There has been ongoing and often intense pressure to close professionally-staffed group homes for adults with developmental disabilities in the province since 2001, when the BC Liberals took office.
While MOMS strongly supports personalized choices and efficient spending, the government’s current actions are clearly not driven by the best interests of adults with developmental disabilities. BC’s latest push to reduce quality, close group homes and forcibly relocate residents against their wishes poses grave risks to their safety and wellbeing, prompting growing alarm among families and community living advocates.
There are good reasons to offer alternatives, as group homes are not right for everyone. But despite government’s protestations to the contrary, it has always been clear that the desire to reduce costs supercedes concerns about the risks of abuse, safety and individual wellbeing, and that both Community Living BC and the Province have repeatedly failed to be forthright about a series of initiatives aimed at reducing group home capacity.
A major shift from group homes towards more informal and affordable adult care was a key component of the restructuring proposal that led to the creation of Community Living BC. At the outset, BC Liberal insider/CLBC architect Doug Walls promised that closing group homes and shifting to new support models would reduce community living costs by 20%.
But the promised savings from restructuring were never been achieved and CLBC therefore faces mounting fiscal challenges, with an aging population, a growing client base and budgets that have failed to keep pace with inflation and government-set wages for unionized sector workers. Overwhelming opposition from residents, families, operators and staff has repeatedly thwarted efforts to close group homes, and this on-and-off fight is now heating up again.
In June, the Victoria Times Colonist revealed that the Province had quietly cut CLBC’s budget by $22 million to help offset the provincial deficit, despite promises from Minister Rich Coleman that cuts were being made elsewhere in order to protect services for people with disabilities.
In 2006, when CLBC was under the Ministry for Children and Families, the Minister ordered a $2 million survey called the Residential Options project, which required CLBC staff to interview every one of its almost 3,000 group home residents to try to persuade them to move to a less formal setting. Despite government assurances that this was about offering more choices, not about saving money, residents responded with an overwhelming No!
The review generated much anxiety (see Public Eye reports here and here, and here) but the exercise fizzled after the final report in June 07 confirmed that group home residents would not voluntarily give up their homes. In a letter to families, Minister Christensenpromised “that CLBC and this government remain committed to meaningful choice, person-centred services and the continued operation of licensed group homes.” Further, the Minister promised that the review’s second phase would “include a review of family care homes [i.e. home sharing] to ensure that individuals in all residential services are living in their choice of residence.” That was never done.
In 2008, the Provincial government commissioned an external review of CLBC. The resulting Queenswood report frankly discussed the Province’s desire to close goup homes and relocate residents to less formal settings in order to cut costs and the barriers to doing so. The report concluded that since CLBC could not force people to move, the crown agency was instead directing all incoming clients to less-costly “home sharing” and basically waiting to close group homes one by one as their residents died off. (See Pg. 95 of the report – PDF Pg. 109).
No evidence of savings
The Queenswood report assumed – with no evidence – that home sharing is intrinsically more affordable than group homes, while offering care that is equally safe and appropriate for any adult with developmental disabilities. This contradicts studies from other jurisdictions which, as Public Eye’s Sean Holman reported in 2007, have found no evidence of savings, if the comparisons of different options involve people with similar needs and abilities.
Home sharing is only intrinsically more affordable if support and oversight levels are reduced, which is neither safe nor appropriate for high-needs individuals who require intensive support, along with careful oversight to prevent abuses.
Most of the resistance to giving up group homes stems from the failure to demonstrate that the Province and/or CLBC have adequate quality control, oversight and independent evaluation to assure the safety of the new informal care models that they are promoting.
These models can work very well for more independent residents if care providers are committed and altruistic. But what prevents disreputable contractors from collecting their payments while keeping residents under abusive conditions? Such arrangements are also inherently less stable and therefore unsuitable for individuals (e.g. many people with autism) who cannot cope with stress and change. Yet another concern is that aging residents will need more supportive models, but those who give up their group homes know they will never get back in.
The latest push began this year, when media reports revealed that provincial budget cuts were fuelling a new CLBC initiative to “rank” client needs and adjust funding levels. The resulting cuts to community agency contracts have made it impossible for them to maintain group homes, so residents are being forcibly relocated to less costly settings like home sharing.
The relocation push is not the only impact of budget pressures. Anecdotal reports suggest quality and standards of care are eroding within group homes. For example, staffing cuts have led to residents being “locked down” for the evening once day-shift staff leave, eliminating any opportunity for getting out in the community or socializing.
CLBC is also again promoting “cluster care,” a backwards shift to institutionalization that community living advocates overwhelmingly rejected when the BC Liberals first proposed it in 2002, and which then-Minister Gordon Hogg promised would not be part of CLBC’s delivery model.