Monitoring Seniors? Services 2015 OFFICE OFTHE SENIORS ADVOCATE 1-877-952-3181 Contents B.C. Seniors’ Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Seniors with Regular Doctors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . First Link . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Home Care – Home Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Home Care – Professional Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Home Care – Complaints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Complaint Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Assisted Living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Residences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Waitlist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Complaints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Site Inspections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Incident Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Resident to Staff Aggression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Resident to Resident Aggression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Police Incident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Missing/Wandering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Attempted Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unexpected Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Abuse or Neglect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fire/Flood/Gas Leak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Disease Outbreak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Admissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Preferred Bed Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Complaints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Complaint Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Annual Inspections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Facilities Licensing – Complaints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Facilities Licensing – Reportable Incidents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Abuse or Neglect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Disease Outbreak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Falls with Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Missing or Wandering Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Resident on Resident Aggression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Incidents Reported under the CCALA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Incidents Reported under the PSLS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Use of Antipsychotics Without a Diagnosis of Psychosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MONITORING SENIORS’ SERVICES 6 6 7 7 7 8 8 9 9 10 10 11 11 12 13 13 14 15 15 15 15 16 16 16 16 16 16 16 16 17 18 19 19 20 20 21 22 22 22 22 22 23 24 24 25 1 Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Renting in B.C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Shelter Aid for Elderly Renters (SAFER) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subsidy Amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Seniors’ Subsidized Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recipients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Seniors Waiting for SSH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Homeowners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Homeownership Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Property Tax Deferment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 26 27 27 28 28 29 29 29 30 30 31 Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Service by Community . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HandyDART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ride Requests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Regular Rides Provided . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unfulfilled Ride Requests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TransLink Standby Rides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rides Delivered On Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Taxi Saver Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Complaints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BC Bus Pass Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Active Drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 32 32 32 33 33 33 34 34 35 35 36 37 Income Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Cost of Living in B.C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Federal and Provincial Income Supports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MSP Premium Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Supplementary Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Drug Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dispensing Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 38 38 40 40 41 42 Elder Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Public Guardian and Trustee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Seniors Abuse and Information Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Helpline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 43 45 46 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Data Sources 2 48 48 51 52 54 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 MONITORING SENIORS’ SERVICES January 2016 This report marks the beginning of what will become a yearly report to the public on the status of a number of key services that support B.C. seniors as they age. While some information is being reported for the first time, much of the information in this report is currently available to the public but it is found in a variety of places. The purpose of the Monitoring Seniors’ Services report is to bring all the information together in one place and allow seniors, service providers and policy makers to see the larger picture. As much as possible, we have tried to compare the year 2014/15 with previous years. For some areas, previous years’ data were either not available or they were not comparable, and 2014/15 will form the baseline measurement. For the purposes of this report, we have tried to focus on key services within the Seniors Advocate’s legislated services: health care, personal care, transportation, housing and income support. The health and well-being of seniors depends on a number of factors. Access to health care, support with the activities of daily living, appropriate housing, adequate transportation, protection from abuse and neglect and a sufficient income to meet basic needs such as food, shelter and medicines are key. Through this report we can see that across this spectrum there are a number of supports offered and many needs are being met, however, for some seniors there are needs that appear to be unmet, and there is room for us to do better. To illustrate, highlights of this report include: • • • • • • • • • • • 96% of seniors report having a regular physician At any one time approximately 50,000 British Columbians are living with a diagnosis of Alzheimer’s or another dementia, leaving four out of five seniors aged 85 and over with no diagnosis of dementia The population over the age of 75 has increased by 4% in the past year but the number of home support hours is trending down in three out of five health authorities, while the number of clients has increased in four out of five The number of clients over the age of 75 receiving professional home care services such as nursing, physiotherapy or occupational therapy has increased 5.1% in the past year At any one time there are 27,421 British Columbians living in residential care The number of residential care beds has increased 3.5% since 2012, while the percentage of seniors placed in residential care within 30 days of assessment has decreased from 67% to 63% in the past year 75% reported residential care beds are in single rooms There were 336 incidents of seniors missing or wandering from residential care facilities in 2014/15. All were found, with no fatalities occurring There were between 425 and 550 reported cases of resident on resident aggression that resulted in some harm to the resident in licensed care The increase to Old Age Security (OAS) and Guaranteed Income Security (GIS) was 1.1% Since 2005, the Shelter Aid for Elderly Renters (SAFER) maximum rent that qualifies for a subsidy has increased 9% while rents increased by 34% MONITORING SENIORS’ SERVICES 3 INTRODUCTION • • • • • • • Since 2013, property tax/municipal charges increased by 4.2% and hydro increased by 15% The BC Senior’s Supplement, an additional $49.30 per month for seniors receiving GIS, has not increased in almost 30 years The total number of HandyDART rides decreased by 1% over the previous year 51,926 (1.9%) of regular HandyDART ride requests went unfulfilled in 2014 In 2014/15, the Public Guardian and Trustee received 1,486 referrals regarding financial abuse, neglect, and self-neglect The cases of the Public Guardian and Trustee assuming Committee of Estate or Committee of Person continue to show a decrease Elder abuse was reported in 1,286 calls to the Seniors Abuse and Information Line in 2014, of which 15% reported abuse that had been going on for five or more years These are just a few of the highlights contained in this report. It is important when reading data and information to keep numbers in context and to acknowledge that slight shifts from year to year do not necessarily signal a trend, although they may signal a need to look deeper into the possible reasons for increases and decreases. With this in mind, this report raises some issues that my office will be examining further and discussing with service providers. These issues include: • • • • • The apparent reduction in home support hours and the decreased use of HandyDart within the context of an increasing population and greater desire by both the government and seniors to shift from institutional care to living in the community The increased number of complaints in residential care and high number of facilities (18%) who appear to have had no inspection in the past year The growing gap between rent increases and the Shelter Aid for Elderly Renters (SAFER) The reduced number of new applicants for property tax deferral The growing costs for low and moderate income seniors for PharmaCare and MSP In addition to these and other issues my office will be placing a priority at looking at the number of incidents of resident on resident aggression through a specific systemic review that will commence before the end of January 2016. The compilation of this report reflects the efforts of a significant number of people. While the initiative was led by staff in the Office of the Seniors Advocate, service providers, health authorities, ministries and agencies of government all contributed their time to gathering and reporting the information. My thanks and gratitude to all those who were involved in bringing this report together. Sincerely, Isobel Mackenzie Seniors Advocate Province of British Columbia 4 MONITORING SENIORS’ SERVICES B.C. Seniors’ Population T here are 820,000 seniors in B.C., or 17.5% of the province’s population. Since 2014, the number of British Columbians aged 65 and over increased by 4.4% compared to a 0.4% increase in the number of people under 65. Since 2005, the proportion of B.C. residents aged 65 and over has increased by 3.7%, with the largest increase occurring in the 65-74 age cohort. 86.2% 85.1% 82.5% 2005 2010 2015 % % 17.5 819,139 13.8% 14.9 665,127 581,363 9.9% 8.0% 462,374 7.3% 357,630 305,819 Under 65 65+ 65-74 4.9% 4.9% 5.2% 206,946 219,250 243,816 2.4% 1.6% 2.0% 112,949 75-84 85+ 68,598 88,247 The geographic distribution of seniors shows a slightly lower concentration in Northern Health. 65+ 13% 65+ 17.5% Under 65 82.5% Under 65 87% Northern Health British Columbia 38,762 Senior Population 290,803 Total Population 819,139 Senior Population 4,681,748 Total Population 65+ 16% Under 65 78% Under 65 84% Interior Health 162,615 Senior Population 731,680 Total Population Vancouver Coastal Health 186,429 Senior Population 1,155,296 Total Population 65+ 22% Under 65 78% Island Health 172,173 Senior Population 768,131 Total Population 65+ 22% 65+ 15% Under 65 85% Fraser Health 259,160 Senior Population 1,735,838 Total Population MONITORING SENIORS’ SERVICES 5 Health Care Health care services are increasingly important as we age. This section focuses on some of the key health care services that impact seniors. Seniors with Regular Doctors General Practitioners (GPs), also known as family doctors, are a key point of access to health care in B.C. There are two ways of measuring the percentage of B.C. seniors who have a regular GP. The first is through a Statistics Canada survey of 130,000 Canadian households that asks about the householders’ perceptions of whether they have a regular doctor. The second is to examine patient records to determine if a patient has had a certain number of visits with the same GP or GP practice in a specified period. In 2014, 96% of seniors surveyed said they considered themself to have a regular doctor. This number has remained fairly constant over the last five years. 