Questions & Answers (Home Care)
General Home Care Questions - Assessment
Once a referral is made, a care coordinator will call you and arrange for a time to meet with you to discuss your needs.
Urgent assessments take priority.
The assessment will involve looking at what care services you are eligible to receive based on your needs. Home care will supplement the help you currently have in your community, not replace it:
- If you require the services of a nurse, there is no fee.
- There may be a fee for home support or oxygen service. Your care coordinator will confirm during this assessment. The amount you pay is determined according to your income.
- The care coordinator provides ongoing monitoring and adjustment of the services you need. The services will change as your needs change.
- Care coordinators can help you connect to programs in the community that may help you. Some examples are Meals on Wheels and Foot Care Clinics.
Your care coordinator will explore all options.
Paying for Home Care
Service fees are as follows and are subjected to change
|Home Care hourly rate||$10.88|
|Cancelled visit fee||$54.42|
|Nursing services||No charge|
|Palliative care home support||No charge|
|Home oxygen (Income based)||Starting at $65.30|
There is a monthly maximum amount that a client will pay for home care and home oxygen services. This maximum is based on income and household size. If you use these services, your care coordinator can help you determine your maximum monthly charge.
If you use both home care services and the home oxygen services, your maximum monthly charge will be equivalent to your home care maximum amount. For example, if your maximum monthly charge is $108.83, the maximum you would pay is your home oxygen charge of $65.30, and $43.52 for home care for a total of $106.80 per month.
There is no charge for nursing services provided through home care, or for home support provided under the palliative care program introduced March 1st, 2007.
The fee increase also applies to the self0managed care program.
If you have questions, please contact your care coordinator or call our toll-free information line at 1-800-225-7225.
Facility-Based Respite Care
Respite beds provide caregivers with a planned and temporary break from care giving responsibilities. The break is usually scheduled, but emergency situations where the family caregiver is suddenly or temporarily unavailable may also be accommodated.
A respite bed allows an individual to stay in a long term care facility, like a nursing home or residential care facility for a scheduled amount of time. During the stay, the individual gets the needed care and support from the facility's staff. (i.e.: nurses, personal care workers, etc.) including meals. The individual returns home at the end of the scheduled time in the facility.
A person may access a licensed respite bed for up to a maximum of 60 days in a 12-month period. The maximum continuous length of stay cannot be more than 30 days. Also, no more than 30 days can be taken between July 1 and October 1 to ensure fair access to the beds during high demand periods.
An individual can apply for a respite bed by calling your care coordinator or call the toll-free 1-800-225-7225. Your care needs and eligibility are assessed and if determined to be eligible for the service, arrangements for a stay in the respite bed are made on a first-come, first-served basis.
The standard daily charge for a licensed respite bed is $30.20 and is effective November 1, 2009- October 31, 2009. An individual or family may apply for a reduced rate by completing an application and undergoing an income test.
In emergency situation, every effort is made to complete the application prior to admission. However, if necessary, admission to a long term care facility respite care bed may be granted before the application process is concluded.
A situation is considered an emergency when all the following occur:
- There is a sudden and temporary loss of caregiver;
- Replacement caregivers are not available
- The person needing care cannot live safely alone with normally available home care and other community-based supports;
In an emergency situation:
- The person needing care must be willing to accept the closest available bed; and
- The person needing care or his/her authorized representative must agree to complete any outstanding parts of the application immediately after admission to the respite bed
HELP - Bed Loan Program
To access a bed system through the HELP – Bed Loan Program, you must meet the following criteria:
- Be a resident of Nova Scotia, with a valid Nova Scotia health care;
- Be assessed b a care coordinator as meeting the criteria for loan of the bed system
- Take responsibility for the bed system in the home, or have an individual who is willing to do so.
The bed system includes:
- Hospital-type bed – fully electric model
- Foam pressure reduction mattress
- Full bed rail
There is no cost to eligible clients.
