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Choice in Supports for

Independent Living

Last updated on August 9, 2024

DOWNLOAD the 6 Part Workbook:

Applying for and Managing

Choice in Supports for Independent Living

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Executive Summary

Module 1:  What is CSIL and is it for you?

Module 2:  How to Apply for CSIL

Module 3:  How to be a Successful CSIL Employer

Module 4:  How to be a Lawful CSIL Employer

Appendices: Glossary | Documents | Resources

Choice in Supports for Independent Living (CSIL) is a self-directed option for eligible home support clients. CSIL clients receive funds directly from their local health authority to purchase their own home support services. Clients become employers who manage all aspects of their home support, from hiring and supervising staff to overseeing how CSIL funds are spent. People who cannot manage CSIL on their own may be eligible if a client support group or an individual designated as a representative through a Representation Agreement is acting as the CSIL employer. CSIL clients have control over who they hire to provide personal assistance, when services are scheduled and how tasks are carried out. Health authorities provide funding for services to the CSIL employer, as outlined in an agreement between the health authority and the CSIL employer, who then directly employs their own care providers. Health authorities determine the amount of funds based on assessment of need and the CSIL Categories of Need Guidelines at a minimum hourly rate of: $34.73 effective April 1, 2022 $37.07 effective April 1, 2023 $38.19 effective April 1, 2024 For more information about CSIL and what is involved in becoming a CSIL employer, you can read the: CSIL Online Workbook Is this care right for me? Choice in Supports for Independent Living may be suitable if you have a significant physical disability and desire more control and flexibility in managing your home support services. What are the Choice in Supports for Independent Living eligibility criteria? In addition to meeting the general eligibility criteria for home and community care services, you are eligible for Choice in Supports for Independent Living (CSIL) if you: have been assessed as requiring home support services as part of your care plan; been assessed as having high physical care needs (HPCN), a physical disability, and are medically stable; have assessed needs that can be met within CSIL, within available resources; have agreed to pay the assessed client rate; and can safely coordinate and manage CSIL services or have a client support group or a CSIL representative acting as a CSIL employer. To read the general eligibility criteria for all home and community care services, go to: Are You Eligible? How do I arrange for Choice in Supports for Independent Living services? If you are interested in receiving Choice in Supports for Independent Living services or know of someone who might be in need of these services, you can contact your health authority's home and community care office or you can have a health care professional make a referral on your behalf. For contact information and a detailed description of how to arrange for services, please see: How to Arrange for Care How does Choice in Supports for Independent Living funding work? As a Choice in Supports for Independent Living client, you receive a set amount of funding each month from the health authority to directly purchase your own home support services. The amount of funding you receive is calculated by multiplying the Choice in Supports for Independent Living hourly rate by the number of hours of home support service you require each month (based on a clinical assessment performed by your health authority). For example, if you were assessed as requiring 100 hours of home support per month and the hourly rate is $37.07, you would receive $3,707 per month (100 hours X $37.07 per hour). Is there a cost for Choice in Supports for Independent Living services? If you receive Choice in Supports for Independent Living services, you will pay a daily rate based on your income (and the income of your spouse, if applicable). Your daily rate is calculated by multiplying your “remaining annual income” (as defined in the Continuing Care Fees Regulation) by 0.00138889. For more information on how your remaining annual income is calculated, please see: Continuing Care Fees Regulation To determine your monthly contribution, your responsible assessor will multiply your daily rate by the number of days you receive services in a month. Your monthly contribution will be deducted from the funding amount you receive from your health authority. You are expected to pay your monthly contribution into your Choice in Supports for Independent Living bank account. If you or your spouse has earned income (as defined in the Continuing Care Fees Regulation) you will not be charged more than $300 per month for Choice in Supports for Independent Living services. Make sure you tell your responsible assessor about any earned income when you are completing your financial assessment. If payment of your assessed daily rate would cause you or your family serious financial hardship, you may apply to your health authority for a temporary reduction of your daily rate. For more information, please see "What if I cannot afford my assessed daily rate?”, below. Exceptions You are not required to pay a daily rate for Choice in Supports for Independent Living services for the first two weeks of receiving short-term home support services after being discharged from a hospital, or if you are eligible for palliative supplies and equipment under the BC Palliative Care Benefits program. You are also not required to pay a daily rate for services if you receive one of the following government income benefits: Guaranteed Income Supplement, Spouse’s Allowance or Widowed Spouse’s Allowance under the Old Age Security Act (Canada). Support and shelter allowance under the Employment and Assistance Act or the Employment and Assistance for Persons with Disabilities Act. War Veterans Allowance under the War Veterans Allowance Act (Canada). Information for Couples If you and your spouse are both receiving publicly subsidized home support or Choice in Supports for Independent Living services, you and your spouse will both be assessed the full daily rate. However, only one of you (either you or your spouse) will be charged per service day. Your monthly rate will be recalculated if your living situation changes for any reason and you are no longer living with your spouse. For more general information on the costs of publicly subsidized home and community care services in B.C., please see: Who Pays for Your Care? What if I cannot afford my assessed daily rate? If you are receiving publicly subsidized Choice in Supports for Independent Living services and payment of your assessed daily rate would cause you or your family serious financial hardship, you may be eligible for a reduced rate. Serious financial hardship means that payment of your assessed daily rate would result in you (or your spouse, if applicable) being unable to pay for: adequate food; monthly mortgage/rent; sufficient home heat; prescribed medication; or other required prescribed health-care services. For more information on eligibility and how to apply for a temporary reduction of your daily rate, please see: Temporary Reduction of Your Client Rate Who is my responsible assessor? Your responsible assessor is a health authority employee who is responsible for completing your financial assessment(s). The name and/or contact information for your responsible assessor is included in the client rate notification letter that is mailed out in the fall of each year.

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Engaging Community to Support Older Adults: Lessons from the Waiting Room Revolution Dr. Hsien Seow (McMaster University) is the cocreator of the Waiting Room Revolution social movement that aims to empower patients and families facing a serious illness or condition. Through a podcast, books, and talks around the globe, he has learned about effective strategies to engage the public early in their illness journeys. He’ll share lessons learned from the WRR social movement, and other relevant strategies from compassionate communities, to support CCVN and CDIC project teams to spread their reach.

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This podcast can help anyone dealing with serious illness. Over the years, we have cared for and interviewed thousands of patients and families who tell us they felt overwhelmed and ‘in the dark’ during their illness journey. Yet we sometimes heard stories where individuals felt prepared, in control and ‘in the know.’ What was the difference between these experiences? The answer is the 7 keys. Join your hosts Dr. Samantha Winemaker, palliative care doctor, and Dr. Hsien Seow, health care researcher, as they share real-life stories to explain the 7 keys to being hopeful and prepared when facing serious illness.

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