Publicly Funded Home Care Quebec: CLSC, EESAD, and PEFSAD Programs

Quebec's public home care system is one of the most comprehensive in Canada — but families rarely discover its full scope until they've already spent thousands on private agencies. The province delivers home care through three parallel channels, each covering different types of support.

Channel 1: CLSC Direct Services (Free)

Your local CLSC provides clinical and personal care services at no charge. These are delivered by unionized, public-sector staff — nurses, personal support workers, occupational therapists, and physiotherapists employed by the regional CISSS or CIUSSS.

Services include:

• Nursing care — wound care, medication administration, catheter management, chronic disease monitoring
• Personal hygiene support — bathing, dressing, grooming, toileting assistance
• Occupational therapy — home safety assessments, adaptive equipment recommendations
• Physiotherapy — post-surgery rehabilitation, fall prevention exercises, mobility training
• Equipment loans — walkers, bath benches, hospital beds, transfer aids, provided at no cost

The number of hours your parent receives depends entirely on their ISO-SMAF profile from the CLSC needs assessment. Families with profiles 4 and above typically receive weekly nursing and personal care visits.

Channel 2: EESAD Domestic Help (Subsidized)

Cleaning, laundry, meal preparation, and light housekeeping are not covered by CLSC direct services. These domestic tasks are delivered by accredited social economy enterprises — Entreprises d'economie sociale en aide a domicile (EESADs).

EESADs are non-profit organizations contracted by the provincial government. They employ trained domestic workers who provide regularly scheduled help in seniors' homes.

Costs and subsidies: The PEFSAD program (Programme d'exoneration financiere pour les services d'aide domestique) subsidizes EESAD services based on income. The subsidy has two components:

• A fixed exemption of $4.00 per hour for all eligible seniors
• A variable exemption that increases as income decreases

After subsidies, the net out-of-pocket hourly cost ranges from $9.52 to $31.60, depending on the senior's household income. Compare that to private cleaning agencies, which charge $35 to $50 per hour with no subsidy.

To access EESAD services, your parent's CLSC care coordinator submits a referral to the regional EESAD. The care coordinator handles the subsidy application — you don't need to navigate PEFSAD paperwork directly.

Channel 3: AAD Direct-Hire (Subsidized)

The Allocation autonomie a domicile (AAD), formerly known as Cheque emploi-service, lets your parent hire their own caregiver directly — including family members. The government provides a financial allocation toward the caregiver's wages, and the CTAAD handles all payroll and employer obligations.

This option is ideal for families who want continuity of care (the same person every day) or who have a trusted family member willing to provide care. The per-hour cost after AAD subsidies is typically lower than EESAD rates.

Stacking Programs for Maximum Savings

These three channels are not mutually exclusive. A well-optimized care plan might include:

• Free CLSC nursing visits three times a week
• EESAD domestic help twice a week (subsidized through PEFSAD)
• AAD-funded family caregiver providing daily personal care
• The provincial CMD tax credit reimbursing 40% of all eligible care expenses

The CMD tax credit (Credit d'impot pour maintien a domicile) applies to EESAD costs, AAD caregiver wages, and many other home care expenses for seniors aged 70 and older. Stacking the PEFSAD subsidy with the CMD tax credit on EESAD services can reduce the effective cost by 60% or more.

Getting Started

All three channels are accessed through the CLSC. Call 811 (Option 2 for Info-Social) or visit your parent's local CLSC to open a case file. The CLSC care coordinator will assess your parent's needs and connect you with the appropriate programs.

The Quebec Elder Care Decision Guide includes a home care program comparison worksheet and a step-by-step financial calculator for stacking PEFSAD, AAD, and CMD tax credit savings.

See more Quebec guides →