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Rising cost, demand spurs call for review of B.C.’s assisted-living regulations

Click to play video: 'There’s a growing need for more assisted living facilities in B.C.'
There’s a growing need for more assisted living facilities in B.C.
Much more work needs to be done in order to meet B.C.'s growing demand for assisted living facilities, according to the latest data. Legislative bureau chief Keith Baldrey has the details. – Jun 28, 2023

British Columbia’s seniors advocate is calling for an overhaul of the legislation regulating assisted-living facilities in a new report warning of rising costs and mounting demand in the sector.

In the report issued Wednesday, Isobel Mackenzie, said assisted-living facilities are a crucial resource for seniors and people with disabilities seeking to maintain independence, who need support that doesn’t rise to the level of long-term care.

Click to play video: 'B.C. should review assisted living rules amid rising demand says seniors advocate'
B.C. should review assisted living rules amid rising demand says seniors advocate

As the population of seniors has boomed over the last five years, there has only been a two per cent increase in the number of available assisted-units in B.C., almost all in the private-pay market, the review found.

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New publicly-subsidized units have not kept pace with demand, with a 15 per cent drop in the number of spaces per capita for British Columbians aged over 75, it adds.

Despite public spending on subsidized assisted living climbing 52 per cent in the period reviewed, there has been no increase in the number of units or the level of support provided, it found.

As of 2022 there were an estimated 4,415 publicly-subsidized units and 4,013 private-sector units according to the report. The total number of facilities in all sectors has fallen by six per cent over the last five years.

Meanwhile, the report notes that the percentage of B.C.’s population aged over 75 is set to climb by nearly 65 per cent in the next two decades, from about 8.5 per cent today to 14 per cent in 2040.

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The government has not committed to increasing the number of subsidized units, despite waitlists 50 per cent longer than those to get into long-term care, the report states.

“It is critical that the provincial government take into account that without substantial new provincial capital investment, there will be significantly less access to publicly subsidized assisted living in the next 10 to 15 years than there is currently,” the report reads.

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Learning lessons from last year’s heat dome

At the same time, the report warns that seniors are facing mounting cost pressures.

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Publicly-subsidized units are held at 70 per cent of a senior’s income, which Mackenzie said is now proving hard for many to meet amid the other costs they need to pay.

“There’s lots that is not included in assisted living,” Mackenzie said. “You don’t get your medications covered, you don’t get your equipment covered, you don’t get your supplies covered, you’re often having to pay for your telephone and your cable, you’re required to have tenants’ insurance, the list goes on.”

In the private market there is no cost protection, and some seniors have seen their fees climb by more than 15 per cent “leaving some unable to afford the charges for the additional support services that they need to live safely,” the report found.

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The report also highlighted key gaps in current regulations, finding no minimum staffing levels, training or clinical oversight requirements for both the public and private sectors.

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And it found “significant confusion” among the public, industry and regulators about what counts as assisted living under the Community Care and Assisted Living Act and what qualifies as independent or supportive living governed by the Residential Tenancy Act.

“The result of this confusion has left some seniors without the protections and oversight … making them vulnerable to uncontrolled rent increases and eviction,” the report states.

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Changes coming to long-term care facilities

Mackenzie is calling for a “comprehensive review” of the 20-year-old Community Care and Assisted Living Act to reflect the province’s aging population.

Such a review, she said, should look at revising regulations to improve oversight, including in the areas of staffing and reporting.

It should also better clarify the what is legally considered “assisted living,” while ensuring seniors enjoy the protections of either — or both — the “Residential Tenancy Act and the Community Care and Assisted Living Act, she said.

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The review should also find ways to ensure seniors living in the private market aren’t hit with “unreasonable” cost increases for services, while boosting capacity in the public sector to meet growing demand.

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