The clinical team, not a budget formula

Home care allocations are determined by a clinical team at the CLSC — typically led by a nurse or occupational therapist — based on the standardized functional assessment. The decision reflects clinical judgment about what services are medically and functionally necessary.

Funding constraints and CLSC capacity do play a role in practice, even if care is technically supposed to be need-based. Different territories may have different waiting lists and resource pressures.

Who is involved

The assessor: The clinician who conducts the in-home visit (often a nurse or OT) documents functional status across all domains using the Système de mesure de l'autonomie fonctionnelle (SMAF) or a similar tool.

The care coordinator: Reviews the assessment and coordinates the care plan. They are your main point of contact for ongoing services.

The interdisciplinary team: For complex cases, the care plan may be reviewed by a team that includes social workers, physicians, physiotherapists, or other specialists.

The process is not fully transparent

Families are typically told the allocation — how many hours, which services, how often — but are not always given a detailed explanation of how the number was arrived at.

If you want to understand the reasoning, you can ask the care coordinator directly: "Can you explain what the assessment found and how the care plan was determined?"

You have the right to disagree

If you believe the allocation is insufficient, you can:

1. Ask for a more detailed explanation of the care plan
2. Provide additional information or documentation that was not considered
3. Request a formal review of the decision
4. File a complaint with the CLSC's Quality and Complaints department

See Disagreeing with your care plan for the full process.