A New Long-Term Perspective on Developmental Services Sustainability?

 

There have been no funding increases for Developmental Services agencies in more than 9 years.

This is perhaps a secret that had been kept for far too long, and has served to increase tensions and misunderstandings in the Developmental Services sector.

Since 2006 when the Transformation of Developmental Services got underway, all at once there were new ways of applying for supports (Developmental Services Ontario), new opportunities for individualized funds (provided under the unfortunate name “Passport“), and also a number of frustrations that resulted.

While the overall investment of Province of Ontario dollars actually increased, the impact was not always obvious to communities, and certainly not to individuals and families who continued waiting for services, and/or who found that even with some Passport funds at their disposal, paying fee-for-service to secure help was more expensive than they had anticipated, and in some locations, even with cash in hand there were not necessarily organizations and/or workers available to hire.

In situations of scarcity, and with quality of life and lives on the line (such as aging parents in their senior years waiting for services and still caring for their adult children at home) it is not surprising that a divide developed where agencies and families drifted apart – certainly those on waiting lists had little reason to see agencies as anything but a consumer of resources that they were unable to access.

At the same time, agencies were in a struggle to keep their heads above water and maintain their levels of service and commitments to existing supported individuals. With no increases to their core budgets, they lost ground year after year to rising costs, struggling to recruit new staff, and desperate to retain those with many years of service who had every right to expect that they not lose ground to inflation with flat wages, and living with daily concern about the sustainability of the entire sector.

The situation has been demoralizing and unproductive for all concerned. In the end, Developmental Services is about HUMAN SERVICES. We need quality trained and supported human beings delivery person-centred supports for people with intellectual disabilities, in partnership with their family members (where applicable). There is no magic formula to deliver this result, other than an increased investment in the sector.

Agencies and families using fee-for-service have both been impacted by flat funding. Agency budgets are losing ground to inflation, and so are family budgets.

Throughout 2017 this problem moved to the forefront and became an increasingly public conversation. It all came to a head in a bit of a surprising way, with Bill 148 (Fair Workplaces, Better Jobs Act, 2017).  In some cases, increases to minimum wage will result in direct financial pressures on agencies and families, but it is also felt more generally as yet another serious inflationary pressure.

The dedicated professionals in this sector are seeing their compensation losing ground to inflation at the same time as even entry-level positions in other sectors are closing the gap on their own wages. Ultimately this results in a “race to the bottom” as good people become impossible to retain, and the field loses its ability to attract talent, as they move to opportunities where flat wages are not the accepted norm. Agencies and families find themselves competing for a continually shrinking and increasingly less qualified pool of workers.

There can be no outcome from this other than disaster. After nine years there are no magical “efficiencies” to be found. It is not about “creative business plans.” All such “innovations” are meaningless in the face of rising costs and flat revenues.

These challenges cannot be fixed by “running it like a business.” Such an approach drives solutions like reducing services to supported individuals to reduce costs, increased use of a casual and more transient workers to keep wages low (the opposite of how quality is delivered in human services), and a risk-averse environment where innovation is stifled by the need to keep the lights on.

In late 2017 the Bill 148 issue pushed agencies and families to the edge, and they started to get their message out. The initial response from the Government of Ontario was underwhelming, but those of us who have been a part of Developmental Services for some years knew that bureaucrats and politicians alike were not unsympathetic to these issues.

In fact, formal and informal conversations always reveal a deep understanding of these issues and a desire to address them. However, the type of scarcity that has resulted in conflict within the Developmental Services community is a microcosm of bigger societal issues. We are in competition with sectors like health and education that have a different history. Those sectors have never gone nine years without a base funding increase, and there is no money tree to help Developmental Services join the entitlement system (this issue is addressed in numerous place in the Nowhere To Turn report of the Ombudsman Ontario).

Just when it looked like we’d be heading into 2018 without any hope on the horizon, there came a significant signal that the Province of Ontario is trying to find a way.

We don’t yet fully understand what this announcement means, but it certainly seems to be on the right track – it is addressed to both agencies and families, and it clearly recognizes the problem, and that the problem is in fact a resource issue that only government can resolve.

Hopefully 2018 will be the start of an actual collaboration between government, agencies, and families. We cannot afford (emotionally or financially) to be in competition. We have to work together to champion the importance of quality person-centred supports and services for people with intellectual disabilities so they can get the help they need to live as valued and included members of their communities, with homes, jobs, and natural relationships.

Let’s do our best to rest up for the next 10 days and then let’s start the work of developing a permanent end to the cycle of scarcity and crisis in Developmental Services.