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After Injury, a Job Can Be Vital Medicine

To get people with disabilities back to work, what works? BC's plans are controversial.

By Ainslie Cruickshank 15 Sep 2011 |

Ainslie Cruickshank is completing a practicum at The Tyee.

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Amber Slusar says support from non-profit Neil Squire Society gave her a second chance at life. Photo: Eliot Escalona.

"There was a cracking sound and then searing pain," said Amber Slusar.

"I just turned my head, literally to look out the window and enjoy the spring view and my muscle completely severed."

Slusar, who is 27, was on a bus 10 years ago when the muscles in her neck tore. They were waiting to tear, she thinks, weakened by two previous injuries including severe whiplash from a rear-ender.

Now her muscles are fused together in ways they shouldn't be, causing her chronic pain. She can longer do any heavy lifting. Sitting for long periods wears her down.

Ronn Selnes's injury was on Sept. 27, 2008. "I had a whole pile of strokes and I ended up lying in front of my couch for two days waiting for somebody to find me, watching the same crappy TV for two days," remembers the 53-year-old. "It was lousy."

After seven and half months in the hospital and intensive physiotherapy, Selnes was up and walking around without a wheelchair or cane.

"I was living on my own, having no problem," he said. But a year and several strokes later, he was back in a wheelchair. "That sucked. I thought I was done. But no."

Changes to support slated

"These disabilities can hit anybody, anytime, anywhere," said Michael Prince, a professor of social policy at the University of Victoria and a researcher for the Council of Canadians with Disabilities, adding, "They don't discriminate."

Yet people with disabilities are often discriminated against, as shown by their employment situation in this province, and more broadly in Canada.

In 2006, the unemployment rate for people aged 15 to 64 with disabilities in Canada was 10.4 per cent, compared with 6.8 per cent for Canadians without disabilities, according to Statistics Canada.

For the same year in B.C., the unemployment rate for people with a disability was 8.9 per cent, versus 5.7 per cent for people without a disability. (To see how B.C. compares to other provinces, go here.)

Prince estimates the rates and the gap have increased in the past few years, as a result of the economic recession. Government, he said, needs to not only invest more in programs that get people with disabilities back into the work force, but also focus on making those programs more successful.

That goal of better efficiency is driving a planned revamp of how the provincial and federal government helps people with disabilities in B.C. train for jobs, with big changes slated in spring of next year. But many people working in the field are critical of the approach, saying incentive payments based on how long it takes to find employment for a client and how long the client remains employed could bias service providers towards people with less significant disabilities who are easier to place. This favouring of easier cases is sometimes called "creaming."

Other criticisms focus on added paperwork for service providers as they consolidate.

Those concerns would be more loudly and widely voiced, say some critics, if the government hadn't taken what one journalist calls a "coercive" approach to keeping a lid on complaints (see sidebar).

Without a richer, more public conversation about what's planned, many are unclear whether the new approach really will make work prospects brighter for people like Amber Slusar and Ronn Selnes.

'You have to have enough belief in yourself'

"At first it was just excruciating pain, for a long time I couldn't really think of much else. My brain was in a fog," said Slusar, describing life after her injury.

As time passed, her pain became more manageable, and she began job hunting. She was eventually directed to the Neil Squire Society's Employability program. During the program, she struck up her friendship with Selnes.

Months after they graduated Slusar and Selnes are still in touch. On a recent afternoon they talked about their experience in the employability program, and shared their thoughts on the disability services in B.C.

Slusar said the employability program changed her outlook on life, providing her resources "I had no idea existed."

The Neil Squire Society is a national non-profit based in Burnaby, B.C. that aims to help people with disabilities gain confidence and independence through employment programs and assistive technologies. The program that Slusar and Selnes attended is for people with a physical disability who are unemployed but searching for a job.

While the program is taught in a group setting, strict attention is paid to individual needs. Every client of the employability program leaves with an individualized resume and action plan for attaining their career goals, said executive director Gary Birch. "In a nutshell, we work to rebuild their confidence in themselves," he said.

Both Slusar and Selnes said it has worked for them.

"Right now, I'm employable. I can answer a phone, I can sort books. But you have to have enough belief in yourself first, and they give you that here," said Selnes.

Many clients are also given assistive technologies that ultimately help level the playing field in the work place.

