Understanding Your Home Care Options

Help Me Understand My Options

Understanding Your Home Care Options

Home & Community Care can be arranged in different ways.

The arrangement can affect:
  • who provides your care;
  • what choices you may have;
  • how much responsibility you or your legal representative may take on;
  • how your care is organized.
But there is an important difference between:

how your authorized care is delivered

and

what care or funding is authorized.

Choosing or discussing a delivery arrangement does not mean that you decide your own:
  • eligibility;
  • assessed needs;
  • authorized services;
  • funded hours.

Those decisions happen through the Home & Community Care assessment and authorization process.

This section will help you understand the different arrangements, compare the facts and prepare questions for your case manager or program contact.

It will not tell you which arrangement is best for you.

Learn

Alberta's formal provider framework

For publicly funded Home & Community Care health and personal-care services, Alberta currently uses three provider types.

Official provider type

Type 1

Care is provided directly by:

Assisted Living Alberta (ALA).

Official provider type

Type 2

Care is provided by an organization that has an agreement with:

Assisted Living Alberta.

This means publicly arranged care may be delivered directly or through a contracted provider.

Official provider type

Type 3

This is a client-directed model.

The client has a role in choosing or hiring a Home & Community Care provider within the applicable program.

Current examples include:

  • Client Directed Home Care Invoicing — CDHCI;
  • Self-Managed Care.

A person may sometimes receive services involving more than one provider type.

A simpler way to learn the options

KYR's beginner learning structure

The official three provider types are important, but they do not describe every kind of help that a person may use at home.

For learning purposes, KYR groups the information into four areas:

Learning area 1

Publicly arranged or delivered care

This includes:

Type 1 and Type 2.

Care may be delivered directly by Assisted Living Alberta or through a provider that has an agreement with Assisted Living Alberta.

Learning area 2

Client-directed publicly funded care

This is:

Type 3.

Examples include:

  • CDHCI;
  • Self-Managed Care.

These arrangements can give the client a different role in how authorized care is delivered.

Learning area 3

Privately purchased care

A person or family may also purchase care or support privately.

This may include using:

  • an agency;
  • a person hired directly.

Private Pay is separate from the publicly funded provider-type framework.

PRIVATE PAY IS NOT TYPE 4.

Learning area 4

Family, friends and community support

Some people also receive help from:

  • family;
  • friends;
  • community members.

This is complementary informal support.

It is not another formal Home & Community Care provider type.

Family or community help may sometimes supplement formal services.

It does not mean that family members are required to provide care.

It also does not mean informal support replaces formal care.

CLIENT-DIRECTED DOES NOT MEAN
CLIENT DECIDES EVERYTHING.

The client does not decide their own eligibility, assessed need, authorized services or funded hours.

Two different frameworks — do not mix them up

Alberta's formal publicly funded provider framework

Type 1
Type 2
Type 3

KYR's beginner learning structure

Publicly arranged/delivered care
Client-directed publicly funded care
Privately purchased care
Complementary family/community support

The KYR structure is designed to make the subject easier to understand.

It does not create four official Alberta provider types.

Where assessment and authorization fit

The process can be understood like this:

Professional assessment of unmet care needs
Publicly funded services are determined or authorized
An applicable delivery arrangement is used
The kind or amount of client choice depends on that arrangement
CHOICE OF DELIVERY OR PROVIDER
IS NOT THE SAME AS
CHOICE OF ASSESSED NEED, AUTHORIZATION OR FUNDED HOURS.
Compare Information

Compare the facts

1. Publicly arranged or delivered care — Type 1 and Type 2

With these arrangements, publicly funded Home & Community Care may be provided:

  • directly by Assisted Living Alberta; or
  • by a provider that has an agreement with Assisted Living Alberta.

The exact amount of choice a person has about the provider, individual worker or schedule should not be assumed.

If those choices matter to you, ask your case manager what choices are available in your situation.

2. Client-directed publicly funded care — Type 3

Type 3 includes client-directed models such as:

  • CDHCI;
  • Self-Managed Care.

These programs involve the client or legal representative differently in arranging or managing the delivery of authorized care.

The amount and kind of responsibility are not the same in every Type 3 program.

Important

Client-directed care changes aspects of how authorized care is delivered.

It does not give the client control over:

  • eligibility;
  • assessed needs;
  • approved services;
  • funded hours;
  • public funding decisions.
Optional Explanation / Learn More — Continuing Care Health Service Standards

There is also a difference in how the Continuing Care Health Service Standards apply.

Type 1 and Type 2 Home & Community Care providers are required to follow the Continuing Care Health Service Standards.

