May 4, 2009

A Framework for Enhancing Home Support in BC


Home support is an important element of the broader home and community care system, which unfortunately tends to get overlooked in many health care discussions. Home support serves an important dual purpose: it improves the quality of life of vulnerable citizens by allowing them to continue living independently in their own homes and it enables efficient public health expenditure by avoiding or delaying much costlier institutionalization.

As the baby boomer generation ages, the need to strengthen and expand the supports available to seniors in their homes becomes more pressing. In our province, the pressures created by the aging population have been compounded by sharp cuts in the numbers of acute care and long-term care beds over the last decade, which shifted the burden of care for the frail elderly onto community-based services and individual families. Without adequate funding to match the increased need, access to home support has been reduced for those with more moderate needs, compromising the preventative functions of home support.

A newly released CCPA paper, Towards an Enhanced and More Accessible Home Support System for BC’s Seniors, puts forward a concrete policy proposal for improving home support in our province.The paper identifies three major areas of concern in home support — recruitment and retention, the organization of home support delivery and the level of service hours provided — and proposes tackling those in tandem. Our recommendations are designed to supports service integration and continuity of care, and to take into account the important interconnections between the quality of service for clients and the working conditions of staff. As a result, our proposed reforms would have mutually reinforcing effects and would ultimately result in better quality care and more accessible care for those who need assistance to remain in their homes.

We cost out our recommendations and call for an immediate increase of the home support budget of health authorities by $100 million per year to implement them. This represents just over 0.7% of provincial health care spending for 2007/08 and is entirely affordable even during a recession. And if this seems like a big number to you, just remember that while enhancing home support costs more at the start, over the long term these reforms can reduce health care costs elsewhere in the system.