NEW LAW
THE MiX Sara Pon and Krista James
Care Facility Admission and Capacity
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n November 4, 2019, new legislation came into force laying out how consent must be obtained for a person to be admitted to a care facility (Part 3 of the Health Care (Consent) and Care Facility (Admission) Act, RSBC 1996 c 181 and the accompanying Health Care Consent Regulation, BC Reg 20/2000). The consent requirements apply to long-term care facilities, short-term respite, and hospice, among other types of care facilities, but do not apply to acute care, assisted living, or involuntary mental health admission.
Consent Process There are three ways a person can be admitted to a care facility. 1. If an adult is capable, he or she must consent. 2. If the adult is not capable of providing that consent, a substitute decision-maker must consent. 3. An adult may be admitted on an emergency basis without prior consent in specific circumstances, as discussed below.
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TABLE OF CONTENTS
Before an adult or substitute decision-maker can consent to care facility admission, the decisionmaker must be provided with all the information needed to make an informed decision about that specific facility, including the care and services offered and when the adult can leave.
For care facility admission, like other health care decisions, all adults are presumed capable. The care facility staff must accommodate the adult’s communication needs and abilities and allow time for questions. The adult can have a supporter to help make that decision. Consent must be voluntary; the adult must not feel any pressure or influence to make the decision. Consent does not have to be in writing. Consent can be verbal or inferred from behaviour if the adult cannot communicate verbally. Care facilities must keep a record of the consent to admission, along with any incapability assessments. It is important to note that consent to admission is not equivalent to advance consent to all health care provided within the facility. Consent by the appropriate person is required for all health care treatment not covered by a care plan that has also received proper BC Notaries Association
consent. Some adults who are not able to consent to admission may still be capable of consenting to medication or other health interventions.
Emergency Admission An adult can only be admitted on an emergency basis without consent, in two circumstances. 1. If the adult is not capable of making this decision and there is a serious danger to the adult or another person. 2. A designated agency has admitted an incapable adult who is being abused or neglected (under section 59 of the Adult Guardianship Act, RSBC 1996 c 6). Within 72 hours of an emergency admission, an incapacity assessment must be conducted and consent must be obtained from the adult or substitute decision-maker.
Capacity For care facility admission, like other health care decisions, all adults are presumed capable. Even if an adult does not have capacity to make financial decisions or has an attorney under a Power of Attorney, the adult may still be capable of consenting to entering a care facility. An adult is capable of deciding whether to enter a care facility if the adult understands the relevant information and how this information would apply to the adult’s own life. Volume 29 Number 1 Spring 2020
