By Pablita Thomas, Executive Director, BC Hospice Palliative Care Association
As we begin 2026, British Columbia enters the second year of Age Forward, a provincial strategy and action plan grounded in connection, prevention, and community-based supports. While Age Forward is led by the Ministry of Health and focuses on aging well, its intent reflects a broader provincial shift toward upstream, community-based approaches that require alignment across health, mental health, and social systems.
Hospice societies across British Columbia already deliver this model in practice. Through specially trained staff and volunteers, they support not only seniors, but children, families, caregivers, and individuals across the lifespan, across cultures, identities, sexual orientations, and housing circumstances, including people who are structurally unhoused, in urban, rural, and remote communities.
This year, the BC Hospice Palliative Care Association’s theme is Presenting the Case: elevating the services hospice societies deliver as essential health and mental health infrastructure, and naming the structural misalignment that has limited their full recognition and integration within provincial planning, policy frameworks, which ultimately has affected equitable funding pathways.
Delivering System Outcomes Without System Positioning
Hospice societies deliver care where health, mental health, caregiving, and social connection intersect.
They provide grief and bereavement support, caregiver stabilization, palliative and end-of-life care, volunteer-led companionship, and low-barrier psychosocial services, often long before crisis points are reached, and long after formal clinical care ends.
These services are delivered by specially trained staff and volunteers, across urban, rural, and remote communities, in partnership with families, clinicians, and community organizations.
Yet despite this impact, hospice societies remain largely outside formal policy and funding architecture.
This is not a gap in delivery.
It is a gap in policy design.
At times, hospice societies are referenced in consultations and community outcomes, but they are not consistently embedded within funding pathways, cross-ministry mandates, or system integration frameworks. As a result, their contributions remain under leveraged at a time when the health system is under historic strain and fiscal pressure.
Hospice Predates Modern Health Integration
To understand this system/policy gap, is to understand how hospice palliative care delivered by hospice societies began in BC.
Hospice societies in British Columbia predate today’s integrated health system structures and the current regionalized health authority model.
Many emerged in the late 1970s and early 1980s through community and volunteer leadership, alongside or ahead of early provincial hospice pilot initiatives. They developed largely outside formalized palliative care structures, as charitable, volunteer-led responses to unmet needs at end of life, in caregiving, and in grief and bereavement.
This community-based origin allowed hospice societies to earn deep local trust, respond flexibly to local realities, and reach people and families the formal health system often could not.
That independence became their strength, and, over time, their vulnerability.
As health systems evolved toward regionalization and integration, hospice societies were never formally repositioned within new policy, planning, or funding architectures. They remained outside the system not by choice, but by historical design.
The result is a paradox: hospice societies now deliver outcomes governments explicitly prioritize, prevention, mental health support, caregiver wellness, social connection, and community resilience, yet remain structurally under recognized and inconsistently integrated as system partners.
A Shift in the Conversation, and a Moment to Act
The 2025 Select Standing Committee on Finance consultation report marked an important shift. For the first time, hospice palliative care, grief and bereavement services, caregiver support, and community-based approaches were raised repeatedly across multiple themes, including health system sustainability, mental health, and community care.
This recognition matters.
But consultation alone does not ensure implementation.
As British Columbia prepares for Budget 2026 release amid fiscal constraints and growing demand for community based care, the opportunity is not only to fund programs, but to align policy, funding, and mandates with infrastructure that already exists and works.
Hospice societies are uniquely positioned to support this alignment. Through its provincial reach and relationships with hospice societies across BC, BCHPCA can help identify where and how community-based palliative approaches intersect with multiple ministries, health, mental health, seniors, children and families, and social development, without duplicating effort or creating new bureaucracy.
What Comes Next
In February 2026, BCHPCA will release a Policy Position Paper outlining how hospice societies can be integrated into BC’s health and mental health systems without being institutionalized or absorbed, and without eroding the community trust that makes them effective.
This paper is not a funding proposal.
It is a systems level policy statement intended to support implementation, interpretation, and alignment, regardless of specific budget allocations.
Our message is simple:
Hospice societies are not charitable add-ons to the health system.
They are community based system stabilizers, mental health partners, and cost containment allies.
If British Columbia is serious about strengthening community care while managing fiscal constraints, hospice societies must be structurally recognized and integrated as essential partners.
This year, BCHPCA will present that case, clearly, constructively, and collaboratively.
