editor
Site Admin
Joined: 31 Oct 2003
Posts: 297
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 Posted: Tue Nov 25, 2003 8:39 pm Post subject: ALL ABOUT Disability Protocols |
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WELCOME!
Disability Protocols - What you need and how to get it
Introduction:
Welcome to the Disability Protocols forum, where we will try to set out brief summaries describing various disabling conditions as well as the medical treatments and social supports necessary to manage the disability and maintain a reasonable quality of life.
We will keep the science to a minimum, focusing instead on narrative. We’re far more interested in what the disabled have to say about a particular condition and what is needed to live with it than we are in scientific research, which is already well publicized. Policy analysts tempted to recommend cutbacks on the basis of some dubious number or economic theory may find it more difficult to justify cuts if there is a sophistocated, searchable database of narrative screaming and fist-banging in devastating poverty, loneliness and isolation.
Please write to us at this forum or to editor@bcdisabilities.com and tell us how you’re doing with the science and social supports currently available. What’s working? What’s missing? Has your life changed significantly as a result of any legislative changes? Personal stories, after all, form the basis of common law. We want to hear from you.
The story so far:
We’re more than a little amazed and disappointed that the development of disability protocols has advanced so little in this technological age. The best proposal we've seen so far is the comprehensive plan by Canada's Roeher Institute from 1994, The Canadian Disability Resource Program: Offsetting Costs of Disability and Assuring Access to Disability-Related Supports, by Marcia Rioux and Cameron Crawford, the organization's top brass. Here's an excerpt from that very innovative, potentially far-reaching plan:
| Quote: | We propose an integrated policy framework and delivery system (emphasis added) to cover direct costs that are specifically related to disability and to ensure the delivery of disability-related supports that are appropriate to individual requirements. In this, our model moves beyond the rigidities imposed by the present system and focuses on what works rather than on what doesn't work. The proposed system is designed to contain the social and economic costs over time more effectively than current arrangements.
Canadians with and without disabilities can achieve well-being through a policy framework that permits social, environmental and coccupational inclusion for all members. A coordinated policy approach to ensuring the well-being of people with disabilities both depends on, and mandates, cooperative partnerships among individuals, governments, voluntary organizations and professionals. (-- p. 3) |
Here, too, is the U.S.-based National Center for Health Statistics , still talking about methodology for statistical analysis in 2003-2004, and theWorld Health Organization's International Classification of Functioning, Disability and Health, a mere compilation of questions. You can now search the ICF questions online, but what about answers? How is a government to come up with a comprehensive disability plan?
The local picture:
Aside from various reports and studies from the Roeher Institute, the most radical approach we’ve seen in this regard is the B.C. government’s mandatory 23-page Persons With Disabilities Designation Form at http://www.mhr.gov.bc.ca/forms/pdf/HR2883R.pdf, the subject of much controversy when it became law in 2002. Many advocates considered such a lengthy form to be completed with a physician as a punishment both to physicians and to the disabled, who were then subject to cutbacks in benefits, supports and even appeal criteria and procedures when benefits were withheld. Here’s what the B.C. Coalition for People With Disabilities, a non-profit advocacy group, had to say about the process last August: http://www.bccpd.bc.ca/mediars.html. (Note: See also http://www.abilities.ca/abilities/archive.html?article=1983 from Abilities magazine Archives and Disability in Canada from Social Development Canada at http://www.sdc.gc.ca/asp/gateway.asp?hr=/en/hip/odi/documents/PALS/PALS003.shtml&hs=pyp. We'll have more to say about these important iniatives soon. Please check back for updates).
Certainly the timing of the new form couldn’t have been worse. It became mandatory just when the long awaited final report of the Romanow Commission on the Future of Health Care in Canada 2002 was about to be released. In addition, much of that report was concerned with expanding health services for an aging and increasingly disabled Canada. See http://www.hc-sc.gc.ca/english/care/romanow/hcc0086.html.
There is no question that we are concerned about any and all cutbacks to disability benefits and services, but we also suspect there’s value in the information contained in those forms, so we asked Human Resources Minister Murray Coell recently if/when the results would be released. When we receive a reply, we’ll post it here.
The ministry replies:
| Quote: | From: "MHR Correspondence Unit MHR:EX" <MHR>
To: <editor>
Sent: Wednesday, January 28, 2004 12:51 PM
Subject: Ref: 71635
Dear Inquirer:
Your electronic letter of November 17, 2003, to the Minister of Human Resources, regarding the Persons with Disabilities Designation Review, has been forwarded to me for response. As the Assistant Deputy Minister, responsible for the Policy and Research Division, I am pleased to respond and apologize for the lengthy delay.
Under the Persons with Disabilities (PWD) legislation, support and assistance is provided for persons with disabilities age 18 and over, who have a severe mental or physical impairment that significantly restricts the person's ability to perform daily living activities either continuously or periodically for extended periods. By focusing on functional limitations rather than medical conditions, the ministry has brought the definition of disability more in line with human rights case law.
Of the 61,932 persons with disabilities receiving assistance in September 2002, approximately 60,775 were found eligible for persons with disabilities assistance under the government's new legislation. Four hundred people had their disability designation rescinded because they did not meet the legislative criteria or chose not to submit their forms. In addition, 695 cases were closed because the individual's financial circumstances had changed; they were employed or their family situation had changed and they were no longer in need of assistance.
