Small private residences for seniors | Quebec will pay for health care

(Quebec) Faced with serial closures, the Legault government will subsidize health services and care in small private seniors’ residences (RPA) to prevent owners from passing the bill on to residents.

The new program deployed by the government provides for the implementation of a personalized allowance per resident which will be paid directly to the RPA. The amount will be assessed based on a new standardized fee schedule for services, a long-standing request from the industry.

“People enter RPA, they are able to pay for room and board, but when an episode of illness or loss of autonomy occurs, they want to stay there, but unfortunately, that is not everyone who can afford care. The government is recognizing this portion and it is extremely important,” explained Minister Sonia Bélanger on Tuesday.


The Minister for Health and Responsible for Seniors, Sonia Bélanger

The Minister for Health and responsible for Seniors telegraphed her intentions last week, on the sidelines of the Coalition Avenir Québec caucus. A new compilation of The Press reported the loss of 2,700 accommodation places in 2023 due to RPA’s change of purpose.

The new government program will affect some 600 RPAs. Minister Sonia Bélanger wants to give oxygen to the smallest residences, those with 30 units or less which offer health care and services to seniors losing their autonomy. In the jargon, these are category 3 and 4 RPAs.

Of the 500 RPAs that closed over the last five years, 80% were residences with 30 units or less, the MSSS argued on Tuesday.

With his new measure, Mr. Bélanger wants to put an end to serial closures by stabilizing the financing of residences. We also hope to encourage these seniors to remain at home and avoid their transfer to CHSLDs. Offering more RPA care could also allow the user to return home more quickly after a hospital stay, the minister said.

It must be understood that health care and services are already partly subsidized by the government. However, due to the explosion in labor costs for example, in a context of shortage, and the aging of the population, the business model of small RPAs which offer care has become over time years difficult to sustain. The bill could then be passed on to the user.

Often, the elder needs more care than he or she receives. With government assistance, Quebec hopes that the supply will be increased to meet the needs of residents. The personalized allowance could “reduce the financial burden” of residents and provide more stability to owners. As shown in the table, the amounts for health services are increased at no cost to the resident.

Quebec will therefore establish a range of care and services that will be entirely paid for by the State as well as a national allocation scale that will standardize the cost of services across the province. “A senior will have the same treatment in Granby or Rouyn, the hourly rate will be standardized,” rejoiced the president and CEO of the Quebec Seniors’ Residence Network (RQRA), Marc Fortin.

In practice, the state of health of a senior will be assessed by the CISSS or CIUSSS of the territory. A “service plan” will be established based on the new national price list. For example, the government subsidy for a bath or the distribution of medicines will be the same everywhere in Quebec. Depending on the user’s needs, a “personalized allowance” will be paid directly to the RPA.

“This measure will allow RPAs that offer services to receive a fixed and determined allocation based on the needs of their residents,” argued Bélanger.

The deployment is planned by next June. The program has been in a pilot phase for a few weeks in Chaudière-Appalaches and Mauricie-et-Centre-du-Québec.

Not a blank check, says Bélanger

The amount is paid to the residence and not directly to the user, who can continue to benefit from the tax credit for home support for seniors. The minister warns RPAs that it is not “a blank check” and that mechanisms are in place to ensure that the money translates into increased care for the user.

“(There will be a team) of 15, 16 people who will be deployed where there are category 3 and 4 RPAs to support the CLSC teams and (…) the RPA nurses,” underlined Bélanger. It also reminds that the user must consent to the personalized allowance being paid to the RPA. “The elder or relative will authorize it and there will be annual evaluations,” she adds.

In the last budget, sums of 200 million over five years were set aside to make the changes, including 42.6 million this year.

The average annual allowance per resident is estimated at $20,000. Quebec estimates that some 2,100 people losing their autonomy will be eligible for the program.

We write in the 2023-2024 budget plan that the measure will notably allow “the financing of more than 1 million hours of RPA services per year for residents losing their autonomy”.

It is already certain that these sums will be insufficient to cover all needs. Additional sums could be committed in the coming years.


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