Governance and Structure of Home Care in Canada

Canada has a complicated structure that supports the planning, funding and delivery of home care services (also referred to as domiciliary care or social care) across Canada. There is no central body of government that regulates home health care, and in 12 of 13 provinces and territories, these senior care services fall under the jurisdiction of the Ministries of Health. The exception is New Brunswick where professional health care services or the 'Extra-Mural Program' is under the jurisdiction of the NB Department of Health and Wellness. Long-term home support services are administered by the NB Department of Social Development.

The provincial / territorial ministries provide overall direction for in-home health care through provincial legislation and policies, as well as funding. They also set and ensure compliance with policies and guidelines for their health care system. The organization responsible for the direct planning, management and delivery of domiciliary care services is different in each province / territory.

According to Canadian Home Care Association, the following government bodies regulate in-home health care in different jurisdictions:

- In British Columbia, Alberta, Saskatchewan, Manitoba, New Brunswick, Newfoundland, the Northwest Territories, and Nunavut, the Regional Health Authorities (or similar entities), which are the governing bodies of the health regions, are provided with global funding from the province and are responsible for setting priorities for health services in the region and planning, managing and delivering in-home skilled care services.

- In Ontario, the 14 Local Health Integration Networks (LHINs) who are responsible for the planning, integrating and funding of local health services, including home care services, work in partnership with the 14 Community Care Access Centres who are accountable for the planning, delivery and ongoing operational management of home care services.

- In Quebec, at a regional level, 18 Regional Authorities (agences de la sante√ƬĀ et des services sociaux) have responsibility for strategic planning and organization for their respective jurisdictions and the allocation of resources between the institutions and communities in their region. In collaboration with their respective Regional Authority, 95 Health and Social Services Centres (CSSS) are responsible for the delivery and operational management of in-home skilled care services.