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article imageOp-Ed: Pressure is growing in B.C. for better disability support Special

By Hans Smedbol     Oct 24, 2011 in Politics
Nelson - The British Columbian government's fiscal policy towards persons with disabilities has mirrored their miserly approach to supporting other vulnerable clients over the last 20 years.
The bottom line has controlled all of their efforts, and continues so to this day.
Over the years, the B.C. Government, no matter what the political stripe, has attempted to deal with its citizens requiring a little extra help, with the same kind of cheapskate attitude that would have done Scrooge proud, before his conversion by the Christmas spirits, in Charles Dickens' 19th Century tale, "A Christmas Carol." Too bad, we can't hope for a similar conversion in government, from seeing these people with disabilities as a liability that they really do not want to pay for, to seeing that they too have a lot to offer us as a society, and individually; and as human beings, no matter what the disability, should receive enough help and economic support that they might be able to live as full lives as possible under the circumstances. Our government on the other hand doesn't see this. Their solution is to cut funding and to move vulnerable clients from the group home settings with professional staff, and a routine to which they've become accustomed, such that they might feel they have a home, to a private care "home-sharing" environment with a family in a private home setting, a setting which puts both parties are serious risk, especially if the clients have a history of self-abuse and violence towards others and property.
Although this might sound like a kind thing to do for them, to put them in a "family", in reality the bottom line is what dictates the move to private care, despite the best interests of the clients with disabilities (both mental and physical). This is appalling behaviour by a government that cares not one whit for its poorer, aged, and disabled citizens, doing at the most, the bare minimum, and often much less for these folks.
Closing all the group homes is not a good move, especially as most of the folks in them these days are potentially the most violent and dangerous clients.These are folks who could not already have been put into "Private Care" as they called it back in the early 2000's.Calling it a "home-share" is a disingenuous move by the government. These clients are often still in the group home environment because they are mentally fragile, and potentially dangerous. If they were easy to get along with, they would have been gone already for years into Private Care.
I worked in a group home environment for some 20 odd years, until the stress and strain of the job took a severe toll on my health, and I was obliged to take unpaid Medical leave, which I am still on, because I have never recovered back to my previous level of health. I worked with people who had the potential to be very violent and dangerous, because that's the main kind of people still in group homes.For the last long while (at least 20 years), the government has been seeking to cut costs, by forcing people with disabilities to move out of their group home environment (in which most of them were comfortable, and used to the staffing and routines) into private care. This model may work for some people, but it doesn't work for those who are most at risk of violence,neither for the client, nor the host home.
In the Nelson Star, online, for October 17, you will find a story that illustrates their practices all too clearly, and which indicates that there is such a need for positive, and more generous change that even members of the Government's own party are criticising the Ministry of Social Development for inappropriate placement of vulnerable individuals.
Whilst rejecting, as simplistic the NDP critic's suggestion of an independenat review panel to investigate the Ministry's issues with People with disabilities, Liberal MLA Randy Hawes told the story of one of his own constituents, who he feels was very inadequately served by the Ministry and Community Living B.C., the government organisation dedicated to working with people with disabilities in the province. Mr. Hawes "described one family whose developmentally disabled son grew to more than six feet tall and became violent as he reached his 20s. He was put in a home-share but that lasted only two weeks.
"It was a fight, a real hard fight, to find a space for him," Hawes said. "Definitely, he has to be in a group home.""
Let it be emphasised that this mistaken placement was done to save money, not to serve the best interests of the young autistic man, nor his family, nor the host family, where he was placed. It must have been truly horrific and traumatic for everyone involved, and my heart goes out to them, especially the ill-served very fragile, vulnerable, yet exceedingly dangerous young man.
In a home care setting, the caregivers may or may not have any real professional training, whereas in a non-profit group home, like the one I served in, such training is demanded of the workers, and there are constant upgrades and seminars in safety and security, as well as health and welfare issues, how to deal with people who go critical (rage) at the drop of a hat, how to deal with people who are attacking you, how to defuse crisis situations, non violently. One thing that Community Support Workers are, is trained, and for the most part, very caring and compassionate towards their clients, many of whom become like family members after a few years of working with them.
However, you have to pay a bit more for people who have the training and who work in group homes, and the government, not really caring about the quality of care, subjectively as seen through the eyes of the clients, goes for bottom line, forgetting that the Ministry of Social Development should not necessarily be run like a business, as its "business" is taking care of people, particularly the people with disabilities, people with mental illness, and the elderly vulnerable people who need care either at home through Home Support workers, or in an "assisted care" facility, where they reside when unable to look after their own affairs, or too ill with some chronic illness to be taken care of at home. I suggest putting a little less money into projects like gas development and so on, and a little more into supporting our vulnerable family members, friends, and neighbours to be able live a life of dignity and with the assurance that they will not be be shipped around casually from place to place at some bureaucrat's whim, just to save a couple bucks.
