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How Could Florence Girard Starve to Death in a BC-Approved Home Share?

Family advocates want the supervising agency and CLBC to be held to account.

Andrew MacLeod 16 Sep

Andrew MacLeod is The Tyee's Legislative Bureau Chief in Victoria and the author of All Together Healthy (Douglas & McIntyre, 2018). Find him on Twitter or reach him at .

In the years that it took Florence Girard to starve to death under the care of Astrid Dahl, nobody outside the home raised the alarm that something was going terribly wrong with her government-approved home share.

Girard was 55 when she died in 2018. She had Down syndrome, and was unable to look after her own needs.

A longtime client of Community Living BC, the provincial Crown corporation responsible for supporting adults with developmental disabilities, Girard had lived in group homes for many years.

Around 2010 she moved into Dahl’s Port Coquitlam home, a home share situation funded by CLBC and provided through the local agency Simon Fraser Community Living, which since changed its name to Kinsight Community Society.

Some 4,200 adults with developmental disabilities in B.C. are living in home shares contracted through local agencies. While CLBC presents shared living as having many benefits that can enhance the quality of life for a person with a disability, some providers say the job is often stressful and poorly supported.

According to a July court document from Dahl’s trial on criminal charges, the roughly five-foot-tall Girard was “significantly overweight” when she started living with Dahl. She dropped to 120 pounds by 2013, a period during which she was monitored through doctor’s appointments.

But around 2014, Dahl stopped taking Girard to doctor or dentist appointments, despite entering care agreements with the agency saying she would. Even as Girard lost dangerous amounts of weight in the months ahead of her 2018 death, Dahl failed to seek medical attention.

In his reasons for judgment, B.C. Supreme Court Justice David Crossin said Dahl had shown a “breathtaking lack of judgment” that demonstrated a “marked departure” from what a reasonably prudent person would have done in the circumstances.

“The accused knew or clearly suspected that by the last week of Ms. Girard’s life, Ms. Girard was dying,” he said. “Yet, the accused decided not to seek medical attention. By then, Ms. Girard had completely, or almost completely, stopped taking food and fluids as well as stopped communicating.”

She had lost a “shocking” amount of weight, he said. “The photo of Ms. Girard taken on the morning of Oct. 13, 2018, is bracing.”

By the time Girard died, she weighed just 50 pounds.

In his July 15 decision, Crossin found Dahl guilty of failing to provide the necessaries of life to Girard, but found her not guilty of criminal negligence.

At a sentencing hearing last week, Crown prosecutor Jay Fogel argued Dahl should receive between 18 and 36 months in jail, while defence lawyer Glen Orris argued no jail time was needed. A decision is expected at the end of September.

In a statement to the court during the sentencing hearing, Dahl said “there are no excuses to make up for what happened” and she takes responsibility.

“I did not know I was breaking any rules or laws caring for Flo the way that I did,” she said. “Now I do, and for that I am truly sorry.”

Dahl said she had known Girard 30 years and believed she was acting in a way that met Girard’s wishes. “I truly knew her and understood her like no one else and believe that I did what was best for her, knowing her as I did and all her wants and needs,” she said. “I dealt with Flo’s end of life how she wanted: to be loved and cared for in a peaceful, safe, familiar space.”

One of Girard’s sisters, Sharon Bursey, testified at the trial and was present throughout the hearings. “When I finally got to see my sister, I was shocked and nauseated,” she said at the sentencing hearing. “She looked like a tiny child in an oversized casket. I kissed her on the forehead and whispered in her ear that I love her and I am so sorry she died this way.”

Bursey told The Tyee that while she was glad that Dahl is being held accountable, she believes both CLBC and Kinsight also failed her sister. “Kinsight’s contract should be cancelled,” she said. “I’m pretty angry.... I assumed my sister was being taken care of.”

The Crown had previously also charged Kinsight, but stayed those charges in 2020. The BC Prosecution Service only approves or continues charges in situations where Crown counsel believes there is a substantial likelihood of conviction and a prosecution is required in the public interest.

Kinsight CEO Christine Scott responded to a request for comment with an emailed statement, saying the agency was limited in what it could say due to privacy issues and the fact the matter remains before the courts.

“This is heartbreaking and not a day goes by when we don’t think about Flo,” Scott said. “Our thoughts continue to be with her family.”

Kinsight supported CLBC staff as they reviewed the agency’s home-sharing files and visited providers contracted through the agency to confirm that service standards were being met, she said.

“We support measures that enhance home sharing and the system of support, including newly established standards for all agencies that strengthen oversight of services, health and safety, and regular monitoring.”

In a June 2021 report, B.C. auditor general Michael Pickup concluded that CLBC had not implemented a monitoring framework to make sure home-sharing providers were complying with all of the standards and service requirements in their contracts.

His recommendations included that CLBC needed to make sure agencies oversaw their home-share providers and that CLBC had the data it needed to oversee that monitoring.

Social Development and Poverty Reduction Minister Nicholas Simons, whose responsibilities include CLBC, was unavailable for an interview.

CLBC spokesperson Randy Schmidt responded to questions by email. “Community Living BC takes this case extremely seriously,” he said. “We offer our deepest condolences to the family for the heartbreaking loss.”

The safety and well-being of the people served is the top priority for both CLBC and service providers, he said, adding that safety measures include setting service standards, criminal record checks of providers, regular monitoring visits and requirements for critical incident reports.

“Any time there is a critical incident involving neglect, serious harm or death, CLBC and its agencies follow strict protocols and support police investigations,” Schmidt said. “CLBC works with the service providing agency to ensure safety of services, review what happened and to identify ways both CLBC and our service providers can collectively improve in relation to service oversight and quality assurance.”

In this case CLBC staff reviewed files from Kinsight and conducted visits to home-share providers to make sure they were meeting CLBC standards, he said.

Schmidt also said that on May 1 it introduced new standards for agencies “that outline requirements for oversight of services, health and safety, and regular monitoring.” CLBC expects agencies to conduct onsite monitoring at least four times a year and requires people living in home shares to visit the doctor and dentist at least once a year.

The changes are part of CLBC’s response to the auditor general’s 2021 report, he said, as is the hiring of 10 quality service analysts whose job it will be to strengthen the monitoring of home shares.

“CLBC continues to work with all agencies to ensure its home-sharing services are safe and effective,” he said. “CLBC will work with supported individuals, families and service providers to be responsive to issues and concerns and continue to improve.”

The president of the BC Home Share Caregivers Association, Selena Martin, attended the sentencing hearing.

Dahl was 100 per cent to blame for Girard’s death, she said in an interview, but so were the agency and CLBC. “Each of them failed the person. Every level failed Florence.”

Martin said she believes it’s not the amount of monitoring that needs to change, but the type. “We need a support team, a network, around people with developmental-intellectual disabilities so we can assure the abuse doesn’t happen and there’s a good quality of life,” she said.

That happens naturally when people live in a community and have regular contacts with family, day programs, health professionals and others, she said.

In too many cases that’s not happening now, she added. “We have for years said that home share is isolating for the caregivers and the individuals.”  [Tyee]

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