Excellent article that everyone should read especially if your an employer, disabled person, non profit sector, or education. It has lots of stats, highlights the challenges individuals with disabilities have finding employment, and then the problems they face once they have secured employment. A lot of the challenges individuals face are small and can easily be resolved with a little bit of on-the-job help. The biggest problem is transitioning from going to school to a job when the disabled individual usually has to set themselves up again with all new supports. And the fractured access to supports which respondents usually have to find on their own. Its probably much like I am finding with community support systems where I learn about them through adhoc conversations with people I consider lucky to meet where they share their knowledge with me. Current systems are too defined, disabled individuals need creative and flexible solutions to meet an individual’s different needs. Click here or on the pdf file to read the full article or an excerpt below. Wow!
Our group of interviewees included the former Lieutenant Governor of Ontario David Onley who was more than willing to have his name identified with his concerns. He told us that despite persistent efforts, he had no gainful income from high school until after he left university. He was turned down for the multiple jobs for which he interviewed and, in desperation, turned to social assistance for financial support. He was not able to get a full-time job until he was age 33.
Pain is an overwhelming, personal experience. If people feel supported emotionally (which includes income support), you heal more quickly and fully. The more worried you are, the slower the healing process. If that support came at the beginning, we’d be saving money. Most injured workers are not complaining about physical supports – they’re lacking a social environment in which they can feel significant.
It is essential to start with people as human beings – saying I care for you as a person, I respect your contribution. That’s key in the early days, and having that support to follow you along. How can we support your hobbies, education and you as a human being? Respectful and authentic human resource policies can help prevent a person from losing hope.
Fortunately, again, and in particular for my graduate degrees, the University of Toronto was both understanding and accommodating – and, more to the point, very creative in helping me achieve the set of accommodations I required for my education. I learned that flexibility, communication and partnership were critical to my then and future success.
Another way to move toward the person-centred delivery of disability supports is through a financing system known as individualized funding, which involves the provision of dollars directly to individuals. It is not simply a transfer of dollars to allow consumers greater choice among existing options. Individualized funding represents a form of purchasing power that can play a vital role in generating a greater supply of supports.
Several provinces employ individualized funding for certain healthand disability-related programs. Direct Funding in Ontario is based in the principle of individualized funding (see Appendix C). Manitoba, Alberta and BC also use this form of financing for various disability-related services.
One respondent described how fortunate he is to be covered by Direct Funding in order to hire his own support workers. The flexibility of the program enables him to work full time. He can vary the hours of the attendants according to his needs. If he has an early meeting, he requests an early morning routine. Most people who are served by community agencies have to wait until the designated organization assigns a worker to them. Their schedule is determined by the agency hours and they don’t have the flexibility afforded through an individually funded approach.
A major strength of Direct Funding is that the services are portable across sectors (i.e., home, school, work) and within the province. The advantage of individualized funding is that disability supports are “attached” or assigned to the person. The supports are not tied to a specific place. It means that the individual can use those supports in whatever venue these are required – at home, school, work or anywhere else in the community. A person who moves into a different life phase (e.g., from school to work or training to job search) can keep the required supports.
Portability is a significant guiding principle when it comes to disability supports. Ontario not only should preserve Direct Funding but also should consider extending the hours of service and the types of support it covers.
Other nations have taken significant steps toward individualized funding. The UK has introduced the Personalisation Agenda initiative that aims to give individuals choice and control over how their needs are met [Government of UK]. Under this approach, consumers are actively involved in producing a support plan, which takes into account not only health but also personal, family, social, economic, educational, mental health, ethnic and cultural background and circumstances. They then receive an associated package of funds based on these assessed needs. The plan is paid for by direct payments and/or the provision of appropriate goods and services.
Australia is another country that has seen growing support for individualized and self-managed funding with a full range of choices within the service system. New Zealand also employs individualized funding to enable the development of a holistic approach to assessment and service provision, which applies across agencies and funding sources.
It is important to acknowledge that there are potential weaknesses to individualized funding. If, for example, an attendant calls in sick in the morning, it may be difficult to get a back-up in place right away. Many individuals prefer not to have to worry about the obligations involved in being an employer. In some cases, specialized supports may not be available even if the person has the dollars to purchase them. Several respondents spoke to the importance of choice in selecting an individualized funding approach or not
Several initiatives in Canada seem to be doing a good job in enabling access to supports. The non-profit Neil Squire Society runs a program that provides essential equipment and services to address disability-related barriers in the workplace.
