Serious curly haired woman manages household family budget calculates expenditures takes care of finances and savings sits at table with receipts dressed in domestic clothes poses at home

Why helping families pay for home care makes sense

For seniors, aging-in-place at home is the most comfortable, safe, and affordable option.

That’s why Gaye Moffett is on the board of Home Care Ontario, to work closely with other home care advocates to keep their work top of mind with every level of government.

Here’s what they’re working on right now to get families more support:

Home care co-payments and tax credits

Right now, anyone admitted to a long-term care facility only pays part of the cost. The government subsidizes the rest. 

As an alternative to moving people to a long-term care facility,  Gaye is advocating for a co-pay option to support clients at home. It’s a good investment for the government to make. With less overhead, providing care at home is more cost-effective than at a facility.

Other government incentives are also on the table, such as enhancing tax credits like the Ontario Seniors Care at Home (OSCAH) tax credit, and exempting family-funded care from sales taxes like the HST.

Raising the reputation, visibility and awareness of family-funded home care

One of the biggest challenges home care providers face is the invisibility of the work they do.

When you drive past a hospital or long-term care facility, you know there are people being cared for within those walls. It’s easy to forget that care is also being provided in people’s private homes.

Gaye and her colleagues are raising awareness by advocating for accreditation for family-funded care providers, agency licensing, an authority to over see allied health, and stronger enforcement of labour standards in the grey market to protect people from unlicensed ‘caregivers’ advertising their services on Kijiji.

Contributing to health system transformation

With health system transformation underway due to the pandemic, Gaye wants people to know how family-funded care providers are contributing to those efforts.

That’s why they’re sending educational materials to Ontario Health Teams (OHTs) about their work. 

They’re also engaging the OHTs directly to explain why enhancing home care services is a better option than creating ‘add-on’ services via retirement homes, which come with overhead costs similar to long-term care facilities.

For Gaye and her fellow advocates, investing in home care just makes sense.

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Critical legislation changes just made home care safer in Ontario

As the founder of GEM Health Care Services and member of the board for Home Care Ontario, Gaye Moffett does a lot of advocacy work for her clients behind the scenes.

After spending the past few years lobbying the provincial and federal governments about three key pieces of legislation to keep clients safe and lower the cost of care, she’s happy to report a recent victory.

The Government of Ontario has passed legislation requiring Temporary Help Agencies to be licensed to continue their operations. 

The eligibility criteria to be licensed is stringent to protect both employees and clients, as well as preventing the loss of tax dollars. 

“We’re certainly in favour of this legislation,” said Moffett. “It stops people from putting up a ‘fly-by-night’ temp agency on Kijiji without any oversight or regulation.”

How do you get a licence?

The bar for a Temporary Help Agency to meet the licensing criteria includes:

  • CRA business number
  • WSIB certificate
  • Liability insurance and indemnification
  • Third party quality control, eg. ISO or other relevant certification
  • Criminal background and vulnerable population checks for all staff
  • Putting $25,000 in escrow to cover wages in the event of bankruptcy
  • Application fee of $750

How does this legislation help?

While the legislation protects temporary employees from unfair wages and exploitation in any industry or sector, it’s especially important for home care staffing agencies.

“Our clients are vulnerable and working conditions for our employees can be precarious due to the unpredictable nature of the work,” said Moffett. “They need a staffing agency that knows how to conduct a care assessment so that clients are getting what they need, and staff are being matched to the right clients on a consistent basis.”

Some online home care staffing agencies that call themselves a “matching platform” claim to lower costs by “avoiding overhead” (such as care assessment conducted by a licensed health care practitioner). 

These outfits will also need to apply for a licence before January 1, 2024 and meet the same criteria or face stiff penalties. The government started accepting applications in July, 2023.

“While temporary help agencies are vital to Ontario’s businesses and jobseekers looking to get their foot in the door, for too long they have operated in a grey zone that allows criminals to prey on vulnerable workers,” said Monte McNaughton, Minister of Labour, Immigration, Training and Skills Development. “Our government’s licensing system will ensure law-abiding businesses can have confidence in the THAs and recruiters they work with and that those who abuse workers face the harshest fines in Canada and are banned from operating in our province.”

How will it be enforced?

Penalties for contravening the act will be stiff, ranging from $15,000 for a first offense, to $25,000 for a second offense within three years of the first, and $50,000 for a third offense within the same three year period.