Selnes, for instance, received a special keyboard so he doesn't have to use his weaker left hand. He is going to begin using software called Dragon Naturally Speaking, which will allow him to talk to the computer instead of type.

Last month, the program received $4 million in funding from the federal government's Opportunities Fund. The fund provides financial support to help people with disabilities find and sustain employment. The $4 million given to Neil Squire means 660 people across Canada will be able to go through the program, either in class or through distance learning.

The funding was given as part a series of cheques for similar programs and initiatives across the country, including the Yellowknife Association for Community Living and Moncton Employment and Training Services Inc.

According to an email from a Human Resources and Skills Development spokesperson, the Government of Canada spends $30 million a year through the Opportunities Fund and transfers $218 million a year to the provinces through another federal/provincial agreement to support employment programs for people with disabilities.

Prince said the funding shows the federal government has an interest in supporting Canadians with disabilities, but said it is not enough by any standard. And while the funding hasn't been keeping up with the demand for services, he adds, someone needs to figure out how best to deliver services, and create a comprehensive strategy.

Behind the new 'one door' approach

On April 1, 2012 the B.C. Ministry of Social Development is introducing the new "one door" approach to its employment services.

The new program is consolidating provincial and federal services, and condensing 400 service providers to 73.

According to Sandy Rodgers, the director of the disabilities and specialized employment division with the Ministry of Social Development, the new program will allow for a much more individualized approach to employment services -- a much-needed move, considering the wide range of disabilities and the various needs of people seeking assistance.

With this new individualized approach, said Rodgers, there will also be more personalized support time frames.

"We could support somebody in the work place for a longer period of time, so somebody would go into the workplace and actually assist if the person has a different learning approach or something like that," she said.

This would be a welcome initiative, according to Birch.

"Often, it's hard to get the resources to support someone once they've started a job and to keep supporting them," he said, "but we find that a lot of people with disabilities really benefit from significant support for the first while, although it can be tapered off over time."

However, according to a 2010 report on how the new employment model will serve people with specialized needs, including people with disabilities, the new program may not work quite the way Rodgers hopes it will.

The payment model for the new program will also include outcome fees.

Although the report said these fees will only account for a small portion of funding, John Weir, chair of the IAM Cares Society said this could make service providers more likely to help the people who are easiest to place.

"For a client who is near ready for employment, the highest outcome fee will be paid for outcomes achieved within two months of program entry, whereas for clients who are not ready for employment, that time period is six months," according to the report.

Rodgers said some workplace modifications and assistive technologies will also be available through the new employment program.

Another problem she said the new program will alleviate is poor communication between case workers and clients -- an issue both Slusar and Selnes have experienced.

"Even with all the different doctors that I've dealt with and people I've talked to about jobs and my frustration with my circumstances, I wasn't referred [to Neil Squire] until late 2010," said Slusar. "The word of mouth and the advertising seem to be missing. They seem like such essential services, and yet you just don't hear about them."

"And people really should," added Selnes.

Rodgers said that is one of the reasons the ministry decided to move to a "one door" approach to employment services.

In the new program, "it won't matter if you go through the door in Williams Lake or in Nanaimo, you will see the full offering of services," she said.

'Not doing someone a favour'

Encouraging employers to seriously consider people with disabilities is one area Birch said still needs a lot of work, but the ministry is not planning on taking the lead on it anytime soon, according to Rodgers.

There aren't any specific programs in the ministry directed at employers at this point, she said, but many of the third body organizations like Neil Squire, that actually run the employment services, are working with employers.

Neil Squire has found that developing one-on-one relationships with employers and helping them get to know a prospective employee has been the most effective way to encourage businesses to consider a person with a disability they might not have considered before, said Birch.

According to Prince, the solution to this problem lies in a cultural shift.

"Our attitudes and assumptions about who's employable or not have been changing, that's part of the good news," he said.

But the work is not done yet.

"Employers in particular, but Canadians in general, have to come to a place where hiring someone with a disability isn't doing them a favour... they'll be productive, they'll be on time, they'll be loyal, they'll be hardworking," he said.

Experts agree that it's a matter of having some flexibility and a willingness to work with employees to determine what they need in order to be most productive -- good advice for any employee, whether or not they have a disability.

It could mean investing in assistive technologies like the special keyboard Selnes received from the Neil Squire Society, or an ergonomic chair to relieve some of the strain on Slusar's muscles. At times, it could mean a bit more of an investment, but experts agree it will pay off many times over.

