Stop bundling the two types of consent together.
Right now, Explicit consent (and only Explicit) consent governs whether the data is shared in HIFIS. CA consent governs whether the data shows up in the CA module. And CA consent can only be provided if Explicit consent is also present. So clients must have two different consent records, both with different start and end dates and attachments and so on.
One problem with this is when you open up a client file, you cannot tell if a client (see attached) has just Explicit consent, or whether they have Explicit + CA consent. So a lot of clients have only Explicit consent because nobody notices the error, ever.
How about this: the client only has one type of consent at a time. If someone provides CA consent, then we record a record that says "Coordinated Access" consent was provided. And a client's data is shared if either CA consent or Explicit consent is provided.
So instead of a typical client having two different consent records, they only have one - either Explicit, or Coordinated Access.