Disability Supports

A key issue for persons with disabilities is that access to disability supports is often tied to the eligibility for income support and other programs. Also, in most cases, supports are not portable across sectors. The supports provided at home can not be used in schools or in the workplace. Inversely, the accommodation provided at school or work cannot be brought home.

At the same time, disability supports often are attached to residential care such as group homes, nursing homes or institutions. Because the funds go to the residences, the services are not portable — creating problems for residents who wish to seek independent living arrangements. The provision of disability supports through welfare also makes it difficult to move off the program.

In Unison proposes a commitment to the principle of portability so that persons with disabilities are not locked into certain living arrangements or income programs in order to retain access to certain disability supports. 'Portability' in this context means that disability supports are attached to the individual; they go with that person regardless of the region or setting in which they are required. A commitment to portability would require each jurisdiction to develop an approach for ensuring access to disability supports. It could include a set of actions that articulates how disability supports might be detached from income and other programs, and 'assigned' instead to the individual. Disability supports should be portable across any and all sectors — at home, school, work and community.

One way to help implement a commitment to portability is through a form of financing known as individualized funding. Individualized funding helps offset the direct and additional costs of disability and allows services to be tailored to individual needs — the amount of payment is different for every person and is determined on an individualized basis depending on specific needs. This form of financing also has the potential to improve the responsiveness and flexibility of disability supports. Several jurisdictions already employ this form of funding, both experimentally and systemically, to meet disability needs. But while individualized funding can help respond to many identified problems, it is not a panacea for resolving all problems related to disability supports. In some areas, services may not be available in the marketplace, thus limiting the effectiveness of individualized funding.

Finally, governments recognize that affordability creates significant problems of access. The cost of disability supports can be prohibitive. Relatively limited assistance is available to help offset these costs. Statistics Canada's Health and Activity Limitation Survey (HALS) estimates that some 33 percent of adults face costs related to their disability that are not reimbursed by any public or private plan.

At all educational levels, students with disabilities often report that they find themselves at a disadvantage. Many have difficulty gaining access to the supports they require to enter or remain at school. There are also concerns with current training. Persons with disabilities typically are relegated to separate programs rather than integrated within existing training initiatives. Even within specialized programs, there are problems of accessibility — often interpreted narrowly to address only physical access.

Barriers to education and training translate into employment problems later in life. Persons with disabilities have lower than average workforce participation — partly because of lower than average educational attainment and lack of disability supports. More than one million adults with disabilities are unemployed or outside the labour force. Women and Aboriginal persons with disabilities generally face more barriers to employment, and as a result, are more likely to be unemployed. While most persons with disabilities would like to work, they face a range of barriers in acquiring the skills and experience which would help them prepare for jobs (see Appendices B and C for further details). Education, training and transition programs need to become more flexible and accessible. This is key to ensuring better educational attainment for persons with disabilities and securing a better economic future through employment.

Canadians whose work is interrupted temporarily or permanently as a result of disability or who have no workforce attachment must rely on various income programs. Multiple assessment and administrative procedures create frustrations and high costs.

Eligibility generally is determined by where and how claimants became disabled or by the nature or severity of their disability. For many Aboriginal Canadians, eligibility to disability supports can depend on residency or status. Those who do not qualify under existing criteria often rely on welfare for financial support.

In determining eligibility, most welfare systems classify persons with disabilities as long-term cases or as 'permanently unemployable.' But this classification ties many persons with disabilities to the welfare system because they typically receive higher benefits, have access to various disability supports and are not required to show continuing proof of job search. Similarly, the Canada Pension Plan (CPP) requires that a person be out of the labour market entirely and incapable of performing any work that would provide sufficient income for basic support.

These expectations regarding employability — or unemployability — are dated. Many persons with disabilities can work, especially if their needs are accommodated through technical aids or equipment, specialized training, modified job or adapted workplace. Indeed, some recent welfare and CPP initiatives actively support workforce participation.

In order to improve service, reduce unnecessary duplication and remove financial disincentives to work, the federal and provincial/territorial governments already have agreed to a strategy for harmonization actions for income support, composed of three key goals to guide future initiatives: removing disincentives to work, rehabilitation and labour market (re)entry measures that encourage independence and social integration, and streamlined assessment and reassessment processes. Jurisdictions also have made a commitment to examine their respective income programs (e.g., CPP and social assistance/Assured Income for the Severely Handicapped) and will select the areas around which they plan to work, both individually and together. A progress report of harmonization initiatives will be produced.

These harmonization activities, many of which are already under way, will help pave the way towards long-term reform. Streamlining multiple assessments and vocational supports, for example, moves well along the path to a more integrated system of income security, a key dimension of comprehensive reform. Streamlined assessment and reassessment can be made possible through the sharing of information. Such sharing potentially could lead to an application process which employs common assessment criteria for determining eligibility. Privacy protocols would have to be developed, however, to protect personal and confidential information.

Moreover, several measures could help remove disincentives to work. Many governments have already implemented some of the following measures. Entitlement to disability supports (e.g., medications) could be retained after entry or return to the labour market. Cut-off levels for qualifying and for maximum benefits could take into account the cost of disability. Rapid reinstatement could be introduced if work efforts do not succeed. Earnings exemption rules within welfare could be revised to encourage workforce participation. Program criteria which automatically disentitle individuals to benefits, such as volunteering or taking credit courses, could be removed. Most recently, jurisdictions agreed to introduce rapid reinstatement of income support for persons with disabilities should employment efforts fail. Jurisdictions also agreed to explore taking the health costs into account when determining cut-off points for income assistance. These efforts reflect the broad recognition of the need to support persons with disabilities in the labour force as well as the need to provide adequate supports for the costs of disability.

The consolidation of income support/ replacement involves many complex issues that require further study. The broader range of potential strategies under consideration, while not precluding work on the integration of income support, provides the opportunity to make more immediate progress on a number of important fronts, including the need to offset disability-related costs.

One possible direction for major reform could be to review the role of disability insurance. Reform could involve, for example, the consolidation of government-mandated programs that require employer contributions and protect employee income in the event of temporary or permanent work interruptions as a result of disability. Welfare would continue to provide last-resort assistance. There are potential advantages to such an approach — e.g., removing the need to establish cause of disability in order to qualify and reducing 'offloading' between programs. Among the disadvantages of such a scheme are the exclusion of persons with little or no attachment to the labour market and the difficulty of determining an appropriate earnings replacement level.