Click here to download as PDF

Long-Term Care Accommodations
Variable Fee Structure Advisory Team
 
Major Findings from Summary Report and Meeting Minutes

The government target to reduce long-term care beds
The government target is to reduce the ratio of long-term care beds to 20% LTC, 60% Designated Assisted Living level 4, and 20% DAL level 3. (page 3, summary report)

Bruce West, Executive Director of Alberta Continuing Care Association, the main industry lobby group,  “explained that in the long-term, the government is looking to shrink LTC by 80% while asking providers to expand services.” Marjory Sutherland, chair of the committee and Executive Director of the Supportive Living and Long-term Care Branch, Alberta Seniors and Community Supports, then indicates that “the fee structure would be implemented long before the 20 year time-frame for the reduction of long-term care”. (page 5, meeting 3)

Significant changes are already in process from Alberta Health for LTC policy
Vivien Lai, Senior Manager/Continuing Care Policy, Health System Transformation at Alberta Health and Wellness, comments that Alberta Health and Wellness is undertaking the following activities as they relate to LTC (page 4, meeting 1):

• Enhancing choice with the development phase underway for payment following the individual for health services.
• Developing a P3 policy on LTC beds similar to the Affordable Supportive Living Initiative (ASLI) approach.
• Amending the ‘first available bed’ policy and reviewing other barriers to choice.

Significant problems identified within the current system
1.Compliance with accommodation standards – Only 54% of long-term care facilities are compliant, even after they are given 2-6 months to address the identified problems. (page 8, meeting 3)

2.“Constrained supply of LTC beds” – 800 seniors currently in the system on waiting lists (ie. in hospitals). (page 8, meeting 3)

3.No choice for seniors, particularly in the rural areas.

4.Inability to attract enough qualified staff.

5.Capital costs are currently being recovered through Alberta Health Services capital funding agreements or in the margins from Alberta Health Services funding and the residents' accommodations fees (intended for operating costs only).  (page 8, summary report) Companies are not supposed to be recovering capital costs in this way.


Considering a market-driven P3 approach for the development of new facilities
Models for pursuing a more market-driven approach to achieving the specific objectives of a new accommodation rate structure were discussed.  Private long-term contracts were the primary option that was proposed. This would give developers significant public dollars and would transfer the ownership of long-term care beds to the private sector. (page 10, meeting 1)

All models presented for deregulation of long-term care costs will transfer costs onto seniors and will result in long-term care hospitals being owned and controlled by corporations and non-profit organizations
Pricing models presented (page 4, summary report):

1.Deregulate the rates – this would be similar to assisted living or lodges, with the requirement that residents are left with a minimum level of disposable income after accommodation fees are paid.

2.Housing model – no prescribed fee but would include a limit on the number of times rent could be increased.

3.Hotel Star system – maximum fees for each ranking.

4.De-regulated rate with a sliding scale for income supports.

5.Existing rate with additional fee for optional services.

6.Deregulated rate with a price floor and income supports.

All of these proposed changes would protect and greatly increase the profits of the companies, and would increase the costs paid by seniors who require these extensive medically necessary services.

There is a strong push to set up a system of “enhanced services” at extra costs – rather than focus on improving quality care for seniors based on their needs. This will lead to a two tiered system.

Industry says they require a 40% increase in rates
Hasmukh Patel, owner of Age Care Inc., says they require a 40% increase in support to cover capital costs, which would raise accommodation fees to $90/day. (page 13, meeting 2)

There appear to be no plans for an independent audit to determine how much profit the corporations are currently making, let alone what these revised variable rates would mean for increased profits. Albertans should know if long-term care corporations are currently making a healthy profit under the existing contracts. 

PDF documents for download:
Long-Term Care Meeting 1 Minutes
Long-Term Care Meeting 2 Minutes
Long-Term Care Meeting 3 Minutes
Long-Term Care Summary