Private Home Care vs Government Home Support in BC

In British Columbia, publicly subsidized home support is delivered through the five regional health authorities' Home and Community Care programs. You request services from your local office, or a doctor, nurse, social worker, or hospital team refers you, and a health professional then assesses your eligibility and needs before any visits begin.

Eligibility is broad. According to the Government of British Columbia, you can be assessed if you are a Canadian citizen or permanent resident (or hold a temporary resident permit), have lived in BC for at least three months, and are 19 or older. Exceptions to the residency and age rules exist, so ask your local office if you are unsure.

The assessment is the front door to everything. A health care professional looks at what help you need, which services fit, and for how long, and calculates your client rate. It helps to have ready: your BC Services Card, your doctor's contact information, a list of current medications, and income details such as a recent tax return or notice of assessment, because the rate for home support is income-based.

Approved clients receive task-based visits: help with bathing, dressing, grooming, toileting, mobility and transfers, and cueing. Visits are scheduled around those assessed tasks rather than around an open-ended block of time, which is the biggest practical difference families notice compared with private personal care.

Demand is heavy. According to the Office of the Seniors Advocate BC's Monitoring Seniors Services report (2024/25 data), home support served 56,513 clients and delivered almost 14.8 million hours across the province, yet the number of clients per 1,000 seniors aged 75 and over declined 7 per cent over six years.

Who to call

• Fraser Health Access Line (Home and Community Care): 1-855-412-2121, seven days a week, 7:00 a.m. to 9:00 p.m.
• Vancouver Coastal Health access lines: Vancouver 604-263-7377, Richmond 604-675-3644, North Shore 604-983-6700.
• Anywhere in BC: call HealthLink BC at 8-1-1 (7-1-1 for deaf and hard of hearing) and a navigator will point you to the right office.
• A doctor, nurse, social worker, or hospital team can also refer you directly.

In British Columbia, publicly subsidized home support covers personal assistance with activities of daily living, such as bathing, dressing, mobility, transfers, grooming, and toileting. It does not provide housekeeping-only visits, transportation, errands, or companionship; the province's policy directs clients who need only that kind of help to community resources instead.

The scope is set out on the province's Home Support page: personal assistance with daily living, including mobility, transfers, bathing, dressing, grooming, toileting, cueing, and help with nutrition. Housekeeping tasks such as laundry and meal preparation appear only as "safety maintenance activities", and only as a supplement to personal care, never on their own.

The Home and Community Care Policy Manual is explicit about the boundary: a client who needs help with instrumental activities such as transportation, housekeeping, or shopping is directed to appropriate community resources rather than given subsidized home support. Companionship visits are not part of the service either.

Scheduling follows the tasks. Visits are organized around assessed needs, so exact timing and visit length are largely set by the program rather than by the family.

This is the space private care fills: companionship, housekeeping, errands and rides, longer visits, and schedules built around the family. If those are the gaps you are trying to close, our companionship care and personal care pages describe how private visits work.

In British Columbia, Better at Home is a province-wide program funded by the provincial government and managed by United Way BC that helps seniors with non-medical tasks: housekeeping, grocery shopping, yard work, home repairs, friendly visits, snow shovelling, and rides to appointments. Fees follow a sliding scale based on income.

According to the Government of British Columbia, low-income seniors can access Better at Home services at no charge, and everyone else pays the sliding-scale fee. Programs run through local community organizations, so the exact menu of services varies from one community to the next.

Better at Home neatly covers part of what home support leaves out, the housekeeping and the rides, though it is not personal care and not a substitute for hands-on help. To find your local program, visit betterathome.ca, call 604-268-1312, or email info@betterathome.ca.

In British Columbia, many families use public home support and private home care together rather than choosing one. A common pattern: subsidized visits cover bathing and other personal care tasks, while a private agency adds companionship, housekeeping, meal preparation, and longer visits the public system does not schedule.

Other hybrid patterns are common too. Some families start private care as a bridge while the health authority assessment is under way, then scale back once subsidized visits begin. Others keep the public visits for personal care and use private hours for respite, so the family caregiver gets a real break. Veterans often layer federal benefits on top; Peridot is a VAC-approved provider, and our VAC home care benefits guide explains how the Veterans Independence Program works.

Public and private arrangements are made separately, so coordination falls to the family. A good private agency will work around the public schedule rather than compete with it, and will tell you plainly which hours you should not be paying for because the public system already covers them.