Type 3 providers are not subject to the same CCHSS requirement.

This is an arrangement-level distinction only.

3. Privately purchased care

Private Pay means:

care or support that is purchased privately.

It is separate from the publicly funded Home & Community Care provider framework.

Depending on the situation, a person might consider:

  • purchasing services from an agency;
  • hiring someone directly.

Private Pay should not be treated as an official Alberta Type 4 provider category.

Questions about legal or employer responsibilities related to direct hiring are outside this Core 3 section.

4. Family and community support

Family, friends and community members may sometimes provide additional help.

This support can exist alongside formal services.

But:

  • family help is not a formal provider type;
  • family members are not automatically responsible for providing care;
  • informal help does not automatically replace formal Home & Community Care.

Different types of support may sometimes be involved at the same time, but a particular combination should not be assumed or promised.

CDHCI vs Self-Managed Care

Both fit within Type 3 — but they are not the same program.

Both CDHCI and Self-Managed Care fit within the client-directed Type 3 framework.

CDHCI

Client-directed

CDHCI is a publicly funded, client-directed Home & Community Care model.

At the current verified source level:

  • Assisted Living Alberta determines eligibility;
  • the client chooses from registered providers;
  • Alberta Blue Cross administers invoicing and direct-billing infrastructure.

The client's funded authorization and funded hours are still determined before the provider-delivery decision.

The client does not choose their own funded hours.

When comparing CDHCI providers

Provider information may include things such as:

  • minimum consecutive visit length;
  • estimated hourly rate;
  • languages;
  • service area;
  • availability.

Minimum consecutive visit length means the shortest continuous visit that a particular provider offers.

These are provider-specific variables.

They are not universal CDHCI rules.

Where relevant, you may also want to ask an individual provider whether there are matters such as:

  • mileage or travel charges;
  • holiday charges;
  • overtime charges;
  • other additional charges.

Do not assume these charges apply to every provider.

Ask.

Self-Managed Care

Client-directed

Self-Managed Care is also a client-directed arrangement.

It involves substantially more direct responsibility for the person or legal representative in managing, arranging or directing funded care than CDHCI.

That difference matters.

SELF-MANAGED CARE IS NOT
CDHCI WITH A DIFFERENT NAME.

Core 3 does not go into detailed employment, payroll, tax or workplace-law responsibilities.

The important point here is simply:

Self-Managed Care involves a materially different level of direct management responsibility.

CDHCI and Self-Managed Care at a glance

CDHCI

Publicly funded: Yes
Provider model: Client chooses from registered providers.
Administration: Alberta Blue Cross administers invoicing/direct-billing infrastructure.
Client responsibility: You choose from registered providers, but you do not manage the care in the same way as Self-Managed Care.
Eligibility and funded hours: Not decided by the client.

Self-Managed Care

Publicly funded: Yes
Provider model: Client-directed.
Client responsibility: Substantially more direct responsibility for managing, arranging or directing funded care.
Eligibility and funded hours: Not decided by the client.

The purpose of this comparison is not to decide which program is better.

It is to help you understand:

What responsibilities would I actually be taking on?

What Kind of Choice?

CHOICE OF WHAT?

When someone says an arrangement gives you "choice," there is an important question to ask:

Different kinds of choice are not the same thing.

Provider choice

Can you choose the organization or provider that delivers the service?

Individual worker or caregiver choice

Can you choose the particular person who comes into your home?

Provider choice does not automatically mean you can choose each individual worker.

Scheduling flexibility

What choices, if any, are available about:

  • days;
  • times;
  • visit arrangements?

Choosing a provider does not automatically guarantee a particular schedule.

Care plan or service authorization

What services have been assessed and authorized?

This is different from choosing who delivers those services.

Care hours and funding

How many funded hours or what public funding has been authorized?

Client direction does not mean the client chooses their own funded hours.

Before comparing arrangements, keep these questions separate:

Who provides the care?
Can I choose the provider?
Can I choose the individual worker?
What scheduling flexibility is available?
What services have been authorized?
What funded hours have been authorized?

Those may have different answers.

Remember

Five important things to remember

1

Alberta has three formal publicly funded provider types.

KYR's four-part learning structure is a teaching tool.

It does not create four official provider types.

2

Client-directed does not mean client decides everything.

Eligibility, assessed need, authorized services and funded hours are not decided by the client simply because the care is client-directed.

3

"Choice" can mean different things.

Provider choice is not automatically the same as:

  • worker choice;
  • scheduling choice;
  • service authorization;
  • funded-hours decisions.

Ask:
Choice of what?

