A secret policy?

Community Living British Columbia may not be talking about its leaked proposed service delivery plan. But the New Democrats are. In an interview with Public Eye, the party's children and family development critic Maurine Karagianis said, "CLBC has said we are not trying to shut down group homes. And yet all of the information I hear within the special needs community is pointing to the fact the government is definitely doing away with group homes. Now we clearly see there's a statement here that they're going to get rid of no more than 100.” Ms. Karagianis also slammed the authority for its plan to convert some group homes into community residences - but not count those changes as closures. "This is the most stealthy, underhanded way of shutting down services for special needs communities."

18 Comments

"Ms. Karagianis also slammed the authority for its plan to convert some group homes into community residences - but not count those changes as closures."

For those of us who don't work in this field, what is the difference between a group home and a community residence? Does the group home have a higher ratio of staff to patients, or do they provide a higher level of care around medications for example? Is there a lower per patient cost in the community residence facilities?

1. it is difficult to distinguish exactly what "the plan " refers too.
2. clbc has a project called 'residential options project' and can be viewed on their website.
3. the 'project' purports to be based on presenting residential options desired by developmentally disabled adults. however desired options must cost less than present services, usually a group-home, so one can see there is also a crucial budget agenda involved.
4. the hoped for cost savings from the clbc's point of view are to occur via the new labor costs associated with the creation of a new contractor class called " family home provider" .
5. the definition of 'family home provider' and the prohibition on collective agreements limiting the government's ability to enter into contracts with them can be viewed in the 'community services labour relations act ' (cslra) passed in 2003.
6. many in the unionized residential care sector view the act as a ticking nuclear bomb the bcliberals hold over unionized residential workers, probably some five to six thousand workers.
7. nov. 30/06 ,clbc applied to lrb to have a broad swath of residential models, indeed virtually all, declared to fall within definition of' family home provider' in the cslra.
8. indications are that the application was not viewed favourably by lrb as clbc is not party to the collective agreement in question.
9. there upon clbc pressured cssea ( the employer's bargaining association) to submit a "service delivery model proposal " to the unions wherein the quotes in the story arise from.
10. the employer representatives met and refused to endorse the proposal and some apparently described it as the wrong proposal for the wrong reasons for the wrong time as the sector has a recruitment and retention crisis resulting from 5 years of bclierals cutbacks.
11. now to answer your question budd, if you are still with me - it appears the difference between what is called a 'group home' and a 'community residence' will be determined by the nature of the labour relations. group homes are typically staffed by unionized employees while 'community residences' will be staffed by some form of contractor under terms that are restricted by the cslra.
12. i understand this has been a long explanation and there is much more also. anyone interested can email me at donfodor@shaw.ca

"Power concedes nothing without a demand. It never did and it never will." -Frederick Douglass

I'm not familiar with the union aspect but I can confirm that since the start of restructuring and CLBC's conception back in 2001, many families have feared that the unofficial intention and a primary goal of it all was to find a politically feasible way to close group homes (as the most obvious way to cut costs in order to meet MCFD's budget reduction targets), and that this would of course seriously deplete BC's commuity living capacity, while posing grave risks to vulnerable adults. See BC FamilyNet's recent concerns expressed to the Minister, for example (http://www.bcfamilynet.org/BCFN_Oct_06-Group_Home_Review__F__.pdf)

CLBC's intent to move away from group homes as a community living model is clearly set out in its Service Plan, along with specific targets. The only debate is about whether this is a purely cost saving measure with serious negative implications for adults and families (as families fear) or whether this is simply CLBC promoting choice and more "person-centred" arrangements, which is how CLBC attempts to dress it up.

The service plan targets clearly contradict the claim of promoting more choice, since they only measure numbers redirected away from group homes. Likewise, the reference here to closing up to 100 group homes directly contradicts CLBC's claims that the current residential options review is about promoting "choice". (How can closing homes promote choice when CLCB admits over 3,000 people waitlisted for group home placements and other services!).

Further, CLBC's claims that more informal residential models are better are contradicted by a recent study that CLBC itself commissioned. It found no evidence to support CLBC's claims that these other arrangements are better, more cost effective, more person centred, etc. than group homes -- in fact, the opposite was often found. Indeed the review found that too few countries had ever tried to house severely impaired individuals (like most of those under CLBC's care) in these less formal models to conclude anything about their safety or appropriateness. As a parent, the new proposals for 16-hour shifts, etc also raise major concerns. How compassionate is any caregiver going to be after 16 hours coping with an extremely challenging individual?

