As someone living with a physical disability, my journey is shaped by everyday challenges. I work diligently and maintain an active lifestyle, cherishing the ability to contribute and engage with my community. Sadly, like many others, I am hampered by a home care system that is perpetually overwhelmed, leaving us to endure a "you get what you get" service model. The inefficiencies are not solely the fault of the dedicated professionals who tirelessly support us, but a result of an overburdened system that struggles to meet growing needs.

Across the globe, countries face similar challenges with their home care frameworks. However, many have successfully embraced a novel solution: a portable home-care funding program. This system empowers individuals by granting them the flexibility and choice to access private home care without being tethered to a single provider under the overstretched health authority system. Families experience greater autonomy, and clients flourish amid personalized, consistent care that meets their unique circumstances.

The British Columbia Ministry of Health has the opportunity to implement this innovative approach, revolutionizing our provincial care system. By adopting a portable home-care funding program, we can alleviate pressure on our public services, improve quality of life for disabled individuals like myself, and set a precedence in Canada for compassionate, effective care.

This change is not just beneficial, but necessary. It promises to significantly reduce the stress on public health services by reallocating resources more efficiently and encouraging a thriving private sector that can adapt swiftly to meet patient-driven needs. By transitioning to this model, we acknowledge and prioritize the dignity, independence, and rights of our citizens needing home care services.

I urge the BC Ministry of Health to consider the potential life-changing impact of this program, sustainable for the long-term health and well-being of thousands. With your support and signature, we can advocate for a system that delivers on its promise to provide better care for all. Please sign this petition to demand immediate action towards adopting a portable home-care funding program in British Columbia. Together, let us drive a much-needed change for our community. Your signature can make a difference.

 

THE MEAT AND POTATOES OF THIS PETITION

1. Purpose

This proposal recommends modernizing the current home-support system in British Columbia by introducing portable home-care funding, allowing approved clients to choose their care provider while maintaining government funding support.

The current model limits client choice and places excessive administrative burdens on disabled individuals who attempt to access self-managed care through the Choice in Supports for Independent Living (CSIL) program.

 

The Core Problem with CSIL (Choice in Supports for Independent Living)

CSIL was designed so that people with disabilities could control their own care budget and hire their own attendants. In theory that gives maximum independence.

In practice, the program requires the client (or a representative) to essentially run a small business, including:

Hiring and firing staff
Payroll, EI, CPP, and tax deductions
WCB registration
Scheduling
Employment contracts
Accounting and reporting to the health authority
For many people — especially those managing complex disabilities — this administrative burden is enormous.

Advocates often say CSIL works best for people who:

already have business or HR experience, or
have a family member willing to run the program for them.
Otherwise it can be extremely difficult to maintain.

Why Advocates Like the Portable Model

This model could potentially:

1. Increase accountability

Agencies would need to keep clients satisfied or lose the funding.

2. Increase flexibility

Clients could choose agencies that better match their needs (culture, language, skill level).

3. Reduce administrative burden

Clients would not have to manage payroll and HR.

4. Create competition

Agencies compete for clients, which can improve quality.

 

The hidden reality (why CSIL approvals are rare)

This is something many applicants learn later.

Case managers often prefer agency home support because:

less administrative work
less employer risk
easier oversight
do not want to lose client funding

So CSIL is often approved only when:

the client pushes for it, or
agency staffing cannot meet the care hours needed
And the timing for CareChoiceBC BC is good…because BC’s home care system is under pressure (aging population, caregiver shortages, waitlists), so models that increase choice and flexibility without costing extra are welcome.

Similar Models Exist Elsewhere

Australia: National Disability Insurance Scheme (NDIS)
UK: Personal Health Budgets
Some U.S. states: Medicaid consumer-directed care programs

These systems allow people to either:

self-manage funds or
assign them to a provider organization.2. The Problem
The existing system primarily delivers home support through regional health authorities such as Island Health.

While this system provides essential services, it presents several challenges:

Clients have limited ability to choose their care provider
Switching providers is often difficult or impossible
Care schedules are frequently short and rigid
Workers report high levels of stress due to staffing shortages and scheduling pressures

The alternative program, CSIL, allows self-managed care but requires participants to effectively operate as small employers, including:

Payroll administration
Tax deductions and remittances
Employment contracts
Workplace insurance
Scheduling and human resources management
For many disabled individuals, this administrative burden is unreasonable and inaccessible.

