Consent to Medical Treatment and Palliative Care Regulations 2014

The instrument organises a small number of operational concepts that implement and refine the Act’s framework. Those concepts are: extension of the statutory definition of health practitioner; person responsible and consent record keeping; prohibition of consent to chemical restraint by certain persons responsible; delegation, mediation and referral protocols between the Public Advocate and the Tribunal; and the fee for applications under section 18C.

Extension of "health practitioner" (reg 4). For the purposes of the Act’s definition in s 14(1), regulation 4(1) declares that ambulance service provision and medical treatment by SAAS staff or other authorised ambulance providers, and paramedics, fall within the ambit of the definition of health practitioner. Regulation 4(2) clarifies that ambulance service, medical treatment and SAAS carry the same meanings as in the Health Care Act 2008.

Person responsible record keeping (reg 5(a)). The person responsible is required to make and keep records "relating to the giving of consent" as may be required under a scheme determined and published by the Minister. The regulation therefore delegates the specification of record formats, retention periods, content and potentially oversight mechanisms to a Ministerial scheme as published in the Gazette. The regulation does not itself provide the content of that scheme.

Prohibition on consenting to chemical restraint (reg 5(b)). The regulation disqualifies a person responsible who falls within paragraph (d) of the Act’s definition of person responsible from consenting to medical treatment that consists of drug administration principally for the purpose of controlling the patient’s behaviour. The instrument includes a statutory note identifying that practice as commonly referred to as chemical restraint.

Delegation, mediator qualifications and immunities (reg 6). For disputes under section 18C of the Act the Public Advocate may delegate mediation, but only to persons for whom the Public Advocate is satisfied have suitable qualifications and expertise in mediation. A mediator delegated by the Public Advocate has the same privileges and immunities as a Tribunal member pursuant to the South Australian Civil and Administrative Tribunal Act 2013. The regulation modifies the usual interaction with the Guardianship and Administration Act 1993 by restricting delegation unless the qualification threshold is met.

Referral protocols between Public Advocate and Tribunal (reg 7). When the Public Advocate refers a matter to the Tribunal under s 18D(1), that referral must be made within seven business days of the end of mediation or refusal to determine an application. The Public Advocate must notify whether parties have consented to referral, give written reasons, provide a summary of the dispute, contact details and "all other information relevant" in its possession, and,if the mediator was a delegate,provide the mediator’s name. Conversely, when the Tribunal refers a matter to the Public Advocate under s 18F(1), the Tribunal must do so within seven business days and provide equivalent information and written reasons, and notify consent status. Regulation 7(3) prevents the Tribunal from referring a matter to the Public Advocate if mediation under s 18C has already occurred.

Fees (reg 8, Schedule 1). The only fee listed in Schedule 1 is an "Application under section 18C of the Act" and the fee for that application is nil. The regulations therefore remove an upfront fee for initiating the mediation pathway under s 18C.

Cross‑referenced statutory material. The regulations refer directly to the Act (Consent to Medical Treatment and Palliative Care Act 1995), to the Health Care Act 2008 for certain definitional terms, to the Guardianship and Administration Act 1993 in respect of delegation (reg 6(1) states "despite section 23 of the Guardianship and Administration Act 1993"), and to the South Australian Civil and Administrative Tribunal Act 2013 in relation to privileges and immunities for mediators.

The regulations are procedural and definitional rather than creating new substantive powers of treatment or new criminal offences. They operate by identifying actors, imposing process and record obligations, conditioning delegation, and prescribing the information flow and timing required between the Public Advocate and the Tribunal.

These regulations directly and indirectly affect five main groups: patients for whom consent issues arise, persons responsible who give consent on behalf of patients, ambulance service personnel (including paramedics), the Public Advocate (and their delegates), and the Tribunal. They also affect ministers and administrative staff because of the Ministerial scheme and publication obligations.

