURE path first.
• Adults who are planning for the future will make two separate documents to cover the following life areas:> Health and personal care matters; and> Financial and legal affairs.
Personal planning for the FUTURE path
Planning for health and personal care
Legal document for health & personal
• A Representation Agreement Section 9 (RA9) is governed by the Representation Agreement Act.
• An RA9 is the strongest and most comprehensive legal document in BC for health and personal care matters.
• An RA9 is about appointing someone – as your representative – to assist you with health and personal care decisions and, if necessary, to act on your behalf.
• You must understand what an RA9 covers and the effect of naming someone to act on your behalf.
Representation Agreement Section 9
• A representative makes decisions according to your verbal (or written) instructions and wishes and your values and beliefs.
• An RA9 includes authority for:> Minor and major health care, and> Personal care matters, and> Refusing health care necessary to preserve your life
(refusing life support).
Representation Agreement Section 9
• An Advance Directive (AD) is a legal document in BC as of Sept. 1, 2011 for certain health care matters. It was lobbied for by staff of some health authorities.
• You must be capable of understanding what it means in order to make an AD.
• An AD is not equivalent to an RA9.> It does not appoint a person; and> It does not cover personal care matters; and> It cannot cover the same range of health care matters
as a Representation Agreement, or respond to unexpected circumstances.
Another legal document for health care
A legal document for some health only
• An AD must be a clear instruction you make when capable about health care you would give or refuse consent to when incapable of informed consent.> The law does not provide wording for instructions.
• You cannot be required to make an AD as a condition of receiving services.
• To make an AD that a health care provider alone could follow, it must apply to the circumstance when it is used. E.g.> Imminent surgery if you and the surgeon agree on wording.> Impending death and you are still competent to make it.
More on Advance Directive (AD)
What steps must be followed to get legal consent for health care?
You – if you are capable of informed consent. If not,*
1. Your representative, authorized in a Representation Agreement, (can also assist you when capable), if no one
2. An Advance Directive if applicable instructions, if none
3. A person selected by a health care provider as your Temporary Substitute Decision Maker (TSDM). This person has short-term, limited authority. If no one
4. The Public Guardian and Trustee (government official).
* Sometimes a family member applies to court to be appointed committee of person (personal guardian). This might happen if an adult is in a permanent coma. If appointed, this person overrides all, including you.
Hierarchy of legal consent to health care
Planning for financial and legal affairs
• We are still on the FUTURE path and are now going to look at planning for financial and legal affairs.
• There are two legal documents available for financial and legal affairs – depending on what you need to cover. > You make ONE, not both.
> We are first going to look at the Enduring Power of Attorney.
Personal planning – financial & legal affairs
EPA for financial and legal affairs
• An Enduring Power of Attorney (EPA) is governed by Part 2 of the Power of Attorney Act.
• An EPA is the most comprehensive legal document in BC for financial and legal affairs.
• An EPA is about appointing someone – as your attorney – to act for your financial and legal affairs. (Attorney does not mean lawyer).
Enduring Power of Attorney
• An attorney makes decisions according to what they think is best for you (your best interests) while considering your wishes and values and trying to meet your health and personal care needs.
• You must be capable of understanding 6 items in order to make an EPA. Read the Nidus fact sheet for full details.> An example of one item: the person you appoint will
be able to do anything for financial affairs that you could do when capable.
Enduring Power of Attorney
• An EPA gives authority for:> Routine financial affairs – e.g. banking, investments,
renewing car insurance, selling a vehicle, Canada Revenue, re-directing the mail.
> Obtaining legal services and instructing counsel – settling insurance claims, representation in court.
Enduring Power of Attorney
• An EPA can also give authority for:> Dealing with real estate (land title).> Acting as director or officer of a company you own or
serve on.> Using your money for personal benefit and making
new loans or gifts to others. > Having discretion with respect to your investments.> Dealing with some matters in another province – for
example a pension plan.
Enduring Power of Attorney
• There is another legal document that some people on the future path might use for their financial and legal affairs.
• In the Representation Agreement Act, under Section 7, it lists routine financial and legal authorities that a representative may be given.> An RA7 F+L does not cover as much as an EPA and it
is not yet as familiar to financial institutions or federal government agencies.
Another option for financial and legal
RA7 F+L – an option for some
• An RA7 F+L gives authority for:*> Routine financial affairs – e.g. banking, investments,
renewing car insurance, selling a vehicle, Canada Revenue, re-directing the mail.
> Obtaining legal services and instructing counsel – settling insurance claims, representation in court.
*The RA7 F+L does not include additional authorities like the EPA has – for example dealing with real estate. If you want or might need the greater coverage, make an EPA.
Representation Agreement Sec 7 F+L
Who has legal authority for managing financial affairs?
You – if capable of managing your finances. If not, only the following have legal authority to act on your behalf.
> An attorney, appointed in an Enduring Power of Attorney.
> A representative, named in a Representation Agreement Section 7 that includes authority for routine finances.
> A committee of estate, appointed by a judge (court order). If appointed, overrides all, including you.
