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Community
Homes Action Group
Report
Card on the Progress of the
Nova
Scotia Government’s Transformation of Services for Persons with
Developmental
Disabilities
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Community
Homes Action Group members involved with this project:
Jean Coleman – Nova Scotia Association for
Community Living (NSACL)
Ken Deal, PhD - Associate Professor,
DeGroote School of Business, McMaster University*
Dr. Brian Hennen - Dalhousie University
Family Medicine *
Paula Hutchinson, PhD *
Wendy Lill
- Member of Parliament (1997 – 2004), Board Member of NSACL*
Lois Miller
- BA, BEd, MA, Member of Boards of Independent Living
Nova Scotia Association & the James McGregor Stewart Society
Stella
Samuels – MA - Nova Scotia Association for Community Living
Nancy
Walker – BScPT, MSc *
Members with an (*) after their
association are family members of persons with disabilities.
Executive
Summary
In 2013, the Nova Scotia Joint Community-Government
Advisory Committee on Transforming the Service to Persons with Disabilities
Program was formed with membership from community advocacy groups, service providers,
persons with disabilities and government due to a widespread consensus that the
system of housing for persons with disabilities was in crisis. Over 1500 people
were living in large care facilities. There were no community-based services
for persons with complex health and behavioural support needs. A moratorium had
been placed on the creation of new small option homes in the 1990’s and the
waitlists for all residential services had grown to well over 1000 people.
There was no flexibility in funding or services to allow for people to engage
in self-directed care and to exercise choice and control. The human and
financial costs of people being housed inappropriately were skyrocketing.
The Joint
Advisory Committee tabled their report Choice, Equality and Good Lives in
Inclusive Communities - A Roadmap for Transforming the Nova Scotia Services to
Persons with Disabilities Program (hereafter Roadmap) and it was accepted
as the way forward by the provincial government. The program is now called
Disability Support Program. Since then, additional transformation documents
have been produced internally by the Nova Scotia Department of Community
Services (DCS) and the Roadmap message has been changing. Some might say that
it has wandered off the road and has produced no significant action.
However, the
most recent message is clear. The current system is not sustainable so where
are we on this new road? Nova Scotia is two years into the Transformation, but
what does it really look like for people with developmental disabilities, their
loved ones and service providers? What progress has been made to date?
Community Homes Action Group (CHAG) was formed in 2010 to stimulate
public and government awareness and promote action on the critical situations
facing persons with disabilities and their families. We have carried out a
province-wide survey to gauge the progress of reforming services two years into
the Roadmap. The questions in the survey were based on the Roadmap’s main
recommendations:
·
Providing person-directed planning and decision-making
·
Providing community-based housing
options
·
Reducing
reliance on institutions
·
Increasing
employment opportunities and
·
Decreasing wait lists.
Through CHAG’s
network, people were invited from across the province to respond to an online
survey or fill out a paper version. Support to fill out the survey was offered
to anyone who needed it. One hundred and sixty-eight (n=168) people responded.
At least one person from every county in Nova Scotia voiced opinions. Family
members and people with disabilities answered as well as professionals from
health, education and community. In addition to rating the government’s
progress on a scale from 1 (poor) to 10 (excellent), our respondents provided
close to 1000 verbatim comments. This was meant to be a snapshot but we heard
people’s voices - loud and clear.
This report
card reflects that Nova Scotia constituents have not seen any significant achievements
by DCS in addressing Roadmap recommendations. People with developmental
disabilities are still waiting for appropriate housing and supports. Their family members’ and service providers’
expectations of the Transformation process have not been met.
CHAG, on behalf of those responding to this survey,
asks the provincial government to honour the Rights of persons with
disabilities as outlined in the United Nations Convention on the Rights of
Persons with Disabilities and produce discernible helpful actions on their
behalf. We ask the provincial government
to:
·
Commit to person-directed planning and support, create community based
living options, close institutions, increase employment and reduce waitlists.
·
Work with families and service providers across the province to create
small community based housing options.
·
Commit to stopping new placements to ARCs or RRCs as of June, 2016 as
outlined in Community Services’ 10-year Plan for Transformation.
·
Begin work to reform all disability related legislation in accordance
with the UN Convention on the Rights of Persons with Disabilities.
·
Report regularly to the community on the number of people with
developmental disabilities on waitlists for housing options and provide updates
on the progress in creating new housing opportunities.
