Publicly funded home support in BC: how it actually works

British Columbia has a publicly funded home support system, and many families pay privately without knowing what they were entitled to. This is a plain explanation.

We are a private agency, and we would still rather you knew.

What home support is

Home support is direct personal care delivered in your own home by community health workers employed or contracted by your health authority. It covers help with mobility, bathing, dressing, toileting, grooming and eating, plus, where it supports safety, some meal preparation, laundry and light housekeeping.

It is not housekeeping, not companionship, and not a service you can book like a tradesperson. It is assessed care.

Who qualifies

You must:

• be assessed by a health authority professional as needing personal assistance or caregiver respite;
• meet the general home and community care eligibility criteria, which include Canadian citizenship or permanent residence and normally three months’ residence in BC; and
• agree to pay the assessed client rate.

The assessment is the gate. Everything follows from it, and there is often a wait.

What it costs

Your daily rate is calculated from your income, after certain deductions, and it is never more than the actual cost of the service.

There is no charge at all if you receive the federal Guaranteed Income Supplement, the Allowance or Allowance for the Survivor, BC Employment and Assistance benefits, or a War Veterans Allowance.

For many older people on modest fixed incomes, publicly funded home support is free or close to it. If that describes your parent, start there.

Where the public system stops

Home support is real and it is worth having. It also has limits that families discover after the assessment rather than before:

• The assessed hours are the assessed hours. They are based on need as the assessor measures it, not on what would make family life manageable.
• Visit times are scheduled by the health authority. If you need someone at 7am specifically, that may not be available.
• The caregiver may change. Continuity is a goal, not a commitment, and for a person with dementia this matters enormously.
• Companionship is generally not funded. Neither is most housekeeping.
• There can be a wait, both for the assessment and for service to start.

The other public routes worth knowing

CSIL: Choice in Supports for Independent Living. If you have a significant physical disability and want to hire and direct your own workers, CSIL gives you the funding directly and makes you the employer. See our guide to CSIL.

Veterans Affairs Canada. The Veterans Independence Program funds housekeeping, grounds maintenance and personal care for eligible veterans and, in some circumstances, surviving spouses.

ICBC and WorkSafeBC. If care is needed because of a motor vehicle crash or a workplace injury, the cost may be covered by the relevant claim rather than by you.

First Nations Health Authority. Home and community care is delivered through FNHA and Nation-based programmes for people living in many First Nations communities.

Extended health and long-term care insurance. Check the policy. Some people hold long-term care cover they have forgotten about.

Where private care actually fits

Honestly, in four situations:

1. More hours than the assessment funds. The public system covers essential personal care; it does not cover four hours a day of companionship because a spouse died in March.
2. A schedule you can rely on. Same time, same days, arranged around dialysis or a day programme or a family member’s work shifts.
3. The same caregiver. For dementia in particular this is not a preference, it is the intervention.
4. Starting now. An assessment queue is no use when someone is being discharged on Thursday.

Plenty of families use both, and we work around a public schedule without complaint.

Where to start

Contact your health authority’s home and community care intake:

• Vancouver Coastal Health: Vancouver, Richmond, the North Shore, Sea to Sky, Sunshine Coast.
• Fraser Health: Burnaby, Surrey, New Westminster, the Tri-Cities, Delta, Langley, White Rock, the Fraser Valley.

You can also call HealthLink BC at 8-1-1, free, twenty-four hours a day, and speak to a nurse or a navigator about what is available.

This is general information, not advice about your situation, and programme rules change. Confirm the details with your health authority.