Written by Nola Galloway, President, Independent Long-Term Care Councils Association of BC, January 2023
Nov 3, 2022, in a public media release, the BC Ministry of Health (MoH) announced new residential care regulations re operations of resident councils and family councils in long-term care (LTC) homes plus the creation of avenues to ensure residents and their families and representatives could elevate their collective voice not only to the LTC facility operator, but to the Health Authority and the MoH.
BEFORE Nov 3, 2022:
Prior to these new regulations, there was minimal regulation in place that allowed residents’ family members and representatives to establish a family council in a long term care home (made up of residents’ family members and representatives) to promote the collective interests of the persons in care. There were also MoH guidelines on their websites, which defined a “Family Council” as self-led, self-determining, and democratic. I stress that there wasn’t sufficient regulatory language in place to support those MoH guidelines and to STOP some LTC facility operators from MARGINALIZING independent family councils.
There was an independent regional association of family councils, the only one of its kind that existed in BC, the Vancouver Island Association of Family Councils (VIAFC). It formed in 2010 to provide a venue and an opportunity for independent family councils across the Vancouver Island Health Authority to network with other councils from within the same region. This networking was an efficient way to determine systemic issues h across the region.
A variety of excellent reports and recommendations have been presented to the MoH over the course of many years. Some are: Ombudsperson’s Best of Care: Getting it Right for Seniors 2009 and 2012; VIAFC in 2015 with its “Proposal for Change” which received wide support throughout BC and the Office of the Seniors Advocates Staying Apart to Stay Safe in 2020. All were looking to enhance regulatory language and to strengthen the role of resident and family councils to give residents and their families a voice in matters that affect them. Many seniors’ advocacy groups spoke out, especially during the covid years and there was a strong outcry in communities right across BC.
The covid experience heightened the importance of LTC residents and their families having a “guaranteed voice” in decisions that affect them. Families felt helpless as decisions in the LTC system were being made that tremendously impacted them and their loved ones in care, yet they had zero input into those decisions. E.g., locking out families from visiting their loved one in care.
In early 2021 under the leadership of Kim Slater, a long-time advocate working to empower the voice of residents and their families, family council members from independent family councils across BC banded together. They first established an association of family councils in every region of BC AND then established a provincial association of family councils “Family Councils of BC” in early 2022. Their purpose being to collaborate with the health authorities and the MOH by bringing forward member councils’ experiences, concerns, and recommendations to be discussed and addressed. In Oct 2022 the provincial association was incorporated under the legal entity name of the “Independent Long-Term Care Councils Association of BC”. (ILTCCABC)
AFTER Nov 3, 2022:
The new regulations re operations of councils in LTC homes are nothing short of a game-changer. FINALLY, a LTC home operator can no longer marginalize the operations of a family council as some so easily did in the past.
THE NEW REGULATIONS
A LTC home operator must NOT:
- Attend council meetings unless invited by the council.
NOTE: This is extremely important as some facility operators previously insisted on management and staff attending every council meeting. Council members need time to meet on their own, to encourage open and frank discussions. Some council members will not bring forward a concern in front of management and staff because they fear speaking out may bring about some sort of retaliation or reprisal against their loved one in care or themselves.
It is far more likely that concerns will be brought forward when council members have the opportunity to meet for at least a portion of the meeting without management or staff real present.
A LTC home operator MUST NOT:
- Interfere with a council member’s participation or prevent them from entering the long term care home premises to attend a council meeting.
Some LTC home operators went as far as dissolving an independent council that refused to follow its “Terms of Reference” (how the operator expected the council to operate) .
A LTC home operator MUST :
- Provide a private meeting room in the long term care home if requested by the council.
Previously some LTC home operators wouldn’t even let an independent council hold a meeting on their premises.
A LTC home operator MUST:
- provide administrative support from an employee approved by the council if the council requests such support.
A LTC home operator MUST:
- provide equipment in the meeting room to give council members options on how they wish to attend the meeting. This equipment must allow for hybrid meetings (combined in-person and virtual attendance).
There are many family members who live out of town who would not be able to attend without the virtual option.
A LTC home operator MUST:
- distribute printed council meeting minutes to each person in care and their families and representatives if requested by the council.
