The BC Government is developing a new standardized funding model for long-term care. This new model could enforce accountability around use of public funds, making LTC less profitable.
A standardized and transparent funding model should:
- Require that all contracted long-term care facilities that receive public money clearly report revenues and expenditures to the public and require that all surplus funds be spent on the care of seniors or be returned.
- Standardize reporting for direct care hours so that staffing levels and ratios can be independently verified and enforced.
- Ensure that all facilities that receive public money are required to be a part of a public sector master collective agreement, and to ban exploitative sub-contracting practices
Over the past twenty years, funding and access to seniors’ care has been reduced and rationed, while more publicly funded services are being delivered by for-profit companies, often in long term care facilities that combine publicly funded and private-pay beds. As a result, between 2008 and 2017, access to publicly subsidized units fell by 17 per cent. This has resulted in inferior care for seniors over many years, and a fractured system that was already in crisis before the start of the pandemic.
In the 2020 report “A Billion Reasons to Care,” the BC Seniors Advocate found that despite receiving the same level of public funding, for-profit long-term care operators were spending about $10,000 less each year per resident than non-profit operators. Those public funds, which were designated to be used for the care of seniors, were and continue to be pocketed as profits.
Most people want to age in place. A National Survey found that 91 per cent of Canadians of all ages, and almost 100 per cent of Canadians 65 years of age and older, report that they plan on supporting themselves to live safely and independently in their own home as long as possible.
- Make home support more accessible by removing the current regulated daily rate co-payment
- Address the staffing crisis by increasing the wages of community health workers so they are paid the same no matter where they work, and create stable working conditions by guaranteeing hours
- Provide comprehensive care by bringing Instrumental Activities of Daily Living back into the home support program
Older adults nearly unanimously wish to live independently at home as long as possible. However, without adequate home support access many seniors experience health decline more rapidly and family caregivers become over-extended, pushing seniors to move into Long Term Care earlier than necessary.
Yet access to publicly funded home care has consistently declined in BC since 2001
BC is one of the last provinces that still limits access to home support by charging a fee. co-payments represent a significant financial barrier to an essential service. Eliminating co-payments will result in a sharp increase in demand for home support services. Meeting this demand will require public investments but will save taxpayer money overall by reducing the burden on Long Term Care. BC must urgently address the staffing crisis by increasing the wages of community health workers so they are paid the same no matter where they work and create stable working conditions by guaranteeing hours. It is not a coincidence that this workforce is overwhelmingly female, deeply under-compensated and also working precarious positions.
The Seniors Advocate reported in 2019 that Community Health Workers (CHWs) who provide home support services are paid less than care aides with equivalent training who are offering comparable care in other sectors. More than 75% of CHWs are employed in a part-time or casual position. Increasing wages for CHWs to be level with those of care aides working in LTC, as well as guaranteeing hours of work, will stabilize the CHW workforce and support efforts to increase service levels and quality of care.
 Office of the Seniors Advocate BC (2019), Home Support: We can do better. https://www.seniorsadvocatebc.ca/app/uploads/sites/4/2019/06/Report-Home-Support-Review_web.pdf
 A. Longhurst (2017), Privatization and Declining Access to BC Seniors’ Care: An Urgent Call for Policy Change, Canadian Poilcy Alternatives—BC Office. https://policyalternatives.ca/publications/reports/privatization-declining-access-bc-seniors%E2%80%99-care