Persons responsible (reg 5). The person responsible is the actor who must "make and keep such records" regarding giving of consent under a Ministerial scheme (reg 5(a)) and is subject to the prohibition on consenting to drug administration principally for behaviour control when falling within paragraph (d) of the Act’s definition of person responsible (reg 5(b)). The regulation therefore places procedural and substantive duties on persons responsible; the regulations do not themselves define the composition of that group, which rests with the Act’s definition in s 14(1).

Patients. Patients are affected through the regulated behaviour of those who may consent for them and by the prohibition on consent to chemical restraint by certain persons responsible (reg 5(b)). The regulations may change how consent is documented, how delegation and mediation operate in disputes over treatment, and who can be treated as a health practitioner under the Act.

Ambulance staff and paramedics (reg 4). The regulations declare ambulance service provision and paramedics to be included in the definition of health practitioner for section 14(1) of the Act. That inclusion brings ambulance personnel within the statutory term for purposes such as who may be required to obtain or give consent, or otherwise be treated as a "health practitioner" in the Act’s regulatory framework. The cross‑reference to the Health Care Act 2008 (reg 4(2)) means definitions used for ambulance service and SAAS in that Act determine the scope of who is affected.

Public Advocate and mediators (reg 6 and reg 7). The Public Advocate is constrained to delegate mediation only to persons the Public Advocate is satisfied are suitably qualified and expert in mediation (reg 6(1)). Mediators delegated by the Public Advocate are given the same privileges and immunities as Tribunal members (reg 6(2)). The Public Advocate must also comply with specified disclosure, timing and reason‑giving duties when referring matters to the Tribunal (reg 7(1)), which affects the Public Advocate’s workflow, decision-making and resource allocations. If the Tribunal refers a matter to the Public Advocate, that Tribunal must observe reciprocal duties (reg 7(2)). These provisions therefore affect the operational responsibilities and interagency communications of the Public Advocate and the Tribunal.

The Tribunal (reg 7). The Tribunal is a recipient of referrals from the Public Advocate and a referrer to the Public Advocate, subject to the seven business day timelines and information duties. Regulation 7(3) constrains the Tribunal by preventing referral to the Public Advocate if mediation under section 18C has already occurred.

Ministers and administrative staff. The Minister is given delegation to determine a scheme for required records under reg 5(a) and publish it in the Gazette. Administrative officers will handle that Gazette publication and may be involved in maintaining the Ministerial scheme. The scheme itself will determine the ongoing compliance obligations for persons responsible.

Indirectly affected groups include healthcare facilities, which may be asked to assist with record provision, and legal representatives, who may operate in the mediation and Tribunal referral processes. The regulations therefore shift administrative and procedural responsibilities across a range of actors without altering the Act’s underlying substantive powers; the immediate operational burdens fall on persons responsible for record keeping, the Public Advocate for delegation and referral practices, and ambulance services and paramedics who become included in the "health practitioner" definition for the Act’s purposes.

The regulations create a specific set of duties and confer certain procedural protections that interact with rights under the Act and other statutes. Below are the primary duties imposed and rights conferred, with the regulating provisions cited.

Duties on persons responsible (reg 5). Regulation 5(a) imposes a duty on the person responsible to "make and keep such records relating to the giving of consent as may be required under a scheme determined from time to time by the Minister and published in the Gazette." That is a continuing, documentary duty; the detailed content, form and retention requirements are not in the regulation but will be set out in the Ministerial scheme. Regulation 5(b) imposes a substantive duty by preventing certain persons responsible (those contemplated by paragraph (d) of the Act’s definition in s 14(1)) from consenting to the administration of drugs principally to control patient behaviour.

Duty to assess mediator qualifications for delegation (reg 6(1)). The Public Advocate must be satisfied that any person to whom mediation is delegated possesses suitable qualifications and expertise in mediation. That is an evidentiary/assessment duty; the regulation makes delegation contingent on the Public Advocate's satisfaction about qualifications.

