• The Home Care Cost Model: A Reference Framework for Aging in Place in Canada
  • The cost model
  • Datasets
  • Engines
  • Findings

§The Home Care Cost Model: A Reference Framework for Aging in Place in Canada

Families across Canada routinely make high-stakes decisions about home care for older adults and people living with disability. Three distinct service categories — personal support (PSW, HCA, HSW), skilled nursing (LPN, RN), and housekeeping or cleaning services — are regulated, priced, and subsidised differently and cannot be freely substituted. The single most common misunderstanding is whether a housekeeper or cleaning service can substitute for a PSW. Legally, the answer is no whenever personal care tasks are required.

§The cost model

The reference implementation takes an assessment triple (Katz ADL score, Lawton IADL score, cognitive and mobility status), the recipient’s jurisdiction, household composition, and primary diagnosis, and returns a recommended service mix, private-pay cost, allocated subsidised hours, and a full federal-plus-provincial tax relief stack indexed to the 2026 taxation year.

§Datasets

Eight open datasets are published under CC BY 4.0:

• home_care_services_canada.csv — scope of practice and rate bands across 13 Canadian jurisdictions
• home_care_tax_parameters_2026.csv — METC, DTC, CCC, VAC VIP parameters
• home_care_subsidy_programs.csv — provincial and territorial subsidised programs
• home_care_scenarios.csv — 5,000 synthetic household scenarios
• home_care_per_province_rate_bands.csv — CPI-adjusted 2019–2026 rate bands
• home_care_cost_model_archetypes.csv — canonical archetype lookup grid
• home_care_tax_relief_sensitivity.csv — tax credit sensitivity by income band
• home_care_subsidy_gap.csv — cross-province subsidy gap analysis

§Engines

Seven language implementations (Python, Rust, Java, Ruby, Elixir, PHP, Go) compute identical results to the cent.

§Findings

• Hybrid service mix (PSW for personal care + cleaning service for housekeeping) is typically 10–20% cheaper than an all-PSW plan.
• METC + DTC + CCC stacking reduces eligible households’ out-of-pocket by 15–35% but is routinely under-claimed.
• Cross-province subsidy gap (model-recommended hours vs allocated hours) varies by a factor of three.

Reference model only. Not clinical or financial advice.

Working paper: https://www.binx.ca/guides/home-care-cost-model-guide.pdf Zenodo DOI: 10.5281/zenodo.19491364 Repository: https://github.com/DaveCookVectorLabs/home-care-cost-model