Choice in Supports for Independent Living, universally called CSIL, is British Columbia’s self-directed alternative to conventional home support. Instead of the health authority sending workers, it sends you the money and you become the employer.
For the right person it is transformative. For the wrong person it is a second job. This guide is about telling the difference.
How it works
If you are eligible, your health authority assesses your need, determines a funding amount using its Categories of Need guidelines, and pays that money to you. You then:
- recruit, interview and hire your own home support workers;
- set their schedules and supervise their work;
- handle payroll, source deductions, WorkSafeBC coverage and employment records;
- keep accounts and report to the health authority on how the funds were spent.
You are a genuine employer, with genuine employer obligations under BC’s Employment Standards Act and WorkSafeBC.
Who qualifies
You must:
- be 19 or over with a significant physical disability;
- already be eligible for provincial home support, since CSIL is an alternative way of receiving it, not a separate entitlement;
- be a Canadian citizen or permanent resident who has lived in BC for at least three months; and
- have been assessed by a health authority professional as needing home support.
You must also be able to manage the employer role, or have someone who can do it for you. Where a person cannot manage it alone, a client support group or a representative appointed under a Representation Agreement can act as the CSIL employer instead. That provision matters: it is what makes CSIL workable for people who need the flexibility most but cannot personally run a payroll.
What people love about it
- You choose who comes into your home. Not a roster, not whoever is available. You.
- You set the schedule. Around work, study, children, a treatment cycle, not around a health authority’s routing.
- Continuity. The same people, for years, because you employed them.
- You direct the work. You decide how tasks are done, which for someone who has lived with a disability for decades is often the entire point.
What people underestimate
- It is administration. Payroll, source deductions, T4s, WorkSafeBC, records, reporting. Every pay period.
- Recruitment is on you. Advertising, interviewing, reference checks, and doing it again when someone leaves.
- You are the backup. When a worker is ill at 6am, no agency covers it. You do.
- You carry employer obligations. Overtime, statutory holiday pay, minimum rest between shifts, termination requirements. They apply to you.
- The funding is the funding. It is calculated on assessed need and does not stretch.
Who it suits
CSIL tends to work best for younger adults with long-standing physical disabilities, stable needs, strong administrative capacity or a committed family member, and a clear view of exactly how they want their care delivered.
It works least well for someone in the middle of a health crisis, for progressive conditions where needs change monthly, and for families already stretched to breaking, who need less to do, not more.
Using CSIL and an agency together
You can. Some CSIL clients hire directly for most hours and bring in an agency for overnight cover, for holidays, or when a regular worker is away, which are precisely the situations where being your own backup is hardest.
If you are a CSIL employer and want that arrangement, tell us and we will work out something that fits around your existing team rather than replacing it.
Where to apply
CSIL is administered by your health authority’s home and community care team. Start with the same intake number you would use for ordinary home support:
Family Caregivers of British Columbia also publishes practical guidance on CSIL and runs a support line.
General information, not advice about your circumstances. Programme rules change, so confirm details with your health authority.