4

Private Pay is separate.

Privately purchased care is not Type 4 of Alberta's publicly funded provider framework.

5

Family and community help is complementary.

Family, friends or community support may sometimes be involved, but they are not another formal provider type and do not automatically replace formal care.

Questions I May Want to Ask

You can start with simple questions.

You do not need to know every government term before asking questions.

Questions about my current arrangement

  • What kind of Home & Community Care arrangement do I have?
  • Is my care Type 1, Type 2 or Type 3?
  • Who is responsible for arranging my current care?
  • What choices do I have about the provider?
  • Do I have any choice about the individual worker?
  • What scheduling flexibility is available?

Questions about client-directed care

  • What responsibilities would I take on under CDHCI?
  • What responsibilities would I take on under Self-Managed Care?
  • What is different between those two arrangements in my situation?
  • If I want to understand another available arrangement, who should I speak with?

Questions when considering a CDHCI provider

  • Is this provider available in my service area?
  • What is the provider's minimum consecutive visit length?
  • What is the estimated hourly rate?
  • Does the provider offer service in the language I need?
  • What availability does the provider currently have?
  • Are there mileage or travel charges that I should know about?
  • Are there holiday, overtime or other additional charges that I should ask about?
  • What should I know before selecting this provider?

Remember that provider practices may differ.

Ask the provider rather than assuming that a rule or charge applies to every CDHCI provider.

Questions about combining support

  • Can more than one type of support be involved in my situation?
  • How would privately purchased care fit with my current services, if applicable?
  • How does family or community help fit with my formal care?
  • Who should I speak with if my current arrangement no longer seems to meet my needs?
Discuss / Decide

The next step is to ask questions about your own situation.

Now that you understand the main arrangements, the next step is not to score them or choose one from a list.

The next step is to:

ask questions about your own situation.

You may want to discuss with your case manager or the appropriate program contact questions such as:

  • what arrangement you currently have;
  • what other arrangements may be available to discuss;
  • what provider choices may exist;
  • what responsibilities each arrangement would involve;
  • what scheduling or worker choices may or may not be available.

An arrangement or provider situation is not necessarily permanently fixed.

If you want to understand whether another arrangement may be available, ask your case manager or program contact.

Do not assume that a change is guaranteed.

The purpose of Core 3 is to help you understand the information and prepare useful questions.

KYR HELPS YOU UNDERSTAND THE OPTIONS.

YOU DISCUSS YOUR SITUATION WITH THE APPROPRIATE HOME & COMMUNITY CARE CONTACT.

Print / Take-With-Me

Print / Take-With-Me

IF I RECEIVE PUBLICLY FUNDED HOME & COMMUNITY CARE, DO I KNOW MY PROVIDER TYPE?

  • Type 1
  • Type 2
  • Type 3
  • I do not know yet.

These are the official provider types used for publicly funded Home & Community Care.

OTHER SUPPORT I USE OR WANT TO ASK ABOUT

  • Privately purchased care/support
  • Family/community support
  • I am not sure

These are not additional official Alberta provider types.

They are included here because they may also be part of the support a person uses or wants to ask about.

Who is my case manager or program contact?

Who currently provides my care?

What kind of choice do I have?

Provider
What choices do I have?
Individual worker
Do I have any choice?
Schedule
What flexibility is available?
Authorized services
What services have been authorized?
Funded hours
What funded hours have been authorized?

Questions I want to ask

  • What kind of Home & Community Care arrangement do I have?
  • If I receive publicly funded Home & Community Care, is my provider Type 1, Type 2 or Type 3?
  • What choices do I have about the provider?
  • Do I have any choice about the individual worker?
  • What scheduling flexibility is available?
  • What responsibilities would I take on under CDHCI?
  • What responsibilities would I take on under Self-Managed Care?
  • If I am considering CDHCI, what should I ask each provider?
  • Can more than one kind of support be involved?
  • Who should I speak with if I want to understand other available arrangements?

My other questions

Remember

Client-directed does not mean you decide everything.

Provider choice, worker choice, scheduling and funded hours are different questions.

Private Pay is not Type 4.

Family/community help is not another formal provider type.

Ask your case manager or program contact about the arrangements that may apply to your situation.

BEFORE I USE THIS QUESTION SHEET

KYR DOES NOT DECIDE WHICH ARRANGEMENT IS BEST FOR YOU.

USE THESE QUESTIONS TO DISCUSS YOUR OPTIONS WITH YOUR CASE MANAGER OR PROGRAM CONTACT.

Sources & references

For KYR's current legislation, standards and program-reference materials:

The Legislation →
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