[Article] Using Public Funds To Manage Your Own Home Care In BC

Read more articles

Among the myriad options for British Columbians looking for home care, one lesser-known option is the ability to apply for government funding for private home care under the Choice in Supports for Independent Living (CSIL) program. This gives patients, and their families, the opportunity to manage their own home support services rather than relying on local Health Authority home support programs. This program is designed to provide greater autonomy and flexibility, allowing people to customize the care they receive.

The CSIL program was established in 1994 to address the unique needs of people with diverse care requirements. Traditional home support services often lack the flexibility to cater to the specific preferences and schedules of individuals. CSIL aims to bridge this gap by empowering patients to take control of their care arrangements.

Under the CSIL program, eligible participants receive funds directly from their local health authority. The amount of funding is determined by case managers based on the amount of hours that they assess a patient needs. As of April 2024, this rate increased to $38.19/hr. These funds are used to hire, train, and manage their own home support workers. This self-directed approach ensures that participants can tailor their care to meet their specific needs and preferences. They are responsible for recruiting and hiring their support workers, setting work schedules, and managing payroll. This level of control allows for a more personalized and responsive care experience. It means that patients can control who comes into their home, and get a familiar face rather than a rotating cast.

There are trade-offs, however. Patients and families in the CSIL program essentially become employers. Although they have greater control over their caregivers, they are still reliant on Health Authority assessments to determine their allotted hours of care. They are also expected to be “medically stable” and not requiring frequent changes in care because of health issues. As a result of these trade-offs, fewer than 1% of patients over age 65 currently receive care through the CSIL program.

On average, elderly patients (65+) registered for home care in BC received 219 hours of home support in 2021/22 (data from the BC Office of the Seniors Advocate). Converting this to CSIL funding would mean a patient could receive nearly $8400 in provincial funding for home support. Even for higher needs patients, needing for example 1000 hours of home supports annually, the $38,190 payment remains much more reasonable than the estimated $82,100 cost of long term care.

With or without CSIL funding, the overall goal should be to provide patients and families with more independence and control in their care, and increase the salary of the home care provider while reducing administrative overhead. The common goal should be to keep British Columbians happy in their own homes despite increasing care needs.

CSIL funding was one of the factors that we considered when launching our Gravitii.care home care portal. The overall goal is to provide patients and families with more independence and control, and increase the salary of the home care provider while reducing administrative overhead. We all share the common goal of keeping British Columbians happy in their own homes despite increasing care needs.

If you or a loved one need home care in BC, take a moment to ask your home care nurse, case manager, or liaison whether the CSIL program might be right for your situation. Be your own self advocate and use some of the new tools available to help you find professional, quality home care, because everyone deserves to find the support they need.

--

Dr. Kevin Wade, CD, MD, CCFP(PC)

Chief Medical Officer @ Gravitii.care

Clinical Assistant Professor, UBC Faculty of Medicine