Patronizing approach is not paying off
The B. C. Liberals should do much more to prepare developmentally disabled adults to find work and keep it, thereby weaning them off a current excessive reliance on paid support from government.
But the obstacles to going that route include an entrenched way of doing things in the bureaucracy and a high level of expectations for continued government support from wellorganized client families.
So said a report from a Victoria-based firm of management consultants, retained by the B. C. government as part of its recent review of Community Living B. C., the agency for delivering programs to the developmentally disabled. The review by Queenswood Consulting, which drew on extensive documentation as well as interviews with those familiar with the system, was released last week along with two other reports on CLBC.
The findings were overshadowed by the news that the province was plowing another $ 40 million into programs for the developmentally disabled, building on an existing budget in excess of $ 700 million.
But in the course of reviewing the agency’s significant progress to date, Queenswood’s 134- page report concluded with a vision of the future.
It called for B. C. to “shift away from the more traditional, custodial and somewhat patronizing approach” in dealing with the developmentally disabled, namely “day programs that focus on recreation and socializing.”
Instead, there’d be longer- term training in both employment and life skills, the better to prepare individuals for an independent life. “This would enhance the employment opportunities for the significant numbers of people with disabilities who have the capacity and desire to participate in the social workforce.”
Whereas according to the consultants, the current system is predicated “on paid services being the end goal for individuals and families,” as opposed to a way station on a more self- reliant life. “Many participants in this review characterized Community Living ( and the developmental disabilities sector in general) as being over- professionalized and overly focused on assessing need for paid care in its service delivery approach,” said the report. “Many believe the current system prepares people to expect paid supports, and to specifically not consider the option of employment.”
Other jurisdictions — the report reviewed comparable systems in Australia and the United Kingdom — promote the concept of “rings” of support for the developmentally disabled, with family, friends and close contacts arranged concentrically on the inside and government as the outermost line of support.
Not with Community Living and the population it serves. “It does not fully utilize the first three rings and instead moves directly to paid supports, which in this province are most often unionized, highly formalized, and costly.”
But the system is not the only obstacle to change.
“Many participants in this review spoke of a sense of entitlement among families in this sector that is stronger than other sectors, “said the report.
“Many of the families that lead advocacy in the sector are highly skilled, resourced, and committed to increasing the level of funding that individuals receive, rather than considering alternative support methods including an expanded custodial and care role for families themselves.”
Further, they “have high expectations for supporting their sons and daughters, and the sector has a demonstrated history of political sophistication to advance its goals.”
They have also been relatively effective, as the report notes by way of providing some perspective. “This sector is now characterized by a much richer per capita funding level when compared to other disabilities ... The average amount of funding that is available for an adult with a developmental disability far exceeds that of adults with other disabilities who have similar levels of impairment.”
The richer funding is partly a legacy of programs that grew piecemeal through a variety of agencies, partly a product of the mishmash of standards, guidelines and assessment techniques. All ripe for rationalization to promote equity and certainty. But there’s that well- organized and entrenched culture of entitlement among the families of the developmentally disabled, as many of those interviewed by the consultants characterized it.
“This is a fundamental contributing factor to the difficulty in making meaningful changes to the service delivery system as evidenced, for example, in the challenges that Community Living experiences when trying to shift individuals living in group homes,” said the report.
“Addressing this culture should be at the core of any directions that government takes towards the service delivery system for people with developmental disabilities.” Communications being the starting point. “Without a renewed emphasis on proactive, positive communications, the constructive and positive work of Community Living, of which there is much to profile, risks being subsumed by the strong voices of advocates, and the inevitable challenges that come with serving this population.”
But as the report notes, communications on this file have been mismanaged to the point where “the message has often been lost.” So much so, I would say any attempt to reform the system along the lines suggested is more likely to summon brickbats than accolades.