"I've had people offering me jobs back out," said Slusar. "If they knew me as a person more, they would see I'm more reliable than half of the people in there."

Flexibility could also mean what Birch calls job shaping. Instead of filling specific job criteria, adjusting the criteria to fit the person, shifting certain responsibilities to other employees or even creating two positions instead of one.

"We need to be imaginative," said Prince "and have an open mind."

The cost of unemployment

"Work provides the major source of income for most Canadians between the ages of 20 and 65, and also brings social networks and contacts, friends and status," said Prince.

A secure job means a chance to get off social assistance and out of poverty, too.

In B.C., a single person with a disability is eligible for $906 a month in disability supports. Of that, $375 is the maximum shelter allowance. Housing is generally considered secure if it costs 30 per cent or less of a person's income.

Both Slusar and Selnes are living on disability assistance as they continue their job search. Slusar currently pays just over $600 in rent, over 60 per cent of her income. Selnes is currently living in a group home for people with acquired brain injuries. After rent, which includes meals, he is left with $95 spending money for the month.

Clearly, not many people given the option would choose to live on $906 a month, especially in the Lower Mainland where the cost of living is high.

But Birch said there is an economic disincentive for a lot of people with disabilities receiving assistance, which sometimes prevents them from entering the work force.

582px version of Ronn Selnes of Neil Squire Society
Ronn Selnes says the Neil Squire Society's Employability program gave him belief he could be a useful employee. Photo: Eliot Escalona.

There is an economic argument for the ministry to fix it, though. B.C.'s policy allows people on disability support to earn up to $500 before losing any assistance.

The problem is, people will now often work just enough to make the $500 to avoid losing any of their support, especially if they are not confident their employment is secure.

"If the goal is to get them off social assistance, it's not working that way," said Birch.

Research shows that investing in people with disabilities pays off. When a person is employed, it reduces the strain on social assistance and creates revenue when they begin paying taxes, said Birch.

A 2008 report by the B.C. office of the Canadian Centre for Policy Alternatives suggests maintaining the $500 flat rate earnings exemption and then gradually reducing assistance as income increases until the person is earning $1,733 a month.

No national plan

Beyond the basic human rights reasons for increasing employment opportunities for people with disabilities, businesses have an incentive to do so -- a looming labour shortage.

"The more businesses can improve their expertise at integrating and supporting people with disabilities into the workforce, the more they're going to have access to a relatively untapped labour pool," said Birch.

A labour pool that is ready and willing to work.

"It's important for employers to recognize that because somebody is there with a disability it doesn't make them inept by any means," said Slusar.

Taking down barriers to work for people with disabilities should be a national project, said Birch. And there's a lot to be done to make that happen. Marie White, the past chair of the Council for Canadians with Disabilities can vouch for that.

"Right now the provinces don't have the same provisions for disability support. There are different levels of support provided to different disabilities depending on where you live. There's absolutely no consistency in anything across the country," said White.

"We have all the mechanisms we need, government just has to decide to use them," White said, including an international treaty on the rights of persons with disabilities.

Birch said a national action plan, aimed at meeting Canada's commitments under the U.N. convention and other legislation that already exists in Canada, is needed.

In response to questions about possible plans for a national strategy, The Tyee received the following email response from a Human Resources and Skills Development Canada spokesperson:

"The Government of Canada works closely with the provincial and territorial governments, non-governmental organizations and individual Canadians to support the inclusion of people with disabilities in all aspects of society and community life including employment. A number of national programs and projects are underway and HRSDC continuously monitors developments with respect to employment supports for people with disabilities."

'Willing and proactive'

"My experience with employment has been frustrating, and I'm not even bound to a chair, I'm not dependent on mobility devices. I can't imagine if I was dealing with something more severe or of a different nature," said Slusar, adding that still "it's really hard to have any peace of mind or stability even when you're as willing and proactive as I am."

Slusar wants to work as a grief counselor, incorporating art and music therapy into her practice.

For now, she's waiting to hear whether she's been accepted into the art therapy programs she's applied for. As of last week, she'd had an interview and thought it went well.

As for Selnes, he is going to be taking sign language classes at Kwantlen Polytechnic University and is on a waiting list for a subsidized apartment that will cost him closer to 30 per cent of his income.

He plans to become an advocate for people with disabilities.  [Tyee]

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