Public Consultation on Draft Vulnerable Adults Bill 2016

Ministry of Social and Family Development

Ministry of Social and Family Development (Family Development Group)

Consultation Period: 27 Jul 2016 - 23 Aug 2016
Status: Closed - Summary of Responses
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Consultation Outcome
STRONG SUPPORT FOR NEW VULNERABLE ADULTS BILL IN COMPLEMENTING ROLE OF FAMILY AND COMMUNITY


1. The Ministry of Social and Family Development (MSF) received 43 responses during the public consultation on the proposed new Vulnerable Adults Bill held from 27 July to 23 August 2016. The four-week public consultation saw feedback from the Family Service Centres, Law Society of Singapore, Singapore Medical Council, Families for Life Council and AWARE.

2. Feedback contributors were strongly supportive of the Bill. They acknowledged the Bill’s importance in preparing for the country’s ageing population, as well as the longer lifespans of persons with disabilities. Many contributors felt that the Bill complemented the roles played by the family and community in looking after its vulnerable members. Several contributors also mentioned that the State should not take over the role of the family in caring for vulnerable members.

3. Most contributors also expressed support for the State to intervene in high-risk cases where vulnerable adults need to be protected from abuse, neglect and self-neglect. While some commented that the State should be involved in a wider range of cases, others cautioned that State powers should not be left unchecked. MSF agrees that these are valid concerns, hence checks and balances have been put in place. For instance, vulnerable adults who have mental capacity must give their consent to State interventions involving removal and out-of-home placements. They may also decide not to receive help. At the same time, the draft Bill allows for the State to enter and assess the vulnerable adult to offer timely and effective protection.

4. Many contributors also supported MSF’s proposal to enhance penalties for offences committed against vulnerable adults under the Penal Code and the Protection from Harassment Act. This is reflective of our society’s strong disapproval of such behaviours.

5. MSF would like to thank our stakeholders and members of the public who provided feedback on the draft Vulnerable Adults Bill. MSF will consider all feedback received in our review of the proposed Bill. The summary of responses is detailed in Annex A.

Introduction

The Ministry of Social and Family Development (MSF) invites the public to give feedback on the draft Vulnerable Adults Bill.

Scope of the Consultation Exercise

This public consultation seeks your views on the following:

a. The key definitions and principles of the draft Vulnerable Adults Bill;
b. The proposed powers to be given to the State to protect vulnerable adults from abuse, neglect and self-neglect;
c. The proposed orders that the Courts may grant to protect and ensure the safety of a vulnerable adult, and parties who may apply for them;
d. The designation of places of temporary care and protection and places of safety for vulnerable adults;
e. The disclosure of confidential information for the purpose of protecting vulnerable adults;
f. The protection from personal liability for those involved in protecting the vulnerable adult; and
g. The enhancement of penalties in other laws for offences committed against vulnerable adults.
Period of Consultation
The period of consultation is from 27 July to 23 August 2016.

Feedback Channel
Interested members of the public can submit their comments on the draft Bill by 2359 hours on 23 August 2016 via the following channels:
• Fax to: 6708 7138, or
• Post to:
Family Development Group
Ministry of Social and Family Development
20 Lengkok Bahru, #04-02
Singapore 159053
Summary of Responses
We will publish a summary of the main comments we receive on the REACH website, together with our responses. The identity of respondents will not be disclosed in the summary.

Documents to Download
For further reference, please download the relevant documents relating to this public consultation exercise.

Detailed Description

Aim

1. The Ministry of Social and Family Development (MSF) invites the public to give feedback on the draft Vulnerable Adults Bill

Background

2. Singapore’s population is ageing rapidly. By 2030, there will be over 900,000 residents aged 65 and above, a fair number of whom would be single or have no children. Elderly who develop dementia may be unable to care for themselves. This is especially worrying for those who are living alone – this number is projected to increase from 35,000 in 2012 to 83,000 in 2030. Persons with disabilities are also living longer, and more are expected to outlive their parents. Frail elderly and aging persons with disabilities are especially vulnerable to abuse, neglect and self-neglect. 

3. Family members serve as the first line of protection for vulnerable adults, and are supported by a network of community and social service agencies. The proposed Vulnerable Adults Bill allows the State to step in for high risk cases where state intervention is necessary to protect and ensure the safety of the vulnerable adult.

4. In drafting this Bill, MSF has studied how some overseas jurisdictions have addressed the protection of vulnerable adults in legislation. These legislations include the Adult Support and Protection (Scotland) Act 2007, the Adult Protection Act (Nova Scotia, Canada) and the Welfare & Institutions Code (California, USA). 

Stakeholders’ Feedback 

5. MSF has engaged various Voluntary Welfare Organisations (VWOs), healthcare institutions and other relevant agencies regarding the proposed legislation. These partners include social workers and practitioners who provide services to frail elderly and persons with disabilities at Family Violence Specialist Centres, Family Service Centres and Senior Activity Centres. They are supportive of MSF’s proposal to introduce new legislation to enhance the protection of vulnerable adults.

