Shift Continuing Care to Public Sector

From the December 8 Edmonton Journal:

Written by Executive Director Sandra Azocar and Public Interest Alberta's Seniors Task Force Chair Noel Somerville

Government should redirect public funding from for-profit continuing care facilities, say Noel Somerville and Sandra Azocar

Alberta’s continuing care facilities have a patchwork of ownership models. While these facilities are all funded by public money, they are owned and operated either publicly, through Alberta Health Services and its subsidiaries (CapitalCare in Edmonton and Carewest in Calgary), or privately, by both non-profit organizations and for-profit corporations.

There are issues that exist regardless of who the provider is: staffing levels are not meeting the needs of patients, and continuing care is chronically underfunded in Alberta. However, fixing only those issues ignores the bigger picture.

Evidence provided by the 2013 Parkland Institute report From Bad to Worse shows that Alberta’s publicly owned long-term care facilities are “significantly better than for-profit facilities” for hours of care they provide to each facility resident.

This should not come as a surprise, since the primary responsibility of a for-profit corporation is to ensure adequate shareholder return on investment. These facilities are funded by government dollars, and information made public last year shows corporations expecting to make an average profit level of 27 per cent, or $5,500 per bed, per year. That money would be better spent on care for Albertans instead of being pocketed by shareholders.

A large portion of those profits are possible because of unregulated “hospitality” fees, and an operational funding model that does not require government funds for front-line staff to actually go toward staff pay. No regulation exists for staff-to-patient ratios or to ensure patient and family councils are welcomed at each facility.

Contracts between these providers and the government are confidential, meaning Albertans do not have the right to know how much public money is being doled out or what the terms of the contract are, and whether or not care is the No. 1 priority in these arrangements.

This “wild west” model of continuing care providers was set up by the previous PC government, but it remains in place under the NDP government. However, there is hope that positive change is coming.

While the PC government significantly expanded the role of for-profit corporations in continuing care, the new government has taken a different position. Responding to promises from the previous government to open new care beds in Alberta, on Nov. 19, 2014, then-opposition leader Rachel Notley said in the legislature, “We don’t argue with the need for more spaces for seniors; we do think that they should be publicly funded, publicly delivered.”

In the same spirit, the NDP’s election platform promised to open 2,000 public long-term care beds and “end the PCs’ costly experiments in privatization, and redirect the funds to publicly delivered services.”

The previous government not only stopped building new public beds, but also unnecessarily closed hundreds of functional public long-term care beds and often funded the construction of replacement beds owned by for-profit corporations. Some of the closed facilities, such as the Valley Park Manor in Red Deer, are currently empty and could still be reopened for public use.

In light of the problems the previous government created by funding private, for-profit care, the new government should begin by standardizing and limiting fees charged to residents, disclosing the amounts these corporations are being given and spending on direct care and how much of the public money is going to their shareholders, and setting standards for staff-to-patient ratios.

The most meaningful sign the new government can send that it is departing from the old government’s reliance on for-profit corporations to provide continuing care would be to make good on their promise to open 2,000 public long-term care spaces, where profit is not a factor and care is the No. 1 priority. Fulfilling that promise should be the government’s first step to phasing out private, for-profit continuing care. Our public health care dollars should not be given to corporate shareholders; it should be spent on care for Albertans.

Private, for-profit care facilities are no more acceptable than Ralph Klein’s short-lived private, for-profit hospitals.