The root of all evil…

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 ).

Overcoming the Fear Factor – Contractor goes public; CLBC, govt suddenly all ears

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

Starting a discussion: How do we guide change in community living?

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 real CLBC vision, startling new directions revealed in secret report

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.

MOMS Report Card: Premier Christy Clark’s solution to the CLBC crisis

Here is an overview of Premier Christy Clark's solution to the crisis in community living, as outlined at a Jan 19 press conference:

1. Funding:

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.

Conclusion: F

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.