Health Authority Long-Term Care Application by Region in BC
Five Health Authorities, One System
British Columbia delivers subsidized home support, assisted living, and long-term care through five regional health authorities: Vancouver Coastal Health, Fraser Health, Interior Health, Island Health, and Northern Health. The co-payment formula, eligibility criteria, and care fee regulations are provincial — set by the Continuing Care Fees Regulation — so the rates are identical regardless of region.
What differs between regions is the intake process, wait times, facility availability, and the practical experience of navigating each authority's bureaucracy.
The Assessment: Same Everywhere
Every health authority uses the same clinical assessment tool — the Resident Assessment Instrument for Home Care (RAI-HC) — to determine the parent's care needs. A case manager (sometimes called a community care coordinator) performs the assessment, which evaluates cognitive function, physical mobility, daily living activities, behavioral symptoms, pain, nutrition, and social support.
The assessment determines two things: (1) what level of care the parent qualifies for (home support, assisted living, or long-term care), and (2) the parent's clinical urgency, which affects their priority on the waitlist.
To initiate the assessment, families contact their regional health authority's home and community care intake line. A hospital social worker can also trigger the process if the parent is admitted and cannot safely return home.
Vancouver Coastal Health
VCH covers Vancouver, Richmond, the North Shore, the Sea-to-Sky corridor, the Sunshine Coast, and parts of the Central Coast. The intake line is the Single Point of Entry — one phone number for all home and community care referrals in the region.
VCH has a range of facilities and demand levels across its region. Facility-specific wait times vary: a bed in a downtown Vancouver facility may have a different wait than one in Squamish or Sechelt. Families are asked to identify their top three facility preferences within the VCH region.
The average provincial wait for public LTC placement is 131 days overall and up to 284 days for non-urgent community admissions. VCH urban facilities tend to sit at or above these averages.
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Fraser Health
Fraser Health serves the largest population of any BC health authority, covering Surrey, Burnaby, New Westminster, the Tri-Cities, Langley, Abbotsford, Chilliwack, Mission, and Hope. The region's growing senior population has outpaced residential care construction, making waitlists persistently long.
Fraser Health's intake process begins through its Home and Community Care referral process. A case manager is assigned and conducts the RAI-HC assessment; timing depends on the parent's urgency and circumstances.
Families navigating Fraser Health should be prepared for the gap period. With extended wait times in many sub-regions, private home care ($32 to $55 per hour from BC agencies) or subsidized short-stay respite ($49.57 per day) is often needed to bridge between the assessment and a bed offer.
Interior Health
Interior Health covers the Okanagan, Kootenays, Thompson, and Cariboo regions — a vast geography with widely dispersed care facilities. The intake process mirrors the provincial standard, but travel distances between home and available facilities can create unique challenges.
In smaller communities, there may be only one or two long-term care facilities within a reasonable distance. The three-choice preference system still applies, but families may find that all three choices have similar wait times. Some families accept a bed in a larger centre (Kelowna, Kamloops) while waiting for one closer to home.
Interior Health's home support program serves many remote communities, which means the case manager's visit may take longer to schedule depending on geography.
Island Health
Island Health covers Vancouver Island, the Gulf Islands, and adjacent islands. Victoria has a concentration of care facilities, but north of Nanaimo the options thin out significantly. The intake process goes through Home and Community Care.
One unique consideration on the Islands: if the parent lives on a Gulf Island and needs long-term care, they may need to relocate to Vancouver Island. There are limited LTC beds on the smaller islands, and the family should factor in the logistics and emotional impact of an inter-island move when planning.
Northern Health
Northern Health serves the northern two-thirds of the province — from Quesnel and Burns Lake to Prince George, Terrace, and Fort Nelson. This is the most geographically dispersed health authority, and care facility availability is the most constrained.
Prince George has the region's largest concentration of LTC beds. Families in smaller communities (Vanderhoof, Smithers, Dawson Creek) may face the choice of a long wait for a local bed or accepting placement in Prince George, potentially hundreds of kilometres from the family's home.
Northern Health's home support program is particularly important for families who want to keep a parent at home as long as possible — in-home care can extend the period before residential placement becomes necessary, and the CSIL (Choices in Supports for Independent Living) self-directed funding model can be especially useful in areas where agency-provided home care is limited.
The Documents You Need
Regardless of the health authority, have the parent's CRA Notice of Assessment available for the co-payment calculation. The authority may also ask for the parent's BC Services Card number, medication list, and primary care physician's contact information.
If someone other than the parent is managing the application, the health authority may ask for proof of legal authority — an Enduring Power of Attorney for financial decisions, or a Representation Agreement for healthcare and personal care decisions. Ask the case manager what authority is needed to handle income verification, rate reviews, or TRR applications.
Our British Columbia Power of Attorney & Personal Directive Kit covers the health authority intake process alongside the legal documents you need to manage it effectively.
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