·
Provide substantive investment to fulfill the promises made to Nova
Scotians with disabilities and those involved in their lives.
The Community Homes Action Group has
given the Nova Scotia Community Services’ Disability Support Program a failing
grade for its initial two years performance in implementing its ten year
transformation strategy.
CHAG has heard from many families across the province that
they remain in crisis. The
DCS Transformation so far has been a failed process, not reaching people in
need, producing no supportive actions, nonresponsive and remaining
crisis-driven. The original Roadmap document has been distorted and diluted and
no longer reflects the initial intent.
With this survey’s results, we can
state with certainty that people having disabilities remain neglected. We believe that austerity is no excuse for
leaving people in crisis. Where has DCS spending gone if it has not alleviated
the needs of disabled members of the Nova Scotia community?
Survey
Methods
The survey sampling was conducted during September and
October of 2015. The final count of completed questionnaires was 168. At least
one person from each county in Nova Scotia responded to the survey request.
Who contributed their opinions?
The Survey
Results
1. Providing Person-Directed Planning
The first
question was: “In your opinion, how effective has the Government of Nova Scotia
been in providing person-directed planning for people with developmental
disabilities during the past two years?”
The government’s
effectiveness was rated by 166 respondents on a scale of 1-10 (1=poor to
10=excellent). Two people said it did not apply to them. DCS was rated below
the scale midpoint by 88%, 35% said “poor” and the average response was 2.8 out
of 10 indicating very low effectiveness. If 10 were equated with A+, 9 to A and
so on, the greatest number of respondents gave DCS a grade of “F”.
There were 112 verbatim
comments. Most of the comments were provided by those who chose low numbers on
the scale. Two positive comments received scores of nine and described the
exemplary efforts of an early interventionist and a care coordinator. Overall
the comments describe a lack of person-directed services.
What people told us:
There is a lack of person-directed planning in
the DCS system. Options for housing for persons with developmental disabilities
are bleak.
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“The system
still is very paternalistic in its approach. There can be no real
‘person-directed’ planning if there are no endpoints to plan for and if there
isn't an actual range of options.”
“While there
is some certainty about DCS personnel understanding the concept at the
intellectual level, there is no evidence to suggest willingness, desire or
conceptual awareness of how to implement person directed planning. There are
isolated local examples of care coordinators and supervisors exploring person
centered planning methods like PATH, and attempts on their part to support
PATH initiatives with consumers. The Department's capacity to relinquish
control over all aspects of a person's life is the largest obstacle to
implementing this particular aspect of the transformation plan.”
“My daughter
has been in an Alternate Family Program with the goal of moving into a
group/options home. In the past 8 years there has been no movement. Recently,
the family in which my daughter resides will not be able to provide service
due to changes in their family dynamic. With a 30 day notice, I was informed
that I have two options. 1. My daughter return to the family home or 2. My
daughter move into Adult Protection. In reality, I was given no option and no
assurance that a place would ever be available. My daughter has gained a
measure of independence which would be lost upon a return to the family home.
(this is not person directed planning......this is crisis management which
has an adverse effect on my daughter and the family.)”
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Without
person-directed planning, people with disabilities have to rely on advocacy
or crises intervention for support. Not everyone has a support system to help
them. Many people are neglected.
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“I am of the opinion that if it weren't for
the parents who are struggling on their own to find services, provide
services, communicate with the individual’s worker, they would not be able to
live independently. Perhaps the line between someone who is marginally living
in the community and being a homeless street person is one family member, who
has taken on the sometimes exhausting role of overall support person,
including: advocate/companion/social facilitator/health care
advocate/transporter to appointments/mental health crisis
intervener/financial advisor/etc.”
“Very little
has happened in this regard - any initiatives have been with Service
Providers. In some situations, when a personal development plan has been
developed by a person with a disability, DCS will challenge it.”
“From my
experience it seems that those individuals who are verbal and can articulate
for themselves are more likely to be listened to but those who have more
significant needs are at the mercy of others.”
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If person-directed planning is to become a
reality, funding must be individualized and follow the person.
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“We don't see
where people have choices that are not Gov't forced or mandated. If people
had choices they would not live in institutions.”
“Government
must stop funding buildings where ‘people are put’ and start investing in
people to live where they want, with whom they want--designing supports
around individual needs & desires with individualized funding.”
“I have seen
some improvements in the supports that my adult son receives. There does seem
to be a little more flexibility and his supports are transportable and
attached to him not some bed in a group home.”
