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Difference between revisions of "Overview of Legal Issues in Residential Care"
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Overview of Legal Issues in Residential Care (view source)
Revision as of 18:02, 11 January 2016
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==Funding: Three Types of Facilities== | ==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: | 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. | : a) A care facility may be directly operated by a regional health authority. These are partially subsidized by public funds. | ||
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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 $1005.80 to $3,198.50 per month (2016 figures). ([[{{PAGENAME}}#References|18]]) | 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 $1005.80 to $3,198.50 per month (2016 figures). ([[{{PAGENAME}}#References|18]]) | ||
From those remaining funds, the resident may be required to pay additional charges for “optional services “ (called “chargeable extras”), including | From those remaining funds, the resident may be required to pay additional charges for “optional services “ (called “chargeable extras”), including specialized wheelchairs, private accommodation, “preferred care products”, haircut, cable, outings and telephone services ([[{{PAGENAME}}#References|19]]). Since January 1, 2016 "basic personal wheelchair for exclusive use" and their basic maintenance is included in the general client rate. 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. ([[{{PAGENAME}}#References|20]])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.([[{{PAGENAME}}#References|21]]) | 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. ([[{{PAGENAME}}#References|20]])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.([[{{PAGENAME}}#References|21]]) | ||
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|- valign=top | |- valign=top | ||
| width="20%" | Inspection reports posted | | width="20%" | Inspection reports posted ([[{{PAGENAME}}#References|32]]) | ||
| width="40%" | Yes | | width="40%" | Yes | ||
| width="40%" | No legal requirement/In practice, yes | | width="40%" | No legal requirement/In practice, yes but varies among health authorities | ||
|- valign=top | |- valign=top | ||
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|- valign=top | |- valign=top | ||
| width="20%" | Legal protections | | width="20%" | Legal protections for people reporting concerns | ||
| width="40%" | Yes for abuse and neglect ([[{{PAGENAME}}#References|33]]) | | width="40%" | Yes for abuse and neglect ([[{{PAGENAME}}#References|33]]) | ||
| width="40%" | No - not under Hospital Act(but come under general Adult Guardianship Act protections) | | width="40%" | No - not under Hospital Act (but come under general Adult Guardianship Act protections) | ||
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#To their local licensing office and their funding body, as well as to the affected resident’s family and the resident’s family doctor. | #To their local licensing office and their funding body, as well as to the affected resident’s family and the resident’s family doctor. | ||
#The Ombuds, Best of Care, pg.208 notes that the Vancouver Coastal Health Authority is the only exception. It has been inspecting private hospital facilities under the Hospital Act regularly since September 2007. | #The Ombuds, Best of Care, pg.208 notes that the Vancouver Coastal Health Authority is the only exception. It has been inspecting private hospital facilities under the Hospital Act regularly since September 2007. | ||
# | # Inspection information can now be found on the specific Health Authority website. A particular health authority may provide summary, limited or no information on the care facilities and private hospitals. Interior Health provides inspection information for both types in a table form, but only identifying if there has been a critcal or non critical infraction and with no other information. However, Interior Health has developed a useful summary of "substantiated complaints" based on inspections which can be accessed online: https://www.interiorhealth.ca/YourEnvironment/ResidentialCareFacilities/Documents/Substantiated-Complaints-in-Seniors-Care-Facilities.pdf. In contrast, Fraser Health provides summary inspection reports on residential care facilities and private hospitals (online: http://www.healthspace.ca/Clients/FHA/FHA_Website.nsf/CCFL-Adult-Frameset-Facilities). Type "hospital" to quickly find private hospitals. It identifies routine inspections and those in response to a complaint. Island Health identifies whether there has been a routine or non routine visit, and if any conditions have been placed on the residential care facility or private hospital. Northern Health also provides very limited information and most of the hospitals have not received an inspection in over 3 years. Vancouver Coastal in comparison provides much more comprehensive and transparent information. As of February 2015 it has a beta website with inspection reports for residential care facilities and private hospitals, with links to the report. It identifies outstanding infractions and outstanding Bill of Rights infraction. Online: https://inspections.vcha.ca/. Vancouver Coastal also has a Legacy Inspection Report website online with older inspection reports: http://vchlegacyinspections.ca/. | ||
#CCALA, s.22. | #CCALA, s.22. | ||
#CCALA facilities are required only to ensure that either a medical or nurse practitioner can be contacted in an emergency. However the funding agreement with the health authority may require a registered nurse to be on site. | #CCALA facilities are required only to ensure that either a medical or nurse practitioner can be contacted in an emergency. However the funding agreement with the health authority may require a registered nurse to be on site. | ||