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Impact of the CCA on recorded involuntary care432IntroductionDespite questions about the effectiveness of involuntary care and restrictive measures in providing safe and good-quality care for people with intellectual disabilities (Heyvaert et al., 2014, 2015), involuntary care is still common (Fitton & Jones, 2020; Schippers, 2018). The Convention on the Rights of Persons with Intellectual Disabilities (United Nations, 2006) states that people who receive care and support in long-term care facilities have the right to make their own choices about the care they receive. One of the ways in which this Convention was implemented in the Netherlands, was by adopting the Care and Coercion Act (hereafter: CCA) regarding involuntary care (Dutch: Wzd, 2020), which legally came into effect from January 1st, 2020. This Act regulates the use of involuntary practices in long-term care for people with intellectual disabilities, as well as people with psychogeriatric disorders, replacing the Special Admissions Act (Dutch: BOPZ, 1994). Table 1 shows the main differences between both laws. Table 1: Main Differences Between the Special Admissions Act and the Care and Coercion ActSpecial Admission Act (in Dutch: BOPZ)%u00a0 Care and Coercion Act (in Dutch: Wzd)Focused on compulsory admission and treatment. Only protected patients who stayed at care homes or at wards involuntarily.Focuses on voluntary care, support and treatment. Protects all clients receiving professional care, also if their stay in a care home is voluntary and if they receive care in their own homes.Regulation of restrictive treatment of patients with psychiatric and mental disorders, including intellectual disabilities.Regulates (in)voluntary care of clients with an intellectual disability or psychogeriatric disorder (involuntary care for people with psychiatric disorders is regulated by the new Compulsory Care Act).Restrictive measures included all forms of measures (physical and verbal) that restricted the freedom of clients.Involuntary care is care to which clients or representatives (in case of legally incapable clients) object. Voluntary care is care to which clients or representatives consent. If the representative consents, but the client resists, care is involuntary.Restrictive measures included five different coercive measures (forced nutrition, hydration and medication; seclusion; limb fixation) and a broad category of %u201cother restrictive measures%u201d, e.g. locks on cabinets, restricted telephone use (Schippers et al., 2018).Nine different categories of involuntary care (administration of nutrition, hydration, medication; restricting freedom of movement; seclusion; supervision; clothing or body searches; searches for dangerous materials or substances in private property; checks for presence of drugs; freedom restrictions in daily life; visitor restrictions).