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Question 1 - Summing Up:
The people who responded to this survey have strongly
endorsed person-directed planning to facilitate decisions related to creating
appropriate housing options. There is an overwhelming opinion that person-directed
planning is not in practice; nor is there is any indication that person-directed
planning has been incorporated into provincial policy. There is a sense of
urgency as one parent states: “My son has
the right to live within his community and have a life. The Nova Scotia
government cannot wait any longer as people like my son are in crises and
families are at risk.”
2. Increasing
Community-based Housing Options
The
second question was: “How effective has the Government of Nova Scotia been in
providing more community-based housing options for people with developmental
disabilities during the past two years?”
The government’s
effectiveness was rated by 153 people on a scale of 1-10 (1=poor to
10=excellent). Fifteen people said it did not apply to them. DCS was rated
below the scale midpoint by 94%, was rated as “poor” by 51% and the average
response was 2.3 out of 10 indicating very low effectiveness and progress.
There were 99
comments. Most of the comments were provided by those who chose low numbers on
the scale. One positive comment was applauding community-based options.
What people told us:
Individuals and families
are advocating for more and improved residential options. Services are given
to those who can advocate and are willing to reveal their family’s private
lives to the media.
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“Families are
not getting answers to their requests to have their children move into the
community. It isn’t about bricks and
mortar, it’s about the will of government to think outside of the box.”
“Only those
families who have been in the media with high-profile cases advocating for
their children to leave institutions have had the luxury of new homes and
seeing their children move into the community. This is how government chooses
to spend its money and lacks the political will to make it happen.”
“There has
been some movement with funding made available for the independent living
support program for individuals who can live independently with visiting
support up to 21 hours per week.
Otherwise new housing options have primarily been developed to address
critical issues where the media/politics have been engaged.”
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It’s confusing. Who
receives an appropriate residential option? Individuals are being turned away
if they are too young, or if their needs are too high, or if they are not
high enough.
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“There are
only a few spots for children in this province at the moment. Also, families do not have a full treatment
centre that they could take their children when in crisis (instead of calling
the police or taking them to emergency).
Before even considering housing, people with disabilities need to be
given the option of staying at home (if that is what they and their parents
desire). If they want to move, more
resources need to be allocated to increase their level of independence and
their ability to gain and sustain a meaningful work placement.”
“I have a son,
28 yrs old, still living at home. He
has been on a waiting list for seven years but they tell us there are too
many others worse off on the list so it will be many more years. My son is depressed and would love to be
out on his own or in a group home.”
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Families in Nova Scotia are
in crisis and afraid of the future.
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“There are not
enough supports for families to create flexible solutions that meet their
adult dependents’ needs. The system
needs to be changed more efficiently and with a shorter timeline…there are
too many people in crisis.”
“Our child is
too young to be affected by this yet, so we are not sure. But terrified for his future.”
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Service providers and
families are developing solutions, and some are cost-neutral, but they are
not being accepted or implemented by the government.
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“I work in a
large facility which supports over 100 individuals. There have been no
efforts to promote or support new placements in the community by DCS. Our organization has submitted new
proposals for community homes which have not been supported or approved.
As a service
provider, we submitted a cost-neutral proposal to the DCS to open a new 4-bed
community home with blended levels of support. All of the individuals wanted to live
together despite their different need…in fact they would be each other’s
“natural support” in their own communities where they grew up and work. This proposal was rejected.”
“For one
service provider, a 10 bed group home for adults who have experienced mental
health issues was replaced with a four bed small option home. The six residents who left the home were
placed within existing small option homes or their own supported
apartments. The net impact of the
change within the region was a loss of 6 residential beds and a gain of six
independent Living (ILS) apartments.”
“Our family
has been trying to access grants for a wheelchair-accessible home for the
past two years and have been thwarted in all our efforts. (People with
developmental disabilities are sometimes physically disabled too.) The staff
we have dealt with at Housing Nova Scotia have not returned our calls or
emails and there is a disconnect between the Housing Nova Scotia website and
the information we sporadically receive from the staff. The information given on the website could
not be farther from reality.”
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Question 2 - Summing Up:
The
Nova Scotia Department of Community Services is seen here as a nonresponsive system,
resistant to staff and/or family suggestions, and reactive mainly to crisis
situations. Families are fearful of the future and their adult children being
left without support as the families age and become less able to provide care.