- You or a family member or friend can call 1-800-225-7225 and speak to a Continuing Care staff member at the intake office.
- Request an assessment by a care coordinator to determine if you or your family member is eligible to receive a hospital-type bed in your home.
- Your family doctor or any member of your care team can send a referral to the intake office on your behalf or your family member's behalf.
- You will meet with a care coordinator from the Department of Health.
- The care coordinator will determine if you or your family member meet the eligibility criteria under the HELP – Bed Loan Program and may also help identify other Continuing Care services that could help you or your family member.
- The care coordinator will send the Bed System Authorization Form to your family member
- Someone from Red Cross will call you to make arrangements for delivery of the bed system.
Once Red Cross receives the Bed System Authorization form, they will call you to find out some information about the layout of your home and set up a convenient time for the delivery.
When you no longer need the bed system, you will be expected to contact Red Cross for pick-up.
The Red Cross is responsible to deliver and set up the bed system in your home and to ensure that it is in good working order. This is done at no cost to you. You will be shown how to use the bed and be given information on how the bed system works. You will be given a contact number in case problems arise.
The Red Cross will deliver the authorized bed system as soon as possible, once it receives the authorization.
The Canadian Red Cross, Nova Scotia Region owns the bed system.
Once you or your family member has been approved to use the bed system, you can keep it for as long as you need it.
If you no longer require the bed system, you should contact the Red Cross and they will come and retrieve the bed. All new requests for bed systems must go through the Continuing Care Intake Office. If you have any additional questions on the program, please contact continuing care at 1-800-225-7225.
The responsibilities include:
- Sign the Red Cross Loan Agreement/Waiver form acknowledging the conditions of the bed system loan.
- Be responsible for the bed system in the home
- Understand the safe operation of the bed system and follow the proper instructions
- Notify Red Cross for pick-up of bed system when it is no longer required.
- Provide reasonable notice (24-36 hours) for the delivery and pick-up of the bed system.
The bed system is a high quality piece of equipment that is simple to operate. However, if you have any questions or concerns after the bed has been delivered to your home, please contact Red Cross toll free at 1-888-496-0103.
Yes. Upon delivery, the Red Cross representative will demonstrate how the bed system works and provide written information on the bed system including written instructions on its care and operation.
The Red Cross is responsible for maintenance of the bed system and will either repair or replace the bed system as necessary in your home. If you require assistance, please contact Red Cross told free at 1-888-496-0103.
All bed provided through the program have a hand crank mechanism in case the power or the bed motor fails. However, if you have any questions or concerns, please contact Red Cross toll free at 1-888-496-0103.
If you cannot operate the bed system for any reason, please contact Red Cross toll free at 1-888-496-0103.
Home Oxygen Services
Nova Scotians who are eligible for Continuing Care services and who need oxygen for medical reasons can access this service. Medical eligibility for home oxygen services is determined by one of several designated respiratory physicians throughout the province. You must also have a physician who is responsible for your ongoing oxygen therapy.
To be medically eligible, you must have a chronic respiratory illness or dysfunction that requires long term oxygen therapy. Typically this service is appropriate for people with chronic hypoxemia and need oxygen for more than 18 hours per day. It may also be for you if you have a medical need for oxygen due to nocturnal exertional desaturation.
Through this program, you will be provided with an oxygen concentrator for your home, along with other supplies including a regulator, nasal cannula, oxygen tubing and a backup cylinder.
If you are eligible, you will also receive a portable oxygen delivery system for use outside your home. This system includes up to 10 oxygen tanks each month, costing up to $18 each, as well as a standard regulator, and a cylinder cart.
Most often, clients are referred to the Department of health for home oxygen services by a designated physician. To be considered for home oxygen services, you will also need to be assessed by a care coordinator at the Department of Health.
