Yes, it's money. Or, as is often the case, the lack thereof...
I love the diverse feedback we get at MOMS. For example one mom this week pointed that what's happened to CLBC is part of a far broader pattern -- a "Neo-Liberal" agenda that's driven policy excesses around the world and created widespread suffering, global instability and economic and social havoc. Overly simplistic assumptions have driven this agenda: that people always thrive when you stop trying to help them, that big government is the problem, and that austerity and deregulation will cure all evils (...like not having enough money).
Voters have been happy to endorse politicians who assure us that excessive taxation is the problem, and that a steady diet of tax cuts will restore health and vigour. It's an alluring message, and as with all false premises, a small grain of truth and a whole lot of wishful thinking gives it a compelling ring. But how true is it?
Premier Christy Clark warned that throwing more money at CLBC was not the answer, even as she claimed to be throwing another $40 million at the troubled authority. A slew of internal reports reiterated over and over that CLBC needed to learn to better manage its money because we can't afford more and we all have to live within our means.
Well, we'd agree that CLBC has done many bad things. But living within its means is one task which even the staunchest critic would have to admit that CLBC has excelled at - notwithstanding high-profile failures like excessive bonuses and moonlighting employees (both serious errors in judgment, to be sure, but not the kind that put any real dent in a $700-million budget). And we can demonstrate the community living sector's fiscal virtue pretty compellingly, thanks to some nifty charts developed by accountants at the Developmental Disabilities Association.
Reporters at the Victoria Times Colonist revealed months ago that CLBC has reduced spending per person significantly since its inception. But with caseloads rising yearly, is the community living budget really unsustainable, as Premier Christy Clark, her predecessor Gordon Campbell and their political colleagues keep insisting?
In fact, in relation to what we earn as British Columbians, we're spending a smaller fraction of our income on community living services today than we did a decade ago, as the first chart shows (click on images to enlarge them).
A common question in the CLBC crisis is why CLBC contractors and agencies that directly support adults have been so reluctant to publicly voice the concerns they share with us privately.
Many contractors and agency directors claim it's a matter of survival. They tell us CLBC makes it very clear that if they don't cooperate in reducing services, or if they complain publicly about risks to their clients, their contracts can be cancelled and handed to someone else with less regard for quality of care.
The allegations are disturbing. But it's been challenging to document how systemic this is and what risks it poses to adults if no one will put complaints on the record.
Premier Christy Clark just released an action plan based on 3 internal reviews, none of which sought to explore these concerns, despite persistent complaints over 18 months. The silence among service providers also emboldened government to go on the offensive against families. One report dismissed advocates as over-zealous parents with a strong culture of entitlement who were blocking CLBC's efforts to improve quality of life and independence for their loved ones!
But CLBC contractors may be finally overcoming the fear factor. Victoria agency director Sarah Balazs, who runs group homes and supported living for high-needs adults, decided enough was enough. She started sharing her complaints with reporters after months of being ignored by CLBC, the Premier and Minister Cadieux. Predictably, CLBC and Ministry staff finally responded as soon as Sarah started copying her complaints to the media. A site visit is planned for tomorrow and we will be closely tracking and reporting on what comes next.
Sarah's complaints support many specific issues that families have raised and that were largely ignored in the recent reports and the Premier's 12-point plan. These include: insufficient funding to support youths turning 19, eroding quality of care due to budget pressures, threats against those who complain, no advocacy voice for adults without families, fundamental flaws in the CLBC model and rationing tools like the Guide to Support Allocation, crisis management focus that inflates costs, and growing health and safety risks.
The overall message is by now familiar to all: The government apparatus responsible for supporting adults with developmental disabilities is still overly focussed on cutting spending, without regard to impacts on health, safety and wellbeing of adults who have nowhere else to turn.
Below are copies of Sarah's correspondence, as shared with MOMS:
- January 19, 2012 letter to families, pointing out that the agency director is funding a deficit from her own pocket because CLBC has not increased funding levels for the agency's basic costs like food and transportation since 1994!!
- Email chain (Oct. 2011 to Jan. 2012), as the agency sought to bring concerns first to CLBC, the minister and Premier, then to news reporters, and eventually to MOMS, after getting no response from any of the above.