2010 2011 2012 2013 2014 IHA 92.5% 94.8% 95.1% 97.2% 95.7% FHA 94.6% 95.9% 97.0% 95.1% 97.1% VCHA 95.7% 94.5% 96.2% 95.0% 96.5% VIHA 93.9% 95.3% 97.2% 96.4% 94.6% NHA 96.6% 92.8% 93.0% 93.4% 91.3% B.C. 94.4% 95.1% 96.3% 95.7% 95.9% Source: 1 In 2013/14, 92% of seniors were recorded through health records as being attached to a GP or GP practice. The difference between the total B.C. population 65+ and the number 65+ who sought care suggests that about 9% of British Columbians 65+ did not seek physician care at all in the year and are therefore not included in these data. 2013/14 IHA 93.7% FHA 91.9% VCHA 91.7% VIHA 94.6% NHA 93.1% B.C. 91.6% Source: 2 6 MONITORING SENIORS’ SERVICES Attached to a GP HEALTH CARE Dementia As of 2013/14, 50,747 British Columbians were reported to be living with a form of dementia. Of these, 81% were aged 65 and over, and 44% were 85+. Put another way, 95% of seniors and 80% of seniors aged 85 and over do not have a diagnosed dementia. Source: 2 First Link First Link is an early intervention service designed to connect individuals and families affected by Alzheimer’s disease or another dementia with services and support as soon as possible after diagnosis. The program is operated by the Alzheimer Society of BC in 82 communities. First Link receives referrals from healthcare professionals and family members as well as self-referrals and follows up with individuals three to four weeks after their initial diagnosis of dementia. For those who choose to use the service, First Link will provide them with an information package, connect them to Alzheimer Society resources such as support groups and education programs, and provide referrals to other community and healthcare services. Active Clients IHA 3,043 FHA 3,563 VCHA 2,428 VIHA 1,601 NHA 471 B.C.* 11,106 *Formal referrals were only available to the North and Central Okanagan area of Interior Health until Fall 2015. Source: 3 As of August 2015, 11,106 active clients were registered with First Link. In 2014, 65% of First Link referrals were self-referrals. Home Care – Home Support Home support provides clients with specific help with daily personal care activities such as bathing, dressing or toileting. Case managers assess potential home support clients to determine the services and hours they may qualify for. Home support is part of the Home and Community Care Program and is delivered by community health workers paid for by the health authority. Clients may pay a co-payment amount based on income. Home support generally does not include help with grocery shopping, driving to appointments, laundry, or cleaning. MONITORING SENIORS’ SERVICES 7 HEALTH CARE Clients In 2014/15, a total number of 41,223 clients were registered for publicly subsidized home support services. The number of clients increased in four health authorities and decreased in one. The total number of home support clients in B.C. increased by 2% over 2013/14, while the population aged 75 and over increased by 4%. 2012/13 2013/14 2014/15 Change in Last Year Population Change 65+ Population Change 75+ IHA 7,990 8,361 8,797 ↑ 5% ↑ 4% ↑ 3% FHA 11,326 12,225 12,919 ↑ 6% ↑ 5% ↑ 4% VCHA 9,306 9,272 8,833 ↓ 5% ↑ 4% ↑ 3% VIHA 8,817 9,190 9,230 ↑ <1% ↑ 4% ↑ 3% NHA 1,551 1,545 1,598 ↑ 3% ↑ 5% ↑ 4% B.C. 38,837 40,426 41,223 ↑ 2% ↑ 4% ↑ 4%   Clients that received home support in more than one health authority in the same year are counted in each health authority’s total, but only once at the B.C. level. Columns therefore cannot be summed. All home support numbers include Choice in Supports for Independent Living (CSIL) clients and clients receiving short-term home support. Source: 4 Hours The total number of home support hours delivered to all clients receiving service in 2014/15 was 11,067,925, an increase of 1%. The number of hours delivered increased in two health authorities and decreased in three. 2012/13 2013/14 2014/15 Change in Last Year Population Change 65+ Population Change 75+ IHA 1,754,639 1,888,484 1,988,380 ↑ 5% ↑ 4% ↑ 3% FHA 3,099,525 3,533,533 3,777,765 ↑ 7% ↑ 5% ↑ 4% VCHA 2,419,744 2,362,248 2,277,731 ↓ 4% ↑ 4% ↑ 3% VIHA 2,702,168 2,805,741 2,675,009 ↓ 5% ↑ 4% ↑ 3% NHA 386,542 391,563 349,041 ↓ 11% ↑ 5% ↑ 4% B.C. 10,362,619 10,981,658 11,067,925 ↑ 1% ↑ 4% ↑ 4%   Source: 4 In 2014/15, the average hours delivered per client per year was 268, or 5.1 hours per week. This represents a provincial average decrease of 1% from 2013/14. % Pop. Change 65+ % Pop. Change 75+ 0% ↑ 4% ↑ 3% 292 ↑ 1% ↑ 5% ↑ 4% 255 258 ↑ 1% ↑ 4% ↑ 3% 306 305 290 ↓ 5% ↑ 4% ↑ 3% NHA 249 253 218 ↓ 14% ↑ 5% ↑ 4% B.C. 267 272 268 ↓ 1% ↑ 4% ↑ 4%   2012/13 2013/14 2014/15 IHA 220 226 226 FHA 274 289 VCHA 260 VIHA Source: 4 8 MONITORING SENIORS’ SERVICES % Change HEALTH CARE The client population consuming the majority of the home support hours delivered are long-term home support clients. Long-term clients receive ongoing home support, while short-term clients tend to receive support for a specific need such as follow-up for discharge from hospital. Client Type 2013/14 2014/15 Change Long-term 87% (9,554,042 hours) 89% (9,850,453 hours) ↑ 2% Short-term 13% (1,427,616 hours) 11% (1,217,472 hours) ↓ 2% Source: 5 Home Care – Professional Services Home care professional services include nursing (registered nurse), physical therapy (PT), occupational therapy (OT), nutritional services (registered dietician), and social work (registered social worker). These services are provided on a short-term basis only, to address health issues post-discharge from hospital or an episodic illness or injury. Unlike home support, there is no client co-payment for professional services. Clients In 2014/15, a total of 85,251 clients received professional home care services in B.C., an increase of 3% over 2013/14. The number of clients increased in three health authorities and decreased in two. 2012/13 2013/14 2014/15 Change in Last Year Population Change 65+ Population Change 75+ IHA 21,690 22,204 24,431 ↑ 10% ↑ 4% ↑ 3% FHA 19,977 20,652 20,762 ↑ 1% ↑ 5% ↑ 4% VCHA 18,031 18,312 19,001 ↑ 4% ↑ 4% ↑ 3% VIHA 17,866 17,946 17,811 ↓ 1% ↑ 4% ↑ 3% NHA 3,653 3,882 3,673 ↓ 5% ↑ 5% ↑ 4% B.C. 80,791 82,607 85,251 ↑ 3% ↑ 4% ↑ 4%   Clients that received professional services from more than one health authority in the same year are counted in each health authority’s total, but only once at the B.C. level. Columns therefore cannot be summed. Source: 4 Unlike home support where 90% of clients are aged 65 or over and the average client age is 80, only 70% of home care professional services clients are aged 65 and over, and this number reduces to 50% at age 75 and over. MONITORING SENIORS’ SERVICES 9 HEALTH CARE Visits In 2014/15, a total of 1,090,111 visits were made to clients receiving home care services in B.C., an increase of 5% over 2013/14. The number of visits increased in four out of five health authorities. 2012/13 2013/14 2014/15 Change in Last Year Population Change 65+ Population Change 75+ IHA 264,278 257,948 289,396 ↑ 12% ↑ 4% ↑ 3% FHA 244,039 247,465 249,826 ↑ 1% ↑ 5% ↑ 4% VCHA 226,534 224,576 237,996 ↑ 6% ↑ 4% ↑ 3% VIHA 252,293 253,401 254,545 ↑ <1% ↑ 4% ↑ 3% NHA 55,983 58,992 58,348 ↓ 1% ↑ 5% ↑ 4% B.C. 1,043,127 1,042,382 1,090,111 ↑ 5% ↑ 4% ↑ 4%   Source: 4 Home Care – Complaints When clients have complained about their care to their health authority and are unsatisfied with the response they received, they may escalate their complaint to the health authority’s Patient Care Quality Office (PCQO). At this time, PCQO complaints data for home care cannot be separated into home support and professional services related complaints. The following table includes all complaints from the home care sector. In 2014/15, 463 complaints about home care were made to PCQOs in B.C. 2013/14 2014/15 Change IHA 49 45 ↓ 8% FHA 195 217 ↑ 11% VCHA 46 65 ↑ 41% VIHA 122 123 ↑ 1% NHA 19 13 ↓ 32% B.C. 431 463 ↑ 7% Source: 6 10 MONITORING SENIORS’ SERVICES HEALTH CARE In 2014/15, the top six complaint categories captured 50% of total complaints about home care in B.C. Complaint % of Complaints Access Complaint: Care program or service denied 13% Communication Complaint: Inadequate or incorrect information 9% Care Complaint: Inappropriate type or level of care* 9% Care Complaint: Care program or service not available 8% Care Complaint: Care program or service delayed 6% Coordination Complaint: Lack of caregiver continuity 5% All Other Complaints 50% Percentage of total complaints 100% *The degree to which kinds/levels of care provided reflect the expectations of patients, clients, residents and/or their families (e.g. aggressive intervention in palliative cases, not enough intervention, care managed medically rather than surgically, etc.) Source: 6 Complaint Resolution Complaints not able to be resolved at the point of service may be formally lodged with the health authority Patient Care Quality Office (PCQO) for investigation and response. If the complainant is not satisfied with the response by the PCQO, the complainant may request a review of the PCQO’s handling by the Patient Care Quality Review Board. Of the 464 complaints received by health authorities about home support and professional services in 2014/15, 23 (4.9%) were referred to the Patient Care Quality Review Board for review. Assisted Living Assisted living is a housing option that provides seniors with enhanced supports to maintain their independence. Assisted living residences are regulated rather than licensed as is the case for residential care facilities. In B.C., three versions of assisted living exist: subsidized registered assisted living, private pay registered assisted living, and private assisted living (non-registered). Registered assisted living is regulated under the Community Care and Assisted Living Act, which allows facilities to provide residents up to two out of six prescribed services – typically assistance with activities of daily living (e.g. dressing) and administration of medication. Private non-registered assisted living residences are different in that residents make their own arrangements for any personal/nursing care needs and these are not limited to two of the six prescribed services. As residents living in assisted living are deemed competent, assisted living residences are not secure – residents may come and go freely. MONITORING SENIORS’ SERVICES 11 HEALTH CARE Residences In 2015, there were 142 subsidized registered assisted living residences in B.C., with a total of 4,430 units. Subsidized Registered Assisted Living Units 2012 2013 2014 2015 Change since 2012 (%) IHA 925 922 922 931 ↑ 0.6% FHA 1,350 1,395 1,395 1,393 ↑ 3.2% VCHA 838 830 809 798 ↓ 4.8% VIHA 986 1,036 1,021 1,018 ↑ 3.2% NHA 290 289 290 290 0% B.C. 4,389 4,472 4,437 4,430 ↑ 0.9% Source: 7 In 2015, there were 3,247 units of private registered assisted living in B.C., a 25% increase from 2012. Private Registered Assisted Living Units Change since 2012 (%) 2012 2013 2014 2015 IHA 964 1,070 953 1,009 ↑ 4.7% FHA 854 1,023 1,071 1,110 ↑ 30.0% VCHA 385 455 462 483 ↑ 25.5% VIHA 361 492 563 621 ↑ 72.0% NHA 33 23 23 24 ↓ 27.3% B.C. 2,597 3,063 3,072 3,247 ↑ 25.0% Source: 8 In 2015, there were 16,636 private assisted living (non-registered) units in B.C. Private Assisted Living (NonRegistered) 2012 2013 2014 2015 Change since 2012 (%) Units 15,369 15,610 16,609 16,636 ↑ 8% Vacancy Rate 12.6% 11.4% 10.9% 9.1% ↓ 3.5% *Drawn from information on standard seniors’ housing spaces (i.e. the resident receives less than 1.5 hours of care per day). Source: 9 12 MONITORING SENIORS’ SERVICES HEALTH CARE Waitlist In Fraser Health, Interior Health, and Vancouver Coastal Health, individuals may only be placed on one assisted living residence waitlist, however, they may choose which residence to apply to. In Island Health and Northern Health, individuals may place themselves on waitlists for multiple assisted living residences. While there is availability in some Island Health residences, seniors may choose to wait for a unit in their preferred residence. As of December 15, 2015, 943 individuals were on the waitlist for a subsidized registered assisted living unit in B.C. Individuals on Waitlist IHA 237 FHA 251 VCHA 188 VIHA 122 NHA 145 B.C. 943 Source: 10 Cost In subsidized registered assisted living, residents pay a set monthly rate of 70% of their net income up to maximum market rate for the respective community. Whether registered or not, private assisted living costs can range significantly. The table below shows the proportion of private non-registered assisted living units by rental price range. In 2015, 60.5% of private non-registered assisted living units cost $2,500 or more per month. Private Assisted Living (NonRegistered) Change since 2012 2012 2013 2014 2015 7.7% 7.0% 6.6% 7.8% ↑ 0.1% $1,500 - $1,999 14.5% 12.1% 12.0% 10.7% ↓ 3.8% $2,000 - $2,499 22.2% 24.8% 21.3% 20.9% ↓ 1.3% $2,500+ 55.5% 56.1% 60.1% 60.5% ↑ 5.0% <$1,500 Source: 9 MONITORING SENIORS’ SERVICES 13 HEALTH CARE Complaints The Assisted Living Registrar (ALR) ensures that both private and subsidized registered assisted living residences comply with the Community Care and Assisted Living Act and regulations. In 2015, the Registrar received a total of 73 complaints. In these 73 complaints, complainants raised 183 issues, with the largest complaint categories being Internal Complaint Policy and Resident Abuse, Neglect & Self-Neglect. Complaints to the ALR are not tracked in the same format as complaints under residential care licensing, which indicate the number of complaints that have been substantiated. 