Self-Managed Attendant Services in Ontario What is Direct Funding?
Direct Funding is an innovative program enabling adults with physical disabilities to become employers of their own attendants.
Attendants assist with routine activities of living, such as dressing, grooming and bathing.
As employers, participants are fully responsible for managing their own employees within a budget that is developed on an individual basis. Different people have different needs. Direct Funding is intended as an option suited to people with physical disabilities who are willing and able to take on the extra management responsibilities (and possible risks) of the program. Available province wide, the Direct Funding Program enables adults with physical disabilities to receive monthly funds for attendants of their own choosing, to schedule as they please - whether their needs are at home, at work, or in the community. Individuals self-manage their lives, making their own choices with greater flexibility and control.
Through the Direct Funding Program, people with disabilities become the employers and self-managers, taking full responsibility for hiring and managing their own attendants and determining how and when their services are provided. The program is portable, meaning participants can live and travel anywhere within the province of Ontario, taking their services along with them. Direct Funding operates within guidelines set by the Ontario government. You can apply if:
- You are age 16 or over
- You are a resident of Ontario
- You require attendant services due to a permanent physical disability
- You are able to complete the written application on your own initiative and in your own words (you may receive physical assistance to complete the form; however, submissions may not be made by professionals, family members or others on your behalf)
- You are able to schedule attendants
- You are able to hire (and fire, if necessary), train and supervise one or more attendant workers
- You are able to meet all the legal requirements associated with being an employer (these will be clearly explained during the interview process)
- You are capable of managing and accounting for your funding, according to DF program guidelines
The Direct Funding Program is administered by the Centre for Independent Living in Toronto (CILT), Inc., in partnership with the Ontario Network of Independent Living Centres (ONILC). It is funded by the Ontario Ministry of Health and Long-Term Care through the Toronto Central Local Health Integration Network.
Under the direct funding page, can we add another page called self assessment: this can include Self-Assessment
How do I know if DF is right for me?
If you are considering submitting an application to the Direct Funding Program for yourself, or referring a client, you should know that Direct Funding is often the right program for the person who needs attendant services, who wants more control over those services and who is willing to accept responsibility for managing those services. Although the management aspects can seem daunting at first, almost 700 people across Ontario are managing their own services very successfully. Following are a few points to keep in mind if you are thinking of Direct Funding for yourself or your client:
1. You must able to self-direct, which means you understand your disability including what assistance you need, when and how you need it and you can instruct attendants to help you.
1. Self-management, in terms of the Direct Funding Program, describes an individual who is willing and able to accept the responsibilities of recruiting, hiring, training and paying the attendant staff they need to live independently. A self-manager must be able to make difficult decisions about which people they want to hire, and, if the situation arises (which it may) which people must be fired. Direct Funding requires an individual, or “self-manager” to become an employer, register with Revenue Canada, and submit the required monthly and quarterly government submissions. There is money in the budget to hire a bookkeeper and a good bookkeeper is a key part of Direct Funding but ultimate responsibility always rests with the self-manager. Once again, this may sound like a lot of responsibility for someone new to the world of self-management but the plus is that many people are able to hire long-term, reliable staff. Much of this has to do with the important personal fit that can be found when people hire their own attendants.
Following is the list of eligibility criteria for the program. A person must meet all the eligibility criteria for the program in order to receive Direct Funding.
Eligibility Criteria
These eligibility criteria reflect the Regulation Made under the Ministry of Community and Social Services Act: Grants for Persons with Disabilities, which stands as the final authority.
To be eligible for the program a person must be a resident of Ontario, hold a valid Ontario Health Card and must meet ALL the following criteria:
A person is an eligible person for the program if he/she:
- is at least 16 years old;
- requires attendant services as a result of a permanent physical disability;
Service Needs
- requires the attendant services referred to in at least two of 1 to 8 and at least one of them is from 1 to 4 of the following:
- requires attendant services as a result of a permanent physical disability;
“Attendant services” means assistance with activities of living referred to in 1 to 8 of the list below.
An “attendant worker” means a worker who provides any of the attendant services referred to in 1 to 8 of the list below.