Duty to provide reasons and information when referring matters (reg 7). If the Public Advocate refers a matter to the Tribunal under section 18D(1), regulation 7(1) requires that the referral is made within seven business days of mediation ending or an application being refused; the Public Advocate must notify whether parties have consented to referral, provide written reasons, a summary of the dispute, contact details and all other relevant information in its possession, and if applicable, the mediator’s name. Likewise, if the Tribunal refers to the Public Advocate under section 18F(1), regulation 7(2) requires the referral within seven business days and disclosure of consent status, written reasons, dispute summary, contact details and all relevant information in the Tribunal’s possession. Regulation 7(3) imposes a constraint on the Tribunal by prohibiting referral to the Public Advocate where mediation under section 18C has already occurred.

Duty to publish scheme (reg 5(a)). While the duty to determine and publish the scheme sits with the Minister, the regulation requires the record keeping obligations to be set out in a Gazette‑published scheme. That creates a duty on the executive to publish and thereby creates enforceable notice to regulated persons.

Right to immunity/privilege for delegated mediators (reg 6(2)). Mediators to whom the Public Advocate delegates a function under section 18C are granted the same privileges and immunities as a member of the Tribunal under the South Australian Civil and Administrative Tribunal Act 2013. This is a protective right afforded to mediators that affects civil liability exposure and procedural standing.

Fee entitlement (reg 8 and Schedule 1). Schedule 1 fixes the fee for an application under section 18C of the Act at nil. That functionally removes an upfront monetary barrier to invoking mediation under section 18C and is therefore a right of access in fee terms to the mediation pathway.

Cross‑statutory duties and limitations. Regulation 6(1) is framed "for the purposes of section 18C of the Act, and despite section 23 of the Guardianship and Administration Act 1993," which indicates that the regulations displace or constrain how delegation under the Guardianship and Administration Act 1993 would otherwise operate in relation to mediation under section 18C. That phrase creates a regulatorily imposed alignment that affects inter‑Act delegation practice.

Not included in the regulations. The regulations do not set out sanctions or penalties for failing to keep records, nor do they set out procedural rules for how the Tribunal will treat the Public Advocate’s reasons in a referral. The regulations do not define "person responsible" or specify content of the Ministerial scheme; those remain matters for the Act and the Ministerial Gazette instrument respectively.

In summary, duties are documentary (records for consent), substantive (prohibition on consenting to chemical restraints by some persons responsible), procedural (timeframes, reasons and disclosure on referral), and administrative (satisfying mediator qualifications for delegation). Rights granted include immunity/privilege for delegated mediators and removal of the fee for applications under section 18C.

The regulations themselves do not create express criminal offences or specify monetary penalties. They are primarily procedural and directive, setting duties, prohibitions and administrative requirements which must be enforced through the Act and related statutory arrangements.

Absence of statutory penalties in the regulations. There is no clause in these regulations that prescribes a penalty, fine, or criminal sanction for failure to comply with the record keeping obligation in regulation 5(a) or with the prohibition in regulation 5(b). The regulations require the person responsible to make and keep records "as may be required under a scheme determined from time to time by the Minister and published in the Gazette" (reg 5(a)); however, the regulations do not specify enforcement mechanisms for non‑compliance with that Ministerial scheme.

Enforcement pathways implicit through the Act and Tribunal. The regulations repeatedly reference dispute resolution pathways that invoke the Public Advocate (sections 18C, 18D and 18F of the Act) and the Tribunal. Regulations 6 and 7 prescribe delegation and referral processes tied to those provisions. As such, enforcement of duties and compliance is likely to occur through the Act’s dispute resolution mechanisms and through Tribunal processes rather than through new sanctioning regimes in the regulations themselves. The regulations require the Public Advocate and Tribunal to exchange written reasons and documentary information when referring matters within set timeframes (reg 7), which supports adjudicative review and oversight by the Tribunal.