2012 2013 2014 2015 48 30 58 73 Tenancy 3 5 0 0 Possible Unregistered AL 7 3 7 11 External Complaint Policy 0 0 0 4 Internal Complaint Policy 1 2 13 18 Monitoring of Food Intake & Therapeutic Diets 0 0 2 1 Management of Cash 4 1 0 0 Delivery of Medication Services 9 4 8 8 Activities of Daily Living 3 5 1 2 Personal Services Plans 2 1 7 6 Exit Plans 1 3 11 11 Entry 9 5 8 6 Delegated Tasks 2 2 4 3 Staff Qualifications and Ongoing Training 5 3 7 3 Staffing Levels 4 3 7 7 Management 8 14 18 12 Social & Recreational Opportunities 1 1 5 4 24-Hour Emergency Response 4 1 1 7 Meals Services 10 8 10 14 Housekeeping Services 3 5 4 5 Laundry Services 1 3 1 2 Resident Abuse, Neglect & Self-Neglect 9 7 14 18 Infection Outbreaks 1 1 2 2 Accidents, Deaths & Medications Emergencies 3 0 3 11 Emergency Preparedness & Fire Safety 5 1 6 3 Security 0 3 11 9 Building Maintenance 2 5 8 10 Environment 7 3 2 6 Other 5 11 0 0 104 100 160 183 Total Complaints Issues Raised in these Complaints Total Issues These numbers represent all complaints and initial issues raised, and do not include whether or not the complaint was substantiated. Source: 8 14 MONITORING SENIORS’ SERVICES HEALTH CARE Site Inspections Inspections and investigations are conducted by the ALR on an as-needed basis. An inspection can be triggered by a health and safety complaint, the need to determine whether a residence is operating as assisted living without being registered, or to determine if a residence wishing to register meets the requirements to do so. In 2015, the ALR conducted 22 site inspections, of which 7 were to follow up on a health and safety complaint. Type of Inspection 2013 2014 2015 Health and Safety Complaint 9 5 7 Possible Unregistered Residence 1 1 4 Prior to Registering a Residence 1 6 11 Total 11 12 22 Source: 8 Incident Reporting Registered assisted living residences are required to report to the ALR on specific serious incidents where the health or safety of a resident may 2012 2013 2014 2015 have been at risk. IHA 25 40 46 67 In 2015, a total of 235 serious incidents were reported by registered assisted living residences in B.C. The number of incidents reported has increased in part due to the increase of 168 units of registered assisted living. FHA 12 30 44 61 VCHA 12 10 21 36 VIHA 19 22 31 63 NHA 2 3 5 8 B.C. 70 105 147 235 Source: 8 The tables below show the breakdown of these serious incidents by type of incident. Resident to Staff Aggression Resident to Resident Aggression 2012 2013 2014 2015 2012 2013 2014 2015 IHA 0 0 3 0 IHA 0 2 5 1 FHA 0 0 0 0 FHA 0 0 5 0 VCHA 1 0 0 2 VCHA 1 0 1 3 VIHA 0 0 0 1 VIHA 0 1 1 2 NHA 0 0 1 0 NHA 0 0 0 0 B.C. 1 0 4 3 B.C. 1 3 12 6 MONITORING SENIORS’ SERVICES 15 HEALTH CARE Police Incident Unexpected Death 2012 2013 2014 2015 2012 2013 2014 2015 IHA 0 2 3 5 IHA 12 9 13 18 FHA 0 5 5 6 FHA 8 9 14 17 VCHA 0 0 0 2 VCHA 7 6 6 6 VIHA 0 2 1 5 VIHA 8 5 7 8 NHA 0 0 0 0 NHA 1 2 2 2 B.C. 0 9 9 18 B.C. 36 31 42 51 2012 2013 2014 2015 Missing/Wandering Abuse or Neglect 2012 2013 2014 2015 IHA 0 2 5 3 IHA 0 1 2 2 FHA 0 4 8 15 FHA 0 0 0 2 VCHA 0 0 3 2 VCHA 1 0 3 0 VIHA 1 2 1 1 VIHA 0 2 0 7 NHA 0 0 0 2 NHA 0 1 0 0 B.C. 1 8 17 23 B.C. 1 4 5 11 Falls Fire/Flood/Gas Leak 2012 2013 2014 2015 2012 2013 2014 2015 IHA 4 6 10 25 IHA 1 4 2 5 FHA 0 1 5 11 FHA 1 1 0 4 VCHA 0 1 6 10 VCHA 0 0 1 4 VIHA 3 3 2 25 VIHA 0 1 1 3 NHA 0 0 1 4 NHA 1 0 0 0 B.C. 7 11 24 75 B.C. 3 6 4 16 2012 2013 2014 2015 Attempted Suicide Disease Outbreak 2012 2013 2014 2015 IHA 4 6 2 5 IHA 3 3 0 2 FHA 3 4 5 3 FHA 0 1 2 1 VCHA 1 1 0 2 VCHA 0 1 1 2 VIHA 2 0 6 5 VIHA 0 5 7 3 NHA 0 0 0 0 NHA 0 0 0 0 B.C. 10 11 13 15 B.C. 3 10 10 8 16 MONITORING SENIORS’ SERVICES HEALTH CARE Residential Care Facilities Residential care facilities offer seniors 24-hour professional supervision and care in a safe and secure environment. Approximately 3.7% of B.C. seniors live in residential care. The data presented in this section cover residential care facilities that receive public funding, including those that are owned and operated by health authorities and those that are operated by private for profit and private not for profit organizations. Beds As of September 30, 2015 there were 27,421 publicly funded residential care beds in B.C. Across the province, the number of beds has increased 3.5% since 2012. 2012 2013 2014 2015 Change since 2012 75+ Pop. Change since 2012 IHA 5,332 5,589 5,690 5,686 ↑ 6.6% ↑ 9% FHA 7,871 7,997 8,294 8,275 ↑ 5.1% ↑ 12% VCHA 6,800 6,815 6,854 6,856 ↑ 0.8% ↑ 10% VIHA 5,385 5,376 5,379 5,425 ↑ 0.7% ↑ 8% NHA 1,118 1,144 1,153 1,179 ↑ 5.5% ↑ 12% B.C. 26,506 26,921 27,370 27,421 ↑ 3.5% ↑ 10% Source: 7 As of publication, room configuration is available for about 26,067 of the total 27,421 beds. Of these known beds, 19,611, or 75%, are in dedicated single occupancy rooms. Single Rooms Double Rooms Multi-person Rooms (3-5 people) IHA 4,685 230 132 FHA 5,649 576 184 VCHA 4,203 796 205 VIHA 4,045 359 283 NHA 1,029 37 16 B.C. 19,611 1,998 820 Source: 11 MONITORING SENIORS’ SERVICES 17 HEALTH CARE Admissions In 2014/15, 9,060 seniors were admitted to residential care facilities.* This represents an increase of 6.8% over 2013/14. 2013/14 2014/15 % Change IHA 2,060 2,060 0% FHA 2,397 2,741 ↑ 14.4% VCHA 1,915 1,898 ↓ 0.9% VIHA 1,786 2,000 ↑ 12.0% NHA 322 361 ↑ 12.1% B.C. 8,480 9,060 ↑ 6.8% *Does not include brain injury, group homes, hospice, family care homes, or short-term residential care. Source: 12 In 2013/14, 67% of seniors waiting for residential care were admitted to a facility within the target window of 30 days, with 50% of seniors waiting 15 days or less. 2013/14 Admitted Within 30 Days Average # of Days Median # of Days IHA 73% 29 13 FHA 62% 38 21 VCHA 80% 25 9 VIHA 60% 41 18 NHA 27% 122 96 B.C. 67% 36 15 Source: 12 In 2014/15, 63% of seniors waiting for residential care were admitted to a facility within the target 30-day window, a 4% decrease from 2013/14. Admitted within 30 Days 2014/15 Change since 2013/14 Average # of Days IHA 63% ↓ 10% 38 18 FHA 57% ↓ 5% 43 25 VCHA 79% ↓ 1% 28 8 VIHA 62% ↑ 2% 42 17 NHA 35% ↑ 8% 87 63 B.C. 63% ↓ 4% 41 18 2014/15 Source: 12 18 MONITORING SENIORS’ SERVICES Median # of Days HEALTH CARE Preferred Bed Access Individuals placed into residential care are offered the First Appropriate Bed, which may not be at the facility they want. When this happens, residents can ask to transfer to a bed at their preferred facility. The table below illustrates the rate at which the first placement is to the individual’s preferred location and the percentage of residents who must transfer to the preferred location from their initial placement. Clients achieving Preferred Bed at time of Initial Placement Clients achieving Preferred Bed after Initial Placement IHA 45% 22% FHA 30% 4% VCHA 23% 22% VIHA 24% 21% NHA Not Available Not Available 2013/14 Source: 10 Complaints Complaints about care and services received in residential care are initially made through each health authority’s Patient Care Quality Office. Each complaint is added to a province-wide database using standard categories and coding practices. Across B.C. in 2014/15, 621 complaints about residential care were received, up 5.8% from 2013/14. 2013/14 2014/15 % Change IHA 132 105 ↓ 20.5% FHA 210 248 ↑ 18.1% VCHA 75 97 ↑ 29.3% VIHA 155 147 ↓ 5.2% NHA 15 24 ↑ 60.0% B.C. 587 621 ↑ 5.8% Source: 6 MONITORING SENIORS’ SERVICES 19 HEALTH CARE In 2014/15, the top complaint category, at 12%, was for inappropriate type or level of care. Complaint Type 2014/15 Care: Inappropriate type or level of care* 12% Communication: Inadequate or incorrect information 6% Attitude or Conduct: Uncaring behaviour or attitudes 6% Care: Delayed or disruptive care or service 6% Financial: Billing issue – room charges 6% Accommodation: Dissatisfied with placement 4% Care: Medication-related issues 3% Care: Incorrect application of process or procedure 2% Access: Care program or service not available 2% Safety: Personal safety or security issue 2% Environment: Food services not to standards 2% All other complaints 49% Percentage of total complaints 100% *The degree to which kinds/levels of care provided reflect the expectations of patients, clients, residents and /or their families (e.g. aggressive intervention in palliative cases, not enough intervention, care managed medically rather than surgically, etc.) Source: 6 Complaint Resolution Ideally, complainants’ concerns are resolved at the health authority PCQO level. However, where this is not possible, the complainant may request that the Patient Care Quality Review Board review the PCQO’s handling of their complaint. Of the total 621 complaints received by health authorities about residential care in 2014/15, 27 (4.3%) were referred to the Review Board for review. Annual Inspections Residential care facilities governed by the Community Care and Assisted Living Act or the Hospital Act are monitored through regular inspections. Ideally, these inspections should be conducted on at least an annual basis, however, there is no mandatory inspection frequency. As of December 2015 review, 82% of B.C.’s residential care facilities had a reported inspection within the last year. Sites Inspection Within Last Year IHA 82 89% FHA 92 VCHA Of the most recent inspection reported for each facility, including inspections that occurred more than a year ago, 96% were routine or follow up inspections. Sites Routine and Follow Up Inspections Complaint Inspections IHA 82 100% 0% 92% FHA 92 89% 11% 69 72% VCHA 69 100% 0% VIHA 63 89% VIHA 63 97% 3% NHA 27 33% NHA 27 100% 0% B.C. 333 82% B.C. 333 96% 4% Source: 13 20 Source: 13 MONITORING SENIORS’ SERVICES HEALTH CARE Facilities Licensing – Complaints Residential care licensing offices in each health authority also receive complaints about facilities. They conduct investigations to determine whether the complaint is substantiated and to identify any licensing violations. In 2014/15, licensing offices received 438 complaints about residential care facilities, of which 41% found licensing violations during inspection. 2013/14 2014/15 Complaints Received Licensing Violations Found Complaints Received Licensing Violations Found Changes in Violations Found IHA 152 25 141 34 ↑ 36% FHA 62 10 67 19 ↑ 90% VCHA 79 28 30 12 ↓ 57% VIHA 157 85 199 115 ↑ 35% NHA 3 1 1 0 ↓ 100% B.C. 453 149 438 180 ↑ 21% Source: 10 After a complaint has been received, a licensing officer will conduct a comprehensive review of the facility. At this time, the officer will identify which, if any, regulations have been found to be violated. Violations may or may not be related to the original issue identified in the complaint. For example, a complaint about staffing could lead to a licensing officer conducting a review of the facility and finding unrelated violations in the policy and reporting categories. The majority of licensing regulation issues identified were associated with the Care & Supervision category of the regulations. Care & Supervision Staffing Records & Reporting Policy & Procedure All Other IHA 50.0% 17.6% 0% 5.9% 26.5% FHA 25.4% 25.4% 8.5% 8.5% 32.2% VCHA 33.3% 8.3% 0% 16.7% 41.4% VIHA 48.9% 19.2% 13.2% 11.0% 7.7% NHA 0% 0% 0% 0% 0% B.C. 44.1% 19.8% 10.5% 10.2% 15.4% *Facility licensing regulations and definitions are available in detail at http://www.bclaws.ca/Recon/document/ID/freeside/96_2009 Licensing regulation categories are defined in Appendix A. Source: 10 MONITORING SENIORS’ SERVICES 21 HEALTH CARE Facilities Licensing – Reportable Incidents Licensed residential facilities are required to report incidents as defined under the Residential Care Regulation. Licensing officers respond to these reports in order to confirm the incident and do any inspection or follow up necessary. The following is a selection of the reportable incidents for publicly funded facilities licensed under the Community Care and Assisted Living Act. Abuse or Neglect * Disease Outbreak * In 2014/15, there were 121 reported incidents of financial, physical, emotional and/or sexual abuse in B.C. residential care facilities. In 2014/15, there were 122 reported incidents of disease outbreak in residential care facilities in B.C. 2013/14 2014/15 2013/14 2014/15 IHA 62 52 IHA 41 46 FHA 34 22 FHA 34 37 VCHA 8 6 VCHA 14 6 VIHA 33 31 VIHA 17 23 NHA 4 10 NHA 1 10 B.C. 141 121 B.C. 107 122 *Includes neglect and abuse from any source such as staff, visitors or other residents. Neglect does not include self-neglect. Source: 10 *Examples are Influenza or Norwalk outbreaks. Source: 10 Falls with Injury * Missing or Wandering Person Across B.C. in 2014/15, there were 2,367 reported incidents of a resident falling and being injured or an adverse event occurring. Across B.C. in 2014/15, there were 336 reported incidents of a resident going missing or wandering. 