3. Reducing
reliance on Institutions as Housing Options
The
third question was: “How effective has the Government of Nova Scotia been in
reducing reliance on institutions as a housing option for people with
developmental disabilities during the past two years?”
The government’s
effectiveness was rated by 144 people on a scale of 1-10 (1=poor to
10=excellent). Twenty-two people said it did not apply to them. DCS was rated
below the scale midpoint by 93%, was rated as “poor” by 44% and the average
response was 2.6 out of 10 indicating a very low effectiveness. Once again, the
greatest number of people rated DCS as “Poor” with a mark of “F”.
There were 89 verbatim
comments. Most of the comments were provided by those who chose low numbers on
the scale. One positive comment received a score of 10: “There are more small options homes opening up which gives clients the
sense of home.” Overall the comments indicate that institutions are still
thriving in Nova Scotia.
Institutions are major
employers in this province. The government’s investment in these institutions
may be a barrier to community-based living.
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“…it is fine
to write reports but it is not matched with DCS walking the road and taking
real action towards achieving the end of this model in Nova Scotia. As long
as these institutions are seen as being the main provider of good,
well-paying jobs in certain areas it will be very difficult to eliminate them
without clear will of government.”
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When service providers try
to move people into the community they hit roadblocks too.
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“As a larger
facility, we have been trying to move more and more people out – we have had
some success but there are still a number of individuals that could be
supported in the community. Even for our current community homes. In some
situations, in consultation with the resident, we have determined they should
move to a community home. Invariably we end up in a dispute with the Care
Coordinator who knows very little about the person, who will not agree with a
move to a community home.”
“We still
incarcerate hundreds of people. This is unacceptable.”
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There has been no progress
made on the Roadmap. Instead government has been putting its energy into
defending why there has been no change.
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“There is no
published plan of action to implement a closure of these facilities as
proposed in the approved roadmap for transformation. The published timelines
have been delayed two or three times, it is not entirely evident that a
moratorium on new admissions to these facilities has been implemented.”
“They don’t
seem to have done anything but defend institutions.”
“There is no
real reduction in the reliance on institutions. There is a lot of rhetoric,
but no real progress.”
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The health impact on
individuals and their families is significant.
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“One has only
one choice by the time one comes to the end of their rope, so to speak. Put
your young adult in an institution or suck it up, grinding both yourself and
your child into the life of despair.”
“Institutions
are like guillotines hanging over our heads. If we fail or falter and let go
of the rope it falls and severs our family in half. I’ve lived with the fear
that my son would end up in an institution for over twenty years. As long as
institutions exist families will live with this threat.”
“The very few who manage to get out of
institutions do so by embarrassing the government in media or taking them to
court.”
“That was the
option and my daughter lived in the Rehab for 6 weeks then in the nursing
home for 6 months then part time help for her while she lived with me and
some care was available for part time until I had surgery and could no longer
lift her; she only weighs 73 lbs. but I can't lift her because of a large
hernia.”
“There are
still adults with ASD living in institutions who probably got there because
of lack of knowledgeable support workers and team ....including the health
workers. If you are in the autism community … you understand this
thoroughly.....we need autism specific supports and understanding.”
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Question 3 - Summing Up:
The respondents are people from all walks of life; parents,
staff in institutions, families with a son or daughter with a disability. They
have given the government a failing grade. They have not seen any progress to
build capacity in the community to enable people to move out of the
institutions. The case workers are not taking the recommendations of hands-on
staff who have clearly suggested people would be better suited living in the
community. There were very few positive comments;
the feeling is that there is a lack of will by government to help those who
have the greatest needs for assistance. Institutional referrals are being made
on a regular basis and there is no adequate housing capacity being developed by
DCS in Nova Scotia’s communities. In conclusion, DCS still relies heavily on housing
disabled people in institutions, DCS still places those with disabilities into
institutions and Nova Scotians have seen no indication that those inappropriate
actions will stop.
4. Increasing Employment Options
The fourth question
was: “How effective has the Government of Nova Scotia been in increasing
employment opportunities for people with developmental disabilities during the
past two years?”
The government’s
effectiveness was rated by 140 people on a scale of 1-10 (1=poor to
10=excellent). Twenty-eight people said it did not apply to them. DCS was rated
below the scale midpoint by 90%, as “poor” by 44% and the average response was
2.6 out of 10 indicating very low effectiveness. The greatest number of people
gave DCS the lowest rating once again.
