Several months ago, the Alberta Disability Workers Association made a commitment to help ensure that the PDD Review included the voices of the disability workforce. We recently completed a survey of disability workers including positions from frontline to leadership in order to determine the best ways to include them and the topics they felt needed to be discussed in the review. Here is what we heard.
How to include disability workers
Workers felt it was important to have more than one way to have a say. Having both face-to-face meetings and online surveys with plenty of space for comments were seen as important. Most workers said that they would need 1 – 2 weeks of lead time to free up their schedule for a meeting and there was no time of day or week that worked well for more than 19% of those who responded.
Topics that should be included in the review
We asked about the current strengths, challenges and needs that affect workers’ and organizations’ ability to meet the needs of those they support to have the best life possible. These questions produced a set of common themes that people would like to see discussed as part of the PDD Review.
Individual planning and goals – The process and result of developing goals or outcomes is often driven by what PDD requires (e.g., certain wording or types of goals, new goals each period) and does not necessarily reflect what individuals want. The result is that individuals may avoid working toward the stated goals and agencies lose funding because those outcomes were not achieved on time. The process needs to be reviewed as to how it can become more truly person-centred.
Paperwork requirements – PDD’s paperwork requirements have changed and increased multiple times over the past decade. Changes in reporting often require added time to obtain supporting documents as well as technology changes without support for the cost and time to learn the new technology. The time spent on paperwork results in less worktime being available for direct service or in paperwork being done on unpaid time (or both). A discussion is needed about the minimum amount and type of paperwork that would be sufficient to meet the government’s need to be accountable for public funds and quality of service, and that would be read and acted on by PDD staff.
Underfunded supports – Funding dollars are tied to direct service time (i.e., work time spent with the individual with disabilities). Other activities classed as “admin time” are often underfunded, even though they are necessary for a well-functioning organization and effective services. Indirect service time is needed to find and build community connections for individuals (i.e., community development) and to get assistance from community resources (e.g., doctors, therapists) in support of the individual. As well, professional development time—whether it involves attending training, consulting with experts or reading—is indirect service time that benefits the supported individuals but is unfunded or underfunded. Funding for services also does not typically include additional money when the individual is brought into service. Yet, extra time is required to get to know the individual’s history, needs, strengths, likes, dislikes, goals, desires and preferences for type and style of support. PDD workers and service providers separately engage in conversations that result in this picture, increasing costs to the system and delaying the time between when services are requested and when delivery starts to reflect what the individual needs and wants. Staff turnover also means that more time is spent getting to know the individual. Certain groups are also at risk of underfunding of support, such as aging individuals experiencing rapid declines and individuals with cyclical mental health issues, because the system is not responsive to rapid changes. These underfunded real costs of service and how to address them should be part of the PDD Review discussions.
The role of 1-to-1 time in achieving outcomes – Workers noted that group living situations are often funded for a single staff on a shift, which limits individuals’ access to community events if support is required but others in the group are not able or not interested in attending an event. Respondents suggested that everyone deserves a bit of 1-to-1 time in order to achieve outcomes that are specific to them, to build a positive self-image or to get support with private issues (e.g., grief, solving relationship problems). Current resourcing and staffing models do not allow this to be part of every individual’s plan of support. PDD review discussions might suggest how this could be accomplished.
Addressing adversarial relationships – In a system of perceived or actual scarce resources, those controlling the limited money and those requesting the money often take adversarial positions, regardless of having the same mission and values. Collaborating to create workable solutions to issues is an important step in breaking down adversarial relationships and seeing each other as partners with different roles. PDD representatives play an important role in advocating within the system for service funding that individuals need. Some respondents’ experience was very positive; others complained that the PDD rep was largely unavailable, unfamiliar with the individuals on their caseload and changed caseloads frequently. Complaints of changing and high caseloads were most common in urban centres. This is an important area to explore with the community, which may help PDD with creative solutions.
Wage levels appropriate to the nature of the work – Current funding results in wage levels that put the system in jeopardy. Minimum wage levels have increased without adequate increases in contracts to cover both pay and benefits (e.g., CPP and EI). Service providers are competing with the hospitality and retail industries for workers because the pay scales are equivalent and retail/hospitality work is less demanding. In particular, the wage scales are too low to attract and retain educated and skilled staff; as a result, staff require more on-the-job training but without training resources in contracts. Workers frequently take on multiple jobs to make ends meet; as a result, they have little time for family or the self-care required by stressful work. Respondents noted that when workers are worried about money or tired from working too many hours, they are likely to make mistakes or to reduce their efforts on behalf of individuals. Respondents reported that the poor pay made them feel demoralized and unappreciated by society and government funders. Positions are hard to fill and the workforce is spread too thin to provide enough support, and is burning out more rapidly as a result. High turnover creates trust issues for individuals receiving services and they become frustrated by repeatedly having to train new workers about the support they need and how to provide it. The workforce crisis created by low pay and made worse by wage compression has created a variety of problems that increase the likelihood of accidents and the Ministry’s liability. Past efforts to prevent or address issues, such as increased documentation of service has led to less time on shift delivering services and other unintended consequences.
Respondents to our survey shared both issues and ideas to help address those issues. Engaging the disability workforce is an opportunity for the government to partner with those whose job is to fulfill the mission of PDD to “support adults with developmental disabilities to be included in community life and to be as independent as possible.” We have asked for a meeting with the Community and Social Services Minister to discuss the results of this survey and look forward to disability workers’ feedback being considered in the PDD review process.
Click here for a copy of the full survey report.