Upcoming Reforms to Assisted Living Regulation in BC
7 October 2019
By Sara Pon
Introduction to the new Assisted Living Regulations
On August 21st the BC government announced it will bring into effect changes to the Community Care and Assisted Living Act [CCALA] and a new Assisted Living Regulation into force. These changes are set to take effect on December 1st, 2019. Bill 16 – 2016 and the new Assisted Living Regulation [AL Regulation] will do several important things:
- create new classes of assisted living;
- enhance the powers of the Assisted Living Registrar [“Registrar”] to provide oversight;
- change the number of services that assisted living residences [“residences”] may offer;
- define who is not eligible to live in assisted living; and
- set out more detailed regulations of assisted living, which should allow for greater protection of residents’ rights.
This blog will outline these changes.
Classes of Assisted Living
Section 3 of the new AL Regulation creates three classes of assisted living residences—housing for adults receiving assisted living primarily due to:
- a “mental disorder” (category called “Mental Health);
- chronic or progressive conditions linked to aging or disability (category called “Seniors and Persons with Disabilities”);
- substance use (category called “Supportive Recovery”).
Section 4 exempts emergency shelters from these regulations.
Most of the regulations apply to all three classes of residences, although there are a few provisions which apply to only one or two of the classes. This blog will focus on the regulations which apply to the Seniors and Persons with Disabilities class of assisted living.
Increasing Assisted Living Services
Assisted living residences will be allowed to offer as many “assisted living services” as they would like under the updated CCALA (formerly called “prescribed services” and limited to two services). The list of assisted living services will remain largely the same. An “other types” category will be added, which will allow residences to provide a wider array of services. The government noted in its announcement that these changes will allow seniors to stay in assisted living and their communities longer. Needing more than two prescribed services will no longer by itself make a person ineligible for assisted living.
Removing the limitation on the number of prescribed services reflects recommendations contained in the CCEL Report on Assisted Living in British Columbia.
Defining Eligibility for Assisted Living
The new CCALA provisions set out who is not eligible for assisted living in section 26.1. A person is not eligible for assisted living if they:
- cannot make decisions to keep them safe in daily life;
- cannot respond appropriately in an emergency;
- act in a way which would put others at risk; or
- need “on a regular basis, unscheduled professional health services.”
This more nuanced approach to eligibility also reflects recommendations contained in the CCEL Report on Assisted Living in British Columbia.
The only exception to this criterion will be when the person has a spouse who is living with them and can make these decisions on their behalf. The spouse can be away for a short time if another adult can reside in the unit and make these decisions.
Enhancing Powers of the Assisted Living Registrar
The updated CCALA and AL Regulation will give the Registrar a greater ability to inspect both registered and unregistered assisted living facilities. For example, if the health or safety of residents is at imminent risk, the Registrar will now be able to take summary action to quickly protect residents.
Protection of Assisted Living Residents
Several sections will be added to the CCALA to increase protection of residents from abuse.
- Section 28.2 protects employees or others who report abuse of a resident from having adverse action taken against them. Services to a resident cannot be changed due to the suggested or actual report of abuse.
- Section 28.1 seeks to prevent financial crime by not allowing the assisted living operator or any of their employees or agents to encourage a resident to change their will, give a gift, create a benefit, or act as their representative.
- In the AL Regulation, abuse (neglect or emotional, financial, physical, or sexual abuse) will be considered a reportable incident and must be reported to the Registrar within 24 hours. This will reconcile practice with the rules for long-term care facilities.
Regulations of Assisted Living
The current assisted living regulations (the Assisted Living Regulation, BC Reg 218/2004 and Community Care and Assisted Living Regulation, BC Reg 217/2004) do not set out a great amount of detail on how assisted living residences are to operate or provide services. These two regulations will be repealed. The new AL Regulation creates a much more rigorous standard for all aspects of assisted living. This approach should create a stronger foundation upon which to standardize service delivery and protect residents. Below is a short summary of some of the new standards.
- If the residence is housing several classes of residents (or non-residents) in the same building, they must each have separate areas.
- Appropriate social and recreational programs must be provided.
- The residence must be accessible.
- For seniors and persons with disabilities, residents must be able to bring their own furniture and property and control access to their own unit.
- Employees must be screened for criminal records, and work history.
- Employees must be qualified for the job and possess the appropriate skills and attributes.
- Employees must provide proof of qualifications and education.
3- Emergency Preparedness
- Residences must create emergency response plans and conduct emergency drills.
- A staff member trained in First Aid and CPR must always be present.
4- Start of Residency
- Prospective residents are to be screened to ensure they are not ineligible for assisted living.
- Before signing the residency agreement, the prospective resident should receive the residence’s policies on shared common areas, visitors and communication, complaints, end of residency, medication, and cannabis.
- A personal service plan needs to be developed with the resident within 30 days outlining what services they are to receive, and this plan should be approved by the resident.
- The additional requirements for information prior to start of residency align with recommendations contained in the CCEL Report on Assisted Living in British Columbia.
- The right to make decisions and privacy of the resident is to be respected.
- The health and safety of residents are to be monitored while maintaining as much privacy as possible.
- Seniors and persons with disabilities are to be allowed visitors at any time and allowed to communicate freely and in private.
- The residence must establish policies on how residents and others can bring concerns or complaints forward, and how these are to be addressed.
- These new privacy provisions reflect recommendations contained in the CCEL Report on Assisted Living in British Columbia.
6- End of Residency
- Residents cannot have their tenancy ended due to an inability to make decisions unless they have undergone an incapacity assessment performed by a health care professional and been given a copy of the report.
- The residence must develop policies and procedures for ending a residency, including developing a transition plan.
7- Resident Health and Safety
- In receiving services, residents cannot face abuse or neglect.
- The regulations lay out what are reportable incidents, including abuse, physical illnesses or injuries which require hospitalization or medical treatment, medication errors, death, and service delivery problems. These must be reported within 24 hours.
- Procedures must be developed for when a resident is missing.
8- Providing Hospitality Services
- The regulations outline the standards for provision of food, housekeeping, linens, social and recreational activities, and emergency response systems.
9- Providing Assisted Living Services
- The regulations outline the standards for providing assisted living services in the following areas:
- Activities of daily living
- Managing medication
- Safekeeping of money and property
- Managing therapeutic diets
- Behaviour management
- Psychosocial supports
Assisted Living in BC
To find out about assisted living services in BC and how to access these services, visit the BC government’s website