CLBC ‘home’ share abuses exposed

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

Disturbing CLBC reports continue to emerge as Premier dodges external review

The following summarizes some of the serious issues/concerns shared with MOMS regarding CLBC’s management and oversight, particularly regarding efforts to reduce the costs of supports and residential care contracts. These issues are being brought forward by concerned CLBC insiders and service providers as well as families and they illustrate the need for a full independent review of the government’s and CLBC’s management of the $700 million community living sector.

Questionable assessments

Many service providers are being forced to accept reductions as high as 50% to 80% to the value of their contracts, while continuing to deliver the same or higher service levels as their clients age. There are vast discrepancies between the amounts paid to different providers. While these may be justified in some cases, given the range of different needs, it remains very unclear why some providers are targeted for cuts while others are not, and/or to what extent such cuts are reasonable.

Since 2010, when CLBC quietly launched its "service redesign" initiative, the agency has been relying on a controversial new assessment tool called the Guide to Support Allocation (GSA) to try to create a standard measure of need. The GSA remains in draft form – it has never been officially approved as a policy tool and when MOMS first asked about it last year, CLBC insisted it was an internal document that could not be shared publicly!

The GSA has since been widely criticized as flawed and inadequate in assessing real needs. The application of this tool has also been widely criticized. Clients’ needs levels have been dramatically downgraded without any consultation in many cases. Adults, families or care providers who disagree with the results of the assessment have no transparent checks and balances or independent appeal mechanisms to verify that the reductions are reasonable. Budget reductions based on the GSA have been unilaterally enforced by CLBC on contracts for family respite, group homes, day programs and other services. However, contractors tell us that they are warned that if they complain or object, their contracts could be cancelled entirely and given to another contractor who is willing to deliver lower standards of care.

Threats, intimidation: a climate of fear

The mandate to significantly cut costs, coupled with the lack of a fair process for determining funding levels, has led to widespread complaints of both overt and implied threats, intimidation and a general climate of fear within community living. Families, staff and service providers have repeatedly told MOMS that they cannot complain publicly because they have either been told or believe that there will be reprisals, such as further cuts or cancellation of their existing services or contracts, if they go public with complain about CLBC. Agencies and staff are coming to MOMS with complaints because they have nowhere else to go. As a volunteer family support network, we are not equipped to handle such concerns and have been pleading with the minister responsible for over a year now to establish effective mechanisms to address these issues.

Agency objectives, incentives put dollars before people

Bonuses for senior CLBC executives and mid-level managers have been tied to CLBC service plan objectives that promote moving as many adults as possible from group homes into less costly models of care such as home shares. This provided a financial incentive to overlook the appropriateness of a recommended care model and/or the quality of care, as long as the placement produces savings for CLBC. This incentive bonus structure existed at all levels of the organization, not just among senior executives. On Friday, the Minister announced an end to this incentive pay system, although it appears that managers will still receive the same money as part of their regular pay. Moreover, CLBC’s service plan objectives have not changed, so these will continue to guide the kinds of decisions that put savings ahead of the interests of individual clients.

Conflicts of interest

Several sources have told MOMS that some CLBC staff, including senior managers responsible for budget cuts to other programs, are allegedly moonlighting to provide home share themselves. The home share contracts are allegedly subcontracted through agencies and microboards, so they don’t show up in CLBC’s published contract list. If these reports are accurate, it presents a serious conflict of interest, as senior staff would have a financial incentive to protect and promote a model of service from which they are able to derive significant additional financial benefit. If these arrangements are subcontracted as reported, the contracting agency would find it hard to take action against a negligent home share subcontractor who also happens to be a CLBC employee or manager with the power to make budgetary decisions that affect the agency’s or microboard’s viability. In the child welfare system, social workers are not allowed to accept foster contracts because of similar conflicts. CLBC apparently has no such policy with regard to its own staff. This is another symptom of a very disturbing and endemic culture and of the systemic nature of CLBC’s challenges.

Oversight gaps

Most of the adults served by CLBC have limited verbal skills and no family/friends in their lives to speak up on their behalf if something bad happens to them, and so they are particularly vulnerable to all forms of abuse. Checks and balances to address these risks should include licensing, inspections and public reporting by an independent oversight authority, promotion of care models and or individual care plans in which multiple staff or providers can keep a check on each other. CLBC has none of these safeguards in place. The oversight gaps are most serious with the informal models of care like home share, which CLBC has been promoting to save money (Group homes are subject to licensing requirements but not home shares). There is no independent investigation of systemic complaints (the advocate for service quality has an extremely limited mandate and reports to the minister). There is no independent monitoring of caregivers and no public reporting.