Officers will be looking for these contraventions:

  • operating as a temporary help agency without a licence
  • acting as a recruiter without a licence
  • clients knowingly using an unlicensed temporary help agency, or
  • employers, prospective employers or other recruiters knowingly engaging or using the services of an unlicensed recruiter

And if you’re wondering whether the staffing agency that’s sending your home care worker is licensed, you’ll be able to check with an online search of the government’s database.

Check out our other “Buyer Beware” posts for more tips on screening your caregivers for safety and security, as well as their qualifications.

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How to get the right mix of home care services with the resources you have

When the benefits of helping seniors stay at home are so clear, maximizing the home care services you can get with the resources you have makes perfect sense. 

Seniors who age-in-place hold onto their autonomy and independence longer because they’re in a familiar environment and maintain ties to their community. With the appropriate support, seniors can downsize at their own pace rather than being forced to move due to a crisis.

But navigating Ontario’s home care system isn’t as simple as picking up the phone and asking for help. That’s why Gaye Moffett, owner and operator of GEM Health Care Services, often hears from people who are just trying to figure out where to start. 

“This morning someone called and said her father is on a limited income, but needs help doing his housekeeping and laundry,” said Moffett. “I pointed her to the City of Ottawa’s Home Support Services so they can determine if he was eligible for the services they offer.”

Navigating a complex system to get the right mix of services

Moffett has been working in the home care sector long enough to know the ins and outs of navigating a complex system that’s always changing.

Whether you start in the public system or with family-funded home care services, you’ll probably need a bit of help to make sure you’ve got the right mix of services at the right time.

Moffett’s experience running GEM Health Care Services — which currently has a contract with the Ontario government to provide publicly funded, privately delivered services — is why she’s a master at this. 

“I often get people started with family-funded nursing care,” said Moffett. “But if they become eligible for public services, we can adjust their hours to make sure they have the right mix.”

Moffett leverages her nursing background to help her clients maximize their resources. “I once helped a client’s mother get her nursing care covered by writing their insurer a letter,” she said. “Her coverage said the services had to be medically necessary — as a nurse I was able to explain that a PSW can’t manage tube feeding and other care needs that she had.” 

So where should you start if you or your loved one needs home care to “age-in-place”? 

Asking yourself these questions will help point you in the right direction

  1. Are you eligible for publicly funded home-care services? Call Home and community services with the Ontario government to find out.
  2. Do your benefits cover homemaking, nursing or both? You need to ask your insurer how they define “medically necessary.” 
  3. How many family–funded hours do you really to supplement your public services? Talk to a veteran health professional like Moffett to find the right balance, and explain the difference between what’s medically necessary and what isn’t.

Whether you’re on a fixed income, have some benefits for private nursing through your employer, or have enough resources for family-funded nursing care, talking to someone who knows the system like Moffett can give you the confidence that you’re accessing the services you really need with the resources you have.

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Why community PSW’s deserve better compensation

People who receive home care services love their personal support workers (PSWs). 

And why wouldn’t they? PSWs provide the personal care seniors, people with disabilities and other vulnerable populations need to stay in their homes — like bathing, providing medication, meal prep and light housekeeping.

Community PSWs spend more time with home care clients than any other home care worker and become an important presence in their lives. They play a critical role in our healthcare system by significantly improving quality of life for their clients in a cost effective manner — most of the dollars spent on PSWs goes to care rather than on operating an institution. 

So why are community PSWs paid a lot less than PSWs who work in the hospital or long term care? 

Before the pandemic, home care PSWs were paid an average of $16 – $17 per hour. Those who worked in a hospital or long term care facility made $25 to $30 per hour. While the government did increase pay for community PSWs, it’s still falling short by an average of $5 per hour.  

This doesn’t make sense. PSWs in the community need the same skill set and perform the same tasks as those who work in institutions. If anything, home care PSWs have a tougher job because they work alone and in more challenging conditions.

We hire a lot of PSWs and send them everywhere — sometimes almost all the way to Kingston —  but we can’t guarantee them a 9-5 schedule because our clients’ care plans vary and people’s needs are always changing. It’s just the reality of the homecare sector. That’s why a lot of PSWs must work for more than one agency. Understandably, they’ll take whoever can give them the most hours and the best shifts.

The government could help solve this by giving care provider agencies more funds to compensate our PSWs’ for their travel time. We pay a flat rate between shifts, but there’s no incentive for us to pay more for their travel time because we won’t get paid for it. Every time our PSWs need to travel, providers like GEM lose money. 

That’s why we want the Ontario government to invest more in this critical service, so care providers like ours don’t have PSWs leaving us to work for minimum wage jobs that give them steadier work.

The important role PSWs play in our health system has been neglected for long enough.