Sunday, January 17, 2010

Major rent increases coming for people in B.C. residential care

It isn’t often that a landlord can quietly order up a 30 per cent rent increase for more than 2,000 people without anybody making a public fuss about it.
But maybe that’s what happens when your tenants are elderly, frail seniors living in B.C.’s long-term care facilities. As of Jan. 31, “rents” will go up for most of the 26,000 people living in government-subsidized residential-care facilities, in some cases jumping as much as $672 a month.
That barely a word of it has made it into the major B.C. media says one of two things: Either the people in residential care think it’s a fair deal and aren’t complaining; or the reality hasn’t sunk in yet. I guess we’ll know soon enough which one it is.
The rent increase is far beyond what any private landlord could dream of imposing on an existing tenant. The allowable rent increase for B.C. landlords in 2009 was 3.7 per cent.
Alas, residential-care facilities aren’t governed by the same act as home rentals. The provincial Health Services Ministry says people in subsidized long-term care should pay a larger share of their room and board costs, and contends a rate increase of this magnitude is needed to address the problem.
Unlike the “free” care we receive when we go to an acute-care hospital, seniors’ care in a little more complex. Tax dollars fund the medical component of long-term care, but seniors are required to contribute toward the room and board component of their stays. That “co-payment” is currently too low in most cases, contends government.
Right now, the amount a senior has to pay is based on an 11-step grid ranging from $940 to $2,260 a month, depending on income. As of Jan. 31, everyone in residential care will instead pay 80 per cent of their annual income to a maximum of $2,932 a month. Most will also be allowed to keep $275 a month.
It’s not all bad news. Low-income seniors will see a small drop in their monthly rents under the new system. All told, a quarter of the people currently in residential care will see their “rents” either stay the same or decrease a little.
As for the other 75 per cent - well, they’ll be paying more. The co-payment for people in the highest income bracket is going up by $672 a month (effective immediately for those just heading into care, and phased in over this year and the next for those currently in care). Of course, that’s arguably still a bargain compared to the private sector, where room-and-board rates can easily top $5,000 a month in an assisted-living facility.
The increases in the public rates will likely hit hardest for couples in which one spouse is in residential care and the other is still in their own home. They can launch individual “hardship” appeals through the Vancouver Island Health Authority, but that’s a lot to ask of an aging couple at one of the most stressful points in their lives.
One local man whose father is in residential care cautions not to expect an easy solution to such appeals. His mother tried the hardship route under the current system after her husband went into full-time care, but ended up having to legally separate from him to be certain she could retain enough income to live on.
Anticipate some problems as well with the $275 a month that people are allowed to retain for personal expenses. (Most people, anyway: those on income assistance will keep just $95/month).
True, that amount is higher in B.C. than in any other province. But that’s not to say it’s sufficient to cover everybody’s costs. All expenses have to come out of that $275: prescription drugs that aren’t covered under the government plan, over-the-counter drugs, mobility aids, grooming and care products, clothing, haircuts, dental care, phone, and so on.
The government says it will review the rate every three years. But that’s a pointless promise in a system where the average stay is a year and a half. Few of those in long-term care right now will be around to get any satisfaction out of the 2013 rate review.
All in, people in residential care will be paying an additional $54 million a year under the new rates. The government says the money will be reinvested into things like more client care, more staff, more rehab. Read the fine print, though, and it’s no sure thing. Health authorities will actually decide how to spend the money, at sites with “the greatest needs.”
Should we be alarmed by all this? Too soon to say. But the changes affect thousands of vulnerable British Columbians, and that’s a warning sign in itself to proceed with caution. Heads up, people.

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