In 2002, the BC Liberals had a grand plan to provide seniors with home-like settings. Added to that, they promised that the new residences would cost the government about half as much. Who wouldn’t want that?
Home-like residences would be financed through public-private partnerships (P3s). Reduced costs to the government would result by attracting private-sector investors to finance new residences.
However, the plan hasn’t worked out that well.
Sure, the government reduced their costs but it was by shutting down existing facilities. Between 2001 and 2004, the government closed 26 long-term care facilities, resulting in the loss of 2,529 long-term care beds according to a report prepared for the Canadian Centre for Policy Alternatives called Assisted Living in British Columbia, Trends in access, affordability and ownership.
The fallout of the grand experiment is fewer, unaffordable housing units.
According to Statistics Canada and the Canada Mortgage and Housing Corporation (CMHC), the cost of Private-Pay assisted living exceeds the financial resources of seniors with average or low income.
Affordable housing is defined as rent less than 30 per cent of income. While wealthy B.C. senior couples can almost afford rent according to that definition (39 per cent), seniors living alone in a bachelor suite require over 80 per cent of their income for rent, which is clearly unaffordable. At rents that high, seniors will be doing without basic sundries, medications, transportation, and entertainment.
Seniors who can’t find lower cost Publicly Subsidized residences are turning to Private-Pay residences as a last resort, even though they can’t really afford them.
And while the number of Private-Pay and Publicly Subsidized units has increased marginally, it hasn’t kept up with demand. The net new Private-Pay units have only increased by 1,130 in all of B.C. from 2010 to 2017. In the Interior Health region, the net new Private-Pay units only increased by 243.
The number of Publicly Subsidized assisted living units added in the same period is even more dismal -only by 105 for all of B.C. and by 26 for the Interior Health region.
The labels “Private-Pay” and “Publicly Subsidized” are misleading.
Private-Pay suggests that these residences are built independently and rented at market prices, like a hotel. However, the government pays the operator of these facilities a daily resident rate and BC Housing, a crown corporation, pays for housing costs.
Publicly Subsidized is equally misleading. It suggests that the residences are owned and operated by the government. They are not: 63 per cent are owned by a non-profit organization, 33 per cent are owned by a for-profit business, and only 4 per cent are owned by a public health authority. Unlike Private-Pay facilities, renters are subsidized according to their ability to pay.
As the pandemic unfolded, it became apparent that some Private-Pay residences did not meet the legislated standards of care for residents. As a result, health authorities seized control of a number of residences owned by Retirement Concepts, British Columbia’s largest chain of for-profit care homes.
Long-term care facilities in B.C. didn’t meet the needs of most seniors before the COVID-19 pandemic and now the outbreak has focussed a spotlight on those failings.
More Publicly Subsidized residences need to be financed by BC Housing and operated by non-profits and for-profit businesses. The housing may not be grand but when well-designed, they can be comfortable, affordable, safe, and profitable.