There were 97
comments. Most of the comments were provided by those who chose low numbers on
the scale.
What people told us:
People with disabilities face employment
discrimination.
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“I am deeply
disappointed that the government seems to have decided to abandon the
roadmap. It is very concerning that they now speak of only providing help in
finding jobs in the community for people who are ‘employable’. Who decides
who is employable? The starting point should be that every individual is
employable and has something to contribute.”
“I pray each
day that my son will find a job he enjoys and becomes a contributing
citizen.”
“People with
disabilities remain some of the poorest of the poor.”
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With no employment or occupational options “...Parents live in fear of their children
leaving school…”
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“Currently, we
have connection with at least 7 acquaintances (families), who have young
adults who have ‘graduated’ from high school within the past 3 years
(includes our own son), who have NOTHING to do throughout each day, unless
extra money and time is spent by the family to involve and ‘entertain’ that
individual in community activities after daytime work hours. It is even
difficult to find ‘volunteer’ activities in which to engage them.”
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Parents and residential service providers are the ones
developing new employment or day program options in Nova Scotia.
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“Parents are
networking and finding employment. Parents have to create jobs. Beg for
services.”
“The
provincial government is relying on the service providers to develop their
own supported employment opportunities. They are offering no support in this
area.”
“There have
been no directed efforts on a provincial level to advance employment for
persons with developmental disabilities…”
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Most people with
disabilities are unemployed, underemployed, or insecurely employed.
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“I believe
that there are instances where individuals with developmental and
intellectual disabilities are given some employment opportunities. However,
these ‘opportunities’ seem to be extremely low caliber jobs that, in my
opinion, are borderline exploitation. The government puts the onus on
non-profit organizations to hire these people when they do get jobs, but yet,
the government is not stepping up to try and help people fulfill the jobs
they are capable of.”
“My child did
try one program, was paid $1.00 per hour for her part-time training/work, that
lasted for 9 or 10 months, but it didn't lead to any work opportunities…”
“[My] son has
been ‘working’ at same job since 2010. No funding in place to provide
employer incentive to hire, therefore he has been working unpaid for 5 years.”
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Nova Scotia does have
successful employment programs that we can build on.
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“Last year,
there were two more ACHIEVE programs rated at two sites in NS. This is
excellent-we need that to continue. As well, there are programs starting at
universities for developmentally disabled youth. These are good but numbers
are limited.”
“The
government has continued to support several community-based employment
services including the ACEE program of Independent Living Nova Scotia in the
Halifax-Dartmouth area, and outreach services at members of the Directions
Council. There are successful programs like these to build on.”
“There are
some very positive stories coming out of The Flower Cart, but alternatives
for self-employment like CAPRE are seriously under supported.”
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The government needs to
“walk the talk” of inclusive employment policy and practices.
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“Accessibility
legislation is a good start.”
“Though there
have been policies created around diversity, one just has to look at the
makeup of government employees to see that there is a lack of any meaningful
attempt to include people with disabilities in their own ranks. This means
that other sectors certainly can't look to the gov't of NS to be a model of
diversity and inclusive employment. Though there are some national
initiatives (RWA) the province is falling behind.”
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Question 4 - Summing Up:
People are concerned that there is a significant lack
of employment opportunities for people with disabilities in this province, even
after they complete employment readiness programs. Money is being put into
sheltered workshops instead of educating employers on inclusive hiring practices.
Parents are doing the lion’s share of the work to find volunteer and employment
opportunities for their adult children. There is a lack of faith in a
government that does not reflect diversity in its own workforce. Ultimately,
families are fearful for their children’s futures.
5. Decreasing Waitlists
The fifth question
was: “How effective has the Government of Nova Scotia been in decreasing
waitlists and the gridlock within the system for people with developmental
disabilities during the past two years?”
The government’s
effectiveness was rated by 153 people on a scale of 1-10 (1=poor to
10=excellent). Fifteen people said it did not apply to them. DCS was rated
below the scale midpoint by 95% of respondents, rated “poor” by 47% and the
average response was 2.3 out of 10 indicating a very low effectiveness.
There were 89
comments. Most of the comments were provided by those who chose low numbers on
the scale.
What people told
us:
Individuals and families
feel stuck and have no hope that the waitlists will improve.
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“There has been no movement. Every
person with a disability goes into a priority based on their needs determined
by the care coordinator and the placement coordinator. In the priority there
are levels based on care required and then there is their position on the
wait list. My son is priority 3, level 3, position 3, a black hole of despair
for us as parents.”
