British Columbia caregiver guide
BC CSIL: Choice in Supports for Independent Living
Last reviewed: September 2026 — program rules, eligibility requirements and funding amounts can change. Verify current information with your health authority before applying.
CSIL is the self-directed option within British Columbia's publicly funded home-support system. Instead of a home-support agency sending workers on a set schedule, an eligible client receives funding through their regional health authority and takes responsibility for arranging their own support. For families, CSIL is often the part of BC's system that comes closest to the question people actually arrive with: can the person who already provides the care be paid to provide it?
What Is CSIL?
CSIL stands for Choice in Supports for Independent Living. It is a home-support option for eligible people in British Columbia who have significant physical care needs and who want direct control over how that support is delivered.
Rather than receiving services from an agency, the client — or an approved representative acting for them — receives funds and uses those funds to hire and manage their own home-support workers. The health authority still assesses need, approves the funding and monitors how it is used.
How CSIL Differs From Traditional Home Support
With traditional home support, the health authority contracts an agency. The agency employs the workers, decides who is sent, and sets the visit schedule within the approved hours. It is a lower-administration option, but the family has limited say over who arrives and when.
With CSIL, the client becomes the employer. That means real choice — the same familiar person can provide care, visits can be scheduled around the household's actual routine, and continuity is far easier to maintain. It also means real responsibility: recruiting, payroll, scheduling, record-keeping and reporting all sit with the client or their representative.
Neither option is better in the abstract. CSIL suits households that want control and can manage the administration; agency-delivered home support suits households that would rather not take on an employer role.
Who May Be Eligible for CSIL?
Eligibility is determined by the regional health authority through an assessment. Factors that can be considered include:
- Assessed home-support needs through the regional health authority
- Significant physical care needs
- A physical disability
- Medical stability
- The ability to manage and direct care, either independently or with an approved representative or client support group
Meeting some of these factors does not guarantee approval. If the person cannot direct their own care, CSIL may still be possible through a representative or a client support group, depending on the circumstances and the health authority's rules.
How CSIL Funding Works
Funding follows the assessment. The health authority determines the hours of home support the person is assessed as needing, converts that into a funding amount, and provides the funds to the client on an ongoing basis.
The funds are for the assessed home-support services — not a general allowance. Clients are expected to manage spending within the approved amount, keep financial records, and account for how the money was used. As with other publicly subsidized home and community care, a client rate based on income may apply.
What "Self-Directed" Actually Means Day to Day
Self-directed means the client holds the management role an agency would normally hold. In practice, that includes:
- Recruiting, hiring and supervising home-support workers
- Setting schedules and arranging coverage, including for illness and holidays
- Managing the CSIL funds within the approved amount and keeping required financial records
- Meeting employer-related obligations associated with paying workers
- Reporting to the health authority as required
This is the part families most often underestimate. It is worth deciding in advance who will handle scheduling and paperwork, especially if that person is also providing care.
Can a Family Member Be Paid Through CSIL?
In some circumstances, yes. BC policy allows certain family members to be paid to provide care to an eligible CSIL client. This is not a blanket permission and it is not a blanket prohibition — it depends on the relationship and the circumstances.
Non-immediate family members
A family member who is not an immediate family member may be hired and paid when the applicable requirements are met, in the same way as any other home-support worker.
Immediate family members
Payment to an immediate family member generally requires an exception approved by the health authority. The exception process exists precisely because there are situations where the immediate family member is the most appropriate person to provide the care.
Why an exception may be considered
- Rural or remote circumstances where other suitable workers are difficult to find
- Cultural or communication needs that make a specific caregiver more appropriate
- Limited availability of other qualified caregivers
- The nature and intensity of the care required
- Whether appropriate respite can still be arranged for the family caregiver
Eligibility, funding and exceptions are determined by the applicable health authority and program rules — not by FeatherKeep, and not by anything you read online. Ask your case manager directly about your situation, and keep a written record of what you are told.
The Application and Assessment Pathway
CSIL is reached through the regular home and community care route rather than a separate application portal. In broad terms:
- Contact the regional health authority and request a home and community care assessment.
- A case manager assesses the person's care needs and eligibility for home support.
- If home support is approved, ask specifically whether CSIL is an option.
- Discuss who would direct the care and whether a representative is needed.
- Raise the question of a paid family member early, including any exception process.
- If approved, set up the employer arrangements, records and reporting before care begins.
Timelines vary by health authority and by how complete your documentation is when you start.
Questions to Ask Your Health Authority
- Is the person I care for likely to meet the assessed criteria for CSIL?
- How many funded hours would the assessment support?
- Can a representative or client support group manage CSIL on their behalf?
- Which family members, if any, could be paid in our circumstances?
- What does the exception process involve, and how long does it usually take?
- What records and reporting will we be responsible for?
- How is respite handled if a family member is also the paid worker?
CSIL Documentation Checklist
Assessments and exception requests go better when the picture of daily care is already written down. Gather these before your first conversation:
- Assessment reports and correspondence from the health authority
- Medical documentation describing the diagnosis and functional limitations
- A current list of daily care needs and how much help each one takes
- A record of caregiving hours by date, task and duration
- Names and contact details for doctors, case managers and other providers
- Notes on the availability of other caregivers or workers in your area
- Any written communication about a family-member exception request
- Financial and payroll records once CSIL funding begins
Organize Your Caregiving Journey With FeatherKeep
CSIL asks a household to behave like a small employer: assessments, schedules, hours, receipts and reporting. FeatherKeep gives that material one home — care notes for what changed and when, caregiving hours for the work actually done, documents for the assessment and correspondence, and a care journey that shows how needs have progressed over time.
That record is useful long before CSIL is approved. It is what turns a difficult conversation about need into something you can show.
Care notes
Keep important observations, updates and care information organized.
Caregiving hours
Maintain an ongoing record of caregiving time and activities.
Documents
Keep important caregiving-related information organized and easier to find.
Care journey
Build an organized record of the caregiving journey over time.
FeatherKeep is an organization tool. It does not determine government eligibility, apply on your behalf, or guarantee that you will receive a benefit.
Official sources
Program rules, eligibility requirements and benefit amounts can change. Verify current information with the official government or program source before applying.
CSIL is one of several options. For the full picture, see financial assistance for family caregivers in BC, or read about the BC caregiver tax credit.