2013/14 2014/15 2013/14 2014/15 IHA 566 628 IHA 67 69 FHA 667 653 FHA 61 79 VCHA 523 440 VCHA 104 108 VIHA 467 568 VIHA 92 70 NHA 58 78 NHA 9 10 B.C. 2,281 2,367 B.C. 333 336 *An “injury” requires an intervention by a physician or transport to hospital, with or without admission to hospital. Source: 10 22 MONITORING SENIORS’ SERVICES Source: 10 HEALTH CARE Of the 336 residents who went missing or wandering from residential care facilities in 2014/15, 87.5% were found unharmed. The remaining 12.5% were found with 6% requiring medical attention. There were no deaths. Incidents Found Unharmed Found: Medical Attention Sought Deceased Not Found IHA 69 57 (83%) 5 (7%) 0 0 FHA 79 64 (81%) 2 (3%) 0 0 VCH 108 100 (93%) 5 (5%) 0 0 VIHA 70 64 (91%) 6 (9%) 0 0 NHA 10 9 (90%) 1 (10%) 0 0 B.C. 336 294 (88%) 19 (6%) 0 0 2014/15 Source: 10 Resident on Resident Aggression Data collection related to resident on resident aggression in residential care is currently challenging due to the use of different reporting and regulatory systems within the province. Data for this report were collected from two reporting frameworks to capture incidents of resident on resident aggression. There are 229 publicly funded residential care facilities that report under the Community Care and Assisted Living Act (CCALA). Fifty-four of these facilities are owned and operated by the health authorities and may also report through the Patient Safety Learning System. As of December 1, 2013, the CCALA was amended to establish a new category of reportable incidents for aggression between persons in care that result in a degree of harm that requires first aid, emergency care by a medical practitioner or a nurse practitioner, or a trip to the hospital. In 2014/15, there were 213 incidents of this kind reported by facilities governed by the CCALA. MONITORING SENIORS’ SERVICES 23 HEALTH CARE There are 68 facilities that are owned and operated by health authorities that are governed by the Hospital Act as well as four facilities operated by Providence Health Care. These facilities can voluntarily report through the Patient Safety Learning System (PSLS), which is overseen by the Provincial Health Services Authority. Through this system, facilities report cases of physical aggression toward clients. It does not distinguish if the aggressor was a fellow resident, staff member, or visitor. As of 2014/15, health authorities reported to the PSLS a total of 1,076 cases of physical aggression, of which it is estimated 26% caused some degree of harm. For the purposes of this report, the Office of the Seniors Advocate has chosen to deem as comparable the CCALA incidents of resident on resident aggression causing harm and the incidents of physical aggression reported in the PSLS system that also resulted in some degree of harm. Using the overall average, we also assumed that 26% of cases reported in each health authority through the PSLS resulted in some harm. In 2014/15, 280 incidents of physical aggression towards a resident resulting in some degree of harm were reported through the PSLS process. There are 30 private or not for profit residential care facilities governed by the Hospital Act that at this point do not have access to the PSLS and therefore data are not available at this time for these facilities. There are three residential care facilities in B.C. that are governed by both the Hospital Act and the CCALA because they have both CCALA and Hospital Act Beds. Incidents Reported under the CCALA Incidents Reported under the PSLS 2014/15 2014/15 IHA 21 IHA 103 FHA 66 FHA 51 VCHA 54 VCHA 42 VIHA 37 VIHA 47 NHA 35 NHA 37 B.C. 213 B.C. 280 Source: 10 Source: 14 Given the lack of data from 30 facilities and the possible double reporting of 54 facilities, the OSA estimates the number of incidents of resident on resident aggression in 2014/15 to be between 425 and 550. 24 MONITORING SENIORS’ SERVICES HEALTH CARE Use of Antipsychotics Without a Diagnosis of Psychosis In 2014/15, 32.9% of residents were administered an antipsychotic drug compared to 34.3% in 2013/14, a decrease of 1.4%. This compares to the national average of 28.6% in 2014/15 and 31.4% in 2013/14, a 2.8% decrease. The rate of antipsychotic use for those B.C. residents without a diagnosis of psychosis decreased from 32.4% in 2013/14 to 30.1% in 2014/15. This 2.3% provincial decrease compares to a 3.2% decrease from 30.3% in 2013/14 to 27.1% in 2014/15 nationally. B.C. Residents Given Antipsychotics Canada* Residents Without a Diagnosis of Psychosis Total Residents With or Without a Diagnosis Residents Without a Diagnosis of Psychosis Total Residents With or Without a Diagnosis 2013/14 32.4% 34.3% 30.3% 31.4% 2014/15 30.1% 32.9% 27.1% 28.6% *Includes data reported by B.C., Alberta, Saskatchewan, Winnipeg, Ontario, Nova Scotia, Yukon, and Newfoundland and Labrador. Source: 15 MONITORING SENIORS’ SERVICES 25 Housing S eniors in B.C. live in a range of housing types, from detached homes where they live in complete independence to residential care, where they receive 24-hour care. The focus of this section is on the 93% (762,400) of seniors who are living independently, 80% (609,920) of whom are homeowners and 20% (152,480) of whom rent. Twenty-six per cent of seniors live alone, and this increases to 46% for those 85 and over. A snapshot of rental costs and vacancy rates, as well as data on subsidy programs available to assist seniors who are living independently are provided. How B.C. seniors live: 2015 Projection % of Seniors’ Population Single Detached House 418,200 51% Other Houses (Townhouse, Duplex, Semidetached house, or Manufactured home) 165,900 20% Apartment/Condominium 178,300 22% Non-Registered Assisted Living 16,636 (actual) 2% Registered Assisted Living 7,679 (actual) 1% 30,000 4% Residential Care Source: 16 Renting in B.C. On average, 20% of seniors are renters. The distribution of senior renters varies greatly across the province. For example, in Metro Vancouver 23% of residents aged 65 and over are renters – both the largest number and highest proportion – while in Parksville it is 9% and in Kelowna it is 15%. As well as the variability in the distribution of renters across the province, there is a wide range in the average costs of renting, for example $660 for a one-bedroom apartment in Prince George and $1,062 in Vancouver. Vacancy rates vary throughout the province, with a provincial average vacancy rate of 1.6% in 2015. 2013 2014 2015 Change since 2014 Abbotsford-Chilliwack 5.4% 3.9% 3.4% ↓ 0.5% Kelowna 3.5% 1.5% 1.8% ↑ 0.3% Nelson 3.4% 2.3% 2.4% ↑ 0.1% Terrace N/A 0.8% 4.8% ↑ 4.0% Vancouver 2.8% 1.7% 1.2% ↓ 0.5% Victoria 3.7% 2.7% 1.0% ↓ 1.7% B.C. 3.3% 2.2% 1.6% ↓ 0.6% Source: 9 26 MONITORING SENIORS’ SERVICES HOUSING Shelter Aid for Elderly Renters (SAFER) SAFER provides a subsidy directly to those aged 60 or older who live in a private market rental unit and are on a moderate or low income. The average income of single SAFER recipients in the province is $1,515 a month, or $18,180 per year. As of April 2015, the average cost of a one-bedroom apartment in B.C. was $971. Over the last 10 years, average B.C. market rent has increased by 34% while the SAFER maximum rent has increased by 9%. Change in Market Rent 20142015 Change in SAFER Maximum Rent since 2005* Change in Market Rent since 2005 2014 2015 SAFER Maximum Rent AbbotsfordChilliwack $676 $699 $667 ↑ 3.4% ↑ 9% ↑ 24% Kelowna $774 $802 $667 ↑ 3.6% ↑ 9% ↑ 31% Nelson $653 $679 $667 ↑ 4.0% ↑ 9% ↑ 35% Terrace $605 $656 $667 ↑ 8.4% ↑ 9% ↑ 56% $1,039 $1,062 $765 ↑ 2.2% ↑ 9% ↑ 35% Victoria $840 $856 $667 ↑ 1.9% ↑ 9% ↑ 30% B.C. $952 $971 — ↑ 2.0% ↑ 9% ↑ 34% Vancouver *SAFER maximum rents were increased in April 2014, the first increase since 2005. Source: 9 and 17 Recipients As of October 1, 2015, the total number of SAFER recipients in B.C. was 18,696, of which 17,087 (91%) were aged 65 and over. There was an 8% increase in the number of SAFER recipients from October 2014 to October 2015. October 2014 October 2015 # % # % Change IHA 3,290 19% 3,431 18% ↑ 141 (4%) FHA 5,887 34% 6,301 34% ↑ 414 (7%) VCHA 4,502 26% 4,869 26% ↑ 367 (8%) VIHA 3,116 18% 3,462 19% ↑ 346 (11%) NHA 519 3% 631 3% ↑ 112 (22%) B.C. 17,314 100% 18,696 100% ↑ 1,382 (8%) Source: 17 MONITORING SENIORS’ SERVICES 27 HOUSING Subsidy Amounts October 1, 2015 Minimum subsidy The current minimum subsidy amount is $25, the average is $176.70, and median is $169.94. $25 Average subsidy $176.70 Median subsidy $169.94 Source: 17 The average subsidy has increased 17% over the past two years. March 31, 2013 March 31, 2014 October 1, 2015 $150.59 $151.08 $176.70 Average subsidy Source: 17 In 2014/15, SAFER provided $41 million in subsidies. An additional $1 million is budgeted for 2015/16. SAFER Subsidies Provided (millions) 2012/13 2013/14 2014/15 2015/16 (budgeted) $32 $32 $41 $42 Increase from 2012/13 to 2014/15 ↑ 28% Source: 17 Applications The average application processing time for new applicants and re-additions between April 1, 2015 and September 30, 2015 was 7.6 weeks. Seniors approved for SAFER receive the subsidy retroactively from the date of their application. Seniors must reapply to receive SAFER every year. In 2014/15, 20% of those receiving SAFER were receiving it for the first time. 28 MONITORING SENIORS’ SERVICES 2014/15 New applicants Re-additions* Re-applicants 20% 80% * Re-additions are people who were already known to the system as they had either received benefits in the past at some point, or had applied previously and were not eligible. Current recipients applying for continued SAFER benefits are classified as re-applicants. Source: 17 HOUSING Seniors’ Subsidized Housing Seniors’ Subsidized Housing (SSH) is funded by BC Housing and serves British Columbians aged 55 and over, or who have a disability. Accommodation is in buildings that are either owned and operated by BC Housing or by a not-for-profit organization that is funded by BC Housing. Housing is apartment-style living, and usually consists of a one-bedroom unit in a building often with a common room where tenants can gather for programs and activities. In units that are strictly rent-geared-to income, tenants pay 30% of their gross income toward the cost of their housing. Recipients The number of subsidized units in B.C. decreased 1% since 2013/14. 2013/14 2014/15 Change since 2013/14 IHA 4,985 5,078 ↑ 1.9% FHA 9,380 9,205 ↓ 1.9% VCHA 12,246 12,386 ↑ 1.1% VIHA 5,571 5,289 ↓ 5.1% NHA 1,372 1,266 ↓ 7.7% B.C. 33,554 33,224 ↓ 1.0% Units Source: 17 In 2014/15, 672 individuals received a SSH unit. This represents 13% of those waiting for a unit. 2014/15 # Housed % of Those Waiting IHA 123 21% FHA 173 12% VCHA 244 10% VIHA 85 11% NHA 47 20% B.C. 672 13% Source: 17 Seniors Waiting for SSH Seniors in B.C. can apply for subsidized housing in multiple cities and run by different organizations. BC Housing maintains a Housing Registry of people approved for subsidized housing and waiting to be offered a unit. The organizations receiving BC Housing funding may use The Housing Registry, or they may maintain their own database. Those waiting for a unit are prioritized based on need and unit requirements, and/or date of application. Data presented below reflect the seniors in The Housing Registry who are waiting to receive a subsidized housing unit. Data are not available for seniors waiting for a SSH unit operated by an organization not using The Housing Registry. MONITORING SENIORS’ SERVICES 29 HOUSING As of March 31, 2015, the total number of people 55+ on the waitlist for a SSH unit was 4,675, a 7.4% increase from the previous year. Of those waiting, 2,087 (45%) were aged 65 and over. March 31, 2014 March 31, 2015 Change since March 31, 2014 IHA 391 455 ↑ 16.4% FHA 1,255 1,253 ↓ 0.2% VCHA 1,967 2,097 ↑ 6.6% VIHA 593 684 ↑ 15.3% NHA 133 184 ↑ 38.3% B.C. 4,352 4,675 ↑ 7.4% Waitlist Source: 17 As of March 31, 2015, the average length of time those waiting to receive a subsidized unit had been waiting was 2.3 years, up from 2.2 years in 2014. March 31, 2015 Wait Time Snapshot Average (Years) Median (Years) IHA 1.4 1.0 FHA 2.3 1.5 VCHA 2.5 1.8 VIHA 2.2 1.3 NHA 1.3 0.8 B.C. 2.3 1.5 Source: 17 Homeowners Approximately 80% of seniors in B.C. own their own home, and an estimated 78% have no mortgage. Average home values can vary widely from under $300,000 to over $1 million depending on where in the province the senior lives. Homeowners face similar costs for maintaining their home if the home’s value reflects the average value for that community. At least 30% of senior homeowners have an annual income of $24,000 or less. Homeownership Costs Property taxes, municipal charges and hydro are increasing. 