Self-directed personal assistance service

Summary#

• Purpose: to create a Self-Directed Personal Assistance Program for people with disabilities, with financial assistance to hire assistants chosen by the individual.
• Administration: Retraite Québec manages the program; the Minister of Family, Seniors, and the Status of Women oversees the reports.
• Eligibility: must reside in Quebec and have a need for assistance. Exclusion if living in a "substitute living environment" (e.g., establishment or accommodation resource), unless committed to moving out of this environment within the year.
• Benefit: base amount = hourly rate (set by regulation, competitive) × monthly assistance hours. Cash payment, monthly, starting the month after the application. Annual indexing.
• Recognized hours: determined by the individual's self-assessment and evaluation by a designated professional. Review every two years.
• Possible increases: specialized assistance (with medical report), support for service management, payroll and administrative costs, training for assistants, equipment and safety, employer liability insurance, travel/outings costs for assistants.
• Providers: individuals (including a family member) or non-profit organizations. The provider can perform all actions that the person would do themselves if not for their disability.
• Rights and obligations: assistance from Retraite Québec to understand and apply for the benefit; annual declaration with time sheets; supporting documents for increases. Possibility of suspension in case of failure to declare. Written notice 10 days before a reduction/cessation related to an undeclared situation.
• Cumulative: the benefit can be combined with other programs and financial assistance.
• Recourse: internal review (doctor + social professional), then Administrative Tribunal of Quebec (TAQ), with specific deadlines.
• Coming into force: six months after the law is sanctioned. At this stage, it is a bill.

What This Means for You#

• People with disabilities

  • More control: you choose who assists you, when, and how.
  • Monthly financial assistance to pay for assistants, possibly including a relative.
  • Possible combination with other programs; unused amounts from one month can be carried over to the next month.
  • Steps: application to Retraite Québec, required documents, sometimes a medical report; reassessment of needs every 2 years.
  • If you cannot manage the benefit, it can be paid to a person or organization that administers it for you.

• Caregivers and assistants

  • Possibility of being legally compensated for assistance.
  • Training and employment-related costs (pay, liability insurance, equipment) can be covered by increases.

• Non-profit organizations

  • New source of contracts to provide personalized assistance services.

• If you live in a substitute living environment

  • Not eligible, unless you plan and implement, within the year, a solution to live outside this environment.

• Recourse and service

  • Retraite Québec must help you understand the program and contest a decision.
  • Possibility to go to the TAQ if the review does not satisfy you or is delayed.

Costs#

• No publicly available information.
• The cost will depend on:
  • The hourly rate set by regulation and the number of recognized hours.
  • The number of eligible individuals.
  • Increases (specialization, administration, training, equipment, insurance, travel).
  • Administrative costs at Retraite Québec.
• Potential savings are possible if the program reduces institutionalization and pressure on other services, but nothing is quantified.

Supporters' Viewpoint#

• Strengthens the autonomy, dignity, and social participation of people with disabilities.
• Offers flexibility: choice of assistants, including family, and adaptation to evolving needs.
• Simplifies funding: cash benefit, indexed, combinable with other aids.
• Equity: eligibility based on the need for assistance, regardless of the cause of the disability, age, or financial situation.
• Clear quality and recourse mechanisms (assistance with application, review, TAQ).
• Could reduce dependence on substitute living environments and lighten the burden on caregivers.

Opponents' Viewpoint#

• Budget uncertainty and risk of overruns if demand is high or if the hourly rate is high.
• Workforce: difficulty in recruiting and retaining assistants, especially in rural areas; risk of shortage.
• Quality and control: risk of abuse or poorly managed benefits; administrative burden for beneficiaries (declarations, documents).
• Possible overlap with existing services (home support, employment check), complicating the process.
• Choice of Retraite Québec as administrator could raise questions of capacity and consistency with the health and social services network.
• Possible territorial inequities if access to evaluating professionals or assistants varies by region.
• Exclusion of people in substitute living environments deemed too strict by some, even with the transition clause.