Privileges and immunities for mediators (reg 6(2)). The regulations grant mediators delegated by the Public Advocate the same privileges and immunities as a member of the Tribunal under the South Australian Civil and Administrative Tribunal Act 2013. This reduces civil exposure for mediators acting under delegation but is not an enforcement mechanism; it affects litigation risk for mediators by aligning their legal protections with Tribunal members.

Administrative enforcement via the Ministerial scheme. The scheme the Minister determines under reg 5(a) is the likely vehicle for detailing procedural obligations, including potential sanctioning or oversight mechanisms. The regulations' requirement that the scheme be published in the Gazette establishes an administrative channel for enforcement design, but the regulations themselves delegate the specifics to the Ministerial instrument.

Tribunal review and corrective pathways. Because the regulations attach to the Act’s pathways for mediation and Tribunal involvement, failure to follow procedures may be raised in submissions to the Tribunal or by the Public Advocate within referral documents (reg 7 requires provision of all relevant information and written reasons), which creates a record that the Tribunal can use in exercising its functions under the Act.

In short, these regulations set out duties and prohibitions without attaching explicit penalties within the instrument. Enforcement will therefore depend on the Act’s dispute resolution and Tribunal mechanisms, the content and enforcement provisions of the Ministerial record keeping scheme referenced in reg 5(a), and the procedural protections and obligations described in reg 6 and reg 7.

The regulations operate as subordinate legislation to the Consent to Medical Treatment and Palliative Care Act 1995 and cross‑reference several other statutes, creating interdependencies that affect interpretive scope and operational detail.

Primary interaction with the Act (Consent to Medical Treatment and Palliative Care Act 1995). Throughout the regulations, references to specific sections of the Act anchor the operation of the regulations. For example, regulation 4 expands the meaning of "health practitioner" for the purposes of section 14(1). Regulation 5 is made "Pursuant to section 14B(2) of the Act," and regulates consent by a person responsible. Regulations 6 and 7 operate "for the purposes of section 18C," and address the referral provisions under sections 18D(1) and 18F(1). Regulation 8 sets fees "for the purposes of the Act" and links to Schedule 1. The effect is that the regulations supply procedural detail to specific statutory hooks in the Act; they do not create independent bases for treatment or Tribunal jurisdiction.

Cross‑reference to Health Care Act 2008 (reg 4). Regulation 4(2) states ambulance service, medical treatment and SAAS have the same meanings as in the Health Care Act 2008. This means the scope of "health practitioner" for section 14(1) will depend on definitions in the Health Care Act 2008 and on who is authorised to provide ambulance services under it, tying the operation of the consent regime to administrative licensing and authorisation frameworks that sit in the Health Care Act.

Interaction with Guardianship and Administration Act 1993 (reg 6). Regulation 6(1) states that "for the purposes of section 18C of the Act, and despite section 23 of the Guardianship and Administration Act 1993, the Public Advocate may only delegate a function or power under that section relating to mediation to a person if the Public Advocate is satisfied that the person has suitable qualifications and expertise in mediation." This is an express displacement of section 23 of the Guardianship and Administration Act 1993 insofar as it would otherwise govern delegation,regulation 6 imposes an additional, mediation‑specific qualification standard on delegation by the Public Advocate.

Privileges and immunities under the South Australian Civil and Administrative Tribunal Act 2013 (reg 6(2)). Regulation 6(2) grants a mediator delegated by the Public Advocate "the same privileges and immunities as a member of the Tribunal under the South Australian Civil and Administrative Tribunal Act 2013." This imports protections from the SACAT Act to mediators appointed under the Act, affecting civil liability, procedural privilege and potentially evidentiary considerations.

Publication and Legislation Revision and Publication Act 2002 (legislative history notes). The legislative history notes that r 2 was omitted under the Legislation Revision and Publication Act 2002. The history indicates the regulations have been varied multiple times with citations to gazette commencements. That Act therefore influences how the regulations are revised and how cross‑legislative references are handled administratively.