2013 2014 2015 Property tax and municipal charges* $3,205.62 $3,266.30 (↑ 1.9%) $3,341.37 (↑ 2.3%) Hydro ↑ 1.44% ↑ 9% ↑ 6% *Estimated by averaging the property taxes and municipal charges for a representative house in over 160 communities across the province. Source: 18 and 19 30 MONITORING SENIORS’ SERVICES HOUSING Property Tax Deferment B.C.’s Property Tax Deferment regular 2013 2014 Change program allows homeowners 55 and New Users 5,375 4,796 ↓ 11% older, surviving spouses and persons with Source: 20 disabilities to defer paying their property taxes for a low simple interest charge (currently 0.85%) that accrues until they withdraw from the program voluntarily, upon ownership transfer, or upon death. As of the end of August 2015, the total cumulative amount of property tax deferred under the regular program was $733 million, up from $621 million in April 2015. In 2014, 4,796 homeowners started deferring their property taxes. An estimated additional 6,000 homeowners are maintaining deferment accounts opened in previous years but are not deferring the current year’s taxes. In B.C., the median assessed value of the homes for which property taxes have been deferred under the regular program was $603,000. Assessed Value of Home Amount Deferred in 2014/15 Fiscal Year Cumulative Amount Deferred Average $1,567,162 $6,165 $30,958 Median $1,501,000 $5,677 $20,044 Average $636,293 $3,601 $19,342 Median $603,000 $2,868 $12,193 2015 Tax Year Vancouver B.C. Source: 20 In B.C., the median annual interest on deferred 2014/15 property taxes was $28.68. Vancouver B.C. Amount Deferred in 2014/15 Fiscal Year 2014/15 Annual Interest (1.0%) Projected 2015/16 Interest (0.85%) Average $6,165 $61.65 $52.40 Median $5,677 $56.77 $48.25 Average $3,601 $36.01 $30.61 Median $2,868 $28.68 $24.38 Source: 20 In 2014, $122.6 million was deferred under the regular program, of which $15.2 million was new. 2012/13 2013/14 New Amount Deferred $16,545,697 $15,243,705 Total Amount Deferred $115,759,263 $122,558,548 Source: 20 In 2014/15, $55.3 million in property taxes deferred under the regular program was repaid to the province. Deferred Property Taxes Repaid (millions) 2012/13 2013/14 2014/15 $39.7 $45.2 $55.3 Source: 20 MONITORING SENIORS’ SERVICES 31 Transportation P ublic transportation in the province is divided between two service providers: TransLink, which serves the urban geography of Metro Vancouver, and BC Transit, which serves the rest of the province. Public transportation options for seniors in B.C. vary widely based on geography. Urban centres tend to have the highest service levels in terms of operating hours, frequency and routes. Many communities have a regular bus system, some have HandyDART services and taxi savers, and other more rural areas depend on infrequent special trips provided by a larger nearby town. Service by Community HandyDART and conventional public transit service levels vary widely between communities. The tables in Appendices C and D summarize service levels by community. HandyDART HandyDART is a shared ride service for passengers with physical or cognitive disabilities who are unable to use conventional public transit without assistance. HandyDART offers door-to-door service, providing assistance with boarding and exiting the bus, as well as with reaching the door of the destination safely. Seniors must apply for HandyDART and the application process varies by community. Some require physician approval while others do not. Clients Combined, TransLink and BC Transit served 60,801 active HandyDART clients in 2014. The large majority of users are 65 or older: 73% in TransLink and 73% in BC Transit’s Victoria system. The total number of active TransLink HandyDART clients decreased 5.6% from 2013 to 2014. Change in Clients 2013 to 2014 TransLink 2013 2014 All Ages 25,133 23,735 ↓ 5.6% 65+ 18,347 17,327 ↓ 5.6% Source: 21 In 2014, the total number of active BC Transit HandyDART clients was 37,066, with the large majority residing in urban areas. Data were not available for other years. BC Transit Urban 34,679 Semi Urban 2,387 Rural Total Source: 21 32 MONITORING SENIORS’ SERVICES 2014 Unknown 37,066 TRANSPORTATION The number of new clients registering for HandyDART service decreased 17% from 14,986 in 2011 to 12,389 in 2014. 2011 2012 2013 2014 TransLink 8,665 8,808 7,748 6,924 BC Transit 6,321 5,926 5,498 5,465 B.C. 14,986 14,734 13,246 12,389 Source: 21 Ride Requests The total number of HandyDART rides requested in B.C. in 2014 was 2,757,462. Of these, 56% were made in TransLink’s service area. 2010 2011 2012 2013 2014 Change since 2013 TransLink 1,556,277 1,634,110 1,646,820 1,616,702 1,551,451 ↓ 4% BC Transit — 1,232,853 1,225,305 1,220,802 1,206,011 ↑ 1% B.C. — 2,866,963 2,872,125 2,837,504 2,757,462 ↓ 3% Source: 21 Regular Rides Provided The total number of HandyDART rides provided in B.C. in 2014 was 2,354,000. Of these, 50.3% were delivered to clients in BC Transit’s service area. 2010 2011 2012 2013 2014 Change since 2013 TransLink 1,146,638 1,211,492 1,208,917 1,181,371 1,168,861 ↓ 1% BC Transit — 1,210,264 1,206,414 1,203,665 1,185,139 ↓ 2% B.C. — 2,421,756 2,415,331 2,385,036 2,354,000 ↓ 1% Source: 21 Unfulfilled Ride Requests In 2014, 1.9%, or 51,926, of HandyDART regular and standby ride requests were unfulfilled in B.C. Of these, 60% were in TransLink's service area. 2010 2011 2012 2013 2014 Change since 2013 TransLink 1.3% (20,662) 1.7% (28,410) 3.1% (51,205) 3.7% (59,242) 2.0% (31,054) ↓ 48% BC Transit — 1.5% (22,589) 1.5% (18,891) 1.0% (17,137) 1.2% (20,872) ↑ 22% B.C. — 1.8% (50,999) 2.4% (70,096) 2.7% (76,379) 1.9% (51,926) ↓ 32% Source: 21 MONITORING SENIORS’ SERVICES 33 TRANSPORTATION TransLink Standby Rides TransLink accepts regular ride requests up until noon the day before the requested ride date, when the drivers’ schedule is finalized. Any ride requests received after that point are considered “standby” requests and will be accommodated if they can be fit into the schedule. Separate standby requests must be made for each direction of a roundtrip journey, and securing one trip does not guarantee the return trip will also be accommodated. In 2014, TransLink received 26,876 standby requests and fulfilled 44.6%. TransLink Standby Requests 2010 2011 2012 2013 2014 Requests 30,738 33,829 32,016 30,303 26,876 Cancelled by Customer 5,294 1,827 1,213 811 700 Fulfilled 18,240 21,788 17,228 12,660 11,984 Unaccommodated 7,207 10,222 13,515 16,824 14,185 Source: 21 The three main reasons why rides go unaccommodated are: service is not available; contact cannot be made with the customer following the initial request; and customers may decline the offer of a standby ride in one direction if the return direction cannot also be accommodated. BC Transit does not divert and track standby rides as TransLink does. Any unfulfilled BC Transit rides, regardless of when they were requested, are captured in the previous section. Rides Delivered On Time The target window to pick up a client varies by location, with the most common being a 30 minute target window (i.e. pick up occurs within 15 minutes before or after the scheduled pick up time). In 2014, 89.2% of TransLink HandyDART rides were delivered on time. TransLink 2010 2011 2012 2013 2014 91.1% (1,061,204) 89.6% (1,105,019) 88.8% (1,088,817) 88.7% (1,194,031) 89.2% (1,053,314) Source: 21 The collection of on-time ride delivery data is too fragmented across BC Transit regions to be reported. 34 MONITORING SENIORS’ SERVICES TRANSPORTATION Taxi Saver Program Registered HandyDART clients may also choose to hold a HandyCard (TransLink) or handyPASS (BC Transit). HandyCard and handyPASS holders may choose to purchase discounted taxi vouchers through the Taxi Saver Program if it is offered in their community. Depending on their location, clients can purchase up to $80-$100 in taxi vouchers per month at a 50% discount. Clients can use taxi vouchers to book and pay for rides directly with their preferred taxi company. In TransLink communities, HandyCards also allow individuals with permanent physical, sensory or cognitive disability to travel on conventional transit at concession fare prices. In 2014, 14.1% of TransLink HandyCard holders purchased taxi vouchers. TransLink 2013 2014 Voucher Requests 57,534 49,253 $1,441,950 $1,229,475 10.8% (7,392) 14.1% (7,700) Total Value of Vouchers Provided HandyCard Holders Who Use Taxi Saver Source: 21 Across B.C. in 2014, handyPASS clients made 30,940 requests for taxi saver vouchers and received vouchers valuing a total of $1.27 million. BC Transit 2013 2014 Voucher Requests 31,681 30,940 $1,265,893 $1,265,103 — — Total Value of Vouchers Provided handyPASS Holders Who Use Taxi Saver Source: 21 Complaints Both TransLink and BC Transit have processes in place for the receiving and resolving of complaints with the HandyDART services they provide. The majority of the complaints are resolved at the point of service, but in the event that a solution cannot be found, a process for further escalating the complaint is available. In 2014, TransLink received 1,529 complaints, of which 33 were escalated for resolution. TransLink 2010 2011 2012 2013 2014 Complaints Received 1,294 1,394 1,397 1,386 1,529 Service Complaints 545 542 569 740 906 Operator Complaints 749 852 828 646 623 74.0% 71.0% 67.6% 77.1% 92.4% 11 6 13 48 33 Complaints Closed Within 5 Days Complaints Escalated Source: 21 MONITORING SENIORS’ SERVICES 35 TRANSPORTATION In 2014/15, 194 complaints were made to regional transit companies servicing the BC Transit area. Of these, two were escalated to BC Transit for resolution. Complaints Handled by Regional Transit Companies under BC Transit 2012/13 2013/14 2014/15 Central Fraser Valley 0 5 6 Alberni-Clayoquot 0 1 0 Campbell River 28 27 7 Cranbrook 0 0 0 Chilliwack 7 0 0 Kamloops 5 7 10 Kelowna 135 33 43 Kitimat 0 0 0 Kootenay Boundary 0 0 0 Nanaimo 11 10 8 Penticton 16 0 0 Prince George 11 37 23 Prince Rupert 18 25 6 Vernon 2 4 3 Comox Valley 0 0 0 Cowichan 0 0 3 Fort St. John 0 1 1 Summerland 0 2 0 Squamish 0 1 0 Sunshine Coast 0 2 0 Terrace 0 0 0 Williams Lake 1 0 2 Victoria 69 96 82 Total 303 251 194 2 3 2 Complaints Escalated to BC Transit Source: 21 BC Bus Pass Program The BC Bus Pass Program offers subsidized annual bus passes to low income seniors and individuals receiving disability assistance from the province. Seniors pay an annual $45 administrative fee. The program allows users to ride on regular public transit busses but does not include HandyDART. To be eligible, seniors must either be receiving the Federal Guaranteed Income Supplement (GIS), the Federal Allowance, or the Allowance for the Survivor, or be 65 or over and qualify for GIS in all but the 10 year Canadian residency requirement. The Bus Pass Program is administered by the Ministry of Social Development and Social Innovation and the passes are valid in communities served by TransLink or BC Transit. 36 MONITORING SENIORS’ SERVICES TRANSPORTATION The number of Bus Pass Program users has increased each year since 2010. In 2014, there was a total of 95,827 people in B.C. using the subsidized bus pass program, of which 60,472, or 63%, were seniors. 65+ 2010 2011 2012 2013 2014 Change since 2010 TransLink 42,706 44,748 47,255 49,671 52,223 ↑ 22.3% BC Transit 7,280 7,512 8,885 8,122 8,249 ↑ 13.3% B.C. 49,986 52,260 56,140 57,793 60,472 ↑ 21.0% Under 65 2010 2011 2012 2013 2014 TransLink 21,070 22,014 23,081 23,255 24,312 ↑ 15.4% BC Transit 10,575 10,772 11,219 11,003 11,043 ↑ 4.4% B.C. 31,645 32,786 34,300 34,258 35,355 ↑ 11.7% B.C. total for all ages 81,631 85,046 90,440 92,051 95,827 ↑ 17.4% Source: 22 The proportion of Bus Pass users who are aged 65 or over has increased by about 2% since 2010. 