- August 2003 letter to Doug Woollard re cost reductions demanded by the Interim Authority (CLBC's predecessor). This illustrates how long agencies have been fighting and dealing with budget cuts that put their clients at risk. This is just the latest of many rounds that have severely eroded safety, health and quality of life.
MOMS applauds Sarah's courage in standing up to the bullies and demanding better for the adults whom she and her staff support. We offer her our full support in her efforts to secure a fair deal and continue to encourage others to do the same.
Dawn & Cyndi, MOMS
The Vancouver Sun has published my letter to the editor responding to Vaughn Palmer's column on the new Queenswood report . Since they cut out some important parts, I've also linked to the original letter below.
This letter and our recent summaries reflect just one of what I'm sure are many perspectives, which continue to evolve as we pick up new pieces and learn valuable insights from others. The point here is that having conversations about these things is critical, both to fully informing ourselves and the broader public. As one email to MOMS put it:
"What is really important for families to understand is that the
> ground is shifting rapidly and the people who are exerting the
> most influence over what the future will be for people who have
> disability related supported needs, are not their families, but
> those listed in Appendix 2 of the Queenswood Report
> (Participants in the Review). These are people who are
> comfortably ensconced in their ivory tower and fundamentally do
> not understand the direct lived experience of families."
These reports, along with government's 12-point plan, outline another major restructuring: We're looking at potentially radical changes with lifelong implications for people with developmental disabilities. Depending on whether this time you're prepared to trust a governemnt that has failed us repeatedly, those changes portend a welcome break, a frightening descent into deeper crisis, or maybe some of both.
We are again at a critical juncture in community living, with 3 roads open before us:
1. We sit back and let the political leaders and bureaucrats do it their way, after another round of perfunctory consultation with families. This is the default route, one that represents another lost opportunity. The Premier and Minister Cadieux have just concluded no less than 3 reviews that primarily entailed bureaucrats consulting each other to establish the direction of change, I'm not confident that this is a good way to start an inclusive and successful process of reform.The Premier's mandate is to do what she thinks best for the majority of British Columbians in her political base (i.e. contain govt spending) - NOT what's best for community living. The bureaucrats' mandate is to please their political masters (contain costs with a minimum of outside noise) and make life easier for themselves. This is not criticism or partisanship - just reality.
The BC government secretly initiated its own review of CLBC last August, before Minister Bloy's replacement, and months before Minister Cadieux announced the launch of two other internal reviews, the result of which were released last week (see previous post).
Unlike the other reports, the new Queenswood Consulting report is only available on request (but you can download a copy here). This is a must-read for families, self advocates, service providers and individuals from linked sectors such as Health and MCFD, and it re-emphasizes the urgency of securing an indepdendent review of CLBC and community living in BC!
Columnist Vaughn Palmer cites parts of this new report extensively in a Vancouver Sun column.
Below are key extracts from this report, which includes both eye-opening revelations and very troubling warnings about the direction in which the BC Liberal government may be hoping to take community living.
Here is an overview of Premier Christy Clark's solution to the crisis in community living, as outlined at a Jan 19 press conference:
Of the $40 million in "new" funding announced:
- Only $18 million is directed to CLBC operations, of which $9 million was the emergency funding announced last September – leaving $9 million in new money, but an $18 million yearly increase moving forward;
- $12 million is “tagged” by the government from the contingency budget to spend in case of caseload increases;
- $10 million is earmarked from the Ministry of Social Development for day and employment programs and transitioning youth;
Compare this to an estimated $70 million that CLBC needs just to address current waitlists, with at least 3,000 documented unmet requests for support from CLBC-eligible clients on hold. Waitlists grew during a two-year funding freeze in 2010 and 2011 when the number of clients grew by 5% annually. Besides millions needed to resolve the backlog, CLBC needs further budget increases of $35 million in April 2012 and again in April 2013, just to address projected 5% caseload growth for each of the next two years.
Conclusion: Better than zero but this is a Band-aid, not a solution. Stay tuned for more gut-wrenching crises and more outside noise.