One of our clients was put into private care for a while, like the young man above, but after nearly destroying the family she was living with, as well as badly abusing herself, and after a few months, she was put back into the group home setting, where she remains today. In this setting, at least, after a day's shift, the worker can go home and get some rest. As well, the client can get some rest from that worker,and interact with a new one. That client mentioned above, has been doing very well in the group home setting and loves all the action around her. She did NOT do well in private care, despite the wishes of Community Living B.C.(CLBC)
CLBC even tried to put the main client I worked with for the last 20 years into a private care setting, because his violent behaviour outbursts had appeared to improve considerably, for awhile, with the administration of an anti psychotic. In their Hubris, and despite the warnings of the front line staff, they also moved a third high maintenance person into that same house, where he and my usual client had to share the space. It went ok for a short while, until a worker was out one day walking with the client and chattering away like she usually did (highly annoying for an "autistic" client to listen to: WAY too much stimulation!). Suddenly my client lost it entirely and started shouting, and banging his head on the pavement.
After that, the supervisor, who up until then had thought my client a pussycat and easy to work with, concluded she didn't want to work with my client one-on-one any longer. Still all through this she was working with CLBC trying to get my client a spot in a private care setting, and incidentally putting his workers out of a job. This was all in the name of "saving money", disguised as "choices" for the clients, choices most of them were not really into making, nor even, apparently, capable of making, being as they were and are well served in the group home environment. The last thing most wanted would be a major change like moving into private care, where they would obtain less service, less attention, and less opportunities for a fulfilling life in the community, all the while stuck with the same old faces day after day, faces of strangers.
After asking all the current workers (especially some of the "casual" staff) if they would take the client into a private care setting, and finding not one sucker for their money saving program, CLBC finally gave up attempting to put him in private care, and a good thing it was for the client, and for the potential private care family.
This client can be very and unpredictably dangerous, attacking people, breaking things, destroying property, such as windows and electric lights, throwing whatever he can throw, all the while screaming obscenities and threatening bloody murder.
Would you want such a person to move into your house? I suggest to you that any private person who would undertake such a placement, would be better served to have his head examined, unless he be very well professionally trained in working with such dangerous people, and can take the 24/7 pressure and stress of dealing with such a one.
Even then I would be surprised if such a private placement of a dangerous individual, like the young man mentioned above, nor my own client, would ever last longer than a couple of weeks. Most ordinary families would be unable in my view, to take the stress of such work.
Unfortunately, this kind of behaviour as manifested by MLA Hawes' young man, and my own client friend, is not really very manageable with the drugs we have available. This type of fragile, potentially dangerous, client does not do so well in a private care setting, if only because he wears out his welcome with the "home-share" working family very fast, and may even seriously hurt them. And YET the B.C. government persists in its cost cutting measures, continuing to try to place dangerous people with disabilities in an "home-share" setting, despite the fact that it can set back the behavioural "progress" of the person with disabilities to where it was when s/he first got out of the large institution in which many were formerly housed.. This short sighted and even cruel bottom line approach to supporting people with mental and physical disabilities, is making all those years of behavioural work a waste of time, and money.
Even worse, in a private care setting, the worker gets an inadequate salary for his/her efforts (it was around $2200 back then in 2000) for working 24 hours a day, 7 days a week with no time off, no statutory holidays, no sick time, no benefits whatever, no vacation pay, with two weeks of respite care allowed (but you don't get paid for that time if someone else is looking after the client.) If you work that out, you get 24hours X 7 days X 4 weeks = 672 hours per month, on duty. Now divide that into $2200 per month salary, and you will find that you are making $3.27/hr. for dangerous, exhausting life threatening work, in which you can't go anywhere without the client 24/7.
The government thinks this is a great model for people with disabilities: park them with gullible families, out of sight, out of mind, and cheap! They promote "home-sharing" as a "great" job for people! Yeah, they are so generous. They are about as generous with their money, for people with disabilities as a constipated person is generous with feces: not much comes out, a little wind, and a few hard pebbles. That's our Government: lots of wind but no action when it comes to people, totally unlike their behaviour when it comes to Big Business, to whom they donate giant subsidies. It's not that they provide that many jobs if any, but the government thinks it looks good. As well the government ministers are hoping for a nice cushy job after the people boot them out of office for corruption and fraud in their eternal quest to do the bidding of the Chamber of Commerce, hand in glove. In this case, the Chamber is the hand, and the Government is the glove, in our Corporatocratic Province.
Let's give a little history here. At first (1980's) the B.C. Government took the clients out of the hospital type settings, because they thought that was too expensive. They thought that group homes, with cheap unskilled labour (instead of the nurses, RNs and LPNs in the hospital settings) would fit the budget better. When I started working with my client in 1989, they were offering $7.50/hour, and upped it to $8.25 because he was twenty minutes out of town. Of course not too long after they set all this up, the workers started to organise themselves into Unions.