65+ 2010 2011 2012 2013 2014 TransLink 67.0% 67.0% 67.2% 68.1% 68.2% BC Transit 40.8% 41.1% 44.2% 42.5% 42.8% B.C. 61.2% 61.4% 62.1% 62.8% 63.1% Source: 22 2012 2013 2014 Change from 2013 to 2014 65-69 208,000 221,000 233,000 ↑ 5.4% 70-74 142,000 151,000 159,000 ↑ 5.3% 75-79 99,000 103,000 106,000 ↑ 2.9% 80-84 58,000 60,000 61,000 ↑ 1.7% 85+ 31,000 33,000 35,000 ↑ 6.1% 65+ 538,000 568,000 594,000 ↑ 4.6% Active Drivers In 2014, 594,000 seniors – or 76% of all seniors – were maintaining active driver's licences. Of these seniors, 96,000 (16%) were aged 80 or over and therefore required to undergo mandatory medical exams. Source: 23 In 2014, RoadSafetyBC evaluated the fitness to drive of over 148,000 drivers through the Driver Medical Examination Report (DMER). Approximately 1% – or 1,500 – of all those evaluated were referred for a DriveABLE cognitive assessment. Approximately 33%, or 48,840, of all those evaluated through the DMER were aged 80 or over. The DMER, not to be confused with the DriveABLE assessment, is a regular review to identify any possible driver fitness issues that may require further follow-up or special assessment. For those aged 80 and over, the DMER must be completed every two years. The cost of the DMER is determined by the driver’s individual physician and is not covered by MSP. The Doctors of BC fee guide suggests physicians charge $193 for completion of a DMER. Driver’s licences must be renewed with ICBC every five years. The ICBC renewal cost is $75 for those under 65 and $17 for those 65 and over. In 2014, 800 drivers aged 80 and over voluntarily surrendered their licence. MONITORING SENIORS’ SERVICES 37 Income Support B.C. seniors receive income support through federal government Old Age Security (OAS) and the Guaranteed Income Supplement (GIS) as well as the B.C. Senior’s Supplement. The Cost of Living in B.C. Changes in the cost of living can be estimated by considering the national Consumer Price Index (CPI). The CPI is an indicator of changes in consumer prices experienced by Canadians. The CPI is calculated by looking at the cost of a fixed basket of goods and services and comparing the changes in cost over time. The CPI is also used in determining the maximum allowable rent increase, and income supports such as the OAS, GIS and CPP. The most recent year to year comparison of the CPI is November 2014 to November 2015. During this one year period of time, the CPI rose 1.4%. Federal and Provincial Income Supports Income supports provide financial assistance to low or moderate income seniors. The main national supports include the Old Age Security (OAS) pension and the Guaranteed Income Supplement (GIS). OAS is a monthly payment available to most seniors who meet the Canadian legal status and residence requirements, regardless of whether the senior ever worked or is still working. GIS is a monthly benefit for seniors receiving OAS who are on a low income – $17,280 or less. OAS, GIS and the Canada Pension Plan (CPP) are indexed to the CPI, meaning they are adjusted on a regular basis if there is an increase in the cost of living as measured by the CPI. OAS is taxable while the GIS is non-taxable. All numbers provided in this section are based on a single senior living alone. In October to December 2015, low income single seniors received $1,392.08 a month in federal and provincial income supports, an increase of about 1.1% from October to December 2014. Oct-Dec 2013 Oct-Dec 2014 Oct-Dec 2015 Change from 2014 to 2015 OAS $550.99 $563.74 $569.95 ↑ 1.1% GIS $747.11 $764.40 $772.83 ↑ 1.1% B.C. Senior’s Supplement $49.30 $49.30 $49.30 0% $1,347.40 $1,377.44 $1,392.08 ↑1.1% Total Source: 24 and 25 The BC Senior’s Supplement is a monthly top-up to the federal OAS/GIS or federal Allowance payments. It remained the same in 2015 as it was in 1987: $49.30 per month. Over 2002-2004, the Senior’s Supplement was gradually reduced to zero. In 2005, the supplement was reinstated to the full $49.30, and the amount has not changed since. 38 MONITORING SENIORS’ SERVICES INCOME SUPPORT The total number of seniors receiving the Supplement fluctuates monthly based on the status and reported OAS/GIS income received from the federal government. In December 2015, 54,183 seniors received the Supplement. December 2013 December 2014 December 2015 Change since 2013 52,745 53,342 54,183 ↑ 2.7% Seniors Receiving B.C. Senior’s Supplement Source: 22 Most provinces and territories in Canada offer seniors a financial benefit similar to the BC Senior’s Supplement, although it may be offered monthly, quarterly, annually, or as an income tax refund. The table below shows the calculated amount of each benefit per month. Province Monthly Amount Alberta Seniors Benefit $280 maximum Manitoba 55 PLUS Program $53.93 maximum Ontario GAINS $2.50 – $83.00 New Brunswick Low-Income Seniors' Benefit Nova Scotia $33.33 $50 - $10,000 (refund of provincial income tax) Newfoundland and Labrador Seniors' Benefit $88.25 maximum Yukon Seniors Income Supplement $247.53 maximum NWT Senior Citizen Supplementary Benefit $160 Nunavut Senior Citizen Supplementary Benefit $175 BC Senior's Supplement $49.30 Source: 25 In 2015, the maximum CPP payment amount was $1,065.00. CPP Payment 2013 2014 2015 Change from 2014 to 2015 Maximum Payment $1,012.50 $1,038.33 $1,065.00 ↑ 2.6% Average Payment to All Beneficiaries $527.56 $535.96 Not Yet Available — Source: 24 In 2015, the average payment for new beneficiaries was $640.23. MONITORING SENIORS’ SERVICES 39 INCOME SUPPORT MSP Premium Assistance B.C. residents pay Medical Services Plan (MSP) premiums on a monthly basis. In 2015, the full premium amount was $72, with stepped subsidies known as Premium Assistance beginning for those on an annual income of $30,000 or less. Premium $ Increase from Previous Year % Increase from Previous Year 2013 $66.50 $2.50 4.0% 2014 $69.20 $2.70 4.1% 2015 $72.00 $2.80 4.1% 2016 $75.00 $3.00 4.2% Source: 26 Premium Assistance begins at a 29% subsidy and increases to a 100% subsidy for those on an income of $22,000 or less. Net Income Premium Premium Assistance $0 100% $22,001 to $24,000 $12.80 82% $24,001 to $26,000 $25.60 64% $26,001 to $28,000 $38.40 47% $28,001 to $30,000 $51.20 29% Over $30,000 $72.00 0% Up to $22,000 Source: 26 In 2014, 267,667 seniors received some level of premium assistance, an increase of 4.8% over 2012. Seniors Receiving Premium Assistance 2012 2013 2014 255,320 260,750 267,667 Source: 26 Seniors enrolled in MSP through the Ministry of Social Development and Social Innovation because they are in receipt of support such as disability, welfare or employment assistance do not pay MSP premiums. Likewise, seniors served by the First Nations Health Authority (FNHA) do not pay MSP premiums, rather the FNHA pays a yearly flat fee. In 2014, 21,376 seniors did not pay MSP premiums. Seniors Enrolled in MSP Through SDSI 2012 2013 2014 19,471 20,377 21,376 Source: 26 Supplementary Benefits Seniors receiving MSP premium assistance are eligible for a limited amount of coverage for a set of supplementary benefits. MSP will contribute $23 per visit for a combined annual limit of 10 visits per calendar year for the following services: physical therapy, non-surgical podiatry, chiropractic, massage therapy and accupuncture. MSP will also cover $46.17 toward one full eye exam per year. 40 MONITORING SENIORS’ SERVICES INCOME SUPPORT Drug Coverage B.C. provides universal drug coverage under its Fair PharmaCare program. This program ensures that B.C. residents, including seniors, do not pay more than 4% of their net income on eligible drug costs. Fair PharmaCare assistance levels are income-tested and set out deductibles, the maximum a family will pay in a year, and the portion that PharmaCare will pay. Fair PharmaCare is scaled to smaller steps in net income than MSP. Fair PharmaCare rates have not changed since 2003, when the portion PharmaCare pays was reduced from 75% to 70% as the program was expanded to cover families in addition to seniors. Seniors who were already receiving or about to receive Fair PharmaCare at the time – those born in 1939 or earlier – were grandfathered in, and continue to receive 5% more in assistance, known as Enhanced Assistance. A Fair PharmaCare review was initiated in 2010 but no changes in the assistance levels or structure were implemented at the time. Families pay 100% of the costs of their prescriptions until they reach their deductible. Deductibles generally range from 0% to 3% of a family’s net income. After the deductible is met, PharmaCare will help pay a percentage of prescription costs until the family maximum is met. After that point, PharmaCare will pay 100% of any eligible prescription costs for the rest of the year. Select Fair PharmaCare assistance levels for families with at least one spouse born in 1939 or earlier are shown below. Family deductibles begin at the $33,000 income level. Family Maximum Example Family Net Income $0 – $3,000 $22,000.01 – $26,000 $30,000 .01 – $33,000 $33,000.01 – 37,500 $42,500.01 – $47,500 $50,000.01 – $52,500 $67,500.01 – $72,500 $87,500.01 – $92,500 $97,500.01 – $106,2500 $118,750.01 – $131,250 Over $475,000 Family Deductible Portion PharmaCare pays after deductible is met PharmaCare covers 100% of the costs for the rest of the year after the maximum is met $0 $0 $0 $350 $450 $1,000 $1,400 $1,800 $2,000 $2,500 $10,000 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 100% $25 $300 $400 $700 $900 $1,500 $2,100 $2,700 $3,000 $3,750 — Source: 26 MONITORING SENIORS’ SERVICES 41 INCOME SUPPORT Select Fair PharmaCare assistance levels for all other families are shown below. Family Maximum Example Family Net Income Family Deductible Portion PharmaCare pays after deductible is met $0 $0 $0 $300 $400 $450 $600 $900 $1,300 $1,600 $3,000 70% 70% 70% 70% 70% 70% 70% 70% 70% 70% 70% $0 – $1,875 $6,250.01 – $8,750 $13,750.01 – $15,000 $15,000.01 – $16,250 $18,750.01 – $21,250 $21,250.01 – $23,750 $28,750.01 – $30,000 $30,000.01 – $31,667 $41,667.01 – $45,000 $51,667.01 – $55,000 $95,833.01 – $108,333 PharmaCare covers 100% of the costs for the rest of the year after the maximum is met $25 $150 $300 $450 $600 $675 $900 $1,200 $1,750 $2,150 $4,000 Source: 26 Dispensing Fees For every prescription dispensed, pharmacies charge a dispensing fee. PharmaCare will reimburse up to a maximum $10 dispensing fee. If the pharmacy charges more than $10, the customer will be responsible for paying the difference.* Dispensing Fee Amount Above PharmaCare Maximum Rexall $12.99 $2.99 Estevan Pharmacy (Independent) $12.75 $2.75 Pharmasave $12.00 $2.00 Shoppers Drug Mart $11.60 $1.60 Thrifty Foods $10.60 $0.60 Walmart $10.00 $0 Save-On-Food & Drugs $10.00 $0 London Drugs $9.60 -$0.40 Costco $4.49 -$5.51 Select Pharmacies** * A pharmacy cannot charge more than the maximum dispensing fee if the individual is receiving full (100%) PharmaCare coverage, and the drug/product is eligible for full PharmaCare reimbursement. ** Dispensing fees may vary between pharmacy chain locations. The numbers above are for select locations in the Victoria area. To look up the dispensing fee at a pharmacy near you, visit http://www.pharmacycompass.ca/ Source: 27 PharmaCare does not reimburse pharmacies for blister packing medications. Whether or not a pharmacy charges clients an additional fee for blister packing medications is discretionary. There may still be an additional cost to the client as blister packs tend to include smaller quantities (for example, a 14-day pack rather than a bottle with 30 pills) and so clients and/or PharmaCare may end up paying dispensing fees more frequently. 42 MONITORING SENIORS’ SERVICES Elder Abuse E lder abuse is any action by someone in a relationship of trust that results in harm or distress to an older person. Neglect is a lack of action by that person in a relationship of trust with the same result. Self-neglect can be another form of harm or distress resulting from a senior’s inability to provide for their own essential needs. Elder abuse can include physical, psychological or financial abuse. It is difficult to establish the number of seniors in B.C. who experience abuse, neglect, or selfneglect as there is no central registry of reported incidents, and many seniors and/or families turn to multiple organizations to seek support. In the interim, the Office of the Seniors Advocate has identified this as a gap and is currently working with government, service providers and seniors groups to establish standardized data collection and reporting. This section includes numbers of incidents of elder abuse reported by some of the agencies most involved in preventing abuse and supporting seniors who experience it. Public Guardian and Trustee The Public Guardian and Trustee (PGT) protects the interests of British Columbians who lack legal capacity to protect their own interests. The PGT supports individuals who require decision making assistance and protection in their legal, financial, personal and health care interests. The PGT may be appointed to manage a person’s financial and legal affairs generally as Committee of Estate (COE) or may act as a temporary substitute decision maker (TSDM) for health care decisions. In some cases the PGT may be appointed Committee of Person (COP) for personal and health care decisions. A TSDM differs from a COP in that a TSDM can only make decisions regarding health care, while a COP can make decisions in areas such as personal care, health care, access, and placement. Before either COE or COP are explored, all other decision making options such as Power of Attorney, Representation Agreements, and Pension Trusteeship are considered. In 2014/15, the PGT supported 2,754 COEs and 41 COPs for B.C. seniors, a decrease of 9% and 2% from 2013/14 respectively. 