CLBC's wildly unsupported claims to justify its shift away from group homes raise serious alarm bells about the motivations and risks involved, not to mention transparency and due diligence. Even more worrying is that most of the highly vulnerable and easily manipulated individuals who are being encouraged to leave their group homes under the current residential options review have no families or reliable independent advisors who can help ensure that they make decisions that are in their best interest, with a full understanding of the risks involved.

In my view and that of many others who are aware of what is underway, it represents a shocking abuse of the responsibility towards these vulnerable adults, for the sake of saving a few dollars. Truly shameful, when we consider the enormous amounts that have been and continue to be wasted on ill-conceived restructuring, a disastrous new bureaucratic model, an endless parade of consultants and of course the communications experts charged with trying to cover it all up.

Good explanation Donfodor.
I seem to remember the Liberals were set to erase that unionized sector back shortly after they took office in 2001.

However, when the proverbial stuff hit the fan as the Libs began their decade of cuts to people and budgets, the group homes issue was simply pushed off the table lest it stand in the way of other cuts the government had forced on the BCGEU.

It should surprise no one that the Liberals are now back with the axes as it was their stated intention in 2001 to stop the union sector.

To be fair, the 'GEU got a real deal from the then troubled NDP government in the master contract that approved the group home deal, which saw wages jump from minimum to almost above poverty levels.

Question, does privatizing the jobs and cutting staff wages and benefits do anything positive for the residents who depend on those workers?

To answer your questions, bleedingheart, there have always been concerns that rigid union clauses can pit the interests of workers vs residents.

If privatizing jobs and cutting wages and benefits meant that you could provide more quality care for more adults with more flexibility within same budget, it could be argued that yes, it would greatly benefit residents. However, it's questionable whether that would be the case. Privatizing jobs and making families the new employer under CLBC's new direct funding models transfers an enormous administrative burden and complex liabilities that are often poorly understood by already stressed families. Reducing wages and benefits makes it very hard to recruit and retain good caregivers.

Additionally, there is nothing positive for residents about provisions for seniority bumping in the proposed model(e.g. a terrific one-to-one relationship that may have taken years to build could be broken when a caregiver with seniority loses their job and has seniority rights to bump someone else.)

In short, there is little evidence that these changes are primarily about the best interests of residents and a growing body of evidence that they are primarily about cutting costs because CLBC is way over budget and increasingly desperate.

more evidence of du toit's bad management. her focus is exclusively on devolving services to aboriginals and be damned every other child or youth in this province.

This is a very scary situation for many employees of associations that care for old and severely handicapped people.

When is this government going to get rid of the flashy websites and tell people they are just a right wing government that cannot seem to show any form of caring.

It makes me sick to my stomach to think of single parents, people with mortgages, parent with kids in university losing their jobs because of an ideology - that unions are bad and well paying jobs are bad.

"I am made as hell and not going to take it any more."

My thanks to Don Fodor and Dawn Steele for their very detailed explanations.

I vaguely recall during the late 1990s a proposal under the previous government to make some changes to the contractors who were providing services to MCFD. The Liberals were angry, especially Christ Clark, since she claimed that volunteers and low paid staff were going to be replaced by unionized workers.

It makes me "sick to my stomach" too. There IS no Democracy in the minds and actions of Premier Campbell and the leadership of MCFD. They talk a good line but their actions show that it just talk.

This devolution of services to "authorities" comes with some pretty words but behind those words is an effort to save money on the backs of children and youth in British Columbia. This is not a Liberal government. We are governed by Reformers.

What alarms me is the lack of public protest by the tax payers. And why is the press silent on these issues? The only item that I have read about Lesley du Toit was a piece by Jeff Rud in the Times Colonist in which he quoted her friend and business partner in South Africa and noone else. We should all be so lucky to have our friends and business partners reflect us back to the public we were hired to serve.

We are not being served.

'A secret policy'?

Everything that concerns mcfd is now Secret.

Not at all healthy for anyone in British Columbia who is concerned about or who works on behalf of children and youth, or individuals living with any kind of challenge.

Not at all healthy for British Columbia, period.

Simple answer.... I think Tom Christiansen should ask for an entire list of each agency's budgets (revenue and expenditure) along with a clear and honest example of how many individuals each agency supports. Then, he should ask his boss Honourable Gordon Campbell why the Director position at MCFD in May 2006 was not filled with the trained eye that was intended to keep CLBC Leadership honest and on their tippy toes.The original letter - Memorandum of Understanding needs to be revisited with Treasury Board and the much needed " Director" in the room as witness. Only in the province of BC could this continue to exist.... and how long are people gonna let this slide before asking the pertinent questions of who, where, why, what and when their taxpayer dollar is squandered. I wish my son had an average cost of support of $68,000.00 per year like the other folks more fortunate and at closer proximity to the rockpile.As a result of the tied up funds,we are on a waitlist for some emergency respite cause the provincial funding is in the hands of the wrong people. As the dough flows and all on the backs of those less fortunate!

