Better Front Line Outcomes
for Manitobans with intellectual disabilities and the workers who support them.
“Quality is defined at the point of interaction between the staff member
and the person with a disability.”
John F. Kennedy Jr.
Adults with an intellectual disability are being supported by front line workers who are underpaid and lack standardized, consistent training. Further, Manitoba’s Community Living disAbility Services system lacks an effective measurement approach to ensure quality outcomes.
Community living is young in its history. The services offered were advocated for by parents and pieced together without a long-term plan. Community Living disAbility Services is reactive and crisis driven. Agencies have had to develop and deliver training for support workers in-house; requiring intensive resources. Chronically low staff wages and lack of standardized and consistent training have long been recognized as requiring attention. Most other sectors have consistent, comprehensive, standardized training available to front line workers. Coupled with these factors, there is no mechanism to measure quality outcomes within services, despite a significant investment from the province. The recommendations in this briefing note will ensure a proactive service that demonstrates value for the individuals receiving services.
Front line workers are required to work independently, solve quality of life issues and provide complex medical supports and intimate personal care. Staff are paid poorly and their training varies based on the agency. Non-standardized training and inadequate wages in a high responsibility position results in high turnover. Vulnerable adults can have up to 800 different care providers in their lifetime. Turnover means inconsistent care and very high administrative costs for human resources and training.
Additionally, the system needs a quality assurance framework to ensure value for money. The framework needs to be value-based and person-centered with measurable goals and tools for improvements.
The Vulnerable Persons Act, Accessibility for Manitobans Act and the Convention on the Rights of Persons with Disabilities all support the need for appropriate training and supports for people with intellectual disabilities.
The success of the Building on Abilities initiative, which aims to ensure people get the supports they need to lead meaningful lives in welcoming communities utilizing a person-centred approach will ultimately depend on the quality of direct support received. Success will be significantly hampered unless the pervasive training and wage concerns are addressed.
Recommended Action and Financial Impact:
Work collaboratively with community stakeholders to:
- Professionalize the Community Living disAbility sector by implementing standardized training linked to compensation and a quality assurance system. Provide financial support to Abilities Manitoba to investigate and develop consistent training for direct support workers and a quality assurance framework. Significant progress can be made in both areas within one year at a cost of $293,440.00.
- Raise funding for wages to a level that respects the complexity and responsibility of the role of direct support workers. Increase overall funding for staff wages to agencies by 10% within your current term. This will address compression and excluded workers created by the wage enhancement fund and allow agencies who haven’t received a cost of living increase since 2011 to address wages. Ultimately it will provide greater stability and sustainability to a vulnerable population.
Community Living disAbility Services is the only human service sector that lacks consistent, standardized training, does not pay at a level that encourages staff to make a career of their job and does not have a mechanism to measure quality outcomes. These all represent barriers to full participation for adults with intellectual disabilities.
The lack of action in these critical areas makes it appear that government funders and society places less value on the lives of people with intellectual disabilities.