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Quality Public Home Care and Home Support Services: It's All About Equality For Persons With Disabilities

The most vulnerable and poorest citizens of our society--people with disabilities and seniors--benefit the most from home care and home support services. However, the growing gaps and privatization of home care and home support services means less access to essential services for seniors and people with disabilities, and represents a step backwards in our struggle for equality.

According to Statistics Canada, 3.6 million people, 12.4% of our population, have a disability. Survey results confirm that the disability rate gradually increases with age--10% among adults aged 15 to 64, and then dramatically rises to more than 40% among persons aged 65 and over. More than half of Canadians who are 75 years of age (53.3%) report having a disability. Approximately 9.7% of adults [2.3 million] report having difficulty with everyday activities, such as getting dressed or undressed, or cutting one's food.

The Romanow Report on Medicare recognized the need to expand the Canada Health Act to include home care services. Unfortunately, the report distinguishes between home care services and home support services such as help with laundry, food preparation, and housekeeping services. For many persons with disabilities and seniors, these support services are critical to facilitate their active and full inclusion in Canadian society, as well as their ability to live independently in their communities.

Home support services are those services provided by other people and include personal attendant care, home making, respite, etc. It is these important services that support many people with disabilities in obtaining education, being employed and active in their communities. Home support services not only help ensure a stable level of health for people with disabilities, but provide them the same equal opportunity as all other citizens to participate in the social and economic fabric of our society.

Without adequate home support services, many of our citizens with disabilities are often forced to live at home under conditions that put health and well-being at risk, or live in an institution where they are segregated from the rest of society.

Many of the home care and home support services critical to the independent living of people with disabilities were once funded under the pre-1995 federal-provincial cost sharing arrangement known as the Canadian Assistance Plan (CAP), that was eliminated by the famous slash and burn federal budget of then Finance Minister Paul Martin in 1995. The elimination of CAP represented the biggest step backward in the struggle of persons with disabilities to live independently in their communities.

Canada's Medicare system needs to be strengthened and expanded to include a national and comprehensive public system of health and home support services that are unavailable or unaffordable to Canadians with disabilities. While these necessary supports are diverse, the most widespread and acute needs relate to three areas:

  • Personal support services of all kinds (such as self-directed attendant care, home support services, sign language interpretation, communication supports, and support workers);

  • Assistive devices and supplies (such as mobility aids, hearing aids and other communication aids, incontinence supplies, home oxygen, etc.);

  • Prescription drugs and related health needs (such as special diets).

A priority for improving our Medicare system should be a coordinated plan by the Federal/Provincial/Territorial governments in each of these areas, developed in consultation with disability rights activists, to ensure that Canadians with disabilities are guaranteed these supports.

Incorporating home care, home support, other health support services and Pharmacare into the Medicare system would go a long way to promote better health outcomes, greater equality and independence for Canadians with disabilities, and ensure our public universal health care system is strengthened, sustainable and equitable.