Family role discouraged

One agency told MOMS they encourage families to establish Representation Agreements (which give them a legal voice in life decisions on behalf of their adult relative) as a safety check, especially to address the potential for financial abuse and to provide external support and advocacy. But CLBC has actively discouraged this practice among clients, who are penalized under CLBC’s needs assessment tool if their families have a Representation Agreement in place. CLBC was created with the goal of giving families and adults more control at all levels, from policy development to individual care decisions. But former Minister Rich Coleman ended the strong role of families and self advocates on CLBC's board. There was no consultation with families or the public in developing the service redesign process launched in 2010. And families have increasingly been excluded from individual care and support decisions.

Need for independent advocacy

Families sharing their concerns in the past year through MOMS have stressed the urgent need to establish an independent advocate with a broad mandate to ensure that CLBC is able to offer an appropriate choice of support options, with checks and balances to ensure the delivery of support in ways that respect the rights, safety and wellbeing of adults with developmental disabilities and their families. On Friday, the Minister cited the existing Advocate for Service Quality, and suggested that independent advocacy and oversight already exists. The existing office is not independent (it reports to the minister) and the limited mandate prevents the office from providing proactive advocacy, effective oversight and/or addressing systemic issues. The disturbing complaints surfacing via the media are evidence that the current model is ineffective and has allowed bad decisions, abuse and neglect.

On Friday, the Minister also announced the creation of a client response team, with a number to call for complaints. However, that number simply directs callers back to CLBC – the very organization responsible for the problems. Self-policing is not an effective remedy. A further concern is that many adults served by CLBC, especially those with limited or no verbal skills and/or no family in their lives – i.e. those most vulnerable to abuse – will be unable to initiate contact and access support from this client support team on their own, just as they are unable to access the support of the existing Advocate for Service Quality. This is another ill-conceived remedy that fails to understand or address the real systemic issues. This again highlights the need for an independent advocate, especially to look out for the many older adults who may not have families to support them.

Public reporting

CLBC compiles (or used to compile) regular internal reports to its board on reported deaths and critical incidents among residential clients. CLBC may also launch its own investigations when there are allegations of severe abuse. However none of this information is ever made public. It is not known to what extent abuse and neglect go undetected. And where problems are detected, CLBC, its staff and its contracted care providers are allowed to bury the damaging evidence and are not held publicly accountable.

Subcontractor issues

CLBC has been pursuing a major shift from models like group homes run by contracted community agencies to home shares, which are increasingly provided by independent, unlicensed and unacredited subcontractors. This raises a number of concerns, since the agency’s management and accountability system is focussed on contractors. Subcontracted caregivers are not listed in the agency’s public list of contractors and may rarely if ever come into contact with CLBC managers. If something goes wrong with a subcontractor, there is incentive for the contracted “middleman” agency to keep it quiet to avoid jeopardising their own broader contract. CLBC is basically asking its contractors to police their subcontractors. The shift underway therefore raises serious questions issues that warrant consideration by independent experts to ensure that appropriate accountability mechanisms are in place.

Final thoughts

Last week, the last block of Woodlands was torn down, symbolizing the end of an ugly chapter in our province’s history. But the fear is that we have not learned from the past and that indeed the reforms underway in community living may be recreating all the key factors – isolation, lack of transparency, independent oversight and public accountability – that allowed abuse and neglect to thrive in the old institutions.

We know there are many good, committed people throughout the system, who deserve credit and respect for the great work they do and for their unquestionable commitment to helping people with developmental disabilities live lives that respect their enormous potential as fellow human beings as well as their challenges. The Premier needs to stop trying to cover up the problems and take decisive action to restore confidence in community living and to ensure that the positive work being done can be fully recognized and supported.

Dawn & Cyndi, MOMS

MOMS, BC CLAG partners reject Minister’s stop-gap measures: full review needed

Minister Cadieux announced another series of stop-gap measures today, as her government continues to try to deflect widespread calls for a full independent enquiry of CLBC and a stop to service cuts and group home closures.

• Minister launches client support team
• CLCB variable pay compensation system to end

The BC Community Living Action Group, of which MOMS is a partner, has issued a media release in response, rejecting the minister's actions as another stop-gap that won't address the serious, systemic community living issues.

