AGM policy motions address key issues affecting continuing care sector

BC Care Providers Association will hold its Annual General Meeting on October 6th in Vancouver where members will be updated on last year’s key accomplishments and future plans for the organization. Additionally, four policy motions will also be presented to the membership for a vote at the AGM.

Michael Kary, BCCPA Director of Research and Policy

“BCCPA looks forward to having a dialogue with our member on the policy motions at the AGM,” says Michael Kary, BCCPA Director of Policy and Research. “Each which address important areas within the continuing care sector such as increasing staffing levels and home health visit times, reducing ALC days, as well as issues facing assisted living.

“The AGM motions also reiterate many of the positions discussed in previous BCCPA policy papers to improve seniors care and strengthen the sector.”

The motions are presented here for our members to preview.

1. Five Per Cent Alternate Level of Care (ALC) Target

ALC beds are occupied by patients in hospitals who no longer require acute care, but are unable to access home and community care services.

The cost of treating a senior in a hospital in B.C. ranges from $825 to $1,968 per day, while the cost of residential care is approximately $200 per day.

About 14 per cent of hospital beds in Canada are occupied by patients who are ready to be discharged, and about 85 per cent of all ALC patients are seniors over the age of 65.

The ALC issue is the single biggest challenge to improving wait times across the healthcare system. Treating seniors where they live can prevent unnecessary hospitalizations, and reduce the numbers of ALC patients. A 50 per cent reduction in ALC days could generate over $200 million to the health system.

The BCCPA recommends the Ministry of Health and health authorities redirect acute care expenditures—such as a minimum of 1 percent annually over a five-year period—to the home and community care sector.

The BCCPA recommends the Ministry of Health set a target to have no more than 5 per cent of acute care beds occupied each day by seniors who have been assessed as capable of being transferred into a more appropriate residential or home care setting by 2021.

2. Health Human Resources – Canada Cares

B.C. continuing care sector is facing significant labor shortages—70 per cent of long-term care operators and 87 per cent of home support staff report their organization is regularly short-staffed.

The sector also faces significant worker retention challenges—worker injury rates that are up to four times the provincial average, significant levels of worker burnout, and challenging working conditions. Migrants to B.C. from other countries who can fill a significant proportion of job openings face many barriers to employment.

There is also a need to improve the education and training of workers to deal with a rapidly aging population with growing levels of acuity, dementia and chronic diseases.

In 2017, the BC Ministry identified a need to recruit an additional 1,500 full-time equivalent workers in residential care over four years to meet an average of 3.36 direct-care-hours per resident per day in each health authority.

Chronic staffing shortages create not only financial and operational hurdles for providers, but have a direct impact on the quality of care that seniors receive.

The BCCPA recommends the federal and provincial government, in conjunction with the BCCPA, fund and work with health authorities, training and regulatory colleges, and Health Employers Association of British Columbia to establish a program that will address chronic labor shortages affecting the continuing care sector.

3. Review of Assisted Living Funding

Assisted living supports seniors who want to age in their communities. The type of seniors in assisted living has changed over time, and operators are now caring for seniors with more complex care needs.

The proposed Community Care and Assisted Living Amendment Act (Bill 16) introduced in the British Columbia Legislature in March 2016 proposes to remove the two-service limit on prescribed services. Bill 16 would also increase regulatory oversight for assisted living residences.

The Assisted Living Task Force struck in March 2017 found there is a lack of understanding in the scope and implications of Bill 16 among both operators and health authorities, and operators are concerned about the potential for all services to be required, the lack of definition of terms, changes to staffing composition, and increases in operating costs.

The BCCPA recommends the BC Ministry of Health partner with the BCCPA to perform a formal review of assisted living to increase consistency of services, decrease unnecessary administrative burdens on operators, and ensure the flexibility necessary to meet the needs of seniors.

The BCCPA also recommends securing the funding levels necessary to support seniors to live longer in assisted living, particularly those with increasing levels of acuity.

4. Home Care Visits

Many British Columbians receiving home care feel their workers don’t have adequate time to deliver the care they need.

According to a 2016 report from the Office of the Seniors Advocate, the average home support hours delivered in B.C. from 2015 to 2016 decreased by around 2 per cent from the previous year, while the number of clients increased by 2 per cent.

In its 2017 report Strengthening Seniors Care: A Made-in-BC Roadmap, the BCCPA recommended health authorities increase minimum home care visit times from 15 minutes.

Increased funding is required to sustain B.C.’s home care and support sector. The BCCPA calls for a provincial guideline to increase the minimum home care visit time to meet the care needs of the client, and ensure that adequate funding is provided to meet all Subsector Collective Agreement costs, as well as other increased costs related to clinical supervision, administration and scheduling which will ensure the recruitment and retention of skilled health workers, and long-term viability of the sector.