For the past decade, targeted federal funding has helped more Canadians receive care in their own homes. With the bilateral health agreements winding down, Ottawa now needs to decide what comes next. Renewed federal funding can protect the progress already made while addressing gaps the existing agreements have left behind. 

Provincial health ministers are right to call for continued targeted health funding. In Ontario, the Aging with Dignity bilateral agreement has delivered hundreds of thousands of additional hours of personal support, nursing and therapy services in people's homes. 

We have seen what happens when governments invest in both the home care workforce and the infrastructure behind it. OCSA's analysis found that previous investments reduced PSW turnover by 38%, helping retain more than 1,000 workers. Providers added 1,400 new PSWs and 1.8 million additional hours of care, while preventing more than 1.5 million missed personal support and nursing visits. The added capacity was equivalent to 28 hospital beds and 345 long-term care beds. 

Despite those improvements, workforce pressures remain significant. A 2026 study found 23% annual PSW turnover, with 85% of new hires replacing workers who left. Ontario research has also found home care PSW wages roughly 26% below those in long-term care. And wages are not the only challenge. As clients' needs grow more complex, providers need supervisors, clinical supports, technology, data systems and training to deliver care safely. If federal funding ends, that progress is at risk. 

Federal funding also needs to expand beyond home care. Community support services are the meals delivered to a frail senior's door, rides to medical appointments, adult day programs that provide socialization and caregiver respite, homemaking help and assisted living services. They are often what keeps someone out of hospital and out of long-term care, yet they have largely been left out of targeted federal funding. 

The consequences are already visible. The National Institute on Ageing reports that just 54% of Ontario seniors say they can access the community support services they need all or most of the time, while one in five say they rarely or never receive the services they need. That suggests roughly 135,000 people face significant unmet need today. 

For those Ontarians, this isn't an abstract funding gap. It can mean going without a meal, missing a medical appointment or help bathing or dressing. It can mean a family caregiver reaching the breaking point. 

Simply keeping pace with population ageing would require Ontario to increase community support services funding by almost $300 million over the next five years, according to OCSA's estimates. And that would only maintain today's level of access, without reaching anyone currently going without. Beginning to close that gap could require about 40% more annual capacity by 2031, before inflation and wage pressures. 

Ontario has made a significant commitment, including $1.1 billion in new investment for home care over the next 3 years alone. But provinces cannot meet a demographic challenge of this scale alone. 

The federal government should do two things. First, renew targeted home care funding so that the gains in workforce stability and service capacity are not lost. Second, create dedicated, sustained funding for community support services, the part of the system that keeps people well at home but has so far been left behind. 

Through Aging with Dignity, Canada has already committed to helping seniors and people with disabilities live well in their own homes and communities. Keeping that promise means funding the full range of care that makes living at home possible. 

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