The province will pay for part, or all, of the cost of home oxygen services depending on your need, income, and family size. A care coordinator at the Department of Health will help you determine if you will be responsible for any fees. A list of fees (www.gov.ns.ca/DHW/CCS/FactSheets/Home-Care-Fee-Structure.pdf) is also posted on our website. If you are responsible for any fees, they are paid directly to the oxygen vendor. The vendor will invoice the Department of Health for the remainder of the cost.
To protect your health and safety, you must not smoke and must sign a non-smoking agreement.
Following the initial three month period, you are responsible for making arrangements with your physician to be tested to medical eligibility once again. You must also make sure your prescriptions are renewed at least once a year.
In addition, you must keep your care coordinator and oxygen vendor up to date on any changes to your emergency contact information or address. You should also let them know if you expect an interruption in your service. Should your address change, you are responsible for ensuring the home oxygen equipment is safely moved to your new home. Any costs for damaged equipment or additional supplies are your responsibility.
You will be asked to select a vendor of your choice from a list of approved vendors provided to you by the Department of Health. You must remain with the vendor you choose for at least one year. The vendor you choose will deliver, set up, and maintain your equipment.
The Department of Health will cover the cost of home oxygen services if you travel to another part of the province. However, we will not cover any additional costs you might incur. In addition, we will not fund your oxygen services if you travel outside Nova Scotia. Please remember that if you are absent from the province for more than 90 days, you will be discharged from the home oxygen service program.
We will continue to pay for your home oxygen service up to 30 days after you enter the hospital. Funding for the service will be placed on hold if you are hospitalized for more than 30 days. If you are in hospital for more than 90 days, you will be discharged from the Home Oxygen Services program.
Self Managed Care
The program is suitable for a person who requires ongoing physical assistance with the routine activities of daily living as a result of a physical disability. The person must be able to fully participate in decisions, make arrangements regarding his or her own care requirements, and enter into a contractual agreement. To be considered for Self Managed Care program funding, people must be assessed and meet program eligibility requirements.
The Agreement is a legal contract between the Department of Health Continuing Care branch and the self manager. It governs the terms and conditions of the funding care plan.
The person who receives funding under the Self Managed Care program:
- Signs an Agreement with the Department of Health
- Develops a care plan, in consultation with the care coordinator
- Employs care providers
- Develops an emergency back-up plan when the care provider is unavailable
- Ensure the Care Coordinator is notified when there is an interruption in service requirements, such as being admitted to a hospital
- Maintains a separate bank account and keeps all financial records
- Provides Continuing Care with complete accounting of program funding
- Accepts case management and support from Continuing Care
- Notifies Care Coordinator within 24 hours of significant change in health status
- Cooperates with Continuing Care on financial and quality audits.
The self manager must:
- Hire, train, supervise, and terminate care providers
- Perform scheduling and payroll activities
- Ensure quality of care provided by care providers
- Register with Canadian Revenue Agency and Workers' Compensation Board of Nova Scotia
- Comply with Nova Scotia Labour Standards
- Calculate appropriate deductions
An orientation is available to people who are interested in learning more about the requirements of the Self Managed Care program. The orientation session is mandatory for all registered clients. As well, a Client Guide can be found on the Department of Health website at the address below. A list of resources is included in this guide to help people prepare to manage and administer their services.
The Department of Health does not define required qualifications for service providers, however, the Self Managed Care program policy outlines that family members are not able to be hired. Family members who cannot be paid under the Self Managed Care program include:
- Parents or grandparents
- Spouse (or partners, living together in a spousal relationship)
- Children (by birth or adoption)
- Other relatives living in the same household.
If the support needs change, the client may request a reassessment. As well, the care coordinator can recommend modifications to the amount of funding in accordance with policies, procedures, and guidelines. Program funding can be stopped when a request is received within 30 days (written notice) by either the client or care coordinator. The client may choose to receive home support services directly from Continuing Care at this time. Continuing Care may stop funding if the conditions of the Agreements are not met.