Fight for the things that you care about but do it in a way that will lead others to join you.
~ Ruth Bader Ginsburg, US Supreme Court

Showing posts with label Residential Care. Show all posts
Showing posts with label Residential Care. Show all posts

Friday, October 8, 2021

In Residential Care Situations, What Are Essential Visitors?

These days when I come across an interesting issue or article in the media, I generally just post on FaceBook, reasoning that at least that way it will receive some attention. You may not know this but legal blogging is  a very labour and time-intensive craft (at least it is if you want to do it right) and many days I find it hard to keep up with both my practice and my life.

Although something may indeed better than nothing, the downside is that it limits how much commentary I can provide on any given issue, so it really isn't the same, is it? 

So just as I would about to add this link on the MMC Legal Services FB page , I stopped, took a deep breath and made the decision bring it here instead. Consider it a small effort at atonement.

I know for a fact that the restrictions on visitation at Dept of Community Services home in Nova Scotia has affected many individuals and their families. Although I don't know for sure exactly how negatively people have been affected here, I do know that Nova Scotia could sorely use something along the lines of this proposed Private Member's Bill in Ontario.

Many, including Taylor, hope that a private-member’s bill introduced in September 2020 could lead to change. The More Than a Visitor Act, proposed by Lisa Gretzky, NDP critic for the Ministry of Community, Children and Social Services, aims to ensure that caregivers of a group-home resident would not be treated “merely as a visitor,” especially in emergency situations. The bill defines a caregiver as an individual who “continuously or occasionally provides significant, unpaid, non-professional support to a person receiving care, support or services,” shares an “emotional bond” with the person who receives care, and is considered by the person receiving care, or their substitute decision-maker, to be a designated caregiver. “A designated caregiver,” the bill reads, “may be a family member, a neighbour, a friend, a support person, an attorney for personal care or property under the Substitute Decisions Act, 1992 or another similar type of person.”

There's already been one successful human rights decision on this issue in Ontario, in which the Commission found that a child's disability-specific needs were violated when a rigid visitor restriction policy initially allowed for only video calls or drive-by visits and when in-person visits were allowed, they were required to remain six feet apart from residents. Unfortunately, due to a  communications disability, the child could not use words to communicate, instead relying on  touch, hugging, pulling on hands, gestures and other physical displays of expression.

This decision raises (and answers) many complex and timely issues.

Significantly, the Tribunal found that “[h]uman rights protections do not go away in a pandemic”, despite the service provider's argument that the unprecedented nature of the pandemic did not allow space for individual human rights protections or individualized assessment. Although the pandemic raised important and difficult issues, service providers were still required to follow the requirements of the Code. The human rights framework is robust enough to address many contexts – including a pandemic where safety and health considerations require particular attention. 

The next point of interest is Commission's response to the argument that the parents were at fault for failing to try out the alternative methods of communication proposed offered and instead “insisted upon their preferred accommodation.” The Tribunal rejected this, finding that once the parents had made an accommodation request and explained why the alternatives offered were insufficient, it was incumbent upon the Respondent to actually consider their request, as opposed to insisting that their way was the only way. 

Although the duty to accommodate requires the cooperation of both parties cooperative process, the ultimate responsibility for finding and implementing the accommodation solution remains with the respondent.          

The third important finding relates to the effect of government guidance around safety protocols on human rights obligations. The provider asserted that it was required to strictly follow the government guidelines and couldn't deviate from these to accommodate any individual. However, the Tribunal found that such directions were advice and recommendations intended to guide service providers in their decision making. 

This mandated that the service provider implement the government’s guidelines and recommendations with its mind turned to the individual human rights of its residents. The accommodation request must be investigated and an assessment of the actual risk of accommodating the individual must be undertaken. As they had failed to do this, it was unable to demonstrate that accommodating these individual needs would amount to undue hardship.

The ball was in the respondent’s court to consider the applicant’s accommodation request, and seek its own public health advice on that specific request. It did not do so. Instead, it remained steadfast in its approach. Because the respondent did not investigate the applicant’s accommodation request, there is no objective health evidence that it would have caused undue hardship to grant the request in terms of jeopardizing the health and safety of the residents and staff in the applicant’s home. (para 132) 
Although the Tribunal’s decision relied heavily on the individual facts of the case (the child came with particular pressing needs to have meaningful contact with his parents; the group home had only two residents, which was a relatively controlled environment; and the public health authority was supportive of an individualized risk-based assessment informed by the rates of transmission in the region at that time). all of the above were important factors in the Tribunal’s determination. 

I would submit that there is a strong argument to be made that such such accommodations must be guaranteed to  adults as well. There are a myriad of factors to be considered when individuals have developmental disabilities or delays. For example, outdoor visits with strict rules around touching can be very confusing and upsetting for these individuals, no matter their age. 

The definition of "essential visitors" in residential care situations must include parents or other significant individuals and accommodations must be made [to the point of undue hardship] to meet everyone’s needs. The law requires it.

Tuesday, July 21, 2015

Nova Scotia's First Family Demonstration Project

I'm not sure why I have put off posting about this for so long. It definitely wasn't intentional - perhaps just a by-product of how busy my life seems to have become between going back to practice and what I am about to share.

Show of hands, please ... how many of you remember the NDP government's Roadmap for transforming Nova Scotia's Services for Persons with Disabilities Program (as it was then known)? Sure you do, remember the election campaign when all three parties endorsed the Roadmap and promised to implement it?

