Community Health Services

Community Health Services (CHS) provide in-home and community-based care to help people remain healthy and independent.

If your patient is facing challenges living safely at home, we can help.

Our services include home support, case management, and clinical supports such as rehabilitation therapy, nursing, and social work. Our services range from basic personal care (shower assist, med administration) through to complex clinical care for medically frail clients, some of whom are at end-of-life.

How to Refer

Call Our Practitioner Connectors*

North Island:    250-331-8060

Centre Island:  250-739-5922

South Island:    250-519-5282

*For Primary Care Providers only.

Practitioner Connectors are experienced nurses who offer tailored support for you and your clients. They will discuss the client's functional or clinical needs and desired outcome. Practitioner Connectors can also provide referrals and information about relevant services, programs, and resources within Island Health or with community partners.

Practitioner Connectors can:

  • Process referral requests for palliative care and wound care.
  • Connect practitioners to their patient’s community health team.
  • Explore private community resources that might fit the patient/family member’s need(s).
  • Process referrals to case management for case management for ongoing community care, Assisted Living or Long-Term Care..
  • Process referrals to the Geriatric Specialty Services Team (formerly SORT).

Clients and family members can also refer themselves to our services by calling the Community Access Line.

Our Services

Case Management

Case Managers provide assessments and coordinate access to appropriate services for clients who require on-going community care or support.

They help clients and their families:

  • Identify care needs.
  • Understand care options.
  • Connect with appropriate services (e.g., Adult Day Services, Home Support, or Assisted Living).
  • Help with moving to more supportive care when needed.

Case Managers also work with patients and families to ensure smooth transitions between hospital and home, assisted living, or long-term care.

Cost: No costs attached.

Home Support Services

Home support is care provided in the home for people who:

  • Are ill or recovering from illness or surgery.
  • Have physical disabilities.
  • Need assistance with personal care tasks.
  • Need caregiver respite (short-term break from care).
  • Need end-of-life care.

Home support can include help:

  • Getting dressed, groomed, and ready for the day.
  • Bathing, showering, and using the toilet or commode.
  • Heating and serving a simple meal.
  • Getting ready for bed.

Cost: Costs attached.

Nursing

Nursing services are provided in the home and in local ambulatory clinics.

Services include:

  • Assessment, education, and counselling
  • Skin and wound care
  • End-of-life/palliative care
  • Medication management
  • Cardiac health
  • Post-surgical care
  • Post-hospital care
  • Pain management
  • Intravenous care
  • Chronic disease management
  • Ostomy care

Cost: No costs attached.

Rehabilitation Services

Goal-focused physiotherapy and occupational therapy to optimize independence and safety in the home environment.

Occupational Therapists help clients look at ways to continue to care for themselves and be as active/independent as possible. They can:

  • Look at how well clients are able to look after their own daily care needs
  • Identify changes that can make it easier for clients to care for themselves at home
  • Show clients ways to change or modify things in the home to make the home a safer and easier place to live
  • Suggest equipment or devices that help with daily activities and safety

Physiotherapists help with problems caused by pain, injury, disease, or a medical condition. They can:

  • Identify activities and exercises to help with pain and weakness, and make it easier for to move around
  • Suggest equipment and aids to keep clients mobile and safe at home

Cost: No costs attached.

Geriatric Speciality Services

Specialized assessment and support services for frail seniors with complex physical and mental health conditions.

Services include:

  • Functional cognitive assessments and strategies
  • Exercise classes aiding physical function and balance with transition to community classes
  • Complex medication and medical management education and monitoring
  • Family counselling, future planning, and transition management for clients and caregivers
  • Support with psychosocial function, grief and loss, depression and anxiety
  • Liaising with community partners and access to community resources

Cost: No costs attached. Services provided in the south of the Island Health region only.

Social Work

Community Social Workers provide services that support the safety and well-being of people experiencing healthcare challenges.

They focus on short-term interventions including:

  • Advance Care Planning
  • Adjusting to illness
  • Finances and financial assistance
  • Housing issues impacted by medical condition
  • Caregiver support Suspected adult abuse and neglect
  • Palliative care/bereavement
  • Confusion/dementia behaviour management
  • Advocacy

Cost: No costs attached.

Community Nutrition

Registered Dietitians provide assessment, consultation, counselling, and education.

Community Health Services dietitians can also help with health issues such as:

  • Diabetes
  • Swallowing disorders
  • Malnutrition
  • Healing of wounds and pressure ulcers
  • Tube feedings
  • Gastro-intestinal diseases
  • Chronic health conditions
  • Palliative care

Cost: No costs attached.

Assisted Living 

A supportive living environment and help with daily tasks for eligible clients.

Cost: Costs attached.

Health Services for Community Living (HSCL)

Care planning, education, advocacy, and direct care for adults with developmental disabilities.

This non-emergency services adds to and complements existing formal and informal community services.

HSCL addresses the importance of health in its broadest sense, i.e., optimal physical, emotional and intellectual health for the individual in their community.

Cost: Services are free of charge. This service delivery is carried out in partnership with Community Living BC.

Caregiver Support

Therapeutic and recreational activities, and caregiver respite for seniors and people with disabilities via our Adult Day Services, Facility Respite Care services, and  Community Virtual Care Caregiver Support program.

Cost: Costs attached (no costs attached to Community Virtual Care Caregiver Support program).

Community Bathing Programs

Bathing assistance in special bathtubs at facilities across the Island Health region.

Cost: Costs attached.

Partner Programs

Acquired Brain Injury Program: Services to help regain, improve, or maintain function and independence for adults with acquired brain injuries.*

Adult Mental Health and Substance Use Services: A range of services from short-term crisis intervention to rehabilitation and housing for adults with serious mental illness and/or substance use issues.*

Hospice Palliative & End-Of-Life Care: Services for dying people of all ages and their families. 

Long-Term Care: 24-hour professional care and supervision for adults with complex medical and cognitive care needs.*

Community Virtual CareVirtual programs that include chronic disease monitoring and education, palliative supportive care, and caregiver support.

Cost: Services with an asterisk (*) have costs attached.

Eligibility and Costs

The Ministry of Health sets the eligibility and costs for Community Health Services. To be eligible for Home Care Services, a client must be:

  • A Canadian citizen, landed immigrant, or have a Temporary Residence Permit
  • A resident of BC for at least 3 months
  • 19 years of age or older
  • Unable to function independently because of chronic health problems, or needing care due to:
  • A life-limiting condition
  • A recent discharge from an acute care hospital
  • Care required to prevent or reduce the need for hospital services or admission to a long-term care home

Services and programs with costs attached have program-specific eligibility requirements.

Home Support Services, Assisted Living, and Long-Term Care programs base their cost calculations on each client’s current income.

Service and program availability may vary by region.