B.C. needs to 'significantly increase' assisted living capacity, seniors advocate says

B.C. Seniors Advocate Isobel Mackenzie prepares for a news conference on Wednesday, June 28, 2023. (CTV)

B.C.'s seniors advocate is calling on the provincial government to fix the "confusing legislative landscape" governing assisted living facilities in the province, with the goal of protecting seniors from significant fee increases and improving the affordability and availability of care. 

In a new report released Wednesday, Isobel Mackenzie makes five recommendations to the provincial government, but when asked at a news conference which was the most urgent, she didn't hesitate.

"The most pressing need is we need to increase the number of subsidized assisted living units," the seniors advocate said. "That is the most pressing need."

The report, titled "It’s Time to Act: A Review of Assisted Living in B.C.," notes that the only increase in the supply of assisted living spaces in the province in the last five years has been in private facilities. 

Coupled with a growing population ages 75 and older, this dynamic has resulted in a 15-per-cent decrease in the rate of publicly subsidized assisted living units per 1,000 people in the target age group in B.C. over the past five years.

Over that same time period, the provincial government has spent substantially more on assisted living, Mackenzie said, noting that the increased spending has been to cover increased costs, not to improve services or availability.

"There's been a 52-per-cent increase in the funding for assisted living in the last five years, without producing a single additional unit or increasing the service levels at all to the people who are living in assisted living," she said.

Creating more publicly subsidized units would come with even more added cost, but Mackenzie said that investment is both necessary and cost-effective.

"Subsidized assisted living is half the cost of long-term care and a fraction of the cost of acute care, but we are significantly underutilizing it," she said.

The report's first recommendation is to "significantly increase the capacity of the publicly subsidized assisted living program with more units and expanded services."

WHAT IS ASSISTED LIVING?

Other recommendations in the report are aimed at reducing confusion about the system for residents, families and operators.

Mackenzie began her presentation at Wednesday's news conference by noting that 95 per cent of seniors in B.C. live in their own homes, and the remaining five per cent live in congregate living facilities that occupy a spectrum from "independent living" up to long-term care.

While long-term care is clearly defined and includes residents with the most complex needs on the spectrum, the difference between independent living and assisted living is much more murky.

"What's independent living? What's assisted living? The problem is, they look and feel exactly the same," Mackenzie said.

They're not the same, however. Assisted living spaces are registered with the province, while independent living units are not. Sometimes, facility operators include both types of units in the same building, which can cause even more confusion, since residents registered in assisted living will be able to access more care and services than those in independent living.

The report's second recommendation calls for the province to consider prohibiting operators from mixing different types of tenancy within a single building.

"The public, the operators and the regulators need to clearly know what is assisted living, what is not, and what services, oversight and protections apply to whom," the recommendation reads.

RESIDENTIAL TENANCY ACT PROTECTIONS

In a similar vein, Mackenzie said her office has heard from many seniors and their families who have seen the fees they pay rise significantly in recent years, sometimes exceeding the maximum allowable rent increase under the provincial Residential Tenancy Act. 

While some independent living facility operators have argued that their residents are not covered by the RTA, Mackenzie said this is incorrect. All residents of independent living and assisted living in B.C. are protected by either the RTA or the Community Care and Assisted Living Act. 

That means facility operators should not be able to raise rents multiple times per year, nor should they be able to raise rents by more than the maximum allowable increase set by the province each year.

The seniors advocate encouraged independent living residents who experience such increases to contact her office or the Residential Tenancy Branch.

Making protections for congregate living residents explicit in the RTA is the report's third recommendation.

The remaining recommendations are to "address affordability issues in both publicly subsidized and private pay assisted living" and to "strengthen the effectiveness of current monitoring and enforcement systems."

"It's clear that we have to make some significant clarifications, changes to both our legislation and to the practice out there in the industry, to ensure that seniors and their family members are very clear on what they're getting, what they're paying for and what their protections are," Mackenzie said.