Canadian home care regulations present a complex web of requirements. They exist at both the federal and provincial levels, with each government body setting forth its own set of rules for agencies to follow and its own unique roster of responsibilities.
Compliance in home care is, therefore, a pillar of operational excellence. Businesses operating in this space must keep a close eye on their regulatory obligations, as noncompliance can quickly lead to penalties and delayed repayments. Especially given the rapidly evolving landscape of immigration policies and demographic shifts, agencies have a responsibility to proactively seek out new information and updates lest they get left behind.
The Regulatory Landscape in Canadian Home Care
Though Canada has universal health care, home care is not counted among the covered services. The federal government’s role in shaping home care is limited to setting broad health principles, providing funding through various programs, and directly delivering services to groups including First Nations, Inuit, veterans, and federal inmates.
All other responsibilities related to planning, regulating, and providing home care are in provinces’ and territories’ hands. Each region decides who qualifies for home care, which services are covered, and whether they are provided by for-profit companies or non-profit organizations.
For example, Quebec treats home care as part of its public health system and relies more heavily on publicly employed staff. Ontario funds services but contracts them out to private providers, and British Columbia charges fees for some services based on clients’ incomes. In Atlantic Canada and the North – especially in rural and remote areas – access is more limited due to staffing shortages and relative isolation.
While the federal government largely controls the purse strings, it’s up to provinces and territories to manage design and delivery. The result is a patchwork of different care frameworks that are greatly influenced by location, despite home care’s growing prevalence as the population ages.
Important Federal Policies Impacting Home Care
On March 31, 2025, Canada launched the new Home Care Worker Immigration Pilots (HCWP). Managed by Immigration, Refugees, and Citizenship Canada (IRCC), these programs provide a pathway for skilled workers seeking a job offer to obtain their Canadian permanent residency.
Under this umbrella, there are two pilots: one for child care and one for home support, both of which are in very high demand across the country. Within each pilot, there are two application streams depending on whether an applicant is currently working in Canada or outside the country.
With labor shortages looming large, these pilots are expected to help meet increasing demand for home care by lowering barriers for workers and expanding eligibility, while also giving personal support workers stronger incentives to remain in Canada long-term. As a counterbalance, annual intake caps and job-offer requirements ensure the supply of workers matches the actual demand and that standards of employment are respected.
Workers in Canada Stream
The Workers in Canada stream is for individuals who are already employed on a valid permit or, in some cases, out of status but still working in care roles. Normally, having a lapsed permit or visa would disqualify an individual from applying for PR, but IRCC has made an exception: a limited number of personal support workers who are technically “out of status” but already working in child care or home care jobs may apply for residency through this pilot.
These applicants need a full-time job offer in either one of the two in-demand roles, plus basic requirements such as secondary education and an acceptable degree of English or French proficiency.
Applicants Not Working in Canada Stream
This stream is meant for people who are applying for residency from outside the country or currently in Canada without qualifying work experience. While it uses the same minimum requirements for language and education as the other stream, it also asks for proof of settlement funds and is subject to annual caps on the number of applications accepted. Both streams operate outside Quebec and require employers to provide valid full-time job offers at fair wages.
As of this writing, this stream has not yet started accepting applicants, and the government has not announced an official opening date.
Provincial Regulations & Licensing Requirements
Provinces and territories set the laws for who can provide home care, how practitioners are certified, and how care is enforced. Ontario is governed by the Connecting Care Act and recent amendments like Bill 135, which established Ontario Health atHome as a new organization that amalgamates its 14 Local Health Integration Networks (LHINs).
Some provinces use specific licensing frameworks, like British Columbia’s Community Care and Assisted Living Act. This set of laws governs residential care and some types of community care, while giving out licenses to eligible organizations. These licences come with conditions like safety standards, staffing expectations, and reporting requirements. Oversight is handled by a director of licensing and local medical health officers, who can inspect homes, investigate complaints, and issue penalties if rules aren’t followed. Agencies are also required to report serious incidents to regulators.
In Alberta, there is more than one set of home care licensing laws, but the province enforces strict standards for agencies to meet (called Continuing Care Health Service Standards). They detail the rules for things like staffing qualifications, record-keeping, and other day-to-day agency responsibilities. A provincial Licensing and Compliance Monitoring Branch oversees the application of these laws through facility and program inspections, ensuring agencies are following the rules and taking corrective actions if not.
In Quebec, home care is part of the public health and social services system instead of being run by private or separate agencies. Local health centers called CLSCs and larger integrated centers called CIUSSS are in charge of planning and delivering home care.
Quebec sets a single provincial standard for all public home care agencies to follow instead of giving out individual licences per provider. These standards cover service planning, record-keeping, and information sharing between health professionals. Inspectors and administrators ensure the rules are followed, and the government directly manages most of the workforce.
Ontario’s Connecting Care Act
Ontario’s Connecting Care Act centralizes planning and funding through Ontario Health atHome to standardize the province-wide quality, access, and integration of home care. It sets laws that require agencies to track metrics like client outcomes, wait times, and care documentation, alongside staff training and competency requirements. Agencies are also obligated to report safety incidents and maintain comprehensive care plans to maintain a high standard of care.
Newfoundland & Labrador Regulatory Approach
Newfoundland and Labrador’s Personal Care Home Regulations set the rules for operating licensed personal care facilities, including staffing, training, safety, accommodations, and record-keeping. Operators must meet specific requirements like maintaining liability insurance, respecting employee qualification standards, and ensuring personal support workers have the necessary training to provide care. The regulations also establish standards for elements of service quality, including client safety and proper documentation, which are verified and corrected by compliance inspectors.
Compliance Challenges & Solutions for Providers
Agencies that operate in more than one province or territory are prone to compliance challenges. Faced with a unique set of regulations for every jurisdiction, they must navigate different documentation standards, safety protocols, and other requirements that can cause confusion and increase the risk of non-compliance. Staying on the right side of these laws while continuing to deliver consistent, high-quality care is a heavy operational lift – and if agencies fall out of step, they can face hefty fines and service disruptions.
There are a few different ways for agencies to tackle these challenges. First, ongoing staff training gives personal support workers the tools to understand both general care standards and regional requirements, reducing the risk of errors or confusion. Consulting with legal and regulatory specialists can help agencies make sense of complex rules, prepare for inspections, and update their protocols as new regulations are passed down.
To connect all of these efforts, digital home care tools keep all stakeholders connected to a single source of truth. Electronic health records, compliance dashboards, and automated reporting systems create a single access point for documents and staff certifications, with built-in features that treat sensitive information according to regulatory requirements.
Prepare for Canadian Home Care Regulations With AxisCare
Whether you’re breaking into a new market or expanding your current footprint, AxisCare can help you achieve operational excellence at every level. Our software will automatically keep your agency up-to-date on diverse and ever-evolving regulations across Canada, plus countless other purpose-built features. Request a free demo to find out how!
