A Guide to Ontario’s Family-Managed Home Care

For many families in Ontario, ensuring their loved ones receive the care they need can be a challenging process. While services are available through Ontario Health at Home, some families prefer more control over their care arrangements. This is where Ontario’s Family-Managed Home Care (FMHC) comes in—a unique program that allows individuals or their families to hire and manage their own home care services.

In this guide, we will explain what Family-Managed Home Care is, how to apply, and address common questions families often have about the program.

What Is Family-Managed Home Care?

Through the Family-Managed Home Care program, eligible patients or their substitute decision-makers receive funding to purchase home care services or employ care providers. This offers greater flexibility and choice as those approved for Family-Managed Home Care choose their provider, determine how and when the care plan is delivered, and handle all related administrative tasks including managing providers, funding, and reporting requirements.

Good Comfort has extensive experience helping clients navigate the application process and initiate Family-Managed Home Care. We have the expertise and resources to support families throughout the process, ensuring a seamless transition into the program. Additionally, we have trusted partner resources to assist with managing bookkeeping, ensuring compliance with funding and reporting requirements.

Patients must first have an assessment completed to determine their needs, meet the general and specific eligibility requirements for traditional home care, and have a plan of service developed by Ontario Health at Home.

Who Is Eligible?

Family-Managed Home Care is designed for eligible patients in the following groups:

• Children with complex medical needs
• Adults with acquired brain injuries
• Eligible home-schooled children
• Patients in extraordinary circumstances

To be considered for the extraordinary circumstances group, a patient needs to meet the general eligibility criteria for the program and have stable care needs that cannot be met through traditional care services. When making a decision on whether a patient’s situation is an extraordinary circumstance, all of the following factors are considered:

• The nature, frequency, and intensity of care required
• Unique scheduling issues
• Language or communication barriers
• Cultural considerations
• Lack of Ontario Health at Home contracted service providers
• Rural or remote location of care

Substitute decision-makers are also assessed to determine whether they meet the eligibility requirements to take on the required responsibilities under the program, including managing and coordinating the patient’s care employment requirements, providers, as well as managing and reporting on funding to Ontario Health at Home.

Ontario Health at Home patients or their substitute decision-makers can speak to their care coordinator for more information about Family-Managed Home Care. To qualify for Family-Managed Home Care, individuals must:

• Be assessed and deemed eligible by their local Ontario Health at Home organization.
• Have needs that align with Ontario’s publicly funded home care services.
• Have a designated caregiver or representative (such as a family member) who is willing and able to manage the care process.
• Reside in Ontario.

How to Apply

Step 1: Contact Your Local Ontario Health at Home Office

To start the process, families must contact their local Ontario Health at Home office. You can find your local office by visiting Ontario Health at Home.

Step 2: Needs Assessment

A case manager or care coordinator from Ontario Health at Home will conduct an in-home assessment to determine the individual’s care needs and whether FMHC is the right fit. This includes reviewing medical conditions, daily living challenges, and the level of care required.

Step 3: Approval and Funding Determination

If the individual qualifies, Ontario Health at Home will determine the level of funding they will receive. This funding is based on the individual’s care needs and must be used specifically for approved home care services.

Step 4: Hiring and Managing Caregivers

Once approved, the designated caregiver or representative is responsible for:

• Hiring and paying care providers, such as Personal Support Workers (PSWs), nurses, or therapists.
• Managing care schedules and ensuring services align with the individual’s needs.
• Keeping records and submitting invoices for reimbursement.

Step 5: Ongoing Monitoring and Reporting

Ontario Health at Home will conduct regular check-ins to ensure the program is being used appropriately and that the individual’s care needs are being met. Families are required to submit expense reports and comply with program guidelines.

Top Questions

1. What services can be covered under Family-Managed Home Care?

FMHC funds can be used to hire Personal Support Workers (PSWs), nurses, occupational therapists, physiotherapists, and other healthcare providers for approved care services. It does not cover personal expenses, such as rent, groceries, or non-care-related costs.

2. How much funding is provided?

Funding amounts vary depending on the individual’s care needs and the hours of support required. Ontario Health at Home will determine the amount based on the assessment.

3. Can I hire a family member as a caregiver?

Yes, in some cases, family members may be paid as caregivers under FMHC, but they must meet eligibility requirements and be providing direct care services.

4. What are my responsibilities as a family manager?

Families must recruit, hire, and train caregivers, manage payroll, submit documentation, and ensure compliance with Ontario Health at Home requirements.

5. Is Family-Managed Home Care available across Ontario?

Yes, FMHC is available across Ontario. However, funding availability and eligibility criteria may vary by region.

6. What happens if care needs change over time?

If an individual’s care needs increase, families can request a reassessment through Ontario Health at Home to determine if additional funding or services are required.

7. Can I switch back to traditional home care services?

Yes, if managing care becomes too challenging, families can choose to return to traditional home care services provided by Ontario Health at Home-approved agencies.

Final Thoughts

Family-Managed Home Care offers a flexible and personalized approach to home care in Ontario, allowing families to take control of their loved one’s care while receiving government-funded support. However, it does require time and effort to manage caregivers, track expenses, and comply with reporting requirements.

If you believe Family-Managed Home Care might be the right fit for your loved one, reach out to your local Ontario Health at Home office to begin the application process.

For more information, visit Ontario Health at Home or contact Good Comfort to discuss how we can support your home care needs!

Looking for care that puts people first? At Good Comfort, we provide personalized support that brings dignity, respect, and peace of mind to every family.

Connect with us today to see how we can be your Care Partner.