2. Independent Advocate:
The Children's Advocate, Mary Ellen Turpel Lafond, will be given a limited mandate to advocate on behalf of youth turning 19 as they transition into adult services. This is very good news for young adults, but it completely fails CLBC's most vulnerable clients -- the hundreds of older clients who have no families to advocate for them, who can't go to the media when they have a problem, and who are unable to access the support of appeal mechanisms like the Advocate for Service Quality or the Client Support Team.
Conclusion: A+ for extending the mandate of the Children's Adocate, and a resounding F for the disgraceful and cynical failure to provide equal support for the more vulnerable older adult population who can't cause Premier Clark the same kind of political pain by describing their abuse/neglect at the hands of CLBC in front of the TV cameras.
3. Deputies' report
This report by senior provincial bureaucrats relied primarily on the internal audit and the CLBC Board's new vision report, released before Christmas. It proposes better coordination of CLBC services with other agencies and during adult transitions, plus more reliance on non-CLBC services (same old, same old).
In short, the Deputies' advice is that families and adults expect too much and that CLBC and its clients should stop complaining and get used to less support from govt.
4. CLBC Audit report
Key issues are summarized below:
1) Omissions: The auditors did not acknowledge, investigate or report on most of the troubling allegations around CLBC practices, as raised by families and the media:
- Firing of Vancouver coastal director Paul Sibley, which allegations have linked to contracting practices.
- Serious contracting and practice irregularities noted in the Lister consultants report, as reported by Global News and the Victoria Times Colonist.
- Complaints (Vancouver Sun) that CLBC staff improperly changed needs assessments using the GSA tool to justify contract cuts, or misled home share contractors by failing to be transparent about known risks like violence history, in efforts to reduce contract costs.
- Complaints about abusive/unprofessional contracting practices: alleged threats, intimidation, or blackballing of contractors who raise health and safety concerns, allegations re preferential awards & of wildly divergent contract values for similar needs. Allegations that moonlighting CLBC staff paid themselves higher rates while cutting other contractors.
- Complaints about oversight failures: that clients were left in home shares with expired contracts, clients whose placement, status and care was rarely or never inspected by CLBC and or agency supervisors.
Conclusion: F. These are serious omissions that seriously undermine the report's credibility. Sweeping problems under the rug will do nothing to restore confidence in CLBC or help the agency get on track! Expect more outside noise.
2. Projections: The audit admits CLBC has a good handle on projected caseload increases but claims that's meaningless for planning and budget purposes without detailed assessments of exactly what services each future client will need.
It's a ludicrous assertion: In no other arm of this or any other government can bureaucrats predict exactly what will be needed by a consumer who walks in the door a year or two in the future.
3. Waitlists: After months of denying it had any waitlists, CLBC released data in September 2011 showing that 2,126 clients were receiving some services but were waiting for additional or enhanced services; while another 832 eligible adults were waiting and had not yet received any CLBC services.
While imperfect, CLBC's client file management system and waitlist data is better than most other arms of govt. The Children's Ministry, for example, can only guess how many kids most of their programs serve, and claims to have no ability to even estimate unmet service requests.
Yet the government auditors, after reviewing a sample of files from CLBC's Request for Service List (RFSL) and allegedly finding it riddled with errors, concluded that CLBC's waitlist numbers were unreliable and overstated. They concluded therefore that the data did not support the $65 million CLBC has requested from the province to eliminate the backlog, or the new funding required to meet projected caseload increases in 2012 and 2013.
The conclusion is at odds with the results of CLBC's December 2010 customer satisfaction survey, which also addresses the question of unmet needs.
We continue to receive the most amazing, heartbreaking and disturbing letters from families, caregivers and concerned citizens around the province sharing their experiences about BC's community living crisis. I wish we could share them all, but most people are simply too afraid of retaliation if they speak out, or are quite understandably reluctant to sacrifice their family's privacy.
We thank all of you who have entrusted us with your stories, your hopes, your frustration and your fears. We are doing our best to bring these issues to public attention, with the help of our BC Community Living Action Group partners and with strong interest and support from the provincial media, in the hope of finally pressuring government to take real action.
Below, with permission, is an example of one of the dozens of letters in our inbox yesterday.
----- Original Message -----
Sent: Monday, November 21, 2011 1:57 PM
Honorable Stephanie Cadieux:
This morning I had the opportunity to listen to you regarding CLBC on CKNW. It seems that despite the huge crisis in CLBC you still strongly believe (or keep telling yourself and want others to believe) that CLBC is meeting the needs of most families. That the huge media blitz is overrated and that there are just a few families being affected and are in actual crisis.
