Phase 2 of seniors’ homes | Quebec abandons the CHSLD model

(Quebec) Despite the explosion of costs, the Legault government persists and signs with its concept of seniors’ homes. Quebec gives the green light to the reconstruction of 19 CHSLDs according to the CAQ accommodation model. On the net, there will be an addition of only 200 places.

The Minister for Health and Seniors, Sonia Bélanger, has earmarked a budget of 2.9 billion to proceed with the conversion of 19 of the most dilapidated CHSLDs in the public network (D and E rating) into seniors’ homes. A major project whose schedule has not yet been determined.

This first phase of reconstruction confirms the “new orientation” of the Legault government to make seniors’ homes its “model of accommodation in Quebec”.

“That means that we will no longer build public CHSLDs, that’s what that means,” argued Minister Bélanger in an interview with The Press.

This first wave of 19 CHSLDs provides for the reconstruction of 2,400 places, which includes a net addition of only 200 new beds. More than 4,100 Quebecers are currently waiting for a place in a CHSLD, according to the ministry’s dashboard. The 46 seniors’ homes promised in 2018 by the CAQ provide for the addition of 3,054 new places.

With a planned budget of 2.9 billion to rebuild these 19 CHSLDs, we can calculate that the bill will amount to around 1.2 million per room. This is more than what is estimated for seniors’ homes under construction, with a cost per door estimated at $800,000 or even $1 million.

For now, 13 reconstruction projects are on track. The other six projects will be announced in the coming months, Mr.^me Belanger. The focus is first on the institutions in the worst shape. The Minister believes that the CHSLDs built over the “last ten years” are for the most part “really correct” for the moment.

The end of the CHSLD model

The Legault government is therefore committed to converting CHSLDs that require reconstruction according to the model of seniors’ homes rather than renovating them. The decision to officially abandon the CHSLD model came at the start of the second term, said Ms.^me Belanger.

The choice of the Legault government responds to the concern to avoid creating “two classes” of accommodation in the public sector, explained Mr.^me Belanger. “What I was told when I arrived [en poste]it was that the houses of the elders, it would be wow and [que l’offre en CHSLD serait moins attrayante] when it is not our will, ”she pleaded.

“One of my main objectives is really to harmonize the residential environments in Quebec, including the public CHSLDs which have been largely neglected for decades,” added the former CEO of the CIUSSS du Centre-Sud- of-the-Island-of-Montreal.

Phase 2 of the seniors’ homes

During the election campaign, Prime Minister François Legault promised to launch a second phase of construction of seniors’ homes so that there are “everywhere” and “for everyone”. Mr. Legault also said he wanted to deploy “gradually” his phase 2.

However, this second phase will not result in the addition of new seniors’ homes, but rather in the conversion of existing CHSLDs, indicated Ms.^me Belanger.

The costs of the flagship project of the Coalition avenir Québec, which was led by former minister Marguerite Blais, exploded during the first mandate, in particular due to overheating in the construction industry. The bill rose to 1.5 billion in 2020, to 2.36 billion in 2021, then to 2.79 billion last spring. The opposition in Quebec calls for the abandonment of this model which is too costly for the needs.

According to Statistics Canada, the number of Canadians over the age of 90 will triple in about 30 years. In its own forecasts, in May 2022, the MSSS estimated that 20,264 additional people, aged 70 or over, will need a long-term accommodation place in 2028.

“We are going to do our 46 [maisons], it’s a commitment, we’re going to do it,” pleaded Minister Bélanger. But, “with the aging of the population, not everything can just rest […] on the government,” she retorts. M^me Bélanger recalls “that there are not just public CHSLDs” and that private CHSLDs under agreement and private residences for seniors (RPA) are also part of the solution.

She is also leading the contracting process for private CHSLDs in parallel to harmonize the service offer. Quebec must unveil the first five private establishments that will be contracted, that is to say subsidized by the Quebec state, within a few days.

For now, four seniors’ homes are officially open. According to the initial schedule, 33 houses were to be delivered in December 2022. According to the latest update from the Société québécoise des infrastructures, most establishments should be delivered this spring. A period of approximately eight weeks should be allowed between delivery and opening. Moreover, several CISSSs and CIUSSSs are forced to schedule openings in sequence due to staff shortages.