Private firms cut out after helping NDP reach goal for long-term beds
New program moves to exclude private firms in favour of public and non-profits
EDMONTON Nearly three-quarters of the 2,000 seniors beds the Notley NDP government promised to open by next spring are being built and operated by for-profit corporations, even as the province moves to exclude private firms from its next bed-building program.
An outline of that new initiative was quietly released online Friday, showing the province will look to non-profits, Indigenous communities and public agencies to add new units in the future, particularly in areas with high needs.
But for its original 2,000-bed commitment, the government has largely worked with nursing-home corporations by providing them a portion of the construction costs — although a significant number of the beds the NDP is counting on are being created by the firms themselves, with no capital help from the public purse.
The information is included in documents provided to Postmedia that offer a full accounting of how the province intends to reach its highly-publicized election promise for creating new longterm care and dementia beds by next spring.
The heavy reliance on the corporate sector to accomplish the feat seems inconsistent for an NDP administration that has vowed to keep the health system free of “costly experiments in privatization,” and has intervened to keep private firms from expanding their footprint into lab services and medical linen.
However, Health Minister Sarah Hoffman said her government had little choice to meet its goal but to continue with a grant program devised by the former Progressive Conservative administration.
“We really had to do everything we could as quickly as possible to get spaces on line,” she said in an interview Friday. “A big part of that was following through on initial announcements that had been made under the previous government.”
Hoffman praised the private operators involved in the program, many of whom changed their designs at the NDP’s request to include more dementia and longterm care units.
The program in question is known as the Alberta Supportive Living Initiative (ASLI), in which the province provides up to 50 per cent of the construction costs to groups chosen to build and operate new continuing-care facilities.
Two months before its election defeat in May 2015, the Tory government approved 31 new projects under the initiative.
The new NDP government immediately put the approvals on hold while it conducted a review, eventually deciding to proceed with a shorter list of 25 projects while announcing it would begin looking at other options to fund facilities in the future.
ON TRACK FOR 2,081 BEDS BY NEXT SPRING
Three years later, the Notley government says it’s now on track to open 2,081 beds by next spring, and 17 of the ASLI projects are being counted toward the goal. The remaining ASLI projects won’t be finished by next spring ’s deadline, or aren’t being counted because the NDP didn’t need the operators to upgrade the level of care they planned to offer.
Of those ASLI projects included in the NDP’s count, 11 are operated by private companies, three are from non-profits and three are from public agencies.
The ASLI group of 17 is expected to collectively account for 1,759 new beds.
The remaining 322 units are being created mostly by private firms, but with no government contribution.
Asked whether it’s fair to include spaces it played no part in funding toward the 2,000-bed goal, Hoffman said they should count because her government is still providing operational money.
“If we didn’t pay for the operations of those spaces they wouldn’t be available. I really do believe we have created those spaces by funding them,” she said.
All told, of the 2,081 new beds set to open by next spring, the private sector accounts for 72 per cent of them.
Broken down by bed type, corporations are responsible for 76 per cent of the 1,317 dementia spaces set to open, and 65 per cent of the 764 new long-term care units.
Together, all of the projects counting toward the bed goal have an estimated price tag of at least $410 million, of which the government is contributing about $115 million.
The projects managed by private firms are receiving $65 million, which is about 23 per cent of their stated capital costs.
However they are funded, the beds are badly needed to help the province deal with worsening wait times for Albertans to be placed in a continuing care unit.
NEW FOCUS ON PUBLIC AGENCIES, NON-PROFITS
As much as the ASLI program relied on private operators, its replacement does essentially the opposite.
The much-anticipated new initiative, called Building Communities of Care, is a five-phase effort aimed at adding beds without involving private corporations, at minimal to no cost to the government, with a focus on underserved communities.
Hoffman said much of the effort is also aimed at beds that can be brought on line quickly. This could include facilities that have empty, shelled-in space for new units, towns that have already started building facilities without government support, and seniors lodges with excess room that can covert some of their units to care spaces, she said.
For the first phase, Alberta Health Services issued a request for proposals earlier this year to public and non-profit agencies interested in adding more units. The agencies will be responsible for any construction or renovation costs, but the successful applicants will receive operational funding for those added spaces, Hoffman said.
AHS received a “significant” response to its offer, and is currently reviewing the submissions, she said.
The next phases will aim at developing units in seniors lodges and other government-owned facilities, and offer grants to Indigenous communities to help build “culturally appropriate” spaces.
Grants will also be provided to non-profit organizations to build beds in priority areas, followed by a small initiative to build more publicly owned units.
Hoffman said she hasn’t landed on a “hard number” of beds she wants the program to create.
The Alberta Continuing Care Association, which represents both non-profit and corporate operators, said members have mixed feelings about the NDP’s new program.
While non-profit members will continue to have an opportunity, the exclusion of private firms has produced some frustration, board chairman Dale Forbes said.
He said the use of private companies and cost-sharing programs like ASLI are typically speedier, cheaper mechanisms to create new spaces.
Projects that are entirely government funded, such as the $110-million, 144-bed Willow Square Continuing Care Centre in Fort McMurray, are ultimately more expensive for taxpayers, Forbes said.
If we didn’t pay for the operations of those spaces they wouldn’t be available. I really do believe we have created those spaces by funding them.