3. Proposed Solution: Portable Home-Care Funding

Introduce a “Follow-the-Client” funding model.

Under this system:

A health authority assesses a client’s care needs and determines an approved care budget.
The client may choose to receive services from:

the health authority provider system, or
an approved private home-care agency.
If the client wishes to change providers, the funding moves with the client.
This system would allow individuals to select care providers such as private agencies while maintaining government oversight and funding accountability.

4. Benefits

Greater Client Choice

Clients would gain the ability to choose a provider that best meets their needs.

Reduced Administrative Burden

Clients would not be required to manage payroll, taxes, and employment law obligations as in the CSIL model.

Reduced System Pressure

If even hundreds of clients opted for portable funding, this would significantly reduce administrative and scheduling pressures on health authorities such as Island Health, and lessen the daily client load per Home Care worker.

Improved Worker Conditions

Home-support workers frequently report burnout due to:

unrealistic schedules
staffing shortages
fragmented care assignments
Allowing clients to move between providers could help distribute workload more evenly across the sector.

Encouraging Innovation

Competition between care providers may lead to:

improved service quality
better caregiver retention
more flexible care options5. Implementation
A pilot program could begin with:

100–500 participants in one health authority region
The program would:

establish approved provider standards
maintain care assessment through health authorities
allow clients to voluntarily participate

This would allow the government to evaluate outcomes before expanding province-wide.

Everybody will require home care at a point in their life. Wouldn’t you like to work with a Home Care company that fits YOU? Yes you would, trust me! Whether that Home Care service comes from Island Health or any other privately owned, you will have a choice and also be taking a whole lot of burden off of Island Health Home Care.

 

CareChoiceBC invites you to be in control of your home care needs by signing this Petition. We are trying to get to over 5,000 signatures.

6. Summary

British Columbia has the opportunity to modernize its home-support system by introducing portable care funding.

Such a reform would:

increase independence for disabled individuals
reduce pressure on public home-support systems
support workers in a strained sector
lessens Case Managers daily work load
Most importantly, it would place choice and dignity back in the hands of those receiving care.

The System Relief Argument

If a portable “follow-the-client” budget existed, many people would voluntarily move part or all of their care to private providers.

Example scenario:

500 clients choose portable funding
They hire agencies or caregivers outside the health authority system
Those 500 cases are no longer fully scheduled, managed, and staffed by Island Health
Impact on the System:

500 fewer scheduling loads
500 fewer staffing files
Thousands fewer weekly care hours to coordinate
administrative pressure drops dramatically.

Why Workers Would Feel Less Stress:

Common stressors in the current system:

Impossible scheduling routes
Short visits (15–30 minutes)
Staff shortages
Travel time between clients
Constant call-ins and rescheduling

With portable funding:

Lighter caseloads
More realistic schedules
Better continuity of care

500 participants in Victoria BC region

Scenario: 500 clients switch to CareChoiceBC using follow-me funding:

500 fewer scheduling loads
500 fewer staffing files
Average care hours per client/day: 2
Total hours/day: 1,000
Total hours/year: 365,000
System impact: Reduced scheduling, payroll, and admin
Worker benefit: Reduced stress and better schedules, reduced sick time

In closing, when 500 clients participate, over 365,000 hours of scheduling and coordination are shifted out of the health authority system annually. Some say this causes layoffs. I disagree. Layoffs would not be implemented. Client care would improve drastically though, as the CCW would not be rushing clients, or getting to the next client. No need to speed from client to client anymore - win win - the client gets a higher quality of care and the day-to-day stresses of too many clients, too long a drive between clients is eliminated for the care giver.

I thank you for your time and consideration of CareChoiceBC as a solid and complimentary alternative to the existing IHA Home Care model & as a replacement for the antiquated, onerous CSIL program and Thnkyou in advance for you supporting this Health Care initiative.

 

Best Regards,
Brian LePas, Founder
CareChoiceBC