Procedural interaction with Tribunal processes. The regulations require exchange of written reasons, summaries, contact details and other information between the Public Advocate and the Tribunal within seven business days when referring matters (reg 7). This creates a procedural bridge whereby administrative decisions and mediation records become part of Tribunal record flowing across statutory boundaries.

Limitations and gaps. The regulations do not define "person responsible" or the content of the Ministerial record scheme; those remain matters for the Act and executive instruments. They also do not set out enforcement mechanisms, leaving enforcement to the Act, Tribunal oversight, or the Ministerial scheme. The regulations therefore function as a layering instrument, drawing in definitions and protections from other statutes while delegating some procedural substance to Ministerial instruments.

In summary, the regulations operate in a networked way: they extend definitions by reference to the Health Care Act 2008, constrain delegation relative to the Guardianship and Administration Act 1993, import immunities from the SACAT Act 2013, rely on the Act for substantive authority, and depend on the Legislation Revision and Publication Act 2002 for revision mechanics.

The instrument includes a concise legislative history in its final section that records revocations, variations and commencements. That history is the primary source within the regulations themselves for understanding their enactment and subsequent changes.

Revocation and commencement. The Consent to Medical Treatment and Palliative Care Regulations 2014 revoked the Consent to Medical Treatment and Palliative Care Regulations 2004. The principal regulations were Gazette‑published 12 June 2014 at page 2498 and, per the commencement note, came into operation from 1 July 2014 (see the commencement notation r 2 in the history).

Subsequent variations recorded in the legislative history. The legislative history lists three variation instruments in 2015: No. 17 (Gazette 5 March 2015, p 889) commenced 29 March 2015; No. 47 (Gazette 14 May 2015, p 1763) commenced 14 May 2015; and No. 51 (Gazette 28 May 2015, p 2301) commenced 28 May 2015. The history identifies provisions that were varied and commencement dates for those variations. For example, r 2 was omitted under the Legislation Revision and Publication Act 2002 with effect from 29 March 2015. Regulation 4(1) was varied by 51/2015 r 4 effective 28 May 2015. Regulation 6(2) was varied by 17/2015 r 4 effective 29 March 2015. Regulation 7 was substituted by 17/2015 r 5 effective 29 March 2015, with r 7(1) later varied by 47/2015 r 4 effective 14 May 2015. Schedule 1 was substituted by 17/2015 r 6 effective 29 March 2015. Schedule 2 was omitted under the Legislation Revision and Publication Act 2002 effective 29 March 2015.

Practical import of the variations. The history signals targeted, discrete amendments rather than replacement of the entire regulatory scheme. The substitution and variation entries indicate parts of the instrument were amended after initial commencement,particularly the referral procedures in regulation 7 and the Schedule of fees,and some obsolete material was omitted under the machinery of the Legislation Revision and Publication Act 2002.

Publication and notice. The regulations require publication of a Ministerial scheme in the Gazette to implement record keeping obligations (reg 5(a)), and the legislative history demonstrates that Gazette publication has been used as the formal vehicle for variation and commencement. Users should therefore search the South Australian Government Gazette and the consolidated legislative register for the current Ministerial scheme and any subsequent instrument variations.

Documentary record. The legislative history lists specific Gazette citations and commencement dates. It also advises that historical versions of the regulations are available. The history concludes with three historical versions available at dates: 29 March 2015, 14 May 2015, and the original 2014 instrument. Practitioners relying on these regulations should consult the consolidated version and the Gazette for any Ministerial schemes or later amending instruments that may alter operational obligations.

The regulations themselves do not contain or reference any court or Tribunal decisions. The instrument’s text and legislative history do not record litigation, and no cases are named or summarised within the regulation. Consequently there is no litigation history embodied in the statutory text provided.