“Waitlists (particularly in rural
areas) continue to be unacceptably long for younger Nova Scotians.”
“To my knowledge nothing has been
done to decrease waitlists. My own
son has been on the list for over 20 years.
How can this be?”
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The government is not
opening new homes and there has been no commitment to reducing waitlists.
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“There were high hopes there would be
some movement for people on waitlists but nothing has changed. In two years,
DCS seems proud to have placed 62 people in community based options.
Waitlists have not decreased. Nova Scotia's waitlists are so long because
they stopped creating community based options for over a decade and we are
now suffering families and individuals wanting to start independent lives are
enduring the consequences of bad public policy.”
“Placements are being made but no new
infrastructure to build capacity.”
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Aging parents feel that
time is running out for them and they worry what will happen to their adult
children when they die.
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“The fact that our son has to wait
for at least seven years to get into a program at DASC Industries cause me
concern. Especially now that we are
in our seventies.”
“My son is
almost 40 years old and during his life I have had to advocate, even fight,
for him to have a quality of life that is a given for the average
person. Where there have been no
services for him we have created them.
Who will continue to create those services or even maintain them, when
we are gone.”
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People who are on the
waitlist for community-based homes assume that someone else with higher needs
is receiving service.
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“Poor poor and double poor. Plus the system is crisis driven, so when
are the people who are not in a crisis situation ever to hope for a place to
live.”
“Supposedly the waitlists are shorter
for sheltered workshops, but they are still at least two to three years
long. We have been on a list for
housing for over ten years and never been contacted, so I assume it is only
by extreme emergency that housing is made available.”
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Individuals who are
experiencing crisis are falling through the cracks of a broken system.
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“Adults with autism have NO wait
lists because we have no services including.....psychiatrists trained in the
adult system to help with the over 10,000 people in NS who have autism, of
which at least forty percent will develop a Mood Disorder. MY SON ATTEMPTED
TO KILL HIMSELF LAST NIGHT AND I AM SO FRUSTRATED AND ANGRY AND SAD. I FEEL LIKE WE are DISPOSABLE.”
“Son died while waiting for
appropriate care.”
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Question
5 - Summing up:
People have
expressed tremendous disappointment at the lack of progress in tackling
waitlists for housing or employment services.
Individuals are being left in hardship and limbo for five, ten or even
more years. There is a feeling of
helplessness and frustration from families who want to find some security for
their loved ones before they pass away.
Tragically, one parent remarked “my son died while waiting for
appropriate care”, while other elderly parents are genuinely frightened when
thinking of their child’s care when they pass on.
A final quotation:
“It is sad indeed, when NS was actually a leader in the area of
closing children's institutions in our province to where we are today even
after DCS spending has increased so dramatically. We are fighting the same battle as parents 20
& 30 years ago. We know the harm,
neglect and abuse that individuals have endured living in institutions--this is
no longer an argument. It is not difficult to support an individual to live a
good life in their community. The fact
that we have not moved forward with the Roadmap, in this day & age, with
the UN Convention and the Charter of Rights and Freedom, is simply beyond
comprehension.”
Reaching out:
Community
Homes Action Group remains committed to working with government,
community-based organizations, and health and service providers; indeed, with anyone
interested in changing the course. We believe there is a good home for
everyone. We are concerned that many people are not living in safe appropriate
places that support their humanity and provide opportunities for rewarding
lives.
Additional References
Barken, R. (2013). A Place to Call Home: Intellectual
Disabilities and Residential Services in Nova Scotia. Canadian Journal of
Disability Studies, 2, 51-70. http://dx.doi.org/10.15353/cjds.v2i1.70
Choice,
Equality and Good Lives in Inclusive Communities: A Roadmap for Transforming
the Nova Scotia Services to Persons with Disabilities Program, June 2013
Hennen, B.
(2006). Gaps and Silos: Persons with Developmental Disabilities Move to the Community.
(Report of study leave granted by the University of Manitoba, July 2004-June 2005).
Retrieved from http://www.afmc.ca/pdf/2006_hennen_gaps_silos.pdf
Kendrick, M.J. (2001). An Independent
Evaluation of the Nova Scotia Community Based Options Community Residential Service
System. Report to the Department of Community Services.
Nova Scotia Department of Community Services
(June 2008). Report of Residential Services.