The PWD application form was designed to collect information necessary for the ministry to determine eligibility under the Employment and Assistance for Persons with Disabilities Act. Development of the form involved a number of partners, with representatives from key ministries, health professionals and advocacy groups. In addition, the ministry looked at models used in other jurisdictions and other related disability application and assessment forms in creating the new form. [size=18]Questions were focused to produce specific evidence directly related to legislative criteria and not to collect data for planning in terms of disability treatment and management[/size]. (emphasis added) The physicians and qualified health professionals, who complete the forms, determine and report on information relevant to the legislative criteria. Ministry adjudicators have been specifically trained to assess the information received and to relate that information to the criteria defined in the new Act.
The PWD Designation Review forms, identical in design to the application form, were required to collect information necessary for the ministry to determine ongoing eligibility for the PWD designation. The designation review process was intended to be fair and objective, and the ministry's goal was to ensure that clients were assessed objectively and consistently.
Yours truly,
Andrew Wharton
Assistant Deputy Minister
Policy and Research Division
pc: Honourable Stan Hagen
Minister of Human Resources |
Conflict between ministry's reply and debate in the Lgislature Feb. 25/04:
...But hold on. That's not quite true. Have a look at this excerpt from the House debates of Feb. 25/04, during which Minister Hagen sets out very clearly the uses to which the information will be put:
| Quote: | | Hon. S. Hagen: I want to say that in addition to the benefits to the clients, we now have a solid understanding of our clients' ability to carry out daily activities — [i]information which helps us create programs and policies to meet our clients' needs (emphasis added). This is all about service to our clients.[/i] |
If the government is using the information contained in the application forms as the basis for disability programs and policies, which do indeed go directly to treatment and management options, the public must, in our view, have equal access to the information. How else can we assess the effectiveness of our disability programs and policies?
To read the legal challenge concerning B.C.'s benefits scheme posed by one of our visitors, go to B.C.'s Employment and Assistance Tribunal Appeal Process - Is it constitutional? at [b]Disability Law FAQs - B.C. Disability Legislation.
We'll pursue our investigation of protocols further. Please return soon for updates and to submit opinions and stories. We welcome both.
Link to this entry
http://www.bcdisabilities.com/bcdisforum/viewtopic.php?p=76#76
Last edited by editor on Fri Aug 01, 2008 10:04 am; edited 18 times in total |
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Editor2
Guest
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| Posted: Wed Dec 03, 2003 11:10 am Post subject: Authoritative Impairment Evaluation Guides and Treatises |
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Authoritative Impairment Evaluation Guides and Treatises
Guides to the Evaluation of Permanent Impairment
By Linda Cocchiarella, Gunnar Andersson, American Medical Association
After wading through a soggy marsh of disability definitions and manuals, we were pleased to find Guides to the Evaluation of Permanent Impairment edited by Linda Cochiarella in conjunction with the American Medical Association. Although it's American, reviews below suggest it's authoritative in a variety of jurisdictions.
The book is available in the Science Reference section of Vancouver Public Library's Central Branch at [url]http://ipac3.vpl.ca/ipac20/ipac.jsp?session=1OE0472915793.467&profile=pac&uri=link=3100023@!3755384@!3100023@!3100002&aspect=basic_search&menu=search&ri=1&source=207.194.177.185@!horizon&term=Guides+to+the+evaluation+of+permanent+impairment+%2F&index=ALLTITL#focus[/url].
We haven't seen the book yet ourselves, but we were very impressed with the synopsis and reviews at this eNotalone listing, [url]http://enotalone.com/books/1579470858.html[/url], which provides order information and an excellent clickable sidebar of related materials mercifully and thoughtfully separated into categories according to subject.
Click here for a big picture of the book jacket: [url]http://enotalone.com/books/images/1579470858.html[/url].
We'll have a look in the next few days and tell you about it. Please check back for updates. |
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editor
Site Admin
Joined: 31 Oct 2003
Posts: 297
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| Posted: Sun Aug 22, 2004 4:23 pm Post subject: |
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American Association on Mental Retardation (AAMR)
Supports Intensity Scale
We recently discovered this interesting Colorado initiative and sent the following e-mail asking for more information.
From: editor@bcdisabilities.com [mailto:editor@bcdisabilities.com]
Sent: Tuesday, August 17, 2004 4:20 PM
To: Anna
Subject: Supports Intensity Scale
Hello,
We're a disability consumer/advocacy website from Vancouver, Canada at and we were delighted to find you at http://www.aamr.org/Reading_Room/SIS_ColoradoSprings.shtml this a.m. Please send us any papers, discussion, etc. on this fascinating mechanism. How does it compare, we wonder, with the 23-page forms the B.C. govt instituted recently to guage the needs of the province's disabled population? See http://www.bcdisabilities.com/bcdisforum/viewtopic.php?t=44. Are there other schemes similar to yours you could point us to? We see that you've rejected some and we'd like to know more about them and what was unacceptable.
Thanks for your kind attention.
Editor@bcdisabilities.com
http://www.bcdisabilities.com
...And the response:
From: Anna
To: editor@bcdisabilities.com
Sent: Wednesday, August 18, 2004 9:16 AM
Subject: Supports Intensity Scale
Hi - all the information we have available, including sample interview forms, FAQs, and more is online at www.aamr.org.
If you need more information, I'd be happy to talk with you over the phone at 1800-424-3688, Ext. 212.
Thank you for your interest.
Anna
From: editor@bcdisabilities.com
To: Anna
Cc: editor@bcdisabilities.com
Sent: Wednesday, August 18, 2004 1:11 PM
Subject: Supports Intensity Scale
Excellent. Thanks very much.
Ed.
Note: We're very interested in the materials listed under Legislative Goals, particularly the summaries beginning at p. 13, at http://www.aamr.org/pdf/2004LegislativeGoals.pdf. We'll investigate these and post our findings at Worldwide Disability under US legislation. |
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