Difference between revisions of "Overview of Legal Issues in Residential Care"

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Overview of Legal Issues in Residential Care (view source)

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'''NOTE:''' Information on a particular residential care facility’s company website will not always be up to date or accurate. In some case, it may represent the law or process of another jurisdiction.
===4. Funding:  Three Types of Facilities===
The public is often  very confused  about care facilities, who runs  it ,  who is  responsible, and  who  pays.  There is good reason for that confusion:
: a) A care facility may be directly operated by a regional health authority. These are partially subsidized by public funds.
: b) Most facilities are operated by providers that have a contract with a regional health authority. These are financially supported, but not directly operated, by the regional health authority. Most of these rooms are partially subsidized by public funds, but some providers also offer private pay rooms in the same facility.
: c) The third type of facility is not connected with the regional health authority. These facilities only have private pay rooms.  For private pay rooms, all costs are covered by the resident.
Funding for subsidized residential care comes from two main sources: the provincial government (public funds) and monthly payments from residents (or their families on their behalf).
People living in subsidized residential care pay up to 80 per cent of their after-tax income as a residential care fee, provided that they have at least $325 remaining from their income each month. The fee, referred to as a “co-payment,” ranges from $970.50 to $3,092.60 per month (2014 figures).
From those remaining funds, the resident may be required to pay additional charges for “optional services “ (called “chargeable  extras”), including a personal wheelchair, private accommodation, “preferred care products”, haircut, cable, outings and telephone services. The cost of prescription and non prescription drugs are not covered in the residential care fee, except in extended care units. 
The maximum client rate is adjusted annually based on changes to the Consumer Price Index. There is a mechanism for obtaining a “temporary rate reduction” if the amount would cause the person or their family serious financial hardship.  The Ombudsperson Report notes that this information on the availability of a reduced rate often was not being provided to people. The Ministry of Health has begun including the information in letters to clients and now posts it on the Home and Community Care website.
===What Are the Differences Between Licensed Residential Care Facilities and Extended Care or Private Hospitals?===
There are several important differences between residential care facilities that fall under the Community Care and Assisted Living Act and the care facilities that fall under the Hospital Act.    These relate to whether the facility will have  legislated care standards, physical environment  standards or restrictions on  double  occupancy;  whether the facility is  subject  to routine inspections;  whether there are  reporting requirements  for abuse, neglect  or other  incidents; and whether they are required to have  a medical practitioner  or registered  nurse on site.  Some of these differences are summarized in Table 2.
'''Although there are funding and other differences, all three types of facilities are licensed by the health authority.'''
===Table 2 Comparisons of Licensed Residential Care Facilities & Licensed Private Hospitals & Extended Care Units===
{| class="wikitable"
|- valign=top
| width="20%" |
| width="40%" | '''CCALA (Residential  Care Facilities)'''
| width="40%" | '''Hospital Act(Private  Hospitals & Extended Care Hospitals)'''
|- valign=top
| width="20%" | How people are described ''in law''
| width="40%" | Persons in care(residents)
| width="40%" | Patients
|- valign=top
| width="20%" | Legislated care standards
| width="40%" | Yes
| width="40%" | No
|- valign=top
| width="20%" | Residents’ bill of rights  statement
| width="40%" | Yes
| width="40%" | Yes
|- valign=top
| width="20%" |Criminal record checks required by law for staff
| width="40%" | Yes
| width="40%" | Yes
|- valign=top
| width="20%" | Remedies under Patient Quality of Care Review (PCQO/PCQRB)
| width="40%" | Yes
| width="40%" | Yes
|- valign=top
| width="20%" | Detailed physical standards
| width="40%" | Yes
| width="40%" | No
|- valign=top
| width="20%" | Licensed
| width="40%" | Yes
| width="40%" | Yes for private hospital
|- valign=top
| width="20%" | Restrictions on double occupancy room
| width="40%" | Yes
| width="40%" | No
|- valign=top
| width="20%" | Responsibility to report incidents to key parties
| width="40%" | Yes
| width="40%" | Yes
|- valign=top
| width="20%" | “Routine” inspections
| width="40%" | Yes
| width="40%" | No
|- valign=top
| width="20%" | Inspection reports posted
| width="40%" | Yes
| width="40%" | No legal requirement<br/>
In practice, yes
|- valign=top
| width="20%" | Legally required to report abuse or neglect of residents
| width="40%" | Yes
| width="40%" | No –not under Hospital Act
|- valign=top
| width="20%" | Residents’ bill of rights  statement
| width="40%" | Yes
| width="40%" | Yes
|- valign=top
| width="20%" | Residents’ bill of rights  statement
| width="40%" | Yes
| width="40%" | Yes
|- valign=top
| width="20%" | Residents’ bill of rights  statement
| width="40%" | Yes
| width="40%" | Yes
|}




{{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}}
{{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}}
{{Legal Issues in Residential Care: An Advocate's Manual Navbox}}
{{Legal Issues in Residential Care: An Advocate's Manual Navbox}}
Marisa Chandler
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