Now before you say anything, I must admit that I, too, was very cynical had my doubts - after all, how many times have the names of the Programs been changed? And how many times has government commissioned reports, conducted studies and, above all else, promised to change things ... all with no real or meaningful results?

So it was with great surprise (and maybe a little trepidation) that two other families and mine accepted the Department's offer last summer to turn our Transition House Project* into one of the long-awaited pilot projects for the Roadmap.

It took almost nine months to get here but I am pleased to say that my oldest daughter is one of the participants in the Province's first Family Demonstration Projects.

She has two roommates - not individuals imposed upon her (or she upon them), but two young adults that that she has grown up with and who share similar interests. Two good friends.

I must say that they have a VERY nice home. Trust me when I tell you that most of us would have killed to have our very first place out on own as nice as theirs.

But most important of all, our young adult children have the funding required to engage the support people ("house buddies" as we call them) needed so they can successfully live in their own home in the community.

Let's be clear here. This is most definitely not just enough group or small options home in disguise - we, the families (in our particular situation) decide what is needed to ensure that this will be successful for our young adult children. We, the families, are calling the shots - not the government or some residential service provider.

However, as usual, the devil is always in the details. In that vein I have some bad news and some good news for you.

The bad news is that the process, itself, of getting from the idea dream to reality was long and more than a little painful, for both sides. The good news is now that two different groups of families have successfully negotiated with the government and have committed to being in the Family Demonstration Project and one group is successfully up and running, the process for you and your family should be much, much smoother.

What's this all mean, you ask?

To put it simply ... here it is. The time has finally come. What is your dream for the ideal living situation for yourself or your family member? The time is here, people. It can and is, in fact, being done.

Full disclosure - it's a lot of work for the families to take on, there is no denying that. The Department tells us that Third Party Administrator Funding** (meaning that a third party would actually be responsible for handling the all the day-to-day tasks in making sure the financial end of things runs smoothly) won't be available for another two or three years. That leaves us, the families, to take on all aspects of managing and administrating the home, at least for the time being.

But trust me when I say that this is huge - huge for my daughter, for her roommates and for my and their families. But, most important of all, this has the potential to be huge for all persons with intellectual disabilities and their families in this Province.

Break out the band. Pop the champagne corks. We already have.

* Most definitely a story for another day.

** The Roadmap calls for participants or their families (as the case may be) to have the option of either managing the funding themselves or having a third party (I believe the plan is to redefine the roles of the current residential service providers to include acting as Third Party Funding Administrators) manage the funding. [See pp. iv, 23, 25 and 44 at the link.]

Monday, April 13, 2015

Time to Shake Things Up

UPDATE: It gives me great pleasure to advise that this complaint will get a hearing before a Board of Inquiry and the Disabiltiy Rights Coalition has been given standing to be added as a party. Kudos to all involved.

Anybody who has been reading here for any amount of time is quite familiar with my an ongoing love affair with the Dept. of Community Services (DCS). Don't believe me? Follow the link.

On that note, I was very pleased to (very) recently learn about the Human Rights Complaint that has been brought forward against the Services for Persons with Disabilities Disability Support program on behalf of three long-term residents of Emerald Hall.

As noted in Beth's story, Emerald Hall is intended to be an acute care in-patient unit serving clients who live with intellectual disabilities as well as complex mental and/or physical health issues. What Beth's story fails to mention is that Emerald Hall is designed to provide only temporary (up to three months) stabilization care for people who are living in the community.

Note this comment from Capital District Health's Capital District Mental Health Program Services page:
Emerald Hall supports adults living with a mental illness and developmental disability who are not able to live in the community either because of a lack of available resources or a need for intense support that is only available in hospital. Many of Emerald Hall’s current clients are long-term residents. As such its occupancy is almost always 100 per cent. However, crisis admission is sometimes available to registered clients.
(Emphasis added)
Long-term residents is one way to put in I guess - some of those "residents" have lived there for 13 years. That's right - 13 years. And that's not because it was considered medically necessary - these residents individuals have been medically discharged from the NS Hospital years ago but continue to reside there because DCS either can't or won't provide them with placement in the community.

"Sad situation, indeed", you say. "But what exactly does this have to do with my family?", you ask.

Good question. Deserves a good answer.

But before we get there, let me point out one more thing.  From the Chronicle Herald article:
A complaint over the province’s failure to provide supportive, community-based housing for people with disabilities has been accepted by the Nova Scotia Human Rights Commission.

“There has been an investigation and investigative report prepared,” Donna Franey, executive director of the Dalhousie Legal Aid Service, wrote in an email to the media late Friday.

“The report notes that ‘the existence of discrimination cannot be denied in this situation,’ yet the recommendation to the commission is dismissal of the complaint.”
Riddle me this, please. How is it even possible for a Human Rights Commission investigator to find that "the existence of discrimination cannot be denied in this situation", but then go on to recommend that the complaint be dismissed?

Is it just me or does that sound awfully strange to you too? Fortunately this story is far from over.

But back to you. And me. And your children. And mine.

This complaint, if successful, has the potential to shake up the SPD Disability Support program for all of us, in a very positive way. The crux of the case is the argument that the three complainants were discriminated against by being forced to stay in an institution, where they neither want nor need to be. That DCS discriminated against these individuals by providing assistance for people without disabilities, who are in need, to live in the community while failing for many, many years to take into account and accommodate their differing needs and offer supports for them to live in the community.

