This article is reprinted from “The Quill”, Boyne Clarke’s Personal Injury Group’s newsletter, Editor – Matt Napier,

Since December 2005 the Department of Health has been offering the Self Managed Care program. So far the response has been terrific allowing many Nova Scotians with disabilities to take their care into their own hands.

“We have reached our budget capacity but we are going beyond that because of the wonderful response,” said Carolyn Maxwell, Service Delivery Coordinator, Nova Scotia Department of Health, Continuing Care Branch.

The Self Managed Care program is a progressive approach to ongoing care. Funds, based upon the program guidelines, are provided to the eligible individuals and it is left up to them to develop their own care plans and directly arrange and administer their own support services, this includes hiring, training and paying care providers. The program is designed for people who require ongoing physical assistance with routine activities of daily living. To qualify each person must be able to fully participate in decisions, make arrangements regarding their care requirements and enter into a contractual agreement.

The program provides the benefits of independence, flexibility and freedom. However, on the flip side the demands can prove burdensome and challenging. There is also the restriction that family members cannot be paid to provide care.

Gordie Publicover was one of ten involved with the initial pilot project over ten years ago.

“It has been the reason I have been able to be employed for the last ten years,” said Mr. Publicover. “The biggest asset was being able to get the person to help when it’s needed. So if I need some assistance getting up in the morning to be at work at 9am, I can do that, and still get assistance in the evening to get to bed. It allows me to have a productive work day.”

As well as allowing flexibility, Mr. Publicover appreciates having a consistent career. Before going on the Self Managed program he had to deal with a large rotation of different people helping him with very personal things, which he didn’t enjoy.

“It’s hard to keep your dignity when you have a disability,” he said.

Mr. Publicover has the advantage of having a Bachelor in Commerce and many years working experience. He appreciates that the challenge of fully managing your own career can for some people be too much.

“The reality is if someone is anxious all the time about fulfilling the financial responsibilities of self managed care it will impact on the quality of their life,” said Mr. Publicover. “They may have more independence but they’re worried. So it has to be up to them to decide what balance is ok.”

The financial challenges imposed by the program are something Nova Scotia Health is aware of. Ms. Maxwell said the department is current considering the possibility of allowing the financial responsibilities to be given to someone other than the individual.

Currently the department provides a stringent assessment and orientation process to ensure the individual’s capacity to perform the necessary tasks. There is also always the option to withdraw from the program.

“We want the best for our clients so there is nothing locking them in,” said Ms. Maxwell.

One of the major restrictions imposed by the program is that family members are not to be used. Nancy Beaton, Director of Client Services, Canadian Paraplegic Association (Nova Scotia), said the rational behind this probably was put in place to protect individuals, however, it can be difficult for people in rural communities to access care outside the family.

If you are interested in finding out more about the Self Managed Care program please visit Continuing Care Services at or the Canadian Paraplegic Association NS at