Answer to Valerie: The reason the press is silent is because the press often hires a reporter who will allow herself/himself to be silenced. Also, families are not empowered enough to come forward and speak to the press over fear of retribution vs. CLBC/MCFD staff being too darn good at the spin doctor stuff. (you spin me right round baby right round) The funds needed for new services / waitlisted individuals are in the hands of the wrong Contractors? However, the needed funds are indeed available? Tom, as a Minister living in the most effective CLS region in this province, when are you going to do your duty as an elected politician and in a transparent fashion? Further, why would you be delayed to not appoint a trained eye "long lost big brother" over a corporation (CLBC) that can't seem to get past their own internal dynamic tension and corruption? Question now is,who is in charge - MCFD/CLBC/Taxpayers? What we do know is that the taxpayers pay the previous two and legally, remain entitled to hold them each accountable.

Sean, keep up the good work. Valerie, dig deeper for some strength and follow your heart. Me, I just wish I still had the Cadillac service my family previously received for my son before we moved. Collectively, we are not being served.

To Bud - The oversimplified answer is that Yes, there was a deal in the dying days of the NDP government that sector employers and many families considered an overly sweet deal for labour. Before my time, but I was aware that when Doug Walls and the rest came in with the Liberals in fall 2001, this was a big preoccupation and there was a real push to "get back" and "get rid of" unions. The merits of those concerns aside, the situation today is very different. Deep budget cuts, pay rate cuts and a big gap between Ministry/CLBC funding rates for union and non-union rates have all added up to serious challenges in recruitment and retention. Many of the same employers who were mad as hell at the NDP now realize they need to be able to offer good terms if they hope to keep their operations staffed in a tight labour market.

To Joe, the crises facing those on indefinite waitlists represent a real travesty. To CLBC's credit, they have asked for such information and at the root of plans like the above group home closures lies an effort to more equitably spread around the inadequate resources available. There has also been a real squeeze on operators over the past 5 years and many are running on incredibly lean budgets. One big operator in Vancouver/Richmond now relies heavily on its own private enterprise and fundraising to subsidise the public budget being provided for the community living services it provides under contract for CLBC. And re CLBC's current push, is it right to take away vitally needed supports and put one group of individuals at risk in order to serve others on waitlists, instead of providing the resources needed to support all who need assistance to live successfully in their communities? Robbing Peter to pay Paul isn't the answer. It's not even saving money, as the failure to support ends up putting enormous pressure on other services--health, justice, etc. We are a wealthy, civilized society and we can and should do better.

Regarding media, I wouldn't suggest it's about reporters being bought off. The problems are complex and often far removed from the public eye. It's very difficult to tell these stories without massively invading the privacy of vulnerable individuals and families, many of whom also genuinely fear that complaining publicly might bring serious repercussions. Finally, news formats that focus on recording events and incidents (vs. issues), on stories with shock value (Pickton trial) or glamour (diet woes of movie stars) or political conflict (QP name calling) aren't condusive to a slowly unfolding debacle whose effects on a minority of citizens out of the public eye are hard to document. Even the opposition has had trouble with this where there wasn't a very clear focus such as the Sherry Charley case. I think Sean and a few others, mainly at the Times Colonist, are showing it can be done if reporters make the effort and have some support from management, and hopefully others will be prompted by their example to do better.

I'd like to thank Dawn Steele for assessing the media the way she did. It's just not fair to blame the general public for being ill-informed.

Rarely if ever does a reporter get to decide on what stories to follow or how the stories will be written up.

If there's a failure (and God knows, CanWest has a fearsome bias) it comes from the newsroom management.

Try phoning the Editor-in-Chief next time you see a story with an outrageous bias -- or when a whole area of public interest such as Children & Families is simply left out of the picture.

I guarantee, you'll be surprised at their attitude. You'll never blame the reporters again. But because you phoned, the newsroom might think twice about fairness and the public's right to know.

It's awful, in my opinion, to blame the general public -- the victims -- for our imperfect media.

Most of us do our best to be informed. We buy the rotten newspapers because that's all there is in B.C. And we find very little to help us understand our social, political, economic environment.

Q for Dawn Steele: DS wrote - "CLBC's claims that more informal residential models are better are contradicted by a recent study that CLBC itself commissioned. It found no evidence to support CLBC's claims that these other arrangements are better, more cost effective, more person centred, etc. than group homes -- in fact, the opposite was often found. Indeed the review found that too few countries had ever tried to house severely impaired individuals (like most of those under CLBC's care) in these less formal models to conclude anything about their safety or appropriateness."