Can you imagine being forced to be live in a locked unit in a psychiatric hospital even though you neither wanted nor needed to stay in the hospital, let alone in a locked unit?

Can you imagine being unable to properly develop or receive an education, of being deprived of the chance to work, make and interact with friends and do any of the myriad of other things that you and I take for granted in the community?

How about being exposed to the problems of living in a psychiatric ward, including noise and the risk of violence on a daily basis?

Can you imagine your feelings if you were  repeatedly told that you would be found a home in the community but it never happened?

I can and it makes me shudder.

At this point, we can only hope and pray that reason and the rule of law will preside when the matter goes before the Commission for review and a decision is made on whether to dismiss the case or forward it to a board of inquiry.

Monday, May 27, 2013

The Pros and Cons Power of Guardianship

I've written extensively in the past about the various options open to parents to manage their legal relationship with their adult challenged children.

For some families, a power of attorney and personal directive might be the answer. For other families, it won't. For some families, guardianship will be the only sensible option.

I've also written on some of the reasons why guardianship can be such a useful tool in the right circumstances -  for everything from

  • being involved with the adult's medical care and having access to their medical records 
  • to managing their assets (finances)  
  • to the control it gives in dealing with third parties, such as various government departments and agencies on the adult's behalf.

Although all of the above obviously have great potential to be important in your adult child's life, today I would like to take a closer look at the last item listed above; namely, the control guardianship gives in dealing with third parties, such as various government agencies and departments.

Whether dealing with the Canada Revenue Agency around income tax or issues around the Disability Tax Credit, various financial institutions or financial planners as you manage your child's RDSP or Nova Scotia's own Department of Community Services (DCS) in regard to issues of "work placement" or "placement" of your adult child in a residential care facility, guardianship can be a very useful tool.

But guardianship can be particularly useful with regard to that latter item (dealing with DCS). Not only does having guardianship allow you to direct where your child lives and works, but it will allow you to be involved in ongoing care decisions with respect to such placements.

It's no secret that guardianship has, on more than one occasion, proven very valuable for parents who were initially refused access to information and records concerning their adult child who was living in a residential care facility. Both administrators and social workers often consider concerned parents to be nothing more than “busy bodies”.

However, once a guardianship order is obtained, such parents generally find that both  home administrators and social workers stop trying to do an end run around them. Sometimes, being granted access to information and records is enough. Other times, however, concerned parents with guardianship might decide to move their child to a different living situation where the child will be happier and their ongoing interest and involvement are appreciated and encouraged.

A very powerful tool, no?

And yet, the saga continues.

Monday, March 18, 2013

Batter Up

That would be you and me, folks.

Just another reminder that a series of community meetings* start this week across the Province. A series of community meetings that persons with disabilities, their family members and their friends need to attend.

The meetings follow the government's release of the long awaited Continuing Care/Services for Persons with Disabilities discussion paper, "Putting People First - Working Together to Support Independence and Dignity".

Let's admit it. We're all pretty good at moaning and complaining calling the government out on the pathetic situation facing persons with disabilities in this Province, both in housing and otherwise. And rightfully so.

But the question in my mind is "Will we be just as committed to doing our part to find a solution?".

Criticism is easy; finding solutions is often much more difficult.

So here's your chance, read the discussion paper (which, honestly, doesn't tell really tell those who live this day in and day out anything we didn't already know but at least it acknowledges the problem and appears to want to move forward) and come out to a meeting in your area*.

Bring your spouse, your children, your friends. But, most importantly, bring your self.

As they say - you're either part of the problem or part of the solution. Which will you be?

* A meeting in Digby has now been added.
Thursday, April 4, 3013 ~ 4:00 - 6:00 pm
Annapolis Basin Conference Centre
761 Broadway Ave., Cornwallis Park
Cornwallis Room.

Monday, March 4, 2013

Putting People First?

I received an email from NSACL today, with the following information.

The Nova Scotia government has finally released the long awaited Continuing Care/Services for Persons with Disabilities discussion paper. It's entitled "Putting People First - Working Together to Support Independence and Dignity". 

A series of community meetings have been set up by Department of Community Services and parents and self-advocates are encouraged to attend. 

Not only does NSACL strongly encourage you to review the document and attend a local community meeting, but so do I. 

Please. As family members, if they can't make their voices heard on their own, it is up to us to do so for them. Whether that means attending and speaking on their behalf or attending with your family member, speaking yourself and encouraging them to say what they can, we can't miss this opportunity.

And if your family member is relatively high-functioning, you might just want to give the latter a try. I was amazed at how well my daughter did at one of the housing consultations earlier this year. Sitting at a table without me but where she fortuitously knew one other person, she was helped to put together what SHE needed to say and she did a great job. Not only was it incredibly empowering for her but it seemed to make a real impact on the room.

The Discussion Paper : "Putting People First - Working Together to Support Independence and Dignity"

Schedule of Community Meetings

Sunday, August 5, 2012

June 2012 Services for Persons with Disabilities Policy


Some of you might recall our previous discussions around the various programs offered under the Services for Persons with Disabilities (SPD) umbrella.

The policy documents  for each of those individual programs (Independent Living Support, Alternative Family and Direct Family Support) can be accessed by clicking on the relevant link on this page and then looking for the policy link on each program page.