2012/13 2013/14 2014/15 COE 3,095 3,023 2,754 COP 46 42 41 *These data do not include PGT clients under the age of 65, nor less restrictive authorities that the PGT has been exploring in recent years such as Pension Trusteeship. Source: 28 MONITORING SENIORS’ SERVICES 43 ELDER ABUSE The PGT also responds to allegations and investigates cases of financial abuse, neglect, and selfneglect. Referrals that are screened out indicate referrals that did not proceed to investigation for a variety of reasons, but not necessarily because financial abuse was not occurring. For example, a referral would not proceed to investigation if a family member willing and able to support the vulnerable adult was identified. Referrals proceed to investigation and are not screened out when they meet legislative criteria. In 2014/15, the PGT received 1,486 referrals. Seventy individuals had more than one referral. Type of Referral # % Referrals Not Proceeding to Investigation 508 34% Referrals Proceeding to Investigation 978 66% 1,486 100% Total Referrals Source: 28 Of the referrals made to the PGT, 79% of those that proceeded to investigation involved individuals aged 65 and over. Referrals Not Proceeding to Investigation Referrals Proceeding to Investigation Open Investigations as of September 2015 11 227 Average Age of Client 69 75 Under 65 36% 20% Unknown Age 6% 1% Total 65+ 58% 79% 65-75 17% 21% 75-85 20% 31% 85+ 21% 27% Female 56% 54% Male 43% 46% Unknown Gender 1% — Total Referrals 508 978 Type of Referral Source: 28 44 MONITORING SENIORS’ SERVICES ELDER ABUSE Seniors Abuse and Information Line The Seniors Abuse and Information Line (SAIL) is operated by the BC Centre for Elder Advocacy and Support (BCCEAS), a non-profit organization dedicated to protecting the legal rights of older adults, raising public awareness of elder abuse, increasing seniors’ access to justice, and providing supportive programs to seniors who have been abused. The SAIL line is a safe place for older adults, and those who care about them, to talk to someone about situations where they feel they are being abused or mistreated, or to receive information about elder abuse prevention. In 2014, the total number of calls received related to abuse was 1,286. Degree of Harm Reported % No Harm 22.4% (288) Minor Harm 16.1% (207) Moderate Harm 29.6% (385) Severe Harm 18.3% (235) Cannot Determine 13.3% (171) Total Calls 1,286 Source: 29 In 2014, 15.9% of calls involved abuse that had been occurring for longer than five years. Duration of Harm % Very Recent (under 3 months) 28.7% (369) 4-6 months 11.6% (149) 6-12 months 18.7% (241) 1-2 years 15.3% (197) 2-5 years 9.7% (125) 5+ years 15.9% (205) Total 1,286 Source: 29 MONITORING SENIORS’ SERVICES 45 More than one type of harm or abuse may be occurring at the same time, and the percentages below indicate the proportion of time the harm or abuse type is noted, not the number of calls received. Type of Harm / Abuse % Emotional Abuse 17.3% Psychological Abuse 7.8% Financial Abuse 25.6% Medication Related Abuse 1.1% Neglect 35.9% Physical Abuse 2.3% Self Neglect 2.0% Sexual Abuse 0.7% Violation of Rights 4.8% All other categories 2.5% Source: 29 211 Helpline 211 is a non-profit help line operated by bc211 that connects callers with information and referrals regarding community, government and social services in B.C. The service is based in Vancouver and serves about 60% of the province. In 2013 and 2014, individuals aged 55 and over accounted for 5% of all calls to bc211 (including to their other help lines). In 2013 and 2014, bc211 received a total of 550 calls about abuse from individuals aged 55 and over. Of these calls, 383, or 70%, were related to abuse that they were experiencing, while the remaining 30% of calls were about abuse of their family and friends. Callers can report more than one type of abuse. In 2013 and 2014, the 550 calls received involved 787 reported incidents of abuse. Type of Abuse Incidents Reported % of Calls Elder 252 46% Domestic Violence 150 27% Emotional 114 21% Financial 109 20% Physical 62 11% Child 26 5% Sexual 23 4% Historical 15 3% Animal 3 1% Unspecified 33 6% Source: 30 46 MONITORING SENIORS’ SERVICES Summary T his report has been compiled from a variety of sources. The data is either for the period of 2014/15 covering the period April 1, 2014 to March 30, 2015 or for the calendar year of either 2014 or 2015. All data sources are footnoted either in the report or in the appendix on data sources. Where comparative year over year data were available, they have been used in this report and where unavailable this report will provide the baseline for future years. Many individuals at all levels of government and with many different service providers participated in the creation of this report and the Office of the Seniors Advocate (OSA) thanks them for their contributions. The OSA will be using the data in this report to help inform their work in the year ahead. Issues with home support, residential care, transportation, resident on resident aggression and low income will be the subjects of specific reports. Through this monitoring process we will build a solid foundation upon which we can continually measure, through objective data sources, the achievements of local, provincial and federal governments along with service providers in delivering high quality services and support to BC seniors and their families. MONITORING SENIORS’ SERVICES 47 Appendix A Regulation Categories for Residential Care Facilities under the CCALA Licensing – Major Requirements • Continuing duty to inform • Notice of change of operation • Liability insurance • Investigation or inspection Licensing – Facility Requirements • General Physical Requirements • Directional assistance • Accessibility • Windows • Temperature and lighting • Water temperature • Telephones • Monitoring, signalling and communication • Emergency equipment • Equipment and furnishings • Maintenance • Rooms and common areas • Smoking • Weapons Licensing – Bedrooms • Bedroom occupancy • Physical requirements of bedrooms • Bedroom floor space • Bedroom windows • Bedroom furnishings Licensing – Bathroom Facilities • Physical requirements of bathrooms • Bathrooms in facilities other than long term care facilities • Bathrooms in long term care facilities Licensing – Common Areas and Work Areas • Dining areas • Lounges and recreation facilities • Designated work areas • Outside activity areas 48 MONITORING SENIORS’ SERVICES APPENDIX Licensing – Staffing Requirements Division 1 – General Staffing Requirements • Character and skill requirements • Additional criminal record checks • Continuing health of employees • Continuing monitoring of employees Division 2 – Coverage and Necessary Staff • Management and supervisory staff • Staffing coverage • Food services employees • Employee responsible for activities Part 5 – Operations Division 1 – Admission and Continuing Accommodation • Prohibited service • Admission screening • Advice on admission • Other requirements on admission • Continuing accommodation Division 2 – General Care Requirements • Emergency preparations • Harmful actions not permitted • Privacy • General health and hygiene • Program of activities • Identification of persons in care off-site • Access to persons in care • Release or removal of persons in care • Family and resident council • Dispute resolution • Self-monitoring of community care facility Division 3 – Nutrition • Menu planning • Food preparation and service • Food service schedule • Participation by persons in care • Individual nutrition needs • Eating aids and supplements MONITORING SENIORS’ SERVICES 49 APPENDIX Division 4 – Medication • Medication safety and advisory committee • Packaging and storage of medication • Administration of medication • Return of medication to pharmacy Division 5 – Use of Restraints • Restrictions on use of restraints • Reassessment Division 6 – Matters That Must Be Reported • Notification of illness or injury • Reportable incidents Part 6 – Records Division 1 – Records for Each Person in Care • Records for each person in care • Records respecting money and valuables of persons in care • Short term care plan on admission • Care plan needed if more than 30 day stay • Implementation of care plans • Nutrition plan Division 2 – Additional Records • Policies and procedures • Repayment agreements • Records respecting employees • Food services record • Record of minor and reportable incidents • Record of complaints and compliance • Financial records and audits Division 3 – General Requirements Respecting Records • Currency and availability of records • How long records must be kept • Confidentiality Part 7 – Transitional • Transitioned facilities • Unacceptable threat to health or safety • Transition – Criminal record check 50 MONITORING SENIORS’ SERVICES APPENDIX Appendix B Classification of communities served by BC Transit HandyDART Data Reported Geography Type Campbell River Yes Semi Urban Central Fraser Valley Yes Urban Chilliwack Yes Urban Clearwater No Not Assigned Comox Valley Yes Semi Urban Cowichan Valley Yes Semi Urban Cranbrook Yes Semi Urban Creston Valley No Not Assigned Fort St. John Yes Semi Urban Kamloops Yes Urban Kelowna Yes Urban Kitimat Yes Rural Port Hardy No Not Assigned Port McNeill No Not Assigned Nanaimo Yes Urban Penticton & Okanagan-Similkameen Yes Semi Urban Port Alberni Yes Semi urban Powell River No Not Assigned Prince George Yes Urban Prince Rupert Yes Semi Urban Quesnel No Not Assigned Shuswap No Not Assigned South Okanagan No Not Assigned Squamish Yes Semi Urban Sunshine Coast Yes Rural Terrace Yes Semi Urban Vernon Yes Semi Urban Victoria Yes Urban West Kootenay No Not Assigned Williams Lake Yes Semi Urban MONITORING SENIORS’ SERVICES 51 Appendix C Days per week Usual weekday hours Different weekend hours Cut off for booking ride (business days) Single ride rate (1 zone) Pre-paid ride rate TaxiSaver program The table below summarizes HandyDART service by community. Campbell River 6 7am – 5pm ✓ 2 $2.50 $2.50 ✓ Central Fraser Valley 6 7:45am – 4:45pm ✓ 2 $2.25 X ✓ Chilliwack 6 7:45am – 4:45pm ✓ 2 $2.25 X ✓ Clearwater 5 8am – 4:30pm X 1 $2.50 $2.25 X Comox Valley 5 8am – 4:30pm X 2 $2.00 $1.80 ✓ Cowichan Valley 6 7am – 6pm ✓ 2-3 $2.00 $1.80 X Cranbrook 5 7am – 5pm X 3-4 $3.00 X ✓ Creston Valley 5 7:15am – 3:15pm X 1 $1.50 X X Fort St. John 6 7:45am – 5pm ✓ 2-3 $2.00 X X Kamloops 7 7am – 11pm ✓ 2 $2.00 X ✓ Kelowna 6 9:15am – 8pm ✓ 1 $2.25 $2.25 ✓ Kitimat 6 7am – 7:30pm ✓ 1 $2.75/3.75 X X Metro Vancouver (TransLink) 7 6:30am – 12:30am ✓ 1 2.75 $2.10 ✓ Port Hardy 5 Varies X 2 $1.25 $1.05 X* Port McNeill 5 Varies X 2 $1.25 $1.05 X* Nanaimo 7 7:30am – 5pm ✓ 2 X $3.50 ✓ Penticton & OkanaganSimilkameen 5 7am – 5pm X 1-2 $2.00 X ✓ Port Alberni 6 8am – 4pm ✓ 5 $2.00 X X Powell River 6 8am – 5pm ✓ $2.00 X X Prince George 7 7am – 6pm ✓ 2 $2.25 X ✓ Prince Rupert 5 8:45am – 4pm X 1 $1.50 X ✓ Quesnel 5 8am – 4pm X 3 $3.00 X X Shuswap 5 8am – 4pm X 2 $1.75 $1.75 X South Okanagan 4 7am – 5:30pm X 1 Varies X X Squamish 5 7am – 4pm X 1 $1.75 X X Sunshine Coast 6 8am – 4:15pm ✓ 1 $2.25 $2.00 X 52 MONITORING SENIORS’ SERVICES Days per week Usual weekday hours Different weekend hours Cut off for booking ride (business days) Single ride rate (1 zone) Pre-paid ride rate TaxiSaver program Terrace 6 8:45am – 4:10pm ✓ 1 $2.00 $1.80 X Vernon 6 8am – 4:30pm ✓ 3 $1.75 X X Victoria 7 7am – 12am ✓ 10 $2.50 $2.25 ✓ West Kootenay 5 Varies X 4-5 Varies X X Williams Lake 6 8am – 5pm ✓ 3 $1.75 X ✓ *Volunteer Transportation Network, funded and by donation. Fixed HandyDART stops, with pockets of time for directed stops. MONITORING SENIORS’ SERVICES 53 APPENDIX Appendix D Days per week Usual weekday hours Seniors’ single ride rate (1 zone) Seniors’ booklet rate Seniors’ monthly bus pass rate (1 zone) Seniors’ day pass The following table provides a summary of public transportation services by community. Where possible, the range of weekday hours has been estimated; some routes may run outside of these hours. 100 Mile House 5 7:30am – 5:30pm $1.25 $11.25 $28.00 X 103 Mile House / 108 Mile Ranch 5 7:30am – 5:30pm $1.75 $15.75 $28.00 X Lac La Hache 1 Thu By Request $2.50 X X X Agassiz 6 6:30am – 10:30pm $1.50 $13.50 $35.00 X Harrison Hot Springs 6 6:30am – 9:45pm $1.50 $13.50 $35.00 X Ashcroft 5 8am – 6pm $2.00 X X X Cache Creek 2 9:20am $2.00 X X X Clinton 3 9am $2.00 X X X Savona 2 10:50am $2.00 X X X 6 7:30am – 6:30pm $2.50 $22.50 $60.00 X Burnt Bridge By request $2.50 X X X Firvale By request $2.50 X X X Public Transit Systems & Communities Served 100 MILE HOUSE AGASSIZ-HARRISON ASCHCROFT-CLINTON BELLA COOLA VALLEY Bella Coola Glacier View 6 7:30am – 6:30pm $2.50 $22.50 $60.00 X Hagensborg 6 7:30am – 6:30pm $2.50 $22.50 $60.00 X Boundary 5 8:30am – 3:30pm $1.50 X X X Eholt X X X X X X Grand Forks 1 1 weekly trip $1.50 X X X Greenwood 1 1 weekly trip $1.50 X X X Campbell River 7 6:30am – 10pm $1.75 $15.75 $42.00 $4.00 Oyster River 7 6:30am – 10pm $1.75 $15.75 $42.00 $4.00 BOUNDARY CAMPBELL RIVER 54 MONITORING SENIORS’ SERVICES Days per week Usual weekday hours Seniors’ single ride rate (1 zone) Seniors’ booklet rate Seniors’ monthly bus pass rate (1 zone) Seniors’ day pass Abbotsford 7 5:30am – 10pm $1.75 $15.75 $38.00 $4.00 Aldergrove 7 6am – 7pm $1.75 $15.75 $38.00 $4.00 Hatzic 6 7:30am – 5:45pm $1.75 $15.75 $38.00 $4.00 Mission 7 6am – 7pm $1.75 $15.75 $38.00 $4.00 7 7:40am – 9:20pm $1.75 $15.75 $38.00 $4.00 Summer only $1.75 Public Transit Systems & Communities Served CENTRAL FRASER VALLEY CHILLIWACK Chilliwack Cultus Lake Greendale 1 Saturday 9:30am $1.75 $15.75 $38.00 $4.00 Promontory 7 7am – 11:20pm $1.75 $15.75 $38.00 $4.00 Yarrow 1 Saturday 9:20am $1.75 Barriere 3 9:45am $5.00 X X X Birch Island 5 12:38pm $2.50 $22.50 X X By request $1.50 $13.50 X X CLEARWATER Blackpool Clearwater 5 12pm $2.00 $18.00 X X Vavenby 5 12:52pm $2.50 $22.50 X X By request $2.00 $15.00 $42.00 X COLUMBIA VALLEY Akisqunuk Village Canal Flats 5 7:30am – 5:30pm $2.00 $15.00 $42.00 X Edgewater 5 9:30am – 3:30pm $2.00 $15.00 $42.00 X Fairmont Hot Springs 5 8am – 5pm $2.00 $15.00 $42.00 X Invermere 5 8:30am – 4:30pm $2.00 $15.00 $42.00 X Radium Hot Springs 5 9am – 3pm $2.00 $15.00 $42.00 X Windermere By request COMOX VALLEY Black Creek 6 6:30am – 6:30pm $1.75 $15.75 $42.00 $4.00 Buckley Bay 7 8:24am – 10:05pm $1.75 $15.75 $42.00 $4.00 Comox 7 6:20am – 10pm $1.75 $15.75 $42.00 $4.00 Courtenay 7 6:52am – 7:55pm $1.75 $15.75 $42.00 $4.00 Cumberland 