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January 7, 2010

Updated Jan 8 with a link to a Ministry of Health website.

Residential Care Rates Up

One of the things the B.C. Liberals failed to mention during the May 2009 election campaign was their plans to significantly increase user fees for residential care. In an October 8, 2009 news release, Health Minister Falcon announced that 75% of clients will pay more beginning January 2010. The fees increased from 70% to 80% of a person's after-tax income. The new rates provide that a client will keep a minimum retained income of $275 a month; that provision means that 25% of clients will see a reduction in their rates. Overall the government expects the new fees "to generate around $53.7 million in additional revenue" per year.

With the never ending controversy over the Campbell government's failure to fulfill its first term promise of building 5,000 new long term care beds, the government has not made it easy to see how many beds of each type exist in B.C. In 2002 the government started calling long term care "community care", and soon after that new assisted living beds were counted as part of the 5,000 bed promise. The question and answer section of the Community Care Licensing Branch's website makes it clear that there is a big difference between assisted living and a licensed community care facility, with part of the difference defined in terms of the number of "prescribed services" a person requires. The absence of reliable figures on the number of different types of care beds in B.C. makes it difficult to translate the government's estimate of a $53.7 million revenue grab into the average impact per client, but as an example a person with a $30,000 before tax income will pay $163 more per month .

A background document that accompanied Falcon's news release compared the new B.C. rate structure with user fees in other provinces. That comparison indicated that the daily fee in B.C. will be between $29.40 - $96.40, depending on income. That makes B.C.'s fees the lowest at the low end and the highest at the high end. For example, the daily fees in Alberta vary between $44.50 - $54.25 and in Ontario between $53.07 - $71.07.

It is always advisable to go to independent sources to verify the information in government news releases. It would also be good if families dealing with the difficult decision of whether a family member can no longer live independently had easy access to information on the options and costs. Information on the new rate structure is available on a Ministry of Health website that reads like a defence of the government's decision. By contrast, see the webpages for Saskatchewan and Manitoba that clearly show fees; Manitoba's includes a useful online rate calculator.

On December 17th B.C.'s Ombudsperson Kim Carter released her report, The Best of Care: Getting it Right for Seniors in British Columbia, in which she criticized government for not having a single provincial website that contains comprehensive, comparable information about all individual residential care facilities, including direct care hours provided per resident per day, per diem health authority funding, personal care policies and how complaints have been handled. If you try to find something as simple as the residential care user fees on the government's website (other than in the news release), you'll see the government has a very long way to go in providing basic information. There are some corners of the massive structure of the government website that are outstanding, but most of the pages are strong on propaganda and short on basic information.

Before they sit down with an intake worker, community nurse or social worker, a family should be able to do a little research and find out for themselves what to expect if one their members becomes a residential care client. Like government news releases, some information requires verification and some conversations are more productive when everyone has some basic facts.