• BC CLAG: Minister's client support team another hastily-conceived stop gap that won't address serious, systemic community living issues

MOMS continues to receive new and increasingly disturbing reports via our network, including allegations of serious practice issues.

MOMS fully supports the points noted in the BC CLAG statement and again urges Premier Christy Clark to immediately commission a full independent enquiry of CLBC, as an essential first step towards providing real accountability and restoring confidence in the BC government's management of community living

Dawn & Cyndi, MOMS

More reasons CLBC needs external review

More developments in the nightmare CLBC saga!

1. Families form new Facebook group:

• " Outside Noise - BC families for independent CLBC review "

Please join and invite all your other Facebook friends to join to show support for adults with developmental disabilities and their families.

2. CLBC Execs maxed out bonuses while cutting services, turning away adults & families in crisis

Thanks to the sharp-eyed reader who pointed us to this CLBC doc ument showing that top executives at the troubled agency all received their maximum bonuses while cutting services, closing group homes and forcing residents into cheaper accommodations and denying supports to individuals and families in crisis. It seems that CLBC's policy structure actually rewards senior management for doing exactly what has caused the growing crisis in BC's community living sector.

• CLBC Executive Compensation Reporting

3. New CLBC CEO downplays concerns, says CLBC only failed to consult adequately in 15 - 20 cases

CLBC's new Interim CEO Doug Woollard didn't waste any time trying to curry favour with his boss, Premier Christy Clark, travelling to Victoria on Wednesday to try to deflect attacks from Opposition MLAs and members of the Premier's own caucus over her handling of the problems in community living.

Woollard took the unusual step of staging a CLBC press conference at the BC Legislature in which he stated that there were only 15 or 20 cases where CLBC did not adequately consult with families before changing their relative's living arrangements.

• Read a report by BC Local News on what Woollard had to say
• Read quotes from some of the hundreds of emails that MOMS has received in the past 15 months outlining serious complaints that CLBC has refused to address .

MOMS doesn't get paid a cent to support and advocate for families in our network while the CLBC CEO has a $230,000 paycheque at stake. Who are you gonna believe?

4. UPDATE: OK, here's yet one more reason:

CKNW: CLBC has spent thousands to try and polish its media image

"A government agency that needs millions of dollars just to help all of its clients is spending thousands on a media relations contractor.

"Community Living BC interim CEO Doug Woolard laid out the agency's financial needs today.

"Woolard says in order to meet the requests for services for everyone applying to CLBC would cost out between 51.5 million and and 65 million dollars.

"But CLBC has hired a media relations company for a maximum of $25,000, to help get its message out...." Read more

MOMS rejects Premier’s internal probe of CLBC as attempted cover-up

MEDIA RELEASE: October 19, 2011 - For immediate release

VANCOUVER: In the BC Legislature today, Premier Christy Clark acknowledged "big" problems in the managment of Community Living BC (CLBC)and said an internal audit is under way. Minister Stephanie Cadieux described this as a "rigorous," serious investigation.

But at a meeting with Minister Cadieux just last week, MOMS asked the Minister when we could expect to see the results of this internal review. The Minister stated that this is the annual budget planning report that the Ministry produces for the Treasury Board, and, as a Treasury Board document, that report or its contents could never be made public.

MOMS stressed to the Minister that an internal audit undertaken by the same officials responsible for CLBC's serious failures would NOT restore public confidence in the troubled agency.

A secret internal report that will never see the light of day will not shed light on the very serious abuses and failures that are reported to have taken place, it will not hold those responsible for CLBC's failures accountable and it will not provide solid footing to move forward with positive solutions.

Many families will view the Premier's internal investigation as simply an attempt to cover up her government's failures. For 15 months, MOMS has been urging the Premier, the Minister and their numerous predecessors to take urgent action to address the troubling complaints that families have been bringing forward through our provincial family support network. For months, the Premier and the minister responsible for CLBC sought to dismiss many of these disturbing complaints. They refused to acknowledge the growing crisis or to take action to prevent or to stop the appalling treatment of people with developmental disabilities and their families.

MOMS again calls on Premier Christy Clark and Minister Stephanie Cadieux to start listening to families, to start listening to community leaders, to start listening to members of the BC Legislature from across the political spectrum, and to immediately appoint a credible, independent reviewer to conduct a complete "top to bottom" review of CLBC, with the results of that review to be made fully public.

