“There are now 1700 people, vulnerable people, enduring their days in institutions, waiting in group homes, waiting with ageing parents, waiting for that promised right to live with supports in their community,” said Wendy Lill, an advocate for people with disabilities who chairs the Community Homes Action Group.
“How much longer are they going to wait?” Lill asked the Legislative Committee on Community Services. It met today to discuss the government’s stated commitment to close eight adult residential centres.
Most of the 525 people living in adult residential centres have intellectual disabilities, acquired brain injuries, chronic mental illness, or physical disabilities. Many have spent most of their adult lives as residents of the The Meadows community in Bridgetown, Breton Ability in Sydney, Harbourside Lodge in Yarmouth, King’s County Rehab in Waterville, Riverview in Dayspring near Bridgewater, Quest in Lower Sackville, Riverview in Pictou County, and Sunset Community in Pugwash.
“We have been working and we have been moving individuals into the community in preparation for the full phase-out of these adult residential centres,” said Tracey Taweel, deputy minister at the Department of Community Services. “Ensuring that the appropriate supports are in place before individuals are moved is critical. The individualized planning process will play a key role in that, so we have been consulting with stakeholders and families.”
Some $7.4 million annually has been budgeted to move 50 people out of institutions and care for them in smaller homes. Harbourside Lodge in Yarmouth will be the first to close and planning is underway to move its 27 residents within the next 12-18 months.
“I am a big fan of transformation; I want it done yesterday,” said Joyce d’Entremont, the CEO of a community group that operates two adult residential centres in Yarmouth and Bridgetown. “But I do realize for individuals who have been in large institutions all their lives, it takes time. If we move them too fast, we will not succeed.”
“Glacial pace of change”
NDP MLA Kendra Coombes asked why, since the previous Community Service minister had identified 300 people back in 2015 who could be transitioned from larger adult residential centres to smaller group homes, had it taken the government until 2020 to allocate money to begin that process?
Progressive Conservative MLAs also commented on “the glacial pace of change” since the McNeil government had committed back in 2014 to find more homes for disabled adults and close all eight adult residential centres within 10 years.
“Their lack of action on their own commitments directly impacts those waiting to start living their lives in the community,” said Brian Comer, MLA for Sydney River–Mira–Louisbourg.
A news release from the Department of Community Services yesterday announcing the opening of four new group homes promised back in 2017 suggests that the goal of de-institutionalization may have shifted farther down the road. The release said, in part, “the development of more community-based homes for people with disabilities is part of government’s commitment to being an accessible province by 2030.”
The plan is for those homes — which will be built and operated by community groups such as L’Arche, Gateway, and Regional Residential Services — to provide a more homelike setting and more choices for people who haven’t had many. Deputy minister Taweel said the department has developed blueprints and is working on pre-approving builders to make it easier for community groups to develop housing, although COVID has contributed to delays. New building codes have also made it harder for non-profit groups considering renovating existing buildings.
Taweel acknowledged Nova Scotia is the last province to close its adult residential institutions. She also noted that of the 1,700 people with disabilities on the wait list for some type of housing, 70% are people currently receiving services from Community Services. The annual budget for the Disability Support Program stands at $389 million — a figure which has grown by $70 million in the past five years but is still inadequate to meet the need.
It’s the growing size of the wait list and the slow pace of change that is most concerning to community living advocates such as Wendy Lill. She noted that from 1996-2002, the province managed to close the Halifax County Rehab Centre and Scotia Adult Residential Centre, where 270 people once lived.
At what cost to whom?
In 2013 Lill co-chaired the task force that created the Road Map for improved services for people with disabilities. There were 1100 people on the wait list then, now there are 1700. She said the government’s approach to COVID-19 has shown the province can make changes when it has to and it will take the same “all hands on deck” mentality and cooperation among levels of government to make that happen.
Another barrier is one noted by the Community Services deputy minister. “In transitioning residents from adult residential centres and residential rehabilitation centres to small option homes, we are talking about the highest needs people in our Disability Support program,” said Taweel.
“As such, the cost to support these individuals in community will be higher than the costs currently incurred in institutions. We are committed to this work. It is the right thing to do. We want participants to succeed, we want families to have peace of mind, and we will do it as quickly as possible.”
Lill doesn’t accept the position that moving people out of institutions and into the community will necessarily cost more money. She and Taweel agreed to revisit that topic. Meanwhile, Lill’s colleague on the Board of Community Homes Action Group told committee members there is also a cost to doing nothing.
Dr. Karen McNeil is an experienced family doctor who works out of the Dal Medical Clinic in Spryfield. She said many of the disruptive behaviours exhibited by some brain-injured and intellectually disabled adults can improve in a different living situation. At present, she said medication is the only option for institutions dealing with people who are difficult to serve.
“COVID has made it clear our homes are very important to us. These are places of choice and safety, not noisy and crowded. The COVID pandemic has also made it clear that housing vulnerable people in congregated settings where shared bedrooms and bathrooms exist is not acceptable, and a recipe for disaster.”
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