CSIL Program British Columbia: Self-Directed Home Care Funding
What CSIL Is and Why It Exists
CSIL — Choices in Supports for Independent Living — is British Columbia's self-directed home care funding program. Instead of receiving care from health authority-assigned home support workers on a fixed schedule, families receive a monthly funding allocation and hire their own workers directly.
The program exists because the standard home support model doesn't work for everyone. Health authority workers rotate frequently, arrive on the agency's schedule rather than the family's, and can't perform tasks outside their scope — no housekeeping, no meal preparation, no errands. CSIL gives families the flexibility to recruit workers who can be trained on the specific needs of the care recipient and show up when they're actually needed.
How CSIL Funding Works
The health authority case manager first assesses your parent under the standard home care process — the same RAI-MDS clinical assessment that determines eligibility for regular home support. Based on that assessment, the case manager authorizes a specific number of care hours per week.
If the family opts for CSIL instead of agency-managed home support, the health authority converts those authorized hours into a monthly cash allocation. The family then uses that funding to:
- Recruit, hire, and schedule their own care workers
- Handle payroll deductions and employer obligations, including CPP, EI, and WorkSafeBC requirements
- Purchase supplies related to care delivery
The funding amount is based on the number of authorized hours multiplied by a set hourly rate. The family acts as the employer, which means handling payroll, tax remittances, and workplace insurance — or contracting with a payroll service to manage those obligations.
Who CSIL Works Best For
CSIL isn't the right fit for every family. It makes the most sense when:
- Consistency matters: Your parent has dementia or anxiety that worsens with rotating strangers. CSIL lets you hire a small team of familiar workers.
- Scheduling flexibility is critical: Standard home support visits happen on the agency's timetable. CSIL workers come when the family needs them — evenings, weekends, or split shifts.
- The care recipient has specific language or cultural needs: The family can recruit workers who speak their parent's language or understand their cultural practices around food, hygiene, and personal care.
- Someone in the family can manage the administrative load: CSIL requires employer responsibilities — payroll, scheduling, backup coverage when a worker is sick. Families without someone willing to handle this should stay with agency-managed home support.
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Eligibility and How to Request CSIL
CSIL eligibility requires:
- Your parent must already qualify for subsidized home support through the health authority
- The parent must be assessed as having high physical care needs, a physical disability, and medical stability
- The family must demonstrate the capacity to manage the employer responsibilities — or have a client support group or representative act as the CSIL employer
To request CSIL, contact your parent's health authority home and community care office or speak directly with the assigned case manager. Families can raise CSIL as an alternative to agency-managed home support.
The financial assessment for client rates works the same way under CSIL as under standard home support. The daily rate formula (remaining income × 0.00138889) still applies, and the $300 monthly cap for households with earned income still holds.
CSIL vs Standard Home Support: The Trade-Off
| Factor | Standard Home Support | CSIL |
|---|---|---|
| Worker selection | Health authority assigns workers | Family hires directly |
| Scheduling | Agency schedule, limited flexibility | Family sets the schedule |
| Worker consistency | Frequent rotation | Small stable team |
| Administrative load | None for the family | Full employer responsibilities |
| Scope of tasks | Personal care only | Personal care within authorized scope |
| Backup coverage | Agency provides substitutes | Family arranges coverage |
The main risk with CSIL is the backup problem. When a worker calls in sick under standard home support, the agency sends a replacement. Under CSIL, the family is responsible for finding coverage — and if they can't, the care gap falls on them.
Getting Started
If your parent is already receiving home support and the arrangement isn't working — inconsistent workers, scheduling conflicts, or care quality concerns — CSIL is worth discussing with the case manager at the next care plan review.
For families just entering the system, the first step is always the health authority intake assessment. The Arranging Elder Care in British Columbia guide walks through the full intake process, the financial assessment, and includes a framework for evaluating whether CSIL or standard home support is the better fit.
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