We believe this is the only way to start the process of restoring confidence in CLBC and moving forward on developing positive solutions in partnership with families and community leaders.

Families are the major partners in community living and provide the great majority of the lifetime care and support for adults with developmental disabilities in British Columbia. Community living is supposed to be a partnership with families but BC families have been shut out, ignored, abused and/or disrespected by CLBC and its political masters.

Dawn Steele and Cyndi Gerlach

MOMS on the Move

Media contact: Dawn Steele: [email protected] 604 874-1416

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An extraordinary act of courage

One of the hardest things for a politician to do (no jokes, please) is to stand up for his/her constituents when that means publicly standing up to the boss. Especially when that calls for putting political partisanship aside to support colleagues on the other side of the political divide because you think it's the right thing to do.

Which is why MOMS wants to applaud the courage of BC Liberal MLA Randy Hawes, who stood up and delivered a moving statement in the BC Legislature today that publicly challenged Premier Christy Clark today over her handling of BC's community living crisis and urged his own government to commission an external review of CLBC

Read the report on this extraordinary act in the Victoria Times Colonist :

UPDATE: Another BC Liberal MLA, Gordon Hogg, joined Hawes in expressing concern and discomfort over his government's management of community living. Hogg was the minister responsible for community living in 2001 when his government agreed to far-reaching reforms that he promised would significantly improve services for people with developmental disabilities. Many of those early commitment have now been abandonned as CLBC struggles to deal with massive budget shortfalls.

Read Surrey White Rock MLA Gordon Hogg's comments in the Globe and Mail

The comments were made in the BC Legislature today after an NDP motion was introduced by MLA Nicholas Simons, calling on government to stop group home closures. The Opposition NDP has been working tirelessly with families to bring forward the community living concerns and has endorsed community calls for a moratorium on cuts and group home closures and an external review of CLBC. But  the statements by these two government MLAs put their own political careers in jeopardy - the ultimate selfless act for any elected official.

UPDATE #2: Well, something truly extraordinary is unfolding in BC! A third BC Liberal MLA, former Cabinet Minister John van Dongen, has now stepped up and criticized his own government's handling of the community living crisis, as Premier Christy Clark and Minister Stephanie Cadieux continue to try to deny that there is any crisis. And according to this report in the Vancouver Sun, other BC Liberal MLAs have also been privately echoing the concerns that the Opposition NDP members have been raising in the Legislature almost every day.

Read the Vancouver Sun report on MLA John Van Dongen's criticism of his government's treatment of people with developmental disabilities .

Please take a moment to email Mr Hawes ( [email protected] ), Mr. Hogg ( [email protected] ) and Mr Van Dongen ( [email protected]) to thank them for their courageous acts:  Consider cc-ing their boss, Premier Christy Clark, and urging her to follow their leadership: [email protected]

We sincerely thank Mr. Hawes and Mr. Hogg for putting aside partisanship and doing the right thing for their constituents. We urge Premier Clark and their colleagues to do the same and to join the broader community working to resolve the crisis in community living!

Dawn & Cyndi, MOMS

Voices from the front lines of BC’s community living crisis

Last Friday, MOMS was part of the BC Community Living Action Group delegation that finally got an audience with the minister responsible for community living (after six months of repeated requests!). We had the opportunity to share our concerns about the community living crisis and decided to let the voices of families and caregivers speak for themselves, by reading out a sampling from the hundreds of deeply disturbing emails that MOMS has received in the past 18 months.

• Read our Voices from the front lines :

MOMS urged the Minister to adopt the recommendations of the BC Community Living Action Group, including CLAG’s calls for the BC government to:

1. Immediately inject $70 million to address the unfunded backlog of service needs from the past two years.
2. Order a moratorium on CLBC’s service redesign process, group home closures and service cuts.
3. Order an external review of CLBC to investigate the very serious and systemic concerns.
4. Establish an independent advocate to provide independent monitoring, oversight, advocacy and public reporting on behalf of adults with developmental disabilities in BC.
5. Restore the commitment to supporting choice in service options and the meaningful inclusion of families and self advocates in planning and deciding how they will live their own lives.

To learn more about the community living crisis and the BC CLAG campaign, visit the BC CLAG website .

We ask families, caregivers and concerned citizens to continue to urge Premier Christy Clark to start taking this crisis seriously by immediately agreeing to the BC CLAG recommendations. The new CLBC minister – the fourth minister in the past year!! – was unable to make any commitment.

Dawn & Cyndi, MOMS