> The Public Guardian and Trustee as property guardian – after assessment by a qualified health care provider.
Who has authority to manage finances?
Let’s Review
• An adult in BC who makes decisions and manages their own affairs now is on the FUTURE path.> Make your plan while capable so you have the
necessary coverage in case you need assistance or someone to act on your behalf in the future.
Future path review
Planning documents for the future path
What if mental capability is in question?
• What if someone is not considered capable of making a Representation Agreement Section 9 (RA9) and/or an Enduring Power of Attorney (EPA)?
• Mary has had dementia for some time. She now requires considerable support from John (her spouse) with daily living activities and with decision-making. > As a spouse, John, does not have all the authority he
needs to help Mary.> Mary needs help today and she will need ongoing
support.
What if mental capability is in question?
• If someone’s mental capability is currently in question, they may make a Representation Agreement Section 7.> The Representation Agreement Act has a different
view of capability for Agreements under Section 7. Even if someone cannot make decisions independently
or manage their own affairs, they may make an RA7. There are no specific capability requirements that
everyone has to meet; for an RA7 it depends on a variety of factors and the individual.
> John can help Mary make an RA7.
What if mental capability is in question?
• Section 7 lists standard powers or authorities that address ALL four life areas. > If Mary has nothing in place, she could make the
RA7 All to cover all life areas.
• Let’s say Mary made an EPA when she was able to meet the capability requirements (before her dementia advanced). This means she has her financial and legal affairs covered.> She will make an RA7 to cover her health and
personal care authorities (RA7 H+P). She can do this even if her mental capability is currently in question.
What if mental capability is in question?
Mary is on the NEED HELP TODAY path
RA7 All has authorities for all life areas
Information and RA forms www.nidus.ca
• The Representation Agreement Act came into effect in February 2000.> For the first time in BC history:
Health care professionals had to respond to legal planning documents for health care; and
Legal professionals were asked by clients to draft legal planning documents for health care.
> However, neither group had training or education on Representation Agreements. Nidus, who was involved in the development of the law, has been the bridge – providing resources and RA forms.
Get informed – it’s your life!
• In 2012, the Ministry of Health produced a guide to advance care planning, My Voice. > The public and professionals find it
confusing.> The forms included in it meet the legal requirements
(like the Nidus forms) but do not address practical needs, especially for health care situations.
• The Continuing Legal Education Society recently published 30-page RA forms for lawyers to use.> This is completely opposite the goal of accessibility; one
of the guiding principles behind the law.
Other resources
• The Nidus website has lots of information for self-help.> Nidus also provides personal help by appointment –
BOOK NOW at the website, right sidebar.• Find Representation Agreements forms and
instructions on the Nidus website for download and self-help.
• Find information and tips on the Nidus website before meeting with a legal professional to make an Enduring Power of Attorney.
Information and legal forms at nidus.ca
At Nidus home page – pick your situation.
At Nidus home page – pick your situation.
Adults with a developmental
disability, or FASD or young
adult with acquired brain
injury.
You and other adults who are
considered capable and
want to plan for the future .
Mary and other older adults
whose mental capability is currently in
question.
Learn more free webinars
1st Wed — 11:30am – 12:30 pm Demo of Personal Planning Registry
2nd Wed — 11:30am – 12:30 pm Health and Personal Care Planning
4th Wed — 11:30am – 12:30 pm Financial and Legal Planning
Repeated Monthly Webinars (Wednesdays)
Sign up at www.nidus.ca > Self-Help > Presentations
Registering your plans
• The Personal Planning Registry offers a centralized place to store information that matters to you and that others may need to know, in order to help you.> The idea of a Registry was in the original
Representation Agreement Act (1993). Government decided not to implement it.
> The public continued to request a Registry for communication purposes (not for government scrutiny). In 2002, Nidus launched the first online version of the
Registry. In 2014, we launched a new online system.
Personal Planning Registry - voluntary
• Register information and store a copy of your completed document(s).> The only fees are for registration. Each person needs
their own Registry Account. $25.00 for the first registration; $10.00 for additional.
> Access to the Registry is 24/7: View your own record, print information. Update contact information. Grant viewing access to others who need to know.
> Wallet cards are free to download (as many as you want).
Personal Planning Registry
Download and print wallet card
• Lawyers and notaries public can be authorized to register on behalf of their clients.
• When you register a planning document, you can grant viewing access to authorized institutions. For example,> For EPA or RA7 F+L – financial and legal institutions,
government agencies, Public Guardian and Trustee.> For RA9 or RA7 – health and personal care institutions
(hospitals, residential care programs) and PGT. Emergency searches can be done by authorized personnel
using the information on the Registry wallet card – adult’s first and last name and Nidus ID.
• Share viewing access with specific individuals – your representative, financial advisor, family doctor….
Personal Planning Registry
Personal Planning Registry
• Go to www.nidus.ca > click Registry tab.• Then click Online Registry in right sidebar.
Thank you for joining us!
[email protected] | www.nidus.ca