Shortly after the regulations were introduced, a chairperson of a family council asked the manager to circulate out their previous meeting minutes as well as the next meeting agenda and other pertinent information. The manager refused. The chairperson contacted the manager’s superior pointing out the new regulation and explaining why this info was important to get into the hands of families. Within a couple of days everything the chairperson wanted circulated, was circulated.
A LTC home operator MUST:
- allow the council to choose a time and frequency that works best for them and allow them to meet for up to 3 hours.
Most family councils choose to meet in the evening to allow families who work to be able to attend the council meeting. Occasionally the council may wish to hold workshops which of course require extra time.
A LTC home operator MUST:
- respond in writing to all recommendations brought forward by the council and provide rationale for any decision where the operator rejects a recommendation.
Correspondence in writing provides a permanent record for the council that can be referred back to as needed. Previously some LTC home operators were either slow to respond to the council or refused to respond at all!
A LTC home operator MUST:
- share informational materials which the Health Authority want directed to the council. The operator must forward the information to council members in electronic or paper form.
This will improve transparency to council members.
A LTC home operator MUST:
- on request of the minister or the director of licensing inform them whether the council has a chair or co-chairs; the frequency of the council’s meetings; a description of the administrative support the licensee provides to the council.
This regulation holds the operator accountable to encourage operation of a family council.
In addition to new regulations, MoH is creating new resident and family council venues.
MoH has created NEW avenues for resident and family councils to elevate their voice to the Health Authority and MoH. These government venues will be in place by the spring of 2023.
MoH mandated the Health Authorities to form Regional Resident and Family Council Networks (RRFCN) where individual LTC home resident councils AND family councils can become members of this network. A council chair can attend and represent their council at meetings with the health authority at least twice per year with the purpose of providing them the opportunity to network with other councils in the same region and to identify challenges and share best practices.
Ministry of Health will also lead a Provincial committee consisting of chairs of the resident and family councils, health authority leadership and Ministry of Health licensing leadership. They will meet at least once a year. They will focus on addressing systemic issues and look to develop solutions for them.
NOW to our existing Independent Provincial and Regional Associations of Family Councils.
Independent Long-Term Care Councils Association of BC (ILTCCABC) is a “Provincial Association of Family Councils” representing the important collective voice of residents, their families, and residents’ representatives. The ILTCCABC is viewed by the MoH as an important partner (stakeholder in the LTC sector) and a valuable resource for the development of “Family Councils” in Long-Term Care (LTC).
ILTCCABC has its member “Regional Associations of Family Councils” operating in every health authority across BC. Most are in their infancy, only being formed in 2021. These regional associations invite family councils operating in long-term care (LTC) homes to become members of its association to enable them to network with other family councils within the same region.
Additionally, individuals in the community are encouraged to reach out to their respective regional association of family councils to inquire about becoming a volunteer member to advocate for family councils in long-term care homes. (eg. individuals who may currently or in the past have been involved in advocating to enhance the quality of care and quality of life of residents in long term care; individuals who may have previously worked or volunteered in long term care; individuals who may have been a member of a LTC Family Council at some point in time or has lived experiences from when a loved one resided in LTC.). Each regional association determines its membership through its own terms of reference or bylaws.
These regional associations volunteers assist LTC home operators and resident’s families and representatives to learn about, establish and maintain effective “Family Councils”. Experienced volunteers can share their knowledge of the LTC system. The regional associations of family councils offer resources to equip family councils with the tools they need to enable them to advocate effectively on behalf of all residents.
In a collective effort, ILTCCABC and it member associations gather perspectives and recommendations relevant to quality of life and quality of care for all residents. This collective voice is elevated to the Health Authorities and MoH.
PLEASE REACH OUT AND CONTACT:
Provincial Association of Family Councils:
Independent Long-Term Care Councils Association of BC (ILTCCABC) iltccabc@gmail.com
ILTCCABC’s member Regional Associations of Family Councils:
Fraser Association of Family Councils fafc2021alicea@gmail.com
Interior Association of Family Councils interiorfamilycouncils@gmail.com
Northern Association of Family Councils nafc.regional@gmail.com
Vancouver Coastal Association of Family Councils vcafc.regional@gmail.com
Vancouver Island Association of Family Councils viafc.regional@gmail.com