Can you please provide a link to the "recent study that CLBC itself commissioned". Thanks

The study can be found on CLBC's Website: http://www.communitylivingbc.ca/news_and_events/documents/ResidentialAlternativesDocumentCLBC_nov.06.pdf

Its main author is Tim Stainton, one of the primary architects of the new CLBC model and former Interim Board member during much of the transition phase. He puts the best possible spin on the findings in his Exec Summary and Conclusions, so you have to actually read the meat of his literature review (Pages 29 - 45) to see what available studies actually found in comparing these alternate models to group homes. This study was actually commissioned and funded by CLBC, AFTER they'd written a Service Plan identifying these more "cost-effective" alternatives as unequivocally superior.

No one model is right for everyone, of course, and the big question with any model is how well is the home managed, what are the standards and how effective is monitoring and supervision in maintaining those standards. CLBC's new service delivery model creates a huge gap in monitoring and supervision, with the elimination of traditional social workers and their ongoing case management role. We know the majority of residents have no families around to keep an eye on things, so in many cases this means that no one's watching the caregivers any longer. Further, CLBC's new standards are all based on self-reporting. The caregivers simply fill out a checklist and if they answer yes to everything, then it means everything's great! Not surprisingly, the provincial association that represents most caregivers (BCACL) and that also helped design the new model, has been mum on all this to date.

From a parent's perspective, under this new scenario, would you rather put your kid in a group home that has provincial licencing requirements, other residents and different staff coming and going to at least watch each other, or would you tend to put more trust in a "family care" or "room mate" model in which some unknown individual takes your kid home to live in his basement for a fee? We hear of excellent "family care"situations, so this is not to disparage the many excellent families and invididuals providing such care, but where are the assurances?

Perhaps the politicos need to worry about not getting the full story from the folks at CLBC. See Sean's article dated April 20,2006 "long lost big brother". Dawn, what is the difference between provincial licensing requirements and a an agency home that is 3 year accredited? Can you tell me if family care homes or room mate homes are supervised? I have heard horror stories about homes that have a licensed designation too. Does any of the politicos have answers or do they rely on information from the folks at headquarter building? Do other parents have similar / different opinions than I do? Thanks.

Joe, I don't know enough about the accreditation process to answer that, though I have heard skepticism about how much that can do. I don't mean to suggest that licensing alone offers solid guarantees either. You can get awful licensed facilities and luck out with a wonderful informal family care (foster) arrangement. No system is going to be 100% foolproof but the disturbing trend appears to be towards significantly less oversight overall, especially for these less costly, more informal settings like room-mate and family care arrangements that CLBC is marketing as more "person-centred" (which is a complete misnomer. It's like calling that Swedish assemble-it-yourself furniture more person-centred than traditional ready-made or custom-made stuff.)

When CLBC was devolved, an internal provincial govt audit warned that significant risks would arise as CLBC started to implement its service delivery changes. CLBC's 2005 business plan promised all sorts of risk management systems would be in place from the outset. But 18 months later, the changes are already well underway and they're still talking about developing these safeguards in future. What we've seen so far isn't comforting either: elimination of social workers' case management role, new standards based entirely on self-reporting, and a doubling of caseloads for CLBC's managers, who will in future have to keep tabs on somethng like 35 family care homes instead of 15. And the community associations and non-profits that run many of these services face the constant threat that if they don't cooperate, CLBC will give their contracts to someone who will, perhaps a commercial outfit that will have no qualms about streamlining the service to deliver cheaper while still making a nice profit.

This is not like results-based forestry management. It's an especially vulnerable population, and there's a lot of very bad history, so it really calls for a very thoughtful, careful approach, with layers of formal and informal safeguards, honest assessment & discussion of risks with various models & limitations of safeguards and systems of oversight. There needs to be real "person centred" planning that recognizes the human element (residents and caregivers), the individuality of each situation, and that has the flexibility to adjust the safeguards accordingly. And there needs to be public confidence that CLBC takes its oversight responsibilities very seriously and that budget pressures aren't compromising the stated objectives of reforms.

Instead, they keep lurching into the unknown, driven by ideology, launching a parade of "innovations" that turned out to be disastrously ill-conceived. Where things were piloted, no one ever gets to see the evaluation reports. Fancy promises and visions always seem to boil down to cost-cutting in the end. Old systems are torn down before there is anything ready to replace them. Instead of transparency and frank discussion of risks and opportunities, it's all spin and marketing, so it's like watching the ads on TV--hardly anyone really takes the claims seriously any more.

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