Scope of Proposed Bill

6. This public consultation seeks your views on the following: 

a. The key definitions and principles of the draft Vulnerable Adults Bill;
b. The proposed powers to be given to the State to protect vulnerable adults from abuse, neglect and self-neglect;
c. The proposed orders that the Courts may grant to protect and ensure the safety of a vulnerable adult, and parties who may apply for them;
d. The designation of places of temporary care and protection and places of safety for vulnerable adults;
e. The disclosure of confidential information for the purpose of protecting vulnerable adults; 
f. The protection from personal liability for those involved in protecting the vulnerable adult; and
g. The enhancement of penalties in other laws for offences committed against vulnerable adults.

(a) Key Definitions & Guiding Principles (Clauses 1-4)

7. The draft Bill defines a vulnerable adult as an individual aged 18 and above who, as a result of physical or mental infirmity, is unable to protect himself from abuse, neglect or self-neglect. 

8. Abuse may be physical, sexual or psychological in nature. For example, social workers have encountered a case where an elderly lady with dementia was repeatedly threatened and beaten by her son whenever she refused to give him money to spend on cigarettes. The son would also lock her up at home and prevent her from making any contact with her friends. He refused to open the house door despite repeated attempts by social workers to check on the safety of the victim. This case illustrates both physical (beatings) and psychological abuse (social isolation).

9. Neglect refers to the lack of provision of essential care to the vulnerable adult, to the extent of causing or being reasonably likely to cause injury or pain to the individual. Self-neglect concerns the failure of a vulnerable adult to care for himself, resulting in harmful conditions, such as living in grossly unsanitary or hazardous conditions, malnutrition or dehydration. There was a case involving 3 elderly siblings. One was the caregiver and the other two were her dependents. They lived in squalid conditions. There was severe clutter blocking the pathways to the house door. One of the siblings was found on the floor, lying in human waste. The other was found in bed with severe bedsores. Despite repeated engagements by social workers, the caregiver refused to allow access to herself and her siblings. This case illustrates a combination of self-neglect (of the caregiver of her own self) and neglect of her dependent siblings. 

10. In exercising any power under the Vulnerable Adults Act, the State will be guided by the following principles

a. Intervention is for the purpose of protecting the vulnerable adult from abuse, neglect, and self-neglect.
b. A vulnerable adult who does not lack mental capacity is best placed to decide how he wishes to live, and whether or not to accept any assistance. 
c. If a vulnerable adult lacks mental capacity, his views, wishes, feelings, values and beliefs must be considered as far as possible.
d. In exercising powers under the proposed legislation, the State must consider whether there are other ways to intervene which are less restrictive of the vulnerable adult’s rights and freedom of action. 

(b) Proposed Powers of the State to Protect Vulnerable Adults (Clauses 5-11)

11. Currently, social workers who receive information from neighbours or community partners that a suspected vulnerable adult is suffering or at risk of abuse, neglect or self-neglect may face difficulty gaining access to the person if he or his caregiver refuses to allow access. This prevents them from obtaining relevant information, conducting professional assessments and providing assistance in a timely manner. In severe cases, the delay in treatment could lead to long-term health consequences or even death.

12. The draft  Bill seeks to address this gap by granting the State powers to obtain information, enter private premises, as well as assess and relocate vulnerable adults who are suffering or at risk of abuse, neglect or self-neglect. Under the proposed legislation, these powers will be held by the Director of Social Welfare (Director). The Director of Social Welfare currently has statutory powers in the welfare, care and protection of other vulnerable groups, namely, children and young persons under the Children and Young Persons Act, the destitute under the Destitute Persons Act and women and girls under the Women's Charter. 

13. The draft Bill will also empower the Director to appoint ‘Protectors’, who will be specially designated senior officers from MSF’s Adult Protective Service, and authorise them to do the following: 

a. Enter and assess. Currently, the community and government agencies can only rely on moral suasion to enter homes to provide assistance. The draft Bill allows the Protector to enter the home of an individual who is suspected to be a vulnerable adult, if he cannot be accessed. After entering, the Protector is then able to assess his physical health and/or mental well-being, and whether he is suffering from or at risk of abuse, neglect or self-neglect. Where necessary, the Protector will also be able to seek the assistance of registered medical practitioners, nurses, or other qualified persons to conduct the assessment. Where urgent treatment or more in-depth assessment is required, the person may be brought to a medical facility or institution.
b. Obtain information. Currently, appropriate help may not be rendered to a vulnerable adult in a timely manner if relevant information is withheld. Under the draft Bill, the Protector will be empowered to obtain information and examine records about an individual where there is reason to believe that the individual is a vulnerable adult, and suffering from or at risk of abuse, neglect or self-neglect.
c. Remove and relocate. Even in high risk cases, vulnerable adults currently cannot be relocated for their safety, if their caregivers refuse to cooperate. Under the draft Bill, if vulnerable adults cannot safely remain in their residences[1], the Protector may temporarily relocate them to designated facilities for care and protection, or place them under the care of a fit person (such as a relative, friend or the manager of a residential facility). To respect the wishes of a vulnerable adult, out-of-home care placements will only be arranged for vulnerable adults who consent or who lack mental capacity to consent to the removal. As a safeguard, the Protector would have to apply to Court for a longer-term placement order if the period of placement exceeds 3 working days.
(c) Proposed Powers of the Court to Protect Vulnerable Adults (Clauses 12-17)

