As Hamilton seeks to modernize residential care facilities, some warn of risks to residents

In a first step toward modernizing residential care facilities, the City of Hamilton will change the way it funds privately run, subsidized homes. 

Following a vote by City Council’s General Issues Committee in December, city staff will work to implement a new model designed by consultants Hamilton hired. Researchers, operators and advocates for residents say change is welcome but there’s more to do. Some worry the changes risk displacing existing tenants. 

On its website, the city describes residential care facilities (RCFs) as a form of housing for residents who need support with daily living and might otherwise live in shelters, hospitals, or unstable housing. These communal homes have shared spaces and facilities and usually offer services such as meals. 

In August, researchers with the Juravinski Integrated Residential Care Initiative published a report saying RCFs no longer support “the complex needs of today’s residents” and the sector is governed by “outdated legislation.”

The result is that we’re “putting a lot of people with extremely high needs into one place with very, very little support,” research scientist Chi-Ling Joanna Sinn told CBC Hamilton in October. 

At the Dec. 3 committee meeting,  Michelle Baird, Hamilton’s director of housing services, said regulating RCFs also involves bylaw and licensing but noted for now, the focus is on funding, which comes from Hamilton’s homelessness budget. She previously told CBC Hamilton, despite sharing the same budget, RCFs do not follow the same intake and reporting procedures as services like emergency shelters.

Pilar Homerston, Hamilton’s manager of social and community housing told the committee there are 800 subsidized beds shared across 46 providers in Hamilton and those operators get a maximum of $65 per day per eligible resident — a per diem which hasn't changed in “some time.” Homerston said that has resulted in financial strain for operators and affected residents’ quality of care.

RCF operator Sonia Brown, who runs Caring Loving Sharing Retirement Homes, spoke at the committee meeting, saying, by her calculations, the per diem would be at least $77 if it had regular cost of living increases. 

Homerston presented alongside Jarrod Bayne, senior manager with KPMG who led the review of the current funding model. His team suggested a “tiered” model in which the city would fund three levels of RCFs based around resident needs, with more intense supports and greater funding available for those housing people with greater needs. Bayne said the expected benefits include better resident outcomes, oversight, quality assurance and greater sustainability for the sector. 

Homerston and Baird’s department recommended councillors vote to direct staff to create an implementation plan for the tiered funding model, which they did, voting 11-0 in support.

“I’m not a fan,” of the new plan, Brown told CBC Hamilton in January, after voicing her concerns before the committee. Her RCF near Upper James Street and Mohawk Road E., houses 17 people whose needs range from low to high, Brown said, adding there’s a “balance” to it.

If she has to pick one level of need to serve, Brown wonders what that means for her neighbours. 

“We’re dealing with people here,” she said, “not blocks” you can shift around.

Sinn raised similar concerns before the committee, saying the approach isn’t “person centred” and the city should “proceed carefully.”