But, lo and behold, the Department of Community Services (DCS) has now provided the policy document for the entire SPD Policy (dated June, 2012) online. The document covers both financial eligibility for the programs under the SPD umbrella and the "Basic and Special Needs Policy". 

Which, this is big news, because although you may want to first read the policy document for the individual program you are dealing with, you will definitely want to become familiar with the SPD policy itself.

And although it's next on my own personal "to do list", a little birdy has told me that if you find yourself in a dispute with the DCS (be it for yourself or a family member) around the SPD program, this new policy document might just be well worth the read.

H/T to my *little birdy*

Wednesday, May 30, 2012

Happy Days

Remember the story I shared with you last month about what happened when the LeHave Corporation tried to purchase a property in Bridgewaer that was ideally-suited for use as a group home, particularly for three individuals that had lived together for over 18 years?

How afer the neighbours started complaining, the Town of Bridgewater decided that the property couldn't become a group home because that was an "institution", which would violate zoning bylaws that allowed for "low density residential housing" aka single family dwellings?

As I told you then, following a groundswell of public support from across the country and the pointed suggestion that the Town's position might well violate Article 9 and Article 28 of the UN Convention on the Rights of Persons with Disabilities, Bridgewater eventually agreed to change its zoning bylaws to allow the new group home to open.

Well, I'm now very pleased to report that Denice Russell, Melisa Knox and Kim Fairbanks, who have lived together as sisters for 18 years have moved into "Compassion House", as the property is now known. Which made my day feel a little bit brighter.

Go read the story and see for yourself.

And then say those nine words slowly, savouring every one of them ... the UN Convention on the Rights of Persons with Disabilities.

Tuesday, May 1, 2012

Overwhelmed and Underpaid

I am just passing along this email received from the Halifax Association for Community Living.

Because it's a very important issue.
Hi Families and Friends,

One more email before I get out of your hair today! This story is about Toronto, where the waitlist is 8 months for housing. This is our story in NS and even worse. The housing options issue is of monumental proportions with 650 people on the waitlist in Nova Scotia, and a 4 to 5 year wait. The comments on this news story are very telling as well.

You may want to forward this on to your MLA, the premier, the party leaders and the minister of Community services, and share your story as well. I will list the emails for these people:

Percy Paris NDP Waverley-Fall River-Beaver Bank percy@percyparis.ca

David Wilson NDP Sackville-Cobequid dave@davidawilsonmla.ca

Keith Colwell Liberal Preston colwelkw@gov.ns.ca

Michèle Raymond NDP Halifax Atlantic mhraymondmla@eastlink.ca

Howard Epstein NDP Halifax Chebucto hepstein@ns.aliantzinc.ca

Leonard Preyra NDP Halifax Citadel-Sable Island preyra@eastlink.ca

Diana Whalen Liberal Halifax Clayton Park whalendc@gov.ns.ca

Graham Steele NDP Halifax Fairview graham@grahamsteele.ca

Maureen MacDonald NDP Halifax Needham mmacdonald@navnet.net

Mat Whynott NDP Hammonds Plains - Upper Sackville mat.mla@ns.sympatico.ca

Andrew Younger Liberal Dartmouth East info@andrewyounger.ca

Trevor Zinck Independent Dartmouth North tzinck@ns.aliantzinc.ca

Marilyn More NDP Dartmouth South - Portland Valley marilynmoremla@ns.aliantzinc.ca

Darrell Dexter NDP Cole Harbour ddexter.mla@gmail.com; premier@gov.ns.ca

Becky Kent NDP Cole Harbour-Eastern Passage kentbj@gov.ns.ca

Kelly Regan Liberal Bedford-Birch Cove kelly@kellyregan.ca

Denise Peterson-Rafuse Minister of Community Services DCSMIN@gov.ns.ca

Take care,

Yvette Cherry
Halifax Association for Community Living
Family Support Facilitator
www.halifaxacl.com
463-4752 Ext.2

HACL Mission Statement
“We believe that all people should be accepted as responsible, contributing members of their family and society.”

Monday, April 30, 2012

"... To Each According to His [or Her] Need"

Show of hands, please.

How many of us have had dealings with any of the programs under the Province's Services for Persons with Disabilities Program?

It might have been Direct Family Benefits (formerly known as In Home Support), Alternative Family Support or Independent Living (formerly known as Supported Apartment). Or perhaps it involved Small Options, Group Homes/Developmental Residences, Residential Care Facilities, Adult Residential Centres or Regional Rehabilitation Centres.

Anyone? Anyone at all? Yeah, I thought so.

For those of us so blessed, how many have been told that the amount of respite available to your family member is capped at a certain amount or that the Department of Community Services will only pay $10 per hour for respite workers and, if yours happen to charge more, well, so sorry but you will just have to make up the difference yourself?

I see those heads nodding.

How about this one - anyone ever been told (and I mean told) that the government is not obligated to provide these programs, that they do so voluntarily. With the implicit undertone being Do. Not. Rock. The. Boat. Do. Not. Push. Us. Too. Far. Or. You. Will. Find. Yourself. Without. Any. Help. Whatsoever.

Well, then, you're sure to really appreciate this March, 2011 decision from the Nova Scotia Supreme Court.  Check it out. You're going to love it. Trust me.

But first, let me ask you this - how many times have I suggested that we need to help one another, to stand and work together when it comes to getting the system to meet the needs (and respect the rights) of individuals with disabilities and their family members? I only ask because, to me, this decision is a prime example of just how (and why) that works.

