Caredara Regional Demonstration Program
Caredara’s regional demonstrations focus on two connected gaps: short-term support after hospital discharge or a care crisis in the community, before ongoing care is in place; and additional practitioner availability that is fragmented and difficult to coordinate.
Designed for regional collaboration. Enabled by Caredara’s shared activation infrastructure.
Refer urgent care gaps and provide ongoing continuity.
Identify care gaps and support care transitions.
Identify and mobilize additional practitioner capacity.
Connect people to local support and care resources.
Explore regional workforce and economic opportunities.
We’re inviting exploratory conversations across Ontario. Each demonstration would be shaped by local needs, partner readiness, practitioner availability and an agreed funding pathway.
A focused regional demonstration
A regional demonstration would explore how better coordination of additional practitioner hours can help bridge the period between a care disruption and reliable ongoing support.
After hospital discharge or a care crisis in the community, support may be needed before ongoing services can begin or existing care arrangements can be restored.
Demonstration focus
Explore short-term, non-emergency stabilization during that gap, with a planned handoff to an existing or chosen ongoing care provider.
Willing, qualified practitioners may have additional hours available, but that availability is spread across individuals, locations and schedules. It can be difficult to see and coordinate when a care gap arises.
Demonstration focus
Explore how to make additional availability visible and match appropriate practitioners to specific short-term needs, while respecting their existing commitments.
The demonstration is focused on these two gaps. It is not intended to address every health-system challenge, resolve overall workforce shortages, replace emergency services or take over ongoing care.
Explore the published evidence behind these two gaps—and the questions the regional demonstration is designed to investigate.
Explore the researchThe stabilization-to-continuity pathway
The model connects those two problems: identify additional practitioner availability, coordinate a response to a specific short-term care gap, and plan the transition to ongoing support from the start.
Identify qualified local PSWs, RPNs and RNs who want to make additional hours available. Participation should build on their availability without displacing existing care commitments.
Agree how requests are received, assessed and matched to appropriate practitioner availability. Confirm the service area, responsibilities, funding and escalation process before support begins.
Provide agreed short-term, non-emergency support during a care disruption. The scope and duration reflect the person’s needs, practitioner qualifications and the agreed care plan.
Plan continuity from the start. With appropriate consent, coordinate a handoff to existing providers, a chosen agency, community supports or the family’s ongoing care arrangements.
Making capacity usable
A practitioner network tells us who could participate. Care-ready hours help us understand when that participation could become care. The regional demonstration would test how to identify, confirm and activate additional hours around a specific short-term care need.
For the demonstration, we propose treating hours as care-ready only when practitioner readiness, current availability, service area and an agreed service scope have been checked for a defined time window. A specific care request would still need assessment, a suitable match and confirmation before care begins.
Participating PSWs, RPNs and RNs would share the hours, locations and types of work they are willing to offer, alongside their existing commitments.
Reported availabilityCheck qualifications, role and service fit, travel time and current availability. Resolve overlapping offers and existing bookings before counting capacity.
Confirmed capacityMatch a suitable practitioner to an assessed request. Confirm the schedule, care scope, funding and responsibilities, with a continuity plan from the start.
Booked supportRecord the hours actually delivered, any changes or cancellations, and the handoff to existing providers or agreed ongoing supports.
Delivered careA clear measurement approach
Reported, confirmed, booked and delivered hours would be tracked as different measures. They would not be added together into one “available hours” total.
These are proposed measurement principles for the regional demonstration, not a claim of live capacity or guaranteed service availability. The focus remains short-term stabilization before continuity of care, and the coordination of fragmented practitioner capacity.
Help shape a demonstration in your regionFor home care agencies
Home care agencies can help shape both the starting point and the next step. The aim is to strengthen existing care relationships while making short-term support easier to coordinate.
An agency could request stabilization support for an unexpected coverage gap, a delayed care start or another agreed short-term need. Caredara would assess the request and available capacity within the demonstration’s agreed process.
Following stabilization, a person may return to their existing provider or choose an agency for ongoing support. Any connection would depend on consent, service fit and the receiving organization’s capacity.
Client choice and existing provider relationships remain central. Participation does not guarantee referrals, service availability or new clients.
A place for different contributions
Organizations do not all need to play the same role. Some may help convene the conversation; others may bring care needs, available capacity, continuity services or a funding pathway.
Stabilization & continuity
Identify unmet short-term needs, help design workable request pathways and explore ongoing care arrangements after stabilization.
Care transitions & system insight
Help identify transition gaps, introduce relevant operational partners and explore how a demonstration could fit existing care pathways.
Local workforce capacity
Bring labour-market knowledge, practitioner and training connections, and insights into additional willing workforce availability.
Connections & regional opportunity
Help convene organizations and explore workforce participation, regional economic value and potential funding connections.
Local needs & support pathways
Bring knowledge of family and caregiver needs, connect relevant services and help shape accessible local support pathways.
Additional hours & practical insight
Explore opportunities to offer available hours and help shape practical coordination around qualifications, availability and existing commitments.
From a conversation to a demonstration
Begin with an identifiable gap before continuity of care, or fragmented practitioner availability that could help address it. Together, we would assess both sides of a practical regional demonstration.
Discuss where support is missing after discharge or a community care disruption, where additional practitioner availability may exist, and who should help shape a response.
Identify prospective participants, additional practitioner capacity, a continuity pathway and who would fund the support.
Define geography, eligibility, service scope, consent and information handling, responsibilities, handoffs and measures of success.
Begin only when the agreed readiness requirements are met. Review delivery and participant feedback before considering expansion.
Shared learning
Participants would agree measures to assess the two areas of focus: whether short-term care gaps are bridged through to continuity, and whether additional practitioner availability can be coordinated effectively. These are proposed measures, not reported results.
Request response times, support availability and time to an agreed start.
Additional hours identified, hours offered for activation and hours delivered, with existing practitioner commitments respected.
Time supported before ongoing care begins or resumes, completed handoffs and any unresolved gaps.
Feedback from families, practitioners and partners, alongside the cost and practicality of delivery.
Questions, answered
Explore the model before deciding what participation could look like for your organization.
Explore the care activation glossaryThis page is an invitation to explore participation. It does not confirm a launch in a particular region. Contact Caredara to discuss the current stage of planning and what may be appropriate locally.
The proposed model focuses on short-term gaps while ongoing support is arranged or restored. Existing provider relationships and client choice remain central to the continuity plan.
A funding pathway would be agreed before a demonstration begins. Depending on the arrangement, this could involve a participating organization, private payment or a sponsor. No funding commitment is implied by an exploratory conversation.
No. An initial conversation can start with one organization that sees a clear local need or can help introduce the relevant people. The next step is to identify what would be needed for a workable demonstration.
Let’s explore the opportunity
Tell us about your region’s gap between discharge or a community care disruption and ongoing support, or the practitioner availability you would like to help coordinate. We’ll explore whether a focused demonstration could be a fit.
For organizational enquiries. Please do not include personal health information.