31 January 2023

Publicly Funded Disability Insurance: Has the Time Come?

The Canadian federal government in the last 6 years has done more to provide support and address the needs of persons with disabilities that an any time in the last 40 years. There has been the Accessibility Act of 2019, the pending Disability Benefit passing second reading of in October 2022, the passage of the Autism Strategy also in October 2022, as well as legislation on Fetal Alcohol Syndrome Disorder (FASD). On top of this was the launch of the Disability Inclusion Plan also in October of 2022. In historical terms this is nothing short of breathtaking.

But this legislation, enacted and pending, is only part of the story in two ways. First, but significantly, these actions are associated with a change in the disability terrain in Canada - in the collective culture of the sector. Secondly however, it is notable for what issues these actions have not addressed. These two features shall be addressed in turn.

That was then

Only seven years ago,- 2015 - those involved in advocacy and engagement with persons with disabilities at the federal level looked at a landscape that was factious, fragmented disheartened and disillusioned. Starved of resources, most advocates were exhausted, fighting to survive. Noses were to the ground and the capacity to rise above the fray and examine, let alone address, the wider systemic issue in the disability support system (especially collectively) was almost nonexistent. Everyone was fighting their own specialized battles, be it employment, housing, inclusion, transition management for this or that disability. There was a dearth of data, and jurisdictional coordination was non-existent. Initiatives that had been the focus of attention for up to 35 years were still not being addressed. Accessibility for example, and agenda born of the 1982 Senate Report “Obstacles” and championed for years by the likes of Rick Hansen was one. Another was the Poverty agenda, led by Al Edmanski and others from British Columbia. While the latter did have some success with the Disability Tax Credit it was far short of what was hoped for (or needed). Then there was the Autism agenda, born of yet another Senate Report “Pay Now Pay Later’ of March 2007 that even with the championing of the Public Health Agency of Canada found itself stalled.

It was while things were in this state that Every Canadian Counts came along suggesting a complete overhaul and refinancing of the system – advocating for a national disability insurance plan for Canada. The message was not well received in many quarters at the time let alone understood.

This is now

Since 2015, and under the energetic leadership of the Federal Minister for Minister of Employment, Workforce Development and Disability Inclusion Carla Qualtrough, data on disabilities gathered by Statistics Canada has improved significantly. Organizations and activists have been brought together to engage with the federal government on the creation of the various legislative initiatives, supported by new funding. Networks, like the Include-Me Network, and now the Pan Canadian Disability Alliance have been created, building a level of cohesion and cooperation never seen before. And as we look ahead there is in place an action framework for the sector, the Disability Inclusion Action Plan, the DIAP (2022-2040), which, building on the Disability Benefit Legislation (Pillar 1) and the Accessibility Act (Pillar 3) focuses on Employment (Pillar 2) and improved access and relevance of federal government programs and policies (Pillar 4). In short, 2022 saw the plans, policies and directions that had driven disability community activism up to four decades meaningfully addressed.

So, are we done?

Not at all, as the Disability Inclusion Action Plan indicates in its call to ‘undertake research to better understand the additional costs of disability and how these costs impact the financial security of persons with disabilities.’

What are these ‘additional costs?’  Across the sector, they are multitudinous. They range from supportive technology, prosthetics, transport, housing accommodations, therapies, day to day care, care giver compensation, and transportation. These are the most obvious additional costs and if we are serious about inclusion of persons with disabilities they will need to be addressed.

But there are also other costs that need to be acknowledged that are significant These are the system costs, and this is the second part of the story. The current disability support systems in Canada are inefficient, inequitable, often onerous, and inconsistent in application and outcomes. Waiting lists for services, in their tens of thousands, exist in every Province. Chronic underfunding reigns and is getting worse as the population ages, families get smaller and often break down and personal finances get squeezed. Further complicating the picture, in addressing disability issues, policies and actions have come from different major funding envelopes. Employment related programming coming from ESDC while funding for specific strategies on disability such as the Autism and FASD come from Health Canada.

This leaves the question, which funding envelope will cover the ‘additional costs’ and address the systemic issues? Shall it be the costs related to employment (funded by ESDC) or to the costs associated with enabling broader social inclusion as per the Autism Strategy (funded by PHAC). And what of the inefficiencies? How will that be addressed? and by whom? If there is any solace in this unfortunate divide, is that performance measures for both funding envelopes emphasize quality of life and improved functionality as desired outcomes. The room to work together presumably does exist.

What next?

It is not like we do not know what to do or what works. We have the examples and experiences that show us what works, but they are usually isolated efforts, small or partial in scale and precarious in terms of funding and staffing. There is little capacity to ‘scale up’ and generalize. There is not the funding.

The time is fast approaching to consider a national publicly funded disability insurance plan. Operational principles have been established in the Autism Strategy. Under the Disability Inclusion Action Plan, the opportunity exists, following assessment of ‘other needs,’ to analytically examine its feasibility, viability, and desirability.

This is not pie in the sky thinking – the precedent has been set in with the creation of the National Disability Insurance Scheme (NDIS) in Australia. Of its 569,401 participants, 334,487 are receiving support for the first time, including for employment.

Only such a plan can deal with all the issues and all the solutions, simultaneously and comprehensively. The first step has been taken as noted in the bulletin above. Can this be something the entire sector can rally around?

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