Potential adjudicative pathways implied by the regulations. Although no decisions are recorded, the regulations explicitly integrate with the Act’s dispute resolution architecture by prescribing the roles of the Public Advocate and the Tribunal under sections 18C, 18D and 18F of the Act (regs 6 and 7). That framework identifies the Tribunal as the adjudicative body that will receive referrals from the Public Advocate and as the originator of referrals to the Public Advocate, thus creating a clear forum for adjudicating disputes about consent, treatment and the application of the Act. The regulations therefore create procedural steps that will shape how disputes arrive at the Tribunal and what documentary material accompanies referrals.

Topics likely to be litigated given the regulatory design. The regulations create and clarify several procedural issues that are likely to surface in disputes and could be the subject of Tribunal consideration or judicial review of administrative action. Those include:

• Whether a person meets the statutory definition of "person responsible" in the Act and therefore whether reg 5 obligations and prohibitions apply. The regulation refers to paragraph (d) of the Act’s definition in s 14(1), so identity and standing disputes could arise.

• Compliance with reg 5(a) record keeping obligations and with any Ministerial scheme published in the Gazette. Disputes may turn on whether records "relating to the giving of consent" were made and kept as required.

• Whether a purported consent by a person responsible constitutes consent to a form of "chemical restraint" prohibited by reg 5(b). The regulation’s text focuses on drugs administered "principally for the purpose of controlling the behaviour of the patient," a scope that could require factual and legal determination.

• Delegation decisions by the Public Advocate under reg 6(1). A party may contest whether the Public Advocate properly satisfied themselves that a delegate had suitable qualifications and expertise, particularly where the legitimacy of the mediation process is at issue.

• Sufficiency of reasons and information exchanged under reg 7 on referrals. The regulations require written reasons and "all other information relevant to the matter that is in the possession" of the referring body. Parties may contest whether the referring body complied with these disclosure obligations and whether a failure to disclose relevant material affected the Tribunal’s ability to decide a matter.

• Whether the Tribunal acted appropriately in referring or not referring a matter under sections 18D and 18F in light of regulation 7(3), which prohibits Tribunal referrals to the Public Advocate where mediation under s 18C has already occurred.

Absence of precedent in the instrument. Because the regulations record no cases, practitioners will need to search Tribunal and court databases and the consolidated legislative record for any decisions applying these specific regulations. The regulations themselves establish the procedural scaffolding that any such litigation would engage, but they do not summarise how that scaffolding has been interpreted in practice.

In sum, although there is no litigation history attached to the instrument, the regulations identify distinct procedural and evidentiary duties that will frame disputes reaching the Tribunal or involving the Public Advocate, and these are the likely subjects of litigation or Tribunal adjudication in the future.

The regulations are short and tightly drafted, but several practical pitfalls arise from what the instrument delegates, omits or folds into other instruments. Below are the main "gotchas" drawn from the text.

Record keeping is specified but delegated to a Ministerial scheme (reg 5(a)). The person responsible must "make and keep such records relating to the giving of consent as may be required under a scheme determined from time to time by the Minister and published in the Gazette." The regulation does not specify content, format, retention period, or enforcement steps. Practitioners therefore cannot rely on the regulations alone to know what records are required; the applicable Ministerial scheme must be consulted in the Gazette. Failure to check the current Ministerial scheme is a practical trap.

No penalty specified in the regulations for failure to keep records. Regulation 5(a) demands record keeping but the regulations do not itself specify a penalty or enforcement mechanism should the person responsible fail to comply. Enforcement may be via the Act, the Tribunal, or the Ministerial scheme, but the regulations leave that link opaque. Parties should therefore check the Act and the Ministerial scheme for enforcement provisions; practising advisers should not assume existence or non‑existence of sanctions without checking those instruments.

"Person responsible" is not defined in the regulations. Regulation 5(b) relies on the Act’s definition (paragraph (d) of section 14(1)), but the regulations do not restate who qualifies. This is a frequent source of confusion in practice where capacity, hierarchy of decision‑makers, and substitution are contested. Advisers must refer to the Act to determine the identity of the person responsible before applying reg 5 duties and prohibitions.

