Legislative Council: Tuesday, September 06, 2022


Advance Care Directives

57 The Hon. S.G. WADE ().6 July 2022).

1. What non-legislative actions are being implemented or are intended to be implemented in relation to advance care directives ahead of the introduction of legislation to the parliament? In relation to each, what is the anticipated time frame for completion?

2. When does the government anticipate bring advance care directives legislation to the parliament?

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector): The Minister for Health and Wellbeing has advised:

1. The Department for Health and Wellbeing (DHW) has been working on a number of projects to implement both the legislative and non-legislative agenda of advance care planning in South Australia.

DHW has recently appointed an ongoing position with the dedicated role of promoting understanding and awareness of advance care directives (ACDs). This role will work in collaboration with community and advocacy groups to promote the understanding and uptake of ACDs, as well as taking leadership of the ongoing education and training program for clinicians and health practitioners in each of the local health networks.

Advance Care Directive Form and Guide Redesign Project

Over the last 12 months, DHW has led the review and update of the ACD form and the DIY kit. Under the expert guidance of the legal, clinical and community representatives on the Advance Care Planning Oversight Group, the current ACD form and DIY kit have been thoroughly reviewed and a draft ACD form and guide have been developed. The redesigned documents aim to increase uptake in South Australia by making them easier for people to complete without the assistance of a professional, such as a lawyer.

Between 3 June and 15 July 2022, DHW ran a six-week public consultation process on the draft redesign of the ACD form and guide through the South Australian government consultation platform YourSAy. The consultation process also included focus groups with vulnerable communities to understand the enablers and barriers to completing the ACD form. The feedback received will inform the final redesign of the documents, under the guidance of the oversight group.

It is anticipated the redesigned documents will be launched following the passing of the amendment bill and remaking of the regulations to ensure the form and guide accurately reflect the amendments to the legislation.

Training and Education

A targeted education campaign for aged-care providers around ACDs has been developed through investment in innovative programs to improve end of life care in residential aged-care facilities. Three pilot programs have been developed that aim to improve palliative care education and training for aged-care staff, develop internal capability within facilities to care for people at end of life and improve shared care with general practitioners and palliative care teams. A fundamental component of all three programs is the need to demonstrate improved advance care planning for residents.

A comprehensive awareness raising campaign continues throughout the state. The annual plan ahead week in September aims to raise community awareness and literacy about the benefits of early planning and the relevant legal tools. In addition, ACD posters and brochures in 14 languages are available to public and private health services, aged care and disability service providers and community groups.

Further education for witnesses prescribed under the regulations is being developed through an online learning management system. This is anticipated to be completed following the passing of the amendment bill and remaking of the regulations to ensure the education package accurately reflects the amendments to the legislation.

Peer-led workshops for completing Advance Care Directives

DHW has partnered with local government to deliver a peer-led ACD training model across local government areas in SA to increase community understanding and confidence in completing ACDs through a series of community workshops that support participants to complete and execute their own ACD. DHW has provided grants to the City of Onkaparinga (for four councils in southern Adelaide), City of Charles Sturt (for three councils in western Adelaide) and the City of Victor Harbor (covering the Fleurieu region) to deliver the Advance Care Directives Workshops Project over the next two years. DHW is also aiming to target the Murray Mallee region in 2023-24.

Advance Care Planning document for South Australia

A public consultation process was undertaken in 2021 to determine how persons with limited or impaired decision-making capacity can be facilitated to record and convey their preferences for future medical care, accommodation and personal matters. The insight from this process will build on the outcomes of a research project undertaken by the Office of the Public Advocate (OPA) and the SA Health and Medical Research Institute (SAHMRI) looking at supported decision making for people with limited or impaired decision-making capacity. An advance care planning online hub has been designed for the SA Health website as a 'one-stop-shop' to ensure the community know what resources are available to them and this will be launched before the end of 2022.

2. It is anticipated the Advance Care Directives (Review) Amendment Bill 2022 will be introduced into parliament in the early life of this term in government, once work is undertaken to address some of the challenges presented by the legislation's introduction to the Legislative Council in late 2021.