Anne Boudreau went to court to get her son and herself the help they desperately needed, the help the government refused to provide. But in winning a victory for Brian and her family, she also won a victory for you. For me. For all of us. Which explains exactly how I view the world - anything I do for one of my children, I do for other children. And anything I do for another child or family, I do for my children and family.

Brian Boudreau has autism and requires 24/7 care. To assist with this, his mother received money to pay for part-time and full-time personal care workers from the Services for Persons with Disabilities (SPD) Program. But the Boudreaus were unable to keep these workers because they couldn't pay a sufficient hourly rate. Needless to say, this constant turnover was not in Brian's best interests, particularly given his very high level needs.

Receiving funding of only $10 and $12 per hour respectively for part-time and full-time workers [the hourly rates set by the Department, which have remained unchanged since 1998], when the average hourly wage in their area was $14 per hour plus benefits, it shouldn't have surprised anyone when they went through seven workers in the span of one year.

Her request for extra funding to allow her to pay $12 and $15 respectively to the part-time and full-time PCWs denied, 
["As you know the Direct Family Support program bases its respite amount on $10 per hour. Unfortunately Services for Persons with Disabilities (SPD) staff have not been authorized to increase this hourly amount at this time. In regards to the possibility of increasing your monthly amount, in order that you can use the additional funding to pay extra per hour, SPD has not been authorized to allow any increases which result in payments exceeding $2200 per month. As Brian’s current respite allowance already exceeds $2200 per month no increase may be authorized at this time."] 
Mrs. Boudreau appealed. And although initially unsuccessful, she was successful at the second appeal level, to the Assistance Appeal Board.

The Board found that although neither the directive [in November, 2009 a directive had been issued from the Director of the SPD program limiting DFS program approval levels for respite funding to $2200 per month] nor the policy [which also limited DFS respite funding to $2200 per month] supported the appeal, neither was there any Regulation under the Act to support the directive or the policy. [You can find a discussion of how that interaction works from a legal point of view here.]

Instead the Regulations provide a guide to the intention of the Act, which allows for variance from policy and directive when it was in the best interest of the client. Sound familiar?

Not surprisingly, this result did not please the Department, who promptly took the matter to court.

Because the Board had found that Brian was entitled to the additional funding under the Employment Support and Income Assistance Act (ESIAA), one of the issues before the court was which of the three possible pieces of legislation [the Employment Support and Income Assistance Act (ESIAA); the old Social Assistance Act ("SAA"), which was effectively gutted when the ESIAA was proclaimed; or the Homes for Special Care Act] govern the SPD Program. Or, perhaps it was as the Department argued, that the Program is something done out of the goodness of their heart, with absolutely no legislative authority?

For those of us less legally inclined, I am going to provide the summation of what this case actually decided here. Those with interest can read on to see how the court came to the conclusions it did.

In other words, pay attention. Here's the important part.

In the words of Mr. Calderhead*, the Boudreau decision is very important for at least four reasons.
  1. It settles, once and for all, the question of whether the SPD program is authorized by legislation (it is!) and which legislation (the Social Assistance Act and the Municipal Assistance Regulations).
  2. It makes it clear that there is nothing voluntary about the SPD program. That is, once eligibility for services has been shown/accepted, a legal entitlement arises automatically.
  3. Further, as with any other “assistance” under the Social Assistance Act, eligibility triggers not just a right to that assistance but one that is to be immediately provided.
  4. Generally, the SPD Program will fall under the ‘special needs assistance’ provisions in the Social Assistance Act and, in situations where the legislation does not stipulate a maximum amount for such assistance, the Department should be paying “reasonable” amounts sufficient to meet the need.
Mr. Calderhead also notes that this decision establishes that the Department of Community Services must provide a per diem rate that is reasonable. In the Boudreau case, that was found to be $15.00 per hour for a full time employee, and $12.00 per hour for a part time employee.

Now, for those of you brave enough to venture further, you can READ MORE.

Thursday, April 19, 2012

The More Things Change...

I was having a conversation with another parent yesterday about the education system. And she relayed a comment from a friend of hers to the effect that we are still fighting about the same issues as we were 20 years ago.

I don't know about the 20 year part but I do know I first brought this story to you back in July, 2008 - nearly four years ago.
Subject: Family needs support

Importance: High

There is a young woman who lives in the community with another family. She has lived with this family for over 5 years and there are extra supports provided to meet her needs. Community Services agree that she has made progress. She wants to stay there. Her own family wants her to stay there. The family she lives with wants her to stay. Her doctor has written to Community Services to say she should stay.

Community Services are opening the new institution in Lower Sackville next month. They have told the Mom that the young woman must move to the institution when it opens. They have told her, and repeated it today, that they will withdraw funding if she refuses the move.
Ring a bell?

Well, the good news is that that situation was resolved. In 2008.

The bad news? It's back. Again.
Brenda Hardiman's 24 year old daughter is diagnosed with a organic brain disorder, conduct disorder, epilepsy and right sided cerebral palsy. This is her story:

Brenda Hardiman's daughter has lived with an alternative family, for 10 years, through the Persons With Disabilities Program, Nova Scotia Department of Community Services. Four years ago the Nova Scotia Department of Community Services tried to force her move to an institution in Lower Sackville, Nova Scotia. With the assistance of the Nova Scotia Association for Community Living we were able to stop this from happening.