I can tell you that you are very wrong. There are countless families who are needlessly suffering emotional and financial stress due to CLBC's lack of concern, acknowledgement of problems and lack of financial support. Have you had a good chat with any of your front line facilatators or social workers lately? How's the morale?
To pay the CEO bonuses for not adequately supporting families in crisis is morally wrong and unethical. For you and the government to continually support a board that refuses to assist families in crisis is sickening.
Why do I feel this way? Because we are one of those families, we are just one of many. Thank God we have finally received some home share funding for our son but only after a significant long term crisis!
We begged for help. Care Plan after Care Plan was submitted and revised by me as I sought help and made revisions just so our family could survive. Finally we were forced to have our son removed from our home. Still CLBC refused funding, instead they preferred to use up significant police, ambulance and local hospital resources and expected the hospital to provide his housing. Then CLBC staff suggested and threatened that he be moved to the local homeless shelter. I won't go into the details as I have already done that in numerous emails to Premier Christy Clark and the former Minister for CLBC in May 2011.
Already I suspect the funding for our homeshare is not enough; as I am already getting hints from him (only four short months into the contract) that he feels he is not getting enough and was "railroaded" in the contract.
I have friends who are aging, unwell and tired, yet their facilitator told them they will likely not get funding for their son till they die. That's encouraging!
Apparently the funding contract for our son's home share provider is top secret. CLBC and contract provider can't tell; won't tell; confidential. Yet some staff at CLBC are getting multiple funding contracts for multiple homeshare clients. They know funding contracts and are negotiating their own contracts while working full time for CLBC! Interesting. How can this be? Don't home share clients require significant care? How are providers able to work full time or even part time if they are home share providers for needy clients? How do CLBC staff negotiate their own contracts if $ amounts are top secret? Who takes responsibility if our current home share provider feels his funding contract is too low? He's getting wind that others are paid more. What is the funding formula and why is it not consistent? Who negotitiates and advocates on behalf of a potential home share provider who is not familiar with a system full of conflicts of interest? Where's the accountability of home share providers? What safeguards, controls and oversight is there to these home shares? Who's watching that homeshare providers are actually doing what they are supposed to be doing, such as life skills training?
For 18 years I've been a stay at home parent due to my son's significant needs. How does one get one or multiple homeshare clients and still manage to hold down a full time job?
Lots of questions, lots of irregularities, lots of mismanagement and I suspect some are getting rich on the backs of needy, vulnerable individuals and families who are suffering needlessly.
Economy wise; families in crisis don't help the economy much either as it causes unnecessary mental health issues to ALL family members. Hard for a husband to work when his family life is in crisis. Might explain why divorce rates among families with special needs kids is so high. Has the Finance Minister ever considered that? Would Premier Christy Clark be Premier if her son was Autistic, Deaf and had Cerebral Palsy?
My whole family has paid a price!
Also, one more key question...... Can you tell me why there is an endless pot of money in the medical/hospital setting (ex.Children's hospital) where babies of all gestational ages and ailments are saved yet the pot dries out once these vulnerable, needy, disabled children are lovingly placed into the arms of their parents and sent home? Why is it that at that point almost all parents left out in the cold? The "AT Home Program" is not adequately funded, parents receive little supports or respite, if any, and then after 19 long years there is again no funding at the CLBC end. Any answers to that question?
(Name withheld to protect family confidentiality)
The Minister responsible for Community Living, Stephanie Cadieux, suggested in media reports today that families and other community living advocates have been exaggerating the crisis in BC's community living sector because only 63 complaints have been filed to date with a new client support team.
The minister said her client support team has ordered CLBC to provide more services after validating more than 60% of the complaints reviewed to date.
- Find out more about the Minister's community living client support team and how you can file a complaint.
MOMS has written to the Minister to raise a number of concerns relating to her client support team and her comments in the media. Minister Cadieux and Premier Christy Clark are still trying to manage the community living crisis as a public relations exercise when what is needed is a commitment to working in good faith with families and other community partners to effect real change.