14. Currently, individuals subjected to family violence can apply personally for Court Orders under the Women’s Charter, to restrain the perpetrator from committing family violence (i.e. a Personal Protection Order), grant exclusive occupation of a home to the victim (i.e. a Domestic Exclusion Order) or require the victim and/or perpetrator to attend counselling. However, this recourse may not be adequate where the victim is a vulnerable adult, who is unable to apply personally because of his infirmity. 

15. The draft Bill allows the Court to grant the following orders if the vulnerable adult is suffering or at risk of suffering from abuse, neglect, or self-neglect, and requires protection:

a. Restrain abuse
b. Grant exclusive occupation of a home to the victim
c. Restrain the perpetrator’s activity in the vicinity of the victim 
d. Restrict access to the victim
e. Commit the victim to an out-of-home placement 
f. Place the victim under the supervision of an authorised person (e.g. a Protector or an appointed social worker)
g. Require the perpetrator or caregiver to bring the vulnerable adult for medical treatment
h. Require the victim and/or perpetrator to attend counselling
i. Require a person to make the vulnerable adult’s home a safe living environment, by disposing any article or thing to make the home safe, and removing him temporarily to do so if necessary.

16. The draft Bill also provides an expanded list of persons who can apply for the various types of orders. Apart from the vulnerable adult himself, family members, donees and deputies of the vulnerable adult (if he lacks mental capacity) and appointed social workers from certain community agencies will be able to apply for orders under (a) to (d) as listed in paragraph 13 above. The State would be able to apply for any of the above.

17. If the vulnerable adult is in imminent danger of abuse, neglect or self-neglect, the Court may make an expedited order without serving notice on the respondent. The Court will also have powers to vary, suspend or revoke an order if it is in the best interests of the vulnerable adult to do so.

(d) Designated Places of Temporary Care and Protection and Places of Safety for Vulnerable Adults (Clauses 18 – 20)

18. The draft Bill will empower the Minister to designate certain facilities (e.g. Sheltered Homes, Adult Disability Homes, etc.) as places of temporary care and protection or long-term places of safety. Vulnerable adults who can no longer stay in their home environment due to abuse, neglect or self-neglect may be relocated to these facilities, depending on their care needs. Caregivers or perpetrators who obstruct such relocation, or unlawfully remove a vulnerable adult from these designated facilities will then be guilty of an offence. 

19. As a safeguard, a Review Board will be established to review all relocations of vulnerable adults to such places under the proposed legislation. 

(e) Disclosure of Confidential Information for the Protection of Vulnerable Adults (Clauses 21-23)

20. The draft Bill imposes strict safeguards on the broadcast or publication of information that may lead to the identification of a vulnerable adult. Anyone who unlawfully publishes such information will be guilty of an offence.

21. The draft Bill envisages that disclosure of information is necessary for the reporting of cases to the authorities and for effective and timely intervention to take place. Hence, it provides for whistle-blower protection to protect those who come forward with information about alleged abuse, neglect, or self-neglect of a vulnerable adult. It will also permit confidential information to be disclosed and used, only when necessary, to facilitate effective and timely intervention.

(f) Protection from Personal Liability for Those Involved in Protecting Vulnerable Adults (Clause 26)

22. To ensure those charged with the protection of a vulnerable adult are able to perform their duties, the draft Bill protects such persons from legal liability if their actions were done with reasonable care and in good faith.

(g) Enhancement of Penalties in Other Laws for Offences Committed Against Vulnerable Adults (Clauses 31-32)

23. Relevant offences under the Penal Code and Protection from Harassment Act (POHA) committed against vulnerable adults will have their penalties enhanced (e.g. voluntarily causing hurt or grievous hurt, wrongful restraint, wrongful confinement, and causing death by a rash or negligent act. This is to send a strong signal that society disapproves of such behaviours, and would like to better protect its vulnerable members.

References

24. Please refer to the draft Vulnerable Adults Bill, accompanying infographic and list of definitions and Frequently Asked Questions

Feedback

25. MSF welcomes views and comments on the draft Bill. The public is invited to email their feedback to consultations@msf.gov.sg by 2359 hours, 23 August 2016


[1] This could be due to the presence of a perpetrator who may cause further harm to the vulnerable adult, or as a result of the physical environment (e.g. hazardous living environment or dehydration).