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Ministry of Health

About Assisted Living in B.C.

Assisted living is a semi-independent form of housing that is regulated under the Community Care and Assisted Living Act. The Act defines an assisted living residence as:

a premises or part of a premises in which housing, hospitality services, and at least one but not more than two prescribed services are provided by or through the operator to three or more adults who are not related by blood or marriage to the operator.

Assisted living residences offer three key components to adults who require regular help with daily activities: housing, hospitality services and personal assistance services. Residences:

Assisted living is intended for people who are able to make the range of decisions that allow them to live safely in a supportive, semi-independent environment. The housing and services may be adapted to meet the needs of seniors, adults with mental health and/or substance use problems, and adults with physical disabilities or acquired brain injuries.

Philosophy

Assisted living embraces the concepts of resident choice, privacy, independence, individuality, dignity and respect. Residents, with the support of their families and case managers (where involved), determine with the operator the type of accommodation and services they require, all of which is confirmed in a residence occupancy agreement. In this way, assisted living promotes the privacy and self-reliance of people who require help with some day-to-day tasks but can otherwise live independently.

“The philosophy of assisted living is to provide housing with supports that enable residents to maintain an optimal level of independence. Services are responsive to residents' preferences, needs and values, and promote maximum dignity, independence and individuality.”

Assisted living operators must provide residents with choices. They must also respect residents’ privacy and personal decisions, and accommodate residents’ right to take risks — provided that those risks do not place other residents or staff in jeopardy. In assisted living residences, staff provide minimally intrusive assistance and support residents to live as independently as possible and manage their own lives, even when assistance is needed with daily activities.

Differences between assisted living & other forms of housing

Assisted living is a middle option between home support and care in an institution (e.g., a community care facility, also known as residential care or complex care). The Community Care and Assisted Living Act provides that the operator of an assisted living residence does not need the extensive regulation of a community care facility, but that residents should have greater protection than when living in private homes or supportive housing. Facilities that provide high levels of care must be licensed under the Act, while residences that provide assisted living services must be registered.

Supportive housing

Supportive housing and assisted living residences are similar in that they both offer housing and hospitality services. However, they differ in several ways:

  • Supportive housing operators may not always provide all five hospitality services that assisted living operators are required to provide under the Community Care and Assisted Living Act.
  • Supportive housing operators can offer personal assistance, but only at the support level.
  • Supportive housing residents can purchase personal assistance at the prescribed level from someone other than the operator or qualify to receive equivalent home support from their regional health authority.
  • Supportive housing is not regulated by the assisted living registrar.

Some supportive housing residents may purchase personal assistance services at the prescribed level independently of the operator or qualify to receive equivalent home support services from their local health authority. As long as the supportive housing operator is not offering residents personal assistance at the prescribed level, this situation does not qualify as assisted living.

If a significant number of supportive housing residents qualify for publicly subsidized home support services, a health authority may decide to assign a staff person to be on-site each day to provide scheduled home support services to that group of residents. Again, because the supportive housing operator is not offering the personal assistance, this situation does not qualify as assisted living.

Community care facilities

Community care facilities provide care to vulnerable, dependent people in adult residential, group home, drug and alcohol treatment, child day care and child/youth residential settings. Parts 1 and 2 of the Community Care and Assisted Living Act focus on community care facilities.

Community care facilities must be licensed. Medical health officers and licensing officers in the regional health authorities administer the licensing programs. These programs include monitoring and inspecting community care facilities in order to promote the health and safety of people in care, and investigating complaints.

Community care facilities and assisted living residences are both regulated under the Community Care and Assisted Living Act. However, community care facilities differ from assisted living residences in several important ways:

  • Residents in care facilities might have moderate to severe dementia or developmental disabilities (i.e., they might not be able to make decisions on their own behalf).
  • Residents in care may wander.
  • Operators provide 24-hour supervision to people in care.
  • Residents in care might not recognize emergencies and respond appropriately.
  • Professional (e.g., nursing) care can be routinely provided.
  • Three or more personal assistance services may be offered at the prescribed services level. If an operator provides three or more prescribed services, the facility must be licensed as a community care facility.
  • Health and safety inspections by community care facilities licensing officers take place on a regular basis according to a level of assessed risk.

Another important difference is that community care facilities often monitor exit from the facility and/or have key-padded security systems because residents may be confused or wander.

Operators of community care facilities do not need to register their facilities as they are licensed or designated under either the Community Care and Assisted Living Act or the Hospital Act.

Family care homes

In a family care home, operators may provide prescribed services to:

  • only one or two adults to whom they are not related; or
  • any number of adults to whom they are related by blood or marriage.

Operators of family care homes do not need to register their residences, because the Community Care and Assisted Living Act applies only to residences serving three or more adults to whom the operator is not related by blood or marriage.