- turning in bed, lifting, positioning or transferring;
- washing, bathing, showering, shaving or personal grooming;
- dressing or undressing;
- catheterization, emptying and changing a leg bag, using the toilet, urination or bowel routines;
- breathing, or caring for a tracheostomy or respiratory equipment;
- eating;
- meal preparation, dish washing, laundry or other housekeeping tasks; and
- essential communication;
- has attendant services requirements that have been stable over a period of at least one year;
- has service requirements that can be met while residing in his/her home;
Self-Directing
- understands the nature of his/her disability and its impact on his/her ability to carry out the essential activities of daily living;
- is aware of the type of attendant services he/she requires and when, how much and how assistance should be provided;
- is capable of scheduling his/her attendant services as well as making alternative arrangements to ensure that his/her requirements are met in case an attendant worker is not available at a scheduled time;
- is capable of training or arranging the training of, supervising, instructing and communicating with attendant workers;
Managing
- is capable of recruiting, hiring and dismissing attendant workers;
- is capable of understanding and carrying out the responsibilities as an employer of one or more attendant workers;
- is capable of managing and accounting for the expenditure of the funds that would be granted to him/her;
- is capable of evaluating the attendant services he/she would receive and of communicating his/her evaluation; and
- is prepared to undertake the functions referred to in clauses mentioned above and to assume the responsibility and risks inherent in undertaking those functions.
FAQ
No, the program welcomes new applications at this time. If you are interested in Direct Funding, you are encouraged to apply and get on the waiting list.
The average wait for an interview is less than a year, but this is subject to change.
No. We interview applicants at their nearest Independent Living Resource Centre, including cities such as Collingwood, Kapuskasing, Kingston, London, Ottawa, Parry Sound, Sudbury, St. Catharines, Thunder Bay, Toronto, and Waterloo. We also conduct interviews in other Ontario cities/towns. If travel is difficult for you, let us know; we will try to find a suitable location and also offer hybrid interviews.
Finding attendants can be done in a variety of ways, including online job boards such as Craigslist and Kijiji. Some participants place ads in local newspapers or on supermarket bulletin boards. Even in small communities, finding attendants is not usually difficult as it is regular employment. Since you train your attendants, they do not need to have special experience.
This is a common concern but not frequently experienced. The relationship between attendants and participants in the program is different from traditional services. In Direct Funding, the attendant works for you, the employer, and a close relationship of trust and reliance often develops. Attendants are usually reliable. If an attendant needs to be absent, they would inform you, and you can call upon your backup attendant(s). Temporary help from an agency is also available in emergency situations.
Self-managers have devised various arrangements for night-time coverage, such as "sleep-over" arrangements or having someone on call. Sleep-overs can be included, typically at a different rate than daytime shifts, especially if the person can sleep during the night.
The program serves people with a high level of disability who are generally satisfied with it. Needs range from about 1 hour per day to 7 hours per day (or higher for full-time ventilator users). We can connect you with someone who has similar needs. However, the program may not be suitable for everyone, especially those who are very ill or need constant "looking after."
Once you get started, managing the system is not very labor-intensive. A significant help is the funding provided to hire a bookkeeper for payroll and financial reports. Participants often use community resources for advice and support. There is also a network of successful self-managers and trained staff at each ILRC who can assist.
To qualify, you must meet the eligibility criteria listed in the Direct Funding Application Guide and demonstrate this in an interview. Direct Funding involves personally managing your attendant services. There are other, less hands-on options for attendant services in Ontario. Contact your CCAC, local Independent Living Resource Centre, or visit CILT's website under the Attendant Services section for more information.
Direct Funding allows you to have control over your attendant services. You choose your attendants and schedule them around your needs. The program offers control, flexibility, and choice in your attendant services, with funding that is portable within Ontario.
Direct Funding is portable within Ontario. If you move, simply inform us of your new address and phone number; you do not need to be reassessed for the program.
Yes. Many participants with no use of their hands or who are non-speaking successfully manage on Direct Funding. You may use augmentative communication methods to direct the assistance you need. Assistance with the application and paperwork can be provided by others under your direction.
Immediate family members cannot be employed or paid as attendants under the Direct Funding Program. This includes parents, children, siblings, spouses, or persons with whom the participant has lived for at least 1 year. Employing family members is discouraged due to potential conflicts of interest and management challenges.
Direct Funding is generally a lifelong program for Self-Managers, but continuation depends on meeting eligibility criteria and program obligations. Responsibilities include recruiting, hiring, training, and managing staff, complying with employment legislation, and maintaining accurate financial records. Termination is rare but possible if the participant breaches their legal agreement.