The workers in our organisation went with CUPE. As a result, the wages started going up, as CUPE collectively bargained for wages to rise to an equivalent to what workers in other settings were getting. As an example, when I was offered the $8.25/hr in 1990, I had previously trained as a Long Term Care Aide, and Home Support worker. When I did orientations at the local long term care facilities, they were offering close to $15.00/hr, almost twice what a worker in the group homes would get.I went with the group home, because it was not so much like a "factory" environment, which the extended care hospitals were and are, with minimal staffing to cover maximal clients.
It is a bit easier on everybody to get two or three people up than fourteen of them. I believed then and still believe that the residents are under-served in most of these elder care nursing type homes, where many of the residents have minimal contact with anyone at all. In this case, the bottom line wins over ethics and compassion. In a Privately owned facility, the share holders come first, and the residents are merely a reliable income source (until they die that is), and to maximize profits, they minimise care, and numbers of care personnel. Exactly the same philosophy holds true in the group homes for people with mental and physical disabilities. Bottom line reigns, whether in a privately owned group home setting or a non profit run one: in one case to maximize profits, in the other in the interests of frugality, such that needed funds can be used most "effectively", and mostly because that's how the Government tells them to run the institutions.
Funding is set by the Ministry, and set as cheaply as they can get away with, irrespective of the client needs beyond basics. My non-profit organisation was and is staffed by people, even in the management, who care very much about the welfare of the clients, and the welfare of our workers as well. But despite that commitment to the clients and workers, they were forced to work within the ever shrinking budgetary constraints, until even they were not happy with the low amount of service to the clients that the government was forcing us into, due to cuts in hours and increases in staff workloads. I was and still am very proud of my organisation, which has worked very hard to maintain the levels of care and service at adequate levels, and which is committed to working with all sorts of people who fall through the cracks of our social safety nets. They are not to blame for this mess.
Back to the history lesson: of course, as the wages started to rise, the government, unhappy with the extra expense, when the whole group home experiment had been undertaken with the intention of saving money, started insisting on ever greater qualifications for the workers, and ever more restrictive rules in the homes. They forced the homes to get licensed and live up to the standards that CCARF had devised, an American organisation whose rules and regulations are designed to fit US laws, rather than Canadian ones (although they have made some adjustments for Canada). All of this resulted in more work for the Support workers, for the same pay.
Finally as Community Support worker wages started to get closer to the Long Term Care Aide wages (LTCA wages are still a bit higher), the government increasingly sought to save even more money by dumping clients into private care (cheaper wages by far!) as fast as they could, whilst pretending to "consult" the clients and their families (if any). The consults were really experienced as "pressure time" for clients and families. The second strategy they used was to basically freeze, or even cut funding to the non profit organisations who run the group homes, such that even though in a collective agreement, the employer's association, CSSEA, settled for somewhat higher wages per hour, they would almost immediatly have to cut the HOURS of work a corresponding amount, so that the workers would make the same amount of money, and less benefits as they did before the new collective agreement. This was very tricky, and made it very hard for workers to make a reasonable living.
So here we are, in this current mess, which hasn't really changed since the last 10 years or more...and in a place where the PWD (persons with disabilities) continue to receive the barest minimum of support because they have no voice. they have no power. they are dependent upon the kindness of strangers.
Unfortunately, however, we cannot expect to see any kindness nor compassion in the budgetary constraints imposed by the Ministry, and their continual insistence on moving people out of the Group homes that have been their "safe haven" for many years, and into a more risky environment in Private Care. Their mandate is NOT serving people with disabilities. Their mandate, just as the mandate of the rest of the Government, is to serve the interests of the members of the B.C.Chamber of Commerce. Their mandate is to cut costs to the bone, and even further, despite financial hardship for the people with disabilities who depend upon their largesse. Only if you are a member of the aforesaid Chamber of Commerce can you expect any B.C. Liberal Government largesse, in the forms of subsidies and tax breaks. The rest of the population, particularly the most fragile and vulnerable, our aging parents, and our friends and neighbours with mental and physical disabilities, are very ill served by this Government of Business, by Business and for Business.
I urge the people of British Columbia to write to their Members of the Legislature, and let them know that British Columbia is a province with compassion, a province, whose people care about their vulnerable relatives and friends, as well as strangers, and a province whose population will insist that these vulnerable people should be more adequately served, with higher quality care, such that they are not merely warehoused in anonymous degradation, but are able to continue to live rich and varied lives with loving friends and relatives around them, and with the dignity of a safe and comfortable home, and safe and reliable caregivers, professional, compassionate caregivers who have been trained especially for this work, and for whom the well being of their residential clients are foremost in their minds, not the bottom line. As ever, it should be people before money, but our friends in the government haven't quite gotten that message yet.
This opinion article was written by an independent writer. The opinions and views expressed herein are those of the author and are not necessarily intended to reflect those of
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