Prohibition on consenting to chemical restraint is limited in scope (reg 5(b)). The prohibition applies to a person responsible "contemplated by paragraph (d) of the definition of person responsible in section 14(1) of the Act" and concerns administration of drugs "principally for the purpose of controlling the behaviour of the patient." The restriction is therefore both actor‑specific and purpose‑based. That dual limitation means situations where drugs are administered primarily for clinical reasons but have ancillary behavioural effects may fall outside the prohibition. Assessing the "principal purpose" will be fact dependent and could be contested.

Delegation standard for the Public Advocate is subjective (reg 6(1)). The Public Advocate may only delegate mediation functions if "satisfied that the person has suitable qualifications and expertise in mediation." The regulation does not specify objective criteria for "suitable qualifications and expertise," so reviewability may focus on whether the Public Advocate's satisfaction was reasonable. Delegation in the absence of documented assessment of qualifications could be vulnerable to challenge.

Privileges and immunities for mediators may be broader than anticipated (reg 6(2)). Mediators delegated by the Public Advocate have "the same privileges and immunities as a member of the Tribunal" under the SACAT Act 2013. That grants significant legal protection to delegates. Parties should be aware that mediator conduct under delegation is afforded robust legal protections, which affects prospects for civil claims arising from mediation activities.

Time limits and exhaustive disclosure on referrals (reg 7). When the Public Advocate or Tribunal refers a matter, the referring party must do so within seven business days and provide written reasons, a summary, contact details and "all other information relevant to the matter that is in the possession" of the referrer. That phrase is broad and creates a heavy disclosure duty. Failure to compile a complete package within the seven business day window may be prejudicial in Tribunal proceedings and could be the basis of procedural complaints. Organisations should prepare to collate comprehensive files promptly.

Triangular prohibition on Tribunal referral if mediation already occurred (reg 7(3)). The Tribunal may not refer a matter to the Public Advocate if mediation under section 18C has already happened. This can create procedural dead ends if parties expect iterative referral‑mediation cycles. Practitioners need to map prior mediation history carefully before seeking or responding to referrals.

Fees appear minimal but may not be exhaustive (reg 8 and Sch 1). Schedule 1 lists only one fee: nil for an application under section 18C. That removes an upfront fee for mediation application, but the Schedule does not list other potential fees that could apply elsewhere under the Act or other statutes. Parties should not assume that all Tribunal or administrative processes are free based on the single nil entry.

Cross‑legislative definitions matter (reg 4). Including ambulance services and paramedics in the Act’s "health practitioner" definition imports definitions from the Health Care Act 2008. Practitioners should verify authorised providers and definitional scope in that Act to determine who is captured. There is a risk of assuming every ambulance attendant is covered when the Health Care Act’s authorisation status may matter.

In short, the main practical risks are reliance on delegated content in the Ministerial scheme, absence of explicit regulatory sanctions, subjective delegation criteria, broad disclosure duties on referrals, and definitional dependencies on other Acts. Each of these requires checking the Act and the relevant Gazette‑published Ministerial instruments and maintaining administrative systems to ensure timely, complete referral packages and record keeping.

Compliance under these regulations requires both immediate steps (what to do now) and system‑level practices (what to put in place). The regulations allocate duties across persons responsible, the Public Advocate, the Tribunal and the Minister. Below is a compliance checklist tied directly to the regulatory provisions.

1. Identify whether the person is a "person responsible." Before applying reg 5 obligations, consult section 14(1) of the Act to establish whether the individual meets the definition of "person responsible," and specifically whether they fall within paragraph (d) of that definition referenced in reg 5(b). The regulations hinge on that statutory definition.