Read a copy of our letter below:
Dear Minister Cadieux
According to reports in today's media, you have stated that the crisis in community living crisis "is not maybe as large as some would like us to believe it is" because your new client support team has only received 63 complaints.
We wish to express our disappointment at the disrespect your statement shows for the many hundreds of caring families, caregivers and community partners who have contributed enormous volunteer time and effort, in good faith, to help to identify key challenges in community living and offer positive solutions.
Here's a very interesting retrospective from a Burnaby social worker on the problems and flaws that have dogged CLBC from its inception. (She is incorrect about exemption from the Freedom if Information Act - CLBC does have to comply.)
A history of Community Living
By Tracey Young, Burnaby Now
November 11, 2011
Community Living B.C. was doomed from the very beginning. It was never about greater individual and family control and improved service delivery. People have a short memory about how it was that Community Living B.C. was created. Read more
She argues that the flawed CLBC model was doomed from Day 1 and notes that the current crisis is just the latest, coming on the heels of the decision to return children's services to MCFD due to widespread concerns about serious gaps in how children under 19 and their families were being supported by CLBC. She also points out that scandal and alleged contracting irregularities dogged CLBC even before it was officially created in 2005.
Many argued that despite the grand vision, hopes and promises, CLBC was always intended by government to serve primarily as a mechanism to deflect political flack while doing the dirty work of cutting/controlling community living spending.
Media reports continues to expose disturbing complaints about how the BC government and Community Living BC have been managing the $700 million community living program that is supposed to provide residential and other supports to adults with developmental disabilities in BC.
New reports in the past week have revealed more disturbing practices by CLBC and gut-wrenching stories told by families of adults victimized by a brutal agenda to cut costs regardless of the human impacts.
Here are some of the latest stories on the ongoing crisis, with sincere appreciation for the tremendous work being done by BC journalists to expose the reality within community living, as BC Premier Christy Clark continues to resist growing calls for a full public enquiry:
Victoria Times Colonist reporter Lindsay Kines got hold of a secret CLBC report that warned CLBC-funded "home share" placements had gone badly awry due to a lack of standards and oversight, resulting in allegations of serious sexual and physicial abuse. After receiving the report, CLBC's response was to award more home share contracts to the agency responsible. Read the Times Colonist story
Vancouver Sun reporter Jonathan Fowlie investigates allegations that CLBC downgraded the needs assessment rating for one young woman to justify cuts to her supports. Read the Vancouver Sun story
- Here is Global BC on the same story
Vancouver Sun reporter Denise Ryan has been behind a compelling in-depth series highlighting the plight of families dealing with CLBC:
- Woman battling cancer must also fight for autistic son
- Mom's attempt to beat poverty on hold
- Navigating the maze of Community Living BC
- Struggle for care: mother fights to get special needs son back home
More disturbing reports from the front lines of the continuing crisis in community living:
- CTV Vancouver Island: Family turns to CTV for help for disabled son
- Global TV BC: Life in turmoil
- Langley Times: Move still on for Langley group home residents
- Kamloops Daily News: Parents, advocates rally against CLBC cuts
Meanwhile, newspaper editorial boards, columnists and Op Eds have joined the growing chorus calling on Premier Christy Clark to launch an independent review of CLBC:
- Victoria Times Colonist editorial
- Nanaimo Daily News editorial
- Provincial columnist Paul Willcocks
- UVic Prof. Michael Prince's Op Ed for the BC CLAG
How many more families need to sacrifice their privacy and tell their life stories in front of TV cameras before the BC government will "come to its senses," as one frustrated dad told Global News last night, and stop the betrayal of our most vulnerable citizens?
Dawn & Cyndi, MOMS
CLBC has been defending the closure of group homes and forced moves of residents into "home share" contractors with claims that it's about providing more personalized models of care. And for some aduls with developmental disabilities, finding a home with a caring family is exactly that - a happy new beginning.
But CLBC and the ministers who have promoted this shift don't like to talk about the fact that a major driver of these changes is simply a desire to decrease the per person costs of providing residential care.
And in a series of disturbing revelations this week, we are learning more about an even darker, ugly side to this shift.