We are at the same place, four years later. They are forcing her, once again, and this time I'm afraid they're winning. I don't know if I have the stanima to go through this yet again. To go head to head with the Province again. It's so stressful.

My daughter's alternative family wanted to provide some separation between their work and personal lives by continuing to care for my daughter in a home for special care rather than in their home as they have cared for people, in their home, for 18 years. The Nova Scotia Department of Community Services denied their request to license them in this capacity. Their justification was that they had to put submit a request for proposals. But since there is a mortitorium on this type of care, they couldn't. This is their underhanded way of institutionalizing my daughter.
As a side comment, I picked this situation up in 2008 from an email I received. I picked it up today via FaceBook. Perhaps that's a step forward, in that we now have social media to spread our message.

But back to Brenda's story. What are we going to do?

In the words of Laurie Lawson, President of CACL:
NS is the one province that openly endorses institutions and feels they are appropriate. They are forcing individuals into institutions rather than providing the supports to live in community. Brenda received word yesterday that her daughter will be institutionalized May 3rd. Enough!! Time to mobilize and stop this practice in NS!
I'm sad to say that at this point in my life, (or at least this week month),  I just report the news. [Yeah, yeah, I know. I've barely been doing that lately.] Do with it what you will.

Thursday, August 25, 2011

Acceptable?

Article 19 of the UN Convention on the Rights of Persons with Disabilities reads as follows:
‘States Parties to this Convention recognize the equal right of all persons with disabilities to live in the community, with choices equal to others, and shall take effective and appropriate measures to facilitate full enjoyment by persons with disabilities of this right and their full inclusion and participation in the community’
But the government of Nova Scotia lacks any current deinstitutionalization commitment with institutions actively being built and/or renovated. This province views institutions as part of the acceptable continuum of residential services for persons with intellectual disabilities.
• In Nova Scotia hundreds of families/individuals are living in near crisis situations while waiting for appropriate residential supports. Many others are living in types of supportive housing unsuitable fortheir needs and detrimental to their health.

• The Riverview Residential Centre (in Nova Scotia) is ‘Home’ to 96 individuals with intellectual disabilities. A Report was commissioned after 22 incidents of abuse were reported at the facility.

• In Ontario, at least several hundred people are living in large congregate care settings such as Homes for the Aged, Psychiatric facilities, Nursing Homes, etc. for no reason other than their label of intellectual disability and the fact that they cannot access the supports they need from a more appropriate source
Meamwhile, as we await the release of the provincial government's report on the Braemore situation, a new incident of abuse surfaces.

Article 19 of the UN Convention on the Rights of Persons with Disabilities.

Right.

Sunday, July 3, 2011

Subject to Change Without Notice??

The Nova Scotia Department of Community Services (DCS) backed off a clandestine plan to cut medical services for disabled Nova Scotians living in special care homes late Friday Thursday afternoon, hours before it was to take effect.

The province had planned to implement the unannounced cuts over the Canada Day long weekend, but shelved the plan hours after the Canadian Press News Agency sought comment from DCS Minister Denise Peterson-Rafuse. Operators of special care homes were told the policy was “on hold” in late afternoon emails from frontline care coordinators.

The policy would have curtailed coverage for a wide range of medical benefits including dental care, drugs, and medical supplies.

In one case, workers caring for an elderly diabetic who receives a living allowance of just $125 per month were told his daily insulin injections would no longer be covered, because the type of insulin prescribed for his hard-to-control blood-sugar levels is not on a list of approved drugs. The man, who has a developmental handicap, leads an active life and is beloved by his community.

Another agency was told the province would no longer pay for an anti-seizure medication required by one of its residents.
The above is from Parker Barss Donham's blog, Contrarian.

And, if true, it's extremely disturbing. 

Parker's name should be well-known to most Nova Scotians, or at least to those with any interest in politics. Which leads me to the one caveat I offer here; namely that, politics being what it is, I tend to be a mite bit cynical, not just of the party in power, but equally of those associated with the opposition.  Because even those not holding the reins of power have a certain power, colloquially known as the power of "spin".  Meaning that, fair or not, I tend to take anything I come across originating from anyone with a strong connection to any political party with at least a few grains of salt.

I guess what I'm trying to say is this - although on its face deeply disturbing, I have to at least allow for the possibility that there may be a more innocent explanation at play here, one that some would rather not be made public. 

Then again, that being said, my true cynicism, based on years of hard fought experience, lies with government departments, particularly those of Education and Community Services, meaning I have trying real hard not to jump to the conclusion that I would be oh so happy to reach and at least allow for the possibility that all might not be exactly as it seems. I'm trying - it's just not that easy.

On another note, I see that Mr. Dunham has posted various DCS policy documents, which tend to be extremely difficult to access.  The links will be up shortly in the sidebar under the heading "Services for Persons with Disabilities ... Policy Documents".

Just remember, though, that as so aptly pointed out by Mr. Dunham's post, government policies are often subject to change. Without. Any. Notice.

* When researching yesteray's post, I noted that the Department of Health and Wellness' (the new name for the Department of Health) Home Care Policy Manual is dated June 1, 2011.  In a similar vein, I see that both the Services for Persons With Disabilities - Special Needs Policy and the Financial Eligibilty Policy are dated July 1, 2011 (yes, that's two days ago aka Canada Day). It would appear that, perhaps, our NDP government is on some sort of policy revision roll, to an extent that might not quite be accounted for by the various departmental changes made in the recent Government Administration Amendment (2011) Act(ch. 11 of the 2011 Statutes).