2. Locate and implement the Ministerial record keeping scheme. Regulation 5(a) requires the person responsible to make and keep records "as may be required" under a Ministerial scheme published in the Gazette. Compliance steps:

   • Obtain the current Ministerial scheme published in the South Australian Government Gazette governing consent records for the Act.
   • Implement record templates, retention schedules and security/access controls required by that scheme.
   • Train persons responsible, care facility staff and legal advisors on the scheme’s content and retention obligations.
   • Maintain an audit trail demonstrating creation and retention of consent records, including timestamps and authorship.

3. Adhere to the prohibition on consenting to chemical restraint (reg 5(b)). For persons responsible contemplated by paragraph (d) of s 14(1):

   • Do not provide consent to administration of drugs where the principal purpose is controlling the patient’s behaviour.
   • If drugs are proposed that may have behavioural effects, document the primary clinical purpose and supporting clinical evidence demonstrating that the drug is prescribed principally for medical treatment rather than behaviour control.
   • Keep clinical justifications and consult attending health practitioners for written statements of intended therapeutic purpose to mitigate ambiguity about principal purpose.

4. For the Public Advocate: adopt documented qualification assessment procedures for delegates (reg 6(1)):

   • Establish objective criteria or a vetting checklist to demonstrate satisfaction that a mediator has "suitable qualifications and expertise in mediation."
   • Keep records of the assessment and the mediator’s CV, accreditation and prior mediation experience.
   • Ensure mediation delegates are informed they will have the same privileges and immunities as a Tribunal member (reg 6(2)), and confirm any necessary indemnity or insurance arrangements.

5. Prepare to assemble referral packages within seven business days (reg 7):

   • Create a standard referral pack template including written reasons for referral, a summary of the dispute, contact details for all parties, consent statuses, and all other relevant information in the referrer’s possession.
   • Implement document collation procedures so that, when mediation ends or an application is refused, the Public Advocate can make the referral within seven business days.
   • If the mediator was a delegate of the Public Advocate, ensure the referral notes the mediator’s name per reg 7(1)(e).
   • Conversely, Tribunal staff should implement the same pack requirements when referring to the Public Advocate under reg 7(2).

6. Document consent to referral status (reg 7). Both the Public Advocate and the Tribunal must notify whether any or all parties have consented to referral. Ensure party consent capture processes are recorded in the package.

7. Understand referral limitations (reg 7(3)). Before the Tribunal attempts to refer a matter to the Public Advocate, confirm that the matter has not already been the subject of mediation under section 18C, as the Tribunal may not refer such matters.

8. Fee handling (reg 8 and Sch 1). Note that an application under section 18C of the Act carries a nil fee. Ensure internal fee schedules and case management systems reflect this nil fee and do not inappropriately charge applicants for that specific application. Confirm whether other fees apply under the Act or other instruments.

9. Align ambulance and paramedic practice with the Act (reg 4). Health services and ambulance providers should:

   • Review the Health Care Act 2008 definitions to determine who is captured as SAAS or authorised ambulance provider.
   • Ensure training and protocols reflect that ambulance staff and paramedics are treated as health practitioners for purposes of the Act, which may include recognition of consent obligations and responsibilities under the Act.

10. Record retention and disclosure readiness. Given the broad disclosure requirement in reg 7 to provide "all other information relevant to the matter that is in the possession of" the referrer, maintain complete case files and develop a process to identify documents relevant to referrals quickly. Log chain of custody for documents and ensure confidentiality and privacy obligations are met when sharing personal health information between agencies.

11. Legal oversight and audit. Given the regulatory gaps (no specific sanctions in the regulations), perform periodic legal reviews to ensure the Ministerial scheme, the Public Advocate’s delegation practices, and referral processes are consistent with the Act and other applicable statutes.

12. Keep current with amendments. Consult the consolidated regulations and the Gazette for Ministerial schemes and any subsequent amending instruments,for example, the legislative history indicates amendments in 2015. Compliance requires monitoring for future changes.

By implementing these measures, regulated parties align with the obligations and procedural expectations the regulations set out. Where the regulation delegates content (for example, to a Ministerial scheme), ensure the subordinate instrument is obtained and integrated into the compliance process.