First it was revealed that CLBC executives were moonlighting as home share contractors, earning as much as $10,000 a month on the side (on top of their $130,000 executive salaries and bonuses) for providing room and care in their homes to adults with developmental disabilities. These reports indicate that senior managers who ordered cuts to programs, group homes and other contractors may have themselves been awarded contracts valued at double or tripe the rates paid to typical home share providers.
MOMS is receiving reports that this practice may be far more widespread than CLBC's management admits and that it has led to conflicts and unresolved complaints. In one case, the parent of a young man alleges that her son was mistreated in the home of a CLBC executive moonlighting as a home share contractor to two clients (CLBC policy requires that home share contractors take in only a single client unless there are exceptional circumstances). In one community, caregivers say this "double dipping" is common practice among CLBC staff, with contractors allegedly reporting to the same office in which they work to manage contracts and supervise themselves and fellow caregivers.
These contracts are not reported in CLBC's public list of contractors, because they are arranged as subcontracts through community agencies that deliver services for CLBC or through microboard societies created especially to handle the home share arrangements as subcontracts.
These contracts appear to directly violate several provisions in CLBC's conflict of interest policy. That policy is not posted on CLBC's Policy Website but MOMS was able to obtain a copy. Other government departments and agencies do not permit staff to "double dip" as contractors to their own employer for obvious conflict of interest reasons.
Now Global BC News has been revealed that in at least one case, a home share contractor was providing care to five individuals in the same home, and was the subject of serious complaints and a police investigation into alleged sexual and physical abuse.
No charges have been laid. Neither CLBC nor the agency responsible for supervising this home share subcontractor will speak publicly about the incident. The public would never have learned of these troubling reports but for whistle blowers throughout the sector who are now risking their own contracts, careers and funding to expose what many see as a deeply flawed culture and serious systemic problems within BC's troubled community living system.
It is not clear how a CLBC home share contractor could ever have won approval for 5 contracts to care for 5 individuals in the same home, since this is expressly prohibited under CLBC's policies. The incident also highlights serious gaps in monitoring policies and their enforcement -- the serious oversight gaps that families, self-advocates, caregivers, agencies and concerned CLBC staff have been trying to highlight in recent months.
It is not clear how anyone could imagine such an arrangement as consistent with the personalized, individualized "family care" concept that CLBC claims to be promoting when it forces adults out of their homes and into "home share" arrangements.
In another disturbing allegation this week, one care provider says CLBC has obstructed efforts by home share contractors to form their own association to support training, sharing of best practices, standards and advocacy on behalf of the adults whom they support. Home share providers tell us they have been forced to accept budget cuts of 50% and higher imposed by CLBC, with no recourse if they believe it is unreasonable or unfair. Those who complain may get their contracts cancelled and the adult whom they care for reallocated to someone else willing to take them for less money.
MOMS is also learning that some agencies have encouraged their own group home staff to moonlight as home share providers. Colleagues question the practice, pointing out that the care of adults with severe challenges can be emotionally stressful and that such moonlighting, while lucrative, can negatively impact the ability to maintain patience and quality care both at home and at work. One of BC's largest agencies, the Developmental Disabilties Association, says it does not permit such moonlighting amongst its own staff as a policy, and that it encourages individual care and support plans for its clients that involve multiple providers as a way of providing additional checks and balances.
BC has excellent, caring people dedicating their lives to supporting people with developmental disabilities. But CLBC's twisted culture and mandate appears to have fostered all the same conditions that led to horrible abuses and neglect in the old days of institutions like Woodlands and Tranquille: isolation, inadequate oversight, a gross failure of standards, accountability and transparency and a culture that places more emphasis on the dollar value of a care contract than on the human beings that it is supposed to be all about.
What will it take for the BC government to confront this crisis and order a full independent enquiry?
In 2004, when the media revealed that the BC government was considering leaving children exposed to moderate sexual abuse to save money, Premier Gordon Campbell finally relented and commissioned the Hughes enquiry, which led to far-reaching changes and the appointment of an independent child and youth advocate.
Today, the media have again revealed that the BC government not only left vulnerable adults exposed to abuse to save money, but that it has sought to cover it up. It's time for Premier Christy Clark to face the obvious and call in someone of Judge Hughes' stature to investigate and report publicly on what is happening in community living.
Dawn and Cyndi, MOMS