Wednesday, December 30, 2009

Not A Very Merry Christmas

We've talked a bit here and there about Nova Scotia's track record with institutions for the disabled - both the fact that more money seems to be going into them and how residents are treated.

Out this months is the Report on the Riverview Home Corporation released by the Department of Community Services.

As noted by the Nova Scotia Association for Community Living, this is most definitely not the time of year that we look forward to reading reports. That being said, it is requested that we take the time and reflect on our lifestyle in comparison to the descriptions given in this report.
The conditions described are appalling. It is unacceptable and unthinkable that citizens of this province should have to endure such lack of privacy, overcrowding and lack of service. They are unacceptable working conditions for staff as well.

Riverview is an institution outside New Glasgow. NSACL urges that you all take time to read the report and to take action. Please write or call your MLA , the Premier premier@gov.ns.ca or dexter@ns.sympatico.ca 424-6600 and the Minister of Community Services, Denise Peterson-Rafuse petersdi@gov.ns.ca or denisepetersmla@bellaliant.com 424-8296 to express your concerns.

We wish you all peace and health and joy for the coming year.

Nova Scotia Association for Community Living.

To which Dorothy of the Disability Rights Coalition adds this:
We who have loved ones or have a disability ourselves should really be alarmed about this report; our government is in the process of building and renovating more institutions in Nova Scotia. They do not seem to “get it”.

If Newfoundland closed down their institutions in 1996 and Ontario closed their last institution last fall why is it our government feels they have to continue operating these places, they bear no resemblance to a home; they are more like penal intuitions.

Every study indicates that with the right kinds of supports people with disabilities
not only are able to live in their communities they thrive there.

What more must we do to let our politicians understand. I hope as Mary suggests you will all take the time to write or speak to your MLA’s.
'Nuff said.

Sunday, September 20, 2009

Re-opening Pandora's Box

You might recall our previous discussion around the Protection of Persons in Care Act. Initially passed in 2004, the Act did not come into force until October, 2007.

Across the province, 1,625 residents with developmental disabilities are housed at licensed group homes and residential centres that are covered by the Act; apparently, one of the highest per capita rates in Canada.

And since it's passage, we have been hearing reports about investigations following complaints.

The most recent being the nineteen cases of abuse confirmed at the adult residential care centre located in Riverton, Nova Scotia.
The list of founded abuse cases at Riverview — which means an incident is accepted as having happened — includes four instances where staff physically harmed residents.

The 89-year-old centre houses about 100 residents with varying mental disabilities, including Down syndrome and long-term mental illness, with some residents sharing rooms and living in what are called "secure units." It also includes several smaller detached homes.

The cases of abuse were investigated under the Protection of Persons in Care Act, which defines physical abuse as actions "resulting in pain, discomfort or injury, including slapping, hitting, beating, burning, rough handling, tying up or binding."
The Riverview situation involved two founded cases of neglect by staff, defined as failure to provide adequate care; two cases of emotional abuse by staff, defined as "causing emotional harm," by actions such as intimidation or humiliation; and eleven cases were of residents abusing other residents, with 10 of those listed as instances of "non-consensual" sexual contact and one of physical abuse.

Disability groups are, predictably, up in arms.

READ MORE

Monday, September 14, 2009

Never Give Up

Update:
Press Conference

There will be a press conference at 10 a.m. on Friday, September 18th, in the Terrace Room of the Citadel Inn, Brunswick Street, Halifax.

Speakers will include friends, families.advocates and people who are at risk pf being institutionalized because of a label.

All who are concerned are urged to attend.

Mary Rothman
Executive Director
Nova Scotia Association for Community Living

~ ~ ~ ~

These people don't.

Disability Rights Coalition Calls For Immediate Review Of Operations At Outdated Government Funded Institutions: Continued Violations of Rights of Residents Can No Longer Be Tolerated

Halifax, Nova Scotia – September 11, 2009 –The Disability Rights Coalition expresses its outrage and demands the government of Nova Scotia to immediately convene a full, independent review of operations at the Riverview Adult Residential Centre in Riverton, Nova Scotia. This demand is in light of the 19 cases of abuse against residents with intellectual disabilities and mental illness at the Riverview Adult Residential Centre in Riverton, Nova Scotia, and the 22 other reported cases of abuse at other institutions throughout the province as reported in the news earlier this week.
I will likely post more on this topic later but I did want to get this press release out right away. So go ahead and read the rest of it.

Wednesday, January 7, 2009

The Protection of Persons in Care Act In Action

There's a report out in the news about abuse in Nova Scotia's nursing homes.

Apparently, 73 investigations were carried out by the Health Department Oct. 1, 2007 and Sept. 30, 2008, following complaints filed under the Protection of Persons in Care Act.

You might recall that we previously discussed that legislation, which has been in force in the province for just over a year now.
Health Department investigators determined there were 41 incidents of abuse at a wide variety of small and large nursing homes, as well as at hospital wards across the province.

Of those, the department says 30 cases involved staff abusing residents, four were cases of residents abusing other residents, and seven involved family members or visitors abusing a resident.
The Department of Health defines physical abuse as "the use of physical force resulting in pain, discomfort or injury including: slapping, hitting, beating, rough handling, tying up or binding." In these cases, the physical abuse ranged from serious incidents, such as staff members slapping a resident or handling them so roughly that bruising resulted, to less severe cases of staff forcing an unwilling resident to eat a meal or bathe.

