Ruby Roper, a resident of the Weyburn Special Care Home, was one of many seniors caught off guard when the provincial government announced an increase in the cap for long-term care fees, starting this fall.

"I wondered why such a big jump all at once, it was really quite a shock to hear it," said Roper. "It will certainly affect quite a few seniors, and close to $500 out of a person's income is noticeable."

Roper says she should have been forewarned the increase was coming.

"I never heard of such an increase for anyone, never mind seniors. It will especially affect those who may or may not be able to afford it," she said.

Long-term care fees currently range from $797 to $1,036 per month, based on income. As of October 1, residents now paying the maximum charge will be assessed new fees ranging from $1,036 to $1,500 per month. The changes will affect individuals with incomes greater than $1,421 per month.

According to Marga Cugnet, vice-president of patient services for the South Central Health District (SCHD), about 50 district residents out of the approximately 300 in long-term care (excluding Radville) will be affected by the increase. She puts this figure at roughly 21 per cent of residents.

When an individual requiring Level 3 or 4 care is admitted to a care home, he or she undergoes an income test to determine the fees that will be charged. The income varies with each admission, which makes it difficult to determine exactly how much more the fee increase will cost residents so soon after the government announcement.

The service fees, which include rent, food, and laundry services, are estimated to cover less than 30 per cent of the cost of the care.

"The cost of long-term care has risen 28 per cent and the fees have risen only ten per cent," said Judy Junor, Associate Minister of Health. "The fees haven't kept up with the costs."

"There are only 9,000 people in long-term care," she said. "This will affect only those with higher incomes, only 20 per cent in varying degrees. Saskatchewan is at the lower end for long-term care fees in the middle provinces, with the highest fees being charged in Nova Scotia and the lowest being charged in the Yukon."

A second change, estimated to affect 900 couples, is said to help married couples where one partner is a resident in a nursing home. Couples can now choose to base their assessment on half of combined income or the income of the partner requiring care, whichever is more favourable. Again, no clear figures are available on how this will affect Weyburn residents.

Reactions to the announcement have been mixed.

"I just hope the government makes sure they can afford it and not put anyone under the poverty line with this," said Dorothy Bliss, a resident of Weyburn Special Care Home. "A lot of older people have sold their property and I wish the government would be more reasonable and lenient with them. I feel for the people who have an increase. I don't go uptown, but for those who do and cannot drive, a $20 bill is gone like candy."

For some, there are concerns about different rates being charged in a universal health care system which is supposed to offer the same access to care for everyone. There is a perception that those who were able to save more money are being penalized for it.

"It's almost like they're putting a two-tier system in, but of course we don't have that in Canada," said Ron Lutz, South Central Health District (SCHD) board member. "I think to a degree (the fees have) been like that from day one, but this is a pretty healthy chunk of an income. In my opinion, this puts in a two-tier system for our seniors, but we're not allowed to have a two-tiered system in Saskatchewan."

The true impact of the changes in Weyburn won't be known until tax forms are submitted by long-term care residents. Resident fees are based on annual income, including interest income. Personal assets such as land, houses and bank accounts are not taken into account in determining fee levels, according to the government.

The minimum resident charge is tied to the amount of Federal Old Age Security (OAS), Guaranteed Income Supplement (GIS) and Saskatchewan Income Plan (SIP), adjusted quarterly. When combined, the programs provide all seniors in nursing homes a minimum income of $944. Residents at this level pay the minimum fee of $797, retaining disposable income of at least $147 per month to cover drugs, supplies and personal expenses.

"I think it's a dirty shame. People save up their money and it's taken away from them," said Gordon Lindskog of Weyburn. "Those who squandered their's get away scott-free."

"I think it's terrible," said Helen Duczyminski of Weyburn. "It's not right for those who have saved to have to hand it all over. It shouldn't be so high, it doesn't seem that there is anything for us except taxes."

On the other side of the coin are those who believe there is nothing wrong with a system that ensures all are provided for, even though it may be at more expense to some than others.

"My personal opinion is that people who can afford it should pay more," said Ernest Elder, SCHD board chairman. "Those who go to personal care homes pay around the $1,500 mark and I don't see much wrong with it. The government pays for lots of things if you can't afford it - for example, the drug plan. Even with what they are paying, they are still being subsidized by the government in public care homes."

Ruby Rosen is unsure of how, if at all, the fee changes will affect what she is charged each month. She, like Dorothy Bliss, is quick to point out that the staff at Weyburn Special Care Home are very compassionate and caring, and work hard to provide good service. She worries that the public long-term care system will be put in jeopardy if increases continue.