Continuing Care Strategy Falls Short

The Continuing Care Strategy
announced by Minister Liepert in
December 2008 is not new; it’s
an escalation of policies that the
Alberta government has been
developing over the past two
decades.
These policies were first described in
a report titled A New Vision for Long
Term Care in 1988, which proposed:
• Centralized control of access to all
continuing care services;
• A shift from formal institutional
care to “community care”;
• A moratorium on additional longterm
care beds; and
• More integrated and coordinated
community care services including
expanded home care services.
This was followed by a series of
reports from the Long Term Care
Policy Advisory Committee (Broda,
1999 – 2002). Like the
Mazankowski and Graydon reports,
the direction is to limit the services of
public health care funding, and shift
costs to individuals and their families.
The “new” Stelmach/Liepert
Continuing Care Strategy has simply
increased the rate of change to the
private market, user-pay system.
Seniors and their families are
facing ever-increasing cost and
responsibility for essential health
care services.
2
Home care services have already
been reduced and redirected from
seniors in their own homes to subacute
care, to substitute for acute
care hospital services. Now it’s
being shifted to provide care in the
new continuing care institutions –
private sector assisted living facilities.
Health Minister Liepert has said that
$41 million will be provided for the
new initiatives, including more hours
of home care. That’s only a drop in
the continuing care budget. It’s
unlikely to provide either more hours
of care or more services.
This probably means more hours of
care for some, but fewer services for
all. Or, care will be provided only for
persons who already need urgent
care, while others are relegated to
wait lists or referred to private
agencies where they’ll pay.
The moratorium on new, publicly
funded nursing home beds
continues. The 1999, 2005, and
2009 government press releases,
each promising “600 new long term
care beds”, have not produced more
long term care beds. Alberta has
fewer long term care beds than we
had 20 years ago and the second
lowest ratio of care beds to
population in Canada.
The number of seriously ill
seniors waiting for a long term
care bed has doubled in the last
two years. The wait lists are filling
scarce acute care beds and leaving
seniors in the community without
needed care.
3
In the last few years, thousands
of persons assessed for nursing
home care have been diverted to
private sector assisted living or
“Designated Assisted Living”
(DAL) settings. In many cases,
entire continuing care centres have
been converted to, or replaced with,
assisted living facilities. This trend
will increase.
The new Strategy will “adjust the
framework” for setting resident fees.
These have tripled since 1988,
increased 90 percent since 2003, and
are now $1,650 a month. These
fees will no longer be regulated
by the government.
The care facility operators have
indicated that they need at least
$100 a day from residents – double
the current rate – just for rent and
basic “hospitality services”.
Over the last twenty years, we’ve
seen the care services in long term
care reduced to a minimum. They’ll
now be sorted into “basic” and
“enhanced” services, with the
operators free to charge extra for
“enhanced” services. Or maybe we’ll
see two-tier facilities: some with
public subsidies for the eligible poor,
and “enhanced” facilities and services
for those who can pay extra.
The cost of “enhanced” care services
in assisted living has just increased
the prices, by 25 to 50 percent. An
extra bath a week is now $75 a
month, up from $60.