Market-Modelled Home Care in Ontario: Deteriorating Working Conditions and Dwindling Community Capacity

The closure of a non-profit, unionized home support agency in Hamilton in 2002 offers an illuminating case study of the local impacts of Ontario's contractual approach to home care. A survey of the 317 support workers who were laid off revealed that only 38 percent stayed in the home-care sector; most were absorbed by for-profit, non-unionized agencies where their employment conditions deteriorated. These findings are at odds with the long-established connection between quality of home-care employment and quality of home-care service. They have implications for developing criteria for dispersing public funds in mixed economies of community care, and for conceptualizing the capacity-building responsibilities of governments in their coordination.