7 6:30am – 10:30pm $1.75 $15.75 $42.00 $4.00 Merville 6 6:35am – 6:37pm $1.75 $15.75 $42.00 $4.00 Fanny Bay 7 8:20am – 9:45pm $1.75 $15.75 $42.00 $4.00 Oyster River 6 6:41am – 6:15pm $1.75 $15.75 $42.00 $4.00 Royston 7 8am – 10:20pm $1.75 $15.75 $42.00 $4.00 Union Bay 7 8:30am – 10:10pm $1.75 $15.75 $42.00 $4.00 MONITORING SENIORS’ SERVICES 55 Days per week Usual weekday hours Seniors’ single ride rate (1 zone) Seniors’ booklet rate Seniors’ monthly bus pass rate (1 zone) Seniors’ day pass APPENDIX Chemainus 7 10am – 11:15pm $2.00 $15.00 $36.00 $4.00 Cobble Hill 7 7am – 11:30pm $2.00 $15.00 $36.00 $4.00 Cowichan Bay 7 8:05am – 8:10pm $2.00 $15.00 $36.00 $4.00 Crofton 7 9:50am – 11:20pm $2.00 $15.00 $36.00 $4.00 Duncan 7 7:50am – 8pm $2.00 $15.00 $36.00 $4.00 Honeymoon Bay 7 6am – 9:30pm $2.00 $15.00 $36.00 $4.00 Ladysmith 7 6:50am – 6:10pm $2.00 $15.00 $36.00 $4.00 Lake Cowichan 7 6:40am – 10:15pm $2.00 $15.00 $36.00 $4.00 Maple Bay 7 7:45am – 8:20pm $2.00 $15.00 $36.00 $4.00 Mill Bay 7 7:30am – 10:55pm $2.00 $15.00 $36.00 $4.00 Shawnigan 7 7:15am – 11:10pm $2.00 $15.00 $36.00 $4.00 Youbou 7 6:10am – 9:30pm $2.00 $15.00 $36.00 $4.00 7 7:15am – 8:40pm $2.00 $17.00 $35.00 $3.25 Creston 5 8:50am – 3pm $1.00 X X X Erickson 5 10am – 2pm $1.00 X X X Grouse Mountain 2 9:10am – 3:55pm $1.00 X X X Kitchener 2 8:50am – 4:10pm $1.00 X X X West Creston 2 8:50am – 3pm $1.00 X X X Wynndel 4 9am – 3pm $1.00 X X X 6 8:50am – 6:45pm $1.50 $13.50 $40.00 X Elkford 2 8am – 5pm $2.50 X X X Fernie 2 9am – 4pm $2.50 X X X Sparwood 2 8:30am – 4:30pm $2.50 X X X Fort St. John 6 6:40am – 10:30pm $1.75 $15.75 $35.00 X Taylor / Charlie Lake 5 8:15am return 3pm $4.00 X X X 3 11:50am – 4:50pm $1.50 $12.00 $15.00 X By request $1.50 $12.00 $15.00 X Public Transit Systems & Communities Served COWICHAN VALLEY CRANBROOK Cranbrook CRESTON VALLEY DAWSON CREEK ELK VALLEY FORT ST.JOHN HAZELTONS Gitsegukla Glen Vowell Hagwilget 3 9:50am – 3:50pm $1.50 $12.00 $15.00 X Hazelton 3 10am – 4pm $1.50 $12.00 $15.00 X Kispiox 3 10:25am – 4:25pm $1.50 $12.00 $15.00 X 56 MONITORING SENIORS’ SERVICES Days per week Usual weekday hours Seniors’ single ride rate (1 zone) Seniors’ booklet rate Seniors’ monthly bus pass rate (1 zone) Seniors’ day pass APPENDIX Moricetown 4 10:40am – 5:40pm $1.50 $12.00 $15.00 X New Hazelton 3 12:13pm – 6:10pm $1.50 $12.00 $15.00 X South Hazelton 3 12:10pm – 6:05pm $1.50 $12.00 $15.00 X By Request $1.50 $12.00 $15.00 X Public Transit Systems & Communities Served Two Mile KAMLOOPS Aberdeen 7 6:13am – 10:57pm $2.00 $15.50 $34.00 $5.00 Barnhartvale 7 6:40am – 6:10pm $2.00 $15.50 $34.00 $5.00 Batchelor Heights 7 6:45am – 6:32pm $2.00 $15.50 $34.00 $5.00 Brocklehurst 7 6:12am – 9:54pm $2.00 $15.50 $34.00 $5.00 Chase 1 Fri 8:30am – 2:45pm $5.00 X X X Dallas 7 7:45am – 10:15pm $2.00 $15.50 $34.00 $5.00 Juniper Ridge 7 6:45am – 8:24pm $2.00 $15.50 $34.00 $5.00 Kamloops 7 7am – 11:30pm $2.00 $15.50 $34.00 $5.00 Lillooet 1 Tue 8am – 4pm $5.00 X X X Lytton 1 Thu 9am – 4pm $5.00 X X X North Shore / Southgate 5 7:20am – 7pm $2.00 $15.50 $34.00 $5.00 Westsyde / Oak Hills 7 6:20am – 11:30pm $2.00 $15.50 $34.00 $5.00 Rayleigh 7 7:25am – 7:15pm $2.00 $15.50 $34.00 $5.00 Sahali 7 6:34am – 11:18pm $2.00 $15.50 $34.00 $5.00 Savona 1 Thu 10:45am – 4pm $2.00 $15.50 $34.00 $5.00 Valleyview / Rosehill 7 9:10am – 10:30pm $2.00 $15.50 $34.00 $5.00 Black Mountain 7 6:52am – 7:45pm $2.50 $20.25 $45.00 $6.50 Crawford / Lower Mission 7 6am – 9:45pm $2.50 $20.25 $45.00 $6.50 Lake Country 7 6am – 1am $2.50 $20.25 $45.00 $6.50 Lakeview Heights 7 6:30am – 9pm $2.50 $20.25 $45.00 $6.50 Gallaher’s Canyon 7 7am – 8:20pm $2.50 $20.25 $45.00 $6.50 Kelowna 7 6am – 12:30am $2.50 $20.25 $45.00 $6.50 Oyama 5 9:30am – 8:30pm $2.50 $20.25 $45.00 $6.50 Peachland 7 6:50am – 9:45pm $2.50 $20.25 $45.00 $6.50 Quail Ridge 5 7:05am – 6:05pm $2.50 $20.25 $45.00 $6.50 Upper Mission 7 6am – 10:45pm $2.50 $20.25 $45.00 $6.50 West Kelowna 7 6:55am – 9:30pm $2.50 $20.25 $45.00 $6.50 Westbank 7 5:55am – 10:00pm $2.50 $20.25 $45.00 $6.50 Winfield 7 6am – 1:30am $2.50 $20.25 $45.00 $6.50 KELOWNA MONITORING SENIORS’ SERVICES 57 Days per week Usual weekday hours Seniors’ single ride rate (1 zone) Seniors’ booklet rate Seniors’ monthly bus pass rate (1 zone) Seniors’ day pass APPENDIX 4 8:30am – 3:45pm $3.00 X X X Marysville By Request $3.00 X X X Wycliffe By Request $3.00 X X X 7 7am – 9:25pm $1.75 $15.75 $33.00 X Logan Lake 1 8am – 3pm $5.00 X X X Lower Nicola 6 7:15am – 5:15pm $1.25 $11.25 $34.00 X Merritt 6 6:30am – 8:30pm $1.25 $11.25 $34.00 X 7 Some routes 24 hrs $1.75 $1.75 $52.00 $7.50 Coal Harbour 5 9am – 4:30pm $2.50 $21.00 $36.50 X Fort Rupert / Storey’s Beach 5 6:45am – 5:07pm $2.50 $21.00 $36.50 X Hyde Creek / Woss 1 7:35am – 5:30pm $3.75 31.50 $36.50 X Port Hardy 6 7:30am – 6:05pm $2.50 $21.00 $36.50 X Port McNeill 6 7:15am – 6:10pm $2.50 $21.00 $36.50 X Bowser 1 10:25am – 3:40pm $2.25 X X X Deep Bay 1 10:10am – 3:05pm $2.25 X X X Lantzville 7 6:55am – 6:50pm $2.25 $20.25 $41.00 $5.50 Nanaimo 7 6:30am – 11pm $2.25 $20.25 $41.00 $5.50 Nanoose / Qualicum Beach 7 6:20am – 9pm $2.25 $20.25 $41.00 $5.50 Parksville 6 6:20am – 9:30pm $2.25 $20.25 $41.00 $5.50 Mt. Currie 7 6am – 7:30pm $2.50 $22.00 $65.00 X Pemberton Valley 7 5:55am – 6:45pm $2.50 $22.00 $65.00 X Xit’Olacw 7 6:25am – 7:20pm $2.50 $22.00 $65.00 X Naramata 6 7:20am – 4:40pm $1.75 $12.50 $32.00 $3.50 Okanagan Falls 5 7am – 5:40pm $1.75 $12.50 $32.00 $3.50 Penticton 6 7am – 10pm $1.75 $12.50 $32.00 $3.50 PORT ALBERNI 6 6:25am – 6:20pm $2.00 $13.50 $25.00 $4.25 PORT EDWARD 6 7am – 10pm $1.50 $13.50 $40.00 $3.75 Public Transit Systems & Communities Served KIMBERLEY Kimberley KITIMAT MERRITT METRO VANCOUVER (TransLink) MOUNT WADDINGTON NANAIMO PEMBERTON VALLEY PENTICTON AND OKANAGANSIMILKAMEEN 58 MONITORING SENIORS’ SERVICES Usual weekday hours Seniors’ single ride rate (1 zone) Seniors’ booklet rate Seniors’ monthly bus pass rate (1 zone) Seniors’ day pass Public Transit Systems & Communities Served Days per week APPENDIX 2 11am – 4pm $2.50 $20.25 X X By Request $2.50 X X X POWELL RIVER Lund Saltery Bay Texada / Shelter Point / Vanada 1 8am – 2:50pm $6.00 X X X Sliammon/Powell River 7 7:50am – 10:30pm $2.00 $15.25 $34.00 $4.00 PRINCE GEORGE 7 6:45am – 11pm $2.00 $18.00 $48.00 $5.25 PRINCE RUPERT 6 7am – 9:30pm $1.50 $13.50 $40.00 $3.75 Princeton-Penticton 3 8am – 1:30pm $4.00 X X X Hedley-Penticton 3 8:30am – 1:30pm $3.50 X X X Keremeos-Penticton 3 9am – 1:30pm $3.00 X X X Nazjo 1 7am – 7pm N/C X X X Quesnel 6 7am – 6:30pm $1.50 $13.50 $25.00 $3.00 Wells 1 8:15am – 6:30pm $5.00 X X X 6 7:46am – 5:52pm $1.75 $15.75 $37.50 X Fernwood Dock 7 10:45am – 4:30pm $2.25 $20.25 $40.00 $5.00 Fulford 7 6am – 9:30pm $2.25 $20.25 $40.00 $5.00 Ganges Village 7 10:15am – 4:40pm $2.25 $20.25 $40.00 $5.00 Long Harbour 7 1:30pm – 3:00pm $2.25 $20.25 $40.00 $5.00 Vesuvius 7 12:35pm – 5:25pm $2.25 $20.25 $40.00 $5.00 Blind Bay 5 10:50am – 4:40pm $2.25 X X X Canoe 6 7:40am – 5:40pm $1.25 $11.25 $36.0 $$3.00 Deep Creek 1 9am – 2pm $3.25 X X X Eagle Bay 5 8:55am – 3pm $1.25 $11.25 $36.0 $3.00 Salmon Arm 6 7am – 6pm $1.25 $11.25 $36.0 $3.00 Shuswap 6 7am – 6pm $1.25 $11.25 $36.0 $3.00 Sorrento 5 10:30am – 4:50pm $2.25 X X X Gitaus 5 6:40am – 5:25pm $3.75 $34.00 $50.00 X Kitamaat Village 5 10am – 7pm $1.75 $15.75 $33.00 X Kitsumkalum 6 8:30am – 4:50pm $1.75 $15.75 $33.00 X New Remo 5 8:20am – 5pm $1.75 $15.75 $33.00 X Skeena 5 8am – 3:30pm $1.75 $15.75 $33.00 X PRINCETON QUESNEL REVELSTOKE SALT SPRING ISLAND SHUSWAP SKEENA MONITORING SENIORS’ SERVICES 59 Days per week Usual weekday hours Seniors’ single ride rate (1 zone) Seniors’ booklet rate Seniors’ monthly bus pass rate (1 zone) Seniors’ day pass APPENDIX 6 8:15am – 5pm $2.00 $17.00 $45.00 X Oliver 3 8am – 5pm $2.75 X X X Osoyoos 4 7am – 5:30pm $1.75 X X X Brackendale 7 7:25am – 11pm $1.50 $12.00 $20.00 $2.75 Garibaldi Highlands 7 7:30am – 10:45pm $1.50 $12.00 $20.00 $2.75 Tantalus 5 6:50am – 5:30pm $1.50 $12.00 $20.00 $2.75 Valleycliffe 7 6:45am – 10pm $1.50 $12.00 $20.00 $2.75 5 7:15am – 5:10pm $2.00 $18.00 $50.00 $5.00 Gibsons 7 6:15am – 10pm $1.75 $15.00 $38.00 $4.00 Gower Point 7 6:20am – 9:55pm $1.75 $15.00 $38.00 $4.00 Halfmoon Bay 7 6:40am – 11:20pm $1.75 $15.00 $38.00 $4.00 Roberts Creek 7 6:45am – 9:30pm $1.75 $15.00 $38.00 $4.00 Sechelt 7 7am – 9pm $1.75 $15.00 $38.00 $4.00 TERRACE 6 7am – 11pm $1.75 $15.75 $33.00 X Armstrong 6 8:15am – 5pm $1.75 $14.00 $35.00 $4.50 Coldstream 7 6:40am – 7pm $1.75 $14.00 $35.00 $4.50 Enderby 6 8:40am – 4:30pm $1.75 $14.00 $35.00 $4.50 Lumby 5 6:30am – 6:20pm $1.75 $14.00 $35.00 $4.50 Vernon 7 6:25am – 7:20pm $1.75 $14.00 $35.00 $4.50 Brentwood Bay 7 6:50am – 7pm $2.50 $15.00 $45.00 $5.00 Colwood 7 6:10am – 8:40pm $2.50 $15.00 $45.00 $5.00 Esquimalt 7 5:50am – 11:50pm $2.50 $15.00 $45.00 $5.00 Langford 7 5:45am – 12:45am $2.50 $15.00 $45.00 $5.00 Metchosin 7 6am – 10pm $2.50 $15.00 $45.00 $5.00 Oak Bay 7 6am – 11:30pm $2.50 $15.00 $45.00 $5.00 Royal Oak 7 6:15am – 11:30pm $2.50 $15.00 $45.00 $5.00 Saanich 7 5:50am – 12:15am $2.50 $15.00 $45.00 $5.00 Saanichton 7 6am – 12:30am $2.50 $15.00 $45.00 $5.00 Sidney 7 5:45am – 11pm $2.50 $15.00 $45.00 $5.00 Sooke 7 5:40am – 12:30am $2.50 $15.00 $45.00 $5.00 Public Transit Systems & Communities Served SMITHERS / Telkwa SOUTH OKANAGAN SQUAMISH SUMMERLAND / Trout Creek SUNSHINE COAST VERNON VICTORIA 60 MONITORING SENIORS’ SERVICES Days per week Usual weekday hours Seniors’ single ride rate (1 zone) Seniors’ booklet rate Seniors’ monthly bus pass rate (1 zone) Seniors’ day pass APPENDIX Victoria 7 6am – 12:15am $2.50 $15.00 $45.00 $5.00 View Royal 7 6:35am – 12:15am $2.50 $15.00 $45.00 $5.00 Ainsworth Hot Springs 4 8:50am – 6:15pm $2.00 $15.75 $35.00 X Argenta 5 7:30am – 8:45pm $2.00 $15.75 $35.00 X Balfour Ferry 4 9:05am – 6pm $2.00 $15.75 $35.00 X Blewett 5 8:15am – 4pm $2.00 $15.75 $35.00 X Castlegar 6 7am – 6:40pm $2.00 $15.75 $35.00 X Edgewood 1 9:25am – 1:50pm $2.00 $15.75 $35.00 X Fruitvale 6 6:08am – 9:01pm $2.00 $15.75 $35.00 X Kaslo 4 8:30am – 6:35pm $2.00 $15.75 $35.00 X Nakusp 2 8:50am – 6:20pm $2.00 $15.75 $35.00 X Nakusp Hot Spring 1 1:15pm – 3:15pm $2.00 $15.75 $35.00 X New Denver 2 8:45am – 5:40pm $2.00 $15.75 $35.00 X Passmore 2 9:45am – 4:40pm $2.00 $15.75 $35.00 X Rossland 6 6:20am – 9:45pm $2.00 $15.75 $35.00 X Salmo 2 8:20am – 12:45pm $2.00 $15.75 $35.00 X Silverton 2 8:50am – 5:35pm $2.00 $15.75 $35.00 X Slocan 2 9:15am – 5:10pm $2.00 $15.75 $35.00 X Summit Lake 2 8:15am – 6:10pm $2.00 $15.75 $35.00 X Trail 6 8:30am – 5pm $2.00 $15.75 $35.00 X Winlaw 2 9:35am – 4:50pm $2.00 $15.75 $35.00 X WHISTLER 7 6am – 12:20am $2.50 $18.00 $52.00 $7.00 WILLIAMS LAKE 6 7:15am – 6:45pm $1.75 $13.5 $36.00 X Public Transit Systems & Communities Served WEST KOOTENAY MONITORING SENIORS’ SERVICES 61 Data Sources 1 Statistics Canada. Table 105-0501 - Health indicator profile, annual estimates, by age group and sex, Canada, provinces, territories, health regions (2013 boundaries) and peer groups, occasional 2 Ministry of Health: Health System Matrix 6.1 3 Direct request to the Alzheimer Society of BC 4 Ministry of Health: Home and Community Care Annual Report of Volumes and Rates (pre-release) 5 Ministry of Health: Home and Community Care Minimum Reporting Requirements 6 Direct request to the Patient Safety Learning System 7 Ministry of Health: Rpt 03 – Facilities Report – Detailed 8 Direct request to the Assisted Living Registrar 9 Canada Mortgage and Housing Corporation 10 Direct request to health authorities 11 Direct request to residential care facilities, facilities’ websites 12 Ministry of Health: Report 2015_0539 Residential Care Admissions 13 December 2015 review of health authority licensing inspection websites 14 Office of the Seniors Advocate estimate based on information provided by the Patient Safety Learning System 15 Canadian Institute for Health Information - Continuing Care Reporting System eReports 16 2015 estimates based on Canada Mortgage and Housing Corporation: Occupied Housing Stock by Structure Type and Tenure, British Columbia, 1991–2011 (dwelling units) 17 Direct request to BC Housing 18 Ministry of Community, Sport and Cultural Development: Schedule 704 – Taxes and Charges on a Representative House 19 BC Hydro website 20 Direct request to Ministry of Finance 21 Direct request to TransLink and BC Transit 22 Direct request to the Ministry of Social Development & Social Innovation 23 ICBC Quick Statistics, further data provided by RoadSafetyBC 24 Government of Canada website 62 MONITORING SENIORS’ SERVICES SOURCES 25 Province and Territory websites 26 Direct request to the Ministry of Health, Ministry of Health website 27 Direct request to pharmacies 28 Direct request to the Public Guardian and Trustee 29 Direct request to the BC Centre for Elder Advocacy and Support 30 Direct request to bc211 MONITORING SENIORS’ SERVICES 63 Email: info@seniorsadvocatebc.ca By phone: Toll-free 1-877-952-3181 In Victoria: 250-952-3181 Open Monday to Friday, 8:30-4:30 Translation services available in more than 180 languages. By fax: 250-952-2970 By Mail: Office of the Seniors Advocate 1st Floor, 1515 Blanshard Street PO Box 9651 STN PROV GOVT Victoria BC V8W 9P4 Twitter: @SrsAdvocateBC