June 10, 2020

The Sad Truth about the Province’s Annual 1.3 Billion Dollar Expenditure on Seniors

crop senior couple in love hugging while spending time together in nature

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You read that right. Every year the Province provides 1.3 billion dollars towards long term care, both to non-profit and for profit operators.

If you measure society and culture by how well the seniors are treated we’ve just received a huge “fail” on the report card. Please don’t think this will not impact you~the way seniors care works it takes decades to change, has become increasingly privatized, and what you see is likely what you or the older folks in your house will be considering in years to come.

The Covid-19 virus has made very clear the crisis that comes in warehousing seniors in large care homes~over 82 percent of Covid deaths in Canada are in long term care homes, and this is the highest proportion of pandemic deaths in a study undertaken by the International Long Term Care Policy Network.

The long term care model itself is a pre-baby boom phenomena, one that appealed to the Greatest Generation cohort (born between 1910 and 1924) and the Silent Generation Cohort (born between 1925 and 1945).

These two generations considered having food prepared and served restaurant style  in dining rooms, structured and organized activities, and personal service in room cleaning and management a decadent luxury. Today with the Baby Boom Generation (from 1946 to 1964) restaurant meals are part of everyday life, and personal services easily  attainable if needed.

Long term care is no longer a non-profit investment. In British Columbia a third of care homes are managed by the health authorities, a third by non-profits, and a third by for-profit companies.

Companies like Trenchant Capital Corporation listed on the Toronto Stock Exchange own scores of care homes. They outright state that since the industry is regulated by the Province, and in provinces like Ontario no new licences have been granted in over 20 years, that they can offer “predictable cash flows”.  Seventy percent of funding is received directly from the Province and funding increases annually.

But something happened in the rush to privatization~British Columbia Seniors Advocate Isobel Mackenzie’s Report on Long Term Care, “A Billion Reasons to Care” outlines that not-for-profit care homes spend 24 percent more annually for each resident (about $10,000) and exceed direct care hour targets by over 80,000 hours of what they are publicly funded to deliver. For-profit care homes “failed to deliver 207,000 funded direct care hours”. There’s no government oversight for that funding to return to the Province, so that is left to the privately owned companies as profit.

For-profit care homes also pay their employees less.

As Daphne Bramham writes in the Vancouver Sun For-profit operators’ wage costs for each hour of direct care is lower across all classifications than the costs at not-for-profits and the homes run directly by health authorities.Some for-profits are paying care aides, who provide two-thirds of the care, nearly a third less than the industry standard, which works out to $6.63 an hour. Part of the difference is that for-profit operators are more likely to hire part-time rather than full-time workers, which eliminates the need to pay benefits.”

How did this happen? Twenty years ago the Province started to contract out long-term care to private operators who opted out of the Health Employers Association .

While the Seniors Advocate’s  report on Long Term Care was released in February in advance of the Covid-19 Pandemic,  it outlines some of the structural weaknesses that exacerbated the spread of the disease.

Care workers are not hired full-time to work in one facility.  Care workers are also not receiving a living wage.  While there is overall a shortage of care workers, they are understaffed and underpaid, and many facilities rely on families to assist with the feeding and care of residents. The tasks performed by families  ceased at the closing of all  facilities to outsiders during the pandemic.

I have already written about the fact that 93 percent of seniors intend to stay in their current homes and forgo long term care facilities. For those that must use these facilities due to necessity, the  care model must be  more effective and must serve the residents and not the corporate bottom line.

As Daphne Bramham observesIt all needs to change and change quickly before even more public money is funnelled into corporate profits at the expense of vulnerable seniors who aren’t getting the care they need and deserve.”

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Comments

  1. Many thanks, Sandy, for picking up on important information related to the public sector funding of long-term care homes in BC. As has been noted by innumerable observers, the sector is incredibly significant in its experience re incidence and subsequent deaths from contracting COVID-19 – almost 4 of 5 deaths in Canada as a whole. BC’s experience has been similar.

    I’ve examined more thoroughly the recent 2020 report of BC’s Senior Advocate on comparative funding of the public, not-for-profit and for-profit sectors. Given that 56% of all beds added to BC’s total long-term care system in the past two decades have been in the for-profit sector, the Province may have set itself up for even worst experiences in the future. The not-for-profit sector spent $10,000 more per resident per year on direct care than the for-profit sector. Nine percent of spending in the not-for-profit sector was for buildings, while it was 20% in the for-profit sector. We can only hope that the provincial government will be examining its policies in the sector in the light of the significant findings of the Office of the Seniors’ Advocate.

  2. There are some long-term care places that have been excellent; sadly too many have not. The affluent can pay $3,000 to 7,000 per month for their retirement living complex with meal package, laundry help or in suite 1 bedroom suite, meal packages; pay extra fro LPN/Nursing support; very few allow supported living or campus of care. Yep, these “cruise ship” style residences adds up to good profit from those who can afford to be there. Go on the free lunch & tour; then go to the older places for low fixed income disabled persons age 20 (e.g. ALS; MS; other medical conditions) & ages up to elders complex care situations. Both may be in subsidy/health care facility and private pay. What will be there for YOU when needed? Campus of care places in White Rock appear to have good continuous staff. Baby Boomers will be a crunch.

  3. About 1/3 of the ~$60B BC budget is healthcare, roughly $20B. About 50% (!!) is spent on folks in their last year of life, so let’s assume besides accidental or drug death that is mainly seniors. So let’s call that ~$7-8B ! As such the headline is grossly incorrect !

    Seniors that own properties also pay far lower property taxes and can delay the provincial portion until death or home sale. They also get discounts on BC Ferries. Most seniors pay little income taxes and also consume less so pay less PST.

    Should we spend more on elder care in seniors homes? Likely yes, but let’s not pretend we spend only $1.3B on seniors today !