Charges will fill gap between palliative and respite care, minister says
By Wendy Stueck, Globe and Mail
British Columbia has quietly phased in fees for convalescent care, saying such stays amount to "short term residential care."
The fees - a minimum $29.40 per day or $894.40 per month - stem from a January policy change and are being phased in this year by the province's six health authorities.
Similar fees have been in place for palliative and respite care since 2000 but there was a gap when it came to convalescent care, provincial Health Minister Kevin Falcon said on Wednesday.
"We are basically filling that gap," Mr. Falcon said. "The principle is, there is a room and board cost and it is not unreasonable, as it is for palliative and respite categories, to have individuals pay a modest contribution."
The new fees would apply to people, most of them elderly, who have been discharged from hospital and transferred to "convalescent" beds in long-term care facilities. People who feel they can't afford the fee can apply for a hardship waiver.
The fees are to apply to new patients. Patients that have already been receiving convalescent care are to be "grandfathered" and won't be subject to the fee.
Critics say the new charges could result in financial hardship and anxiety for many patients and that the "convalescent" label is often a misnomer.
"What we know about the clients in many of these [convalescent] beds is that these are not candidates for going home," said Debra MacPherson, president of the B.C. Nurses' Union. "These are candidates for long-term care."
A brochure from the Fraser Health Authority, which implemented the charges last month, says the average length of stay in a convalescent program is seven weeks.
The brochure also states that clients who prefer not to pay the fee "should ask about our Home Support program to support you in your discharge."
Provincially funded home-support programs are short of resources and already stretched to capacity, Ms. MacPherson said.
The new charges follow increases to long-term residential care that were introduced earlier this year, said New Democratic Party health critic Adrian Dix.
"They're charging people who haven't been charged before," Mr. Dix said. "Seniors are paying more and getting less. There ought to be appropriate long-term beds, and even convalescent beds, and there are not."
Money generated by the convalescent care fees is to be directed back into home and community care services, the province says. Based on 2007-2008 convalescent care records, the fees would generate about $3.5-million in additional revenue, according to ministry staff, but that number is only an estimate because "clients have the capacity to apply for a reduction in their client rate through a hardship provision, and individual length of stay may be shorter."
"We think there are other things government and health authorities should be looking at to make themselves more efficient and to save dollars rather than charge seniors," B.C. Care Providers Association spokesman David Hurford said Wednesday.
The BCCPA represents private and non-profit seniors care homes in the province and has been lobbying the government to put seniors' care services - some of which are now provided by provincial health authorities - to public tender.
