Publicly Funded Home Care Quebec: CLSC, EESAD, and PEFSAD Programs

Quebec's public home care system is one of the most comprehensive in Canada — but families rarely discover its full scope until they've already spent thousands on private agencies. The province delivers home care through three parallel channels, each covering different types of support.

Channel 1: CLSC Direct Services (Free)

Your local CLSC provides clinical and personal care services at no charge. These are delivered by unionized, public-sector staff — nurses, personal support workers, occupational therapists, and physiotherapists employed by the regional CISSS or CIUSSS.

Services include:

• Nursing care — wound care, medication administration, catheter management, chronic disease monitoring
• Personal hygiene support — bathing, dressing, grooming, toileting assistance
• Occupational therapy — home safety assessments, adaptive equipment recommendations
• Physiotherapy — post-surgery rehabilitation, fall prevention exercises, mobility training
• Equipment loans — walkers, bath benches, hospital beds, transfer aids, provided at no cost

The number and type of services your parent receives are guided by the ISO-SMAF profile and assessed needs. Profiles 4 to 9 are candidates for enhanced public home care, community support, or Intermediate Resources (RIs).

Channel 2: EESAD Domestic Help (Subsidized)

Cleaning, laundry, meal preparation, and light housekeeping are not covered by CLSC direct services. These domestic tasks are delivered by accredited social economy enterprises — Entreprises d'economie sociale en aide a domicile (EESADs).

EESADs are non-profit organizations contracted by the provincial government. They employ trained domestic workers who provide regularly scheduled help in seniors' homes.

Costs and subsidies: The PEFSAD program (Programme d'exoneration financiere pour les services d'aide domestique) subsidizes EESAD services based on income. The subsidy has two components:

• A fixed exemption of $4.00 per hour for all eligible seniors
• A variable exemption that increases as income decreases

After subsidies, the net out-of-pocket hourly cost ranges from $9.52 to $31.60, depending on the senior's household income. Compare that to private cleaning agencies, which charge market rates with no subsidy.

To access EESAD services, your parent's CLSC care coordinator can refer your parent to a regional EESAD. Ask the coordinator or EESAD about the PEFSAD subsidy application.

Channel 3: AAD Direct-Hire (Subsidized)

The Allocation autonomie a domicile (AAD), formerly known as Cheque emploi-service, lets your parent hire their own caregiver directly — including family members. The government provides a financial allocation toward the caregiver's wages, and the CTAAD handles all payroll and employer obligations.

This option is ideal for families who want continuity of care (the same person every day) or who have a trusted family member willing to provide care. The CLSC determines the hourly AAD allocation from assessed needs, and the CTAAD handles payroll and tax withholdings.

Stacking Programs for Maximum Savings

These three channels are not mutually exclusive. A well-optimized care plan might include:

• Free CLSC nursing visits three times a week
• EESAD domestic help twice a week (subsidized through PEFSAD)
• AAD-funded family caregiver providing daily personal care
• The provincial CMD tax credit reimbursing 40% of eligible home-support expenses

The CMD tax credit (Credit d'impot pour maintien a domicile) reimburses 40% of eligible home-support expenses for seniors aged 70 and older. Verify current eligibility and stacking rules before claiming the CMD credit with PEFSAD for the same EESAD services.

Getting Started

All three channels are accessed through the CLSC. Call 811 (Option 2 for Info-Social) or visit your parent's local CLSC to open a case file. The CLSC care coordinator will assess your parent's needs and connect you with the appropriate programs.

The Quebec Elder Care Decision Guide includes a home care program comparison worksheet and a step-by-step financial calculator for comparing PEFSAD, AAD, and CMD tax credit savings.

See more Quebec guides →