The program allows individuals to submit an application online or by mail. A telephone interview is conducted in which applicants explain the nature of their disability and the barriers that exist in their workplace. The interviews are client centred and individualized and may cover a range of devices or services. Cost-sharing is always explored with the individual and/or the employer.
The BC Association for Individualized Technology and Supports is another exemplary program that enables people with severe disabilities, who need assistive technologies, respiratory services and supports, to live independently in the community. The program provides a comprehensive range of equipment and supplies and parts, respiratory therapies, biomedical engineering and peer support within a community-based environment. A registered respiratory therapist is available around the clock to provide individualized information and advice. Biomedical engineers maintain and repair respiratory equipment for clients, including mounting ventilators on wheelchairs.
The resource centre at Simon Fraser University was identified as another positive example. The person in charge was open to experimentation, which is essential when trying to figure out appropriate accommodation suitable to the unique needs of each individual. Equipment upgrades were also possible – a positive feature that many programs do not provide even though technology changes all the time. The program included an employment division to enable transition to the paid labour market after the completion of postsecondary education.
One respondent proposed that when governments update their respective inventories, they could make available this older equipment at little or no cost. Thousands of potential users could benefit from giving the older equipment a ‘second life.’
The Canadian Council on Rehabilitation and Work noted that New Brunswick has introduced some effective programs. It has a robust disability action plan that is linked to its employment action plan. Both plans identify the players specifically responsible for the identified actions.
The province focuses on clients through its Training and Employment Support Services initiative (TESS) – though New Brunswick has also designed a special program intended for employers, discussed below. TESS seeks to reduce or remove the impact of a person’s disability in order to enable participation in training or help the prospective worker obtain or resume employment. Any person with a disability, whether or not receiving income benefits, may be eligible for services under TESS. Disability supports are decoupled from income programs.
Through its focus on both prospective employees and employers, New Brunswick has taken full advantage of the federal-provincial Labour Market Agreement on Persons with Disabilities, which enables jurisdictions to design programs that are best suited to their respective populations. A wide range of activities can be financed through the agreements, which include reimbursement for the provision of disability supports.
Every province and territory has entered into a similar labour market agreement with the federal government. It allows for sharing the cost of disability supports. But this provision raises questions as to whether this funding arrangement itself is creating problems as these supports are used only for work purposes and are funded exclusively through these agreements.
By contrast, supports and services at home typically fall under health care financing. If a person receives equipment through the Assistive Devices Program, it is not supposed to be used for work because it is funded through the Ministry of Health and Long-Term Care. Employers are expected to fund these items.
Similarly, the provision of funds for disability supports at postsecondary educational institutions means that the monies can be used only for supports employed in that venue. They are tied to the place rather than the person. Multiple funding arrangements attached to specific venues are contributing to the complex array of programs that comprise the disability supports ‘system.’
To address this issue and the supply problem more generally, Caledon has called for the creation of a national Disability Supports Fund that would harness federal and provincial/territorial investment in disability supports [Torjman 2015; 2000]. While governments would be the primary funders of disability supports, the disability community in each jurisdiction would be actively involved in decisions regarding their design, delivery and governance.
The proposed financing arrangement would allow flexibility in provincial/territorial design and delivery. But in order to receive federal funds, provinces and territories would be required to adhere to a set of guiding principles related to portability and responsiveness. The Canada Health Act represents a policy precedent for linking conditions to dollars − though it played this role far more effectively in the past than it does today.
A major strength of this proposal is that a Disability Supports Fund would be able to finance disability supports whether they are used at home, at work or anywhere in the community. It would do away with the need for provinces and territories to maximize their revenue by tapping into separate and distinct pools of money, which result, not surprisingly, in the creation of separate and distinct programs.
Moreover, a Disability Supports Fund would establish a national mechanism to enable the provision of disability supports completely apart from income programs. It no longer would be necessary for persons with disabilities to rely on a given income program, such as welfare, in order to obtain essential supports (discussed below). Ideally, the integration of disparate programs and services would also reduce the barriers created by current funding arrangements, which basically make artificial distinctions among health, social and educational services.
One respondent proposed the creation of a pan-Canadian Assistive Devices Program intended for employment. Employers and prospective/ current employees could apply for grants – say worth 80 percent of the projected costs − to offset a substantial portion of total expenditure. Such a program not only would meet the needs of current employees but would also help many prospective employees find work. Often they can’t get a job because they lack the associated aids or equipment. For employers, the proposed new program would provide a central and reliable source of information as well as reduce their own financial contribution.
A group of representatives from various disability organizations is preparing a report on the UN Convention on the Rights of Persons with Disabilities to be presented in the fall in Geneva. It is proposing investment in a national accommodation fund.