The biggest problem here appears to be a lack of proper staff training. As in staff in facilities who have had a dementia care course have an understanding of why some residents might be rebelling at their suggestions.
Since 2006, she said the province has required staff to have a continuing care certification, and in recent years a course on dealing with "challenging behaviours" has been made available to nursing homes and hospitals across the province. However, recruitment of staff remains a challenge, she added, noting there are times when nursing homes are short-staffed because of a lack of qualified staff, which creates more stress for on-duty staff.
However, the Province appears to consider the new legislation as a "success" in that cases are being reported, and remedies such as staff retraining are being implemented. And I would agree. At least up to a point.

The whole idea of abuse in nursing homes, be it physical, sexual, financial or emotional, sickens me. Even more so, given the fact that we were seriously looking at having my mother placed in a nursing home last year.

But there are two positives to be remembered here:

  • Firstly, there is legislation in place affording protection to residents, not just of nursing facilities in Nova Scotia, but any patients and residents 16 years of age and older who are receiving care in a Nova Scotia health facility (which includes hospitals, nursing homes, homes for special care or caring for persons with disabilities, group homes and residential centres). In other words, not just the elderly but also any disabled person in a home for special care, group home or residential centre.


  • And anyone (which includes you and you and you) can report suspected abuse by calling 1-800-225-7225.30.
The first step is having legislation in place. Check.

The second step is using it. And demanding accountability.

That's where you and I come in.


Wednesday, July 16, 2008

Your Immediate Attention Is Required

Update: The NSACL press conference scheduled for 10 am tomorrow morning is cancelled. The Association, Nichele Benn and her family wish to thank the Department of Community Services for their attentiveness to Nichele's needs. Nichele will remain in the community with her supports.

Please circulate this message. We apologize for any inconvenience but are so very happy for Nichele.

Received this missive through the email chain today and thought I better pass it on. Anyone local to Halifax, it would be much appreciated if you could attend.

As background, you might remember that we have discussed the various programs available under the Services for Persons with Disabilities program before. Sounds like this young woman might have been in the Alternative Family program.

You might also remember one of the initial posts on this blawg back in August of last year concerning the Province's announcement that they planned to spend $19million to RENOVATE an aging institution outside New Glasgow and to build 3 replacement group homes. At that time, I noted that this had more than a few groups concerned. My best guess is that this is part of the fallout.
Subject: Family needs support
Importance: High


There is a young woman who lives in the community with another family. She has lived with this family for over 5 years and there are extra supports provided to meet her needs. Community Services agree that she has made progress. She wants to stay there. Her own family wants her to stay there. The family she lives with wants her to stay. Her doctor has written to Community Services to say she should stay.

Community Services are opening the new institution in Lower Sackville next month. They have told the Mom that the young woman must move to the institution when it opens. They have told her, and repeated it today, that they will withdraw funding if she refuses the move.

NSACL is holding a press conference on Thursday at 10am, at the Delta Halifax, Baronet Room 6. (right beside Scotia Square).

I know this is short notice but time is of the essence. They need a show of support. Please try to attend and encourage others. Community Services intends to re-assess all people receiving support from the Services for Persons with Disabilities Program. Someone you love could be affected.

Speakers will include the Mom, People First, another family and a
lawyer.

Mary Rothman

Thursday, May 8, 2008

Where Do You Turn?

Who do you go to if you suspect abuse of a loved one (or anyone else, for that matter) in a hospital, group home or residential care centre?

The Protection of Persons in Care Act came into force on October 1, 2007.** The legislation attempts to provide an extra safe guard from abuse for patients and residents 16 years of age and older who are receiving care in a Nova Scotia health facility (which includes hospitals, nursing homes, homes for special care or caring for persons with disabilities, group homes and residential centres) and requires health facility administrators and service providers (including staff and volunteers) to promptly report all allegations or instances of abuse.

Anyone else (that's you!) can report abuse by calling 1-800-225-7225.

You can find a few more things you need to know, such as the definition of the term "abuse" and exactly what comprises a "health care facility" here.

** Interesting side note. Although the Act was originally passed in 2004, it was not proclaimed (most Acts do not become effective until they are proclaimed) until October, 2007. Anyone else wondering what that three year delay was all about?

    Wednesday, January 23, 2008

    The More Things Change ...

    Remember this? And this?
    Have you heard the latest?

    From the latest edition of Institution Watch:
    NOVA SCOTIA
    More than a year ago (November 2006) the Nova Scotia government announced that it would be renovating an empty building to create an institution to house 24 people. The news release estimated the cost to be $3 million with annual operating costs also estimated to be $3 million. On December 19, 2007 the tender for construction was awarded at a cost of $4,180,000. The costs for design work are unknown.
    There's also a complete look at how other provinces are doing. I can tell you that British Columbia, New Brunswick and Newfoundland are leading the way.

    Nova Scotia? As you can see, we're not fairing too well. But check it out for yourself.

    So what will it take to make a difference here? Who, if not us, is going to make our government move forward on this? That's forward in the right direction. As opposed to what they apparently think is the right direction.

    What are your thoughts and ideas?

    Tick tock. Tick tock.

    Show of hands?