Traffic bustles along the rain-slicked road along Eighth Avenue and Redford Street on a Tuesday afternoon.
Inside the neatly kept olive green house on the corner, Nigel Bell, 65, sits at the kitchen table doing a crossword puzzle, occasionally peering outside while opera music from Cavalleria Rusticana plays in the background.
Across the table from him, Cliff Moore, 66, softly shuffles his worn deck of cards with his weathered hands as he enjoys a game of crib with cook Denise Carter.
Bell and Moore are two residents and clients of Returning the Favour, a private assisted care facility that owner Gina Marling has operated since 2008.
The facility has room for 11 clients and has a staff of three. Currently there are five beds occupied: three of them are subsidized through a temporary contractual arrangement with the Vancouver Island Health Authority.
But the contract between VIHA and the facility expired last year and negotiations for a new one haven’t been successful, Marling said.
With the clock ticking down, a spokesperson from VIHA says if a new contract isn’t concluded soon they’re going to have to consider their options for the beds they subsidize at Returning the Favour.
“This is people’s home, it’s home to them and that’s so important to emphasize,” Marling said. “People don’t come here to end their lives, they come here to live.”
Marling purchased the facility in 2008 and invested half a million dollars into bringing the facility up to code and making it homey inside and out, she said.
Clients either receive medication management or personal care, and there is a staff member on site 24 hours a day, seven days a week.
Marling started her own facility after working in complex and seniors care, she said.
Her home is spacious enough to comfortably accommodate clients even when at capacity, Marling said. She used the words ‘family’ and ‘home’ to describe the quality of life the facility offers.
“We don’t let people wait in line to eat, we eat as a family,” she said. “This is a comfortable home, not an institution.”
The facility already had a temporary contract with VIHA when Marling bought it. But the agreement has remained a temporary one.
VIHA offered Marling a new contract but she doesn’t feel the terms are acceptable so she hasn’t signed it yet.
According to Marling, the contract doesn’t commit to refilling subsidized beds once clients are no longer at the facility.
It also doesn’t increase the number of subsidized beds.
“I signed the original contract based on the need in the community but the new one won’t commit to refilling subsidized beds, and residents can be removed for any reason that VIHA sees fit.
“It doesn’t honour the original contract so why would I sign it,” Marling said.
As well, in order to receive a consistent longer contract she would have to compete with other bidders to perform the service she already has for four years.
Marling said she’s raised concerns about the quality of care for subsidized clients, who are tended to by VIHA staff and not her own.
She raised her concerns with Alberni-Pacific Rim MLA Scott Fraser and more recently with Port Alberni city councillor Cindy Solda, a longtime health advocate.
A verbal agreement was struck about a new contract but hasn’t been followed up on, Marling said.
Subsequently, VIHA raised the rate that one subsidized client pays, from 70 per cent of his income to 80 per cent, to stay at the facility.
Another client is having their cognitive ability assessed and may have to move depending on the results.
VIHA also withheld payment to the facility for three months and resumed only after advocacy by Fraser.
And Home and Community Care officials, whose assessment of clients is required before they can occupy a subsidized bed, stopped referring people to the facility.
“It’s like they have a vendetta but it’s not about me, it’s about the residents, their care and where they want to be,” Marling said.
“When did residents’ rights about what they want stop being valued?”
VIHA does have a temporary contract with Returning the Favour which expired in March 2011, said Norm Peters, VIHA director for contract services.
VIHA has been trying to negotiate a new arrangement with the facility. “But we haven’t been able to successfully conclude negotiations for a new agreement,” Peters said.
Returning the Favour has had a new contract in its hands waiting to be signed since January, he said.
VIHA’s temporary contract with the facility applies for one to two years.
A needs assessment is carried out before it is renewed. “It’s been renewed once and we’re trying to renew it again,” Peters said.
According to health authority policy a request for proposals would have to be issued in order to enter into a permanent contract, Peters said.
The process and contract terms are standard and apply to other health care providers such as Rainbow Gardens, Echo Village and Fir Park Village. “We had our policy and legal sections review it and they say it’s consistent with other arrangements we have,” Peters said.
VIHA has tried to have meetings with Marling but the efforts to do so haven’t been successful, Peters said. “I don’t know why she doesn’t want to meet,” Peters said.
“She’s sent us e-mails saying she doesn’t like the contract but hasn’t provided any specifics as to why,” Peters said.
The situation with the facility is unique and hasn’t been encountered before, Peters said. Nevertheless, operating without a contract can’t continue and movement will have to be made one way or the other soon.
“We’re getting near a point where we have to consider our options and make a decision,” Peters said. “But we haven’t gotten to that final place yet.”
The situation is disconcerting and needs to be resolved, Alberni-Pacific Rim MLA Scott Fraser said.
Fraser said he met recently with families, clients and staff at the facility. “You know, that’s a people’s home and some of those people are fearful that they’ll be moved out,” he said.
There’s a wait list for people to get into facilities such as Returning the Favour yet VIHA won’t increase the number of subsidized beds.
People who need that type of care but can’t find a place are looking to West Coast General Hospital instead, a move that redirects the hospital’s limited resources and creates waits in other areas.
“They’re doing a disservice to seniors but they’re also creating a ripple effect that is impacting health care,” Fraser said.
Fraser said he met with VIHA officials to try and advocate for the facility but that the relationship between the facility and VIHA has deteriorated since.
Fraser has tried to address the issue with Abbotsford West MLA Mike de Jong, the health minister, but has thus far received no response, Fraser said.
“My fear is that at some point these people who are thriving in this setting will be moved,” he said. “They’re on borrowed time there.”