De-Institutionalizing the Mentally Disabled: The Canadian Solution

A Textured Life: Empowerment and Adults with Developmental Disabilities, by Alison Pedlar, Larry Haworth, Peggy Hutchison, Andrew Taylor, & Peter Dunn

Of disabled Americans, about 4 million suffer from developmental disabilities. ¹ Americans with developmental disabilities receive assistance through programs provided by the states with support from the federal government. ² Since the 1960s, the goal of these programs has been to integrate developmentally disabled individuals into communities through small community-based programs. ³ When the Supreme Court decided Olmstead, it held that unnecessary institutionalization is discrimination that is forbidden by Title II of the Americans with Disabilities Act. ⁴ In light of the decision, states are under an obligation to provide developmentally disabled individuals with treatment programs in the least restrictive setting possible. ⁵ For whatever reason, the states have been slow to respond to this requirement, and individuals entitled to alternate services under the decision have sued. ⁶ Perhaps an international view of disability programs would assist states in developing effective community-based treatment programs.

A Textured Life is a comprehensive look at life for Canada's developmentally disabled citizens. Authors Alison Pedlar, Larry Haworth, Peggy Hutchison, Andrew Taylor, and Peter Dunn systematically walk the reader through a developmentally disabled Canadian citizen's home life, work environment, family relationships, personal relationships, and leisure activities.

Throughout the well-researched and well-documented analysis, the authors have interspersed the narrative of their subjects, as well as comments from personal care workers and family members. The authors elected "to use the voices of the individuals with a disability and those around them to illustrate the sorts of lives people have: where they live, how they spend their free time, and how they feel about their work and their relationships with family, staff, and friends." ⁷ Although their analysis provides a description of the challenges that face developmentally disabled Canadian citizens, it is this personal interaction with those who deal with the Canadian Ministries and other national support systems that provides a more complete picture of the challenges and opportunities that Canada's developmentally disabled citizens confront on a daily basis.

Early in the text, the authors describe the support systems that the Canadian government has in place for developmentally disabled citizens, including private, for-profit agencies; private, non-profit agencies; public, non-profit agencies; and microboards. ⁸ Two private, for-profit agencies participated in the study. One basically served as "a stepping stone for people who needed some interim support or training for three to six months," while the other essentially served as a "traditional community-based human service agency." ⁹ The private, non-profit agency that participated in the study generated a family-like environment, with the support generally coming from within the confines of the agency, although it also operated several residences for the disabled throughout the community. ¹⁰ The public, non-profit agencies were primarily set up so that individuals living in a residence were supported by one of the workers assigned to the residence. ¹¹

Microboards are a fairly new concept, where a group of various individuals from a community serve as a board for a developmentally disabled citizen and provide support according to the needs, preferences, and capacities of the person. ¹² Funds for the individual are channeled directly to the microboard, which covers administration, the securing of services, and the person's care. ¹³ Microboards frequently have close contact with a government employee who serves as a link between the board and the funding ministry. ¹⁴

In the US, each state has a different program for administering disability services. For instance, in Florida, a developmentally disabled individual is assigned a support coordinator who helps to develop a support plan, which identifies the services an individual needs. ¹⁵ Funding for the Florida program may be provided by state general revenue or Medicaid Developmental Services Home and Community Based Waiver. ¹⁶ Missouri has started a pilot initiative to develop microboards. ¹⁷ Each state also has a plan for...