Thursday, June 22, 2006

Chopping support for at 19 makes no sense

VICTORIA - Everybody knew something bad could happen if Neil Fahlman was cut loose with no support when he turned 19.
Even the government’s psychologist warned things could go really wrong.
“Without the supports now in place Neil would be extremely vulnerable to his own aggressiveness and impulsivity,” the psychologist found. “He could do significant harm to himself and the community.”
But rules are rules and budgets are budgets. Community Living BC, which delivers services to people with mental disabilities, has a rule that it inherited from government. It is not enough to need help. If your IQ is 70 or above, support stops at 19. You are on your own.
Neil tested at 79, low enough to place him in the bottom 10 per cent of the population. But high enough, according to the policy, that Neil no longer needed help.
This is where the story could have gone very wrong and those warnings of “significant harm” come true.
But Neil’s mother wouldn’t accept the decision. She took the case to B.C. Supreme Court and this month won a victory for Neil and thousands of others.
Fiona Gow adopted Neil when he was five weeks old. When he was diagnosed with Fetal Alcohol Spectrum Disorder, attention deficit disorder and other problems, she sought help. By the time he turned 15, Neil was a big, volatile kid - he’s now over 300 pounds. Gow and her husband couldn’t cope. Foster care didn’t work, for similar reasons.
Community Living BC helped with a solution. With the help of one-on-one support seven hours a day, Neil started living successfully by himself in a small cabin in a quiet Vancouver Island community. (He qualified for social assistance disability benefits.)
Then his 19th birthday approached. And despite the fact that Community Living BC had approved the support for Neil, and despite the warning from its psychologist, the agency said it was cutting off support, citing the IQ policy.
Leave aside the legal issue for the moment. This is a person with serious behavioural problems, possibly living in your neighbourhood, who has been identified as a danger to himself and others. Is it really sensible to cut off support when he turns 19?
The court did look at the legal issues. Mr. Justice Eric Chamberlist found the legislation establishing Community Living BC said it was to "promote equitable access to community living support" and to "assist adults with developmental disabilities to achieve maximum independence and live full lives in their communities." Denying people needed support because of an IQ test score is contrary to the purposes established by the legislation, the court ruled. If the government wants to cut costs by using arbitrary tests, it needs to amend the legislation or pass a cabinet order.
Community Living BC is trying to figure out whether to appeal.
The issue is really money. The IQ standard was a way to restrict the number of people eligible for help, dumping some who needed it. Fahlman's support - seven hours a day, every day - costs about $1,500 a week.
If Community Living BC has to honour its obligations to people like Fahlman - and there are many of them - it will have to cut somewhere else.
Unless the government recognizes that it is wrong and foolish to abandon people like Fahlman. Impulsive, easily led, unable to consider consequences they can easily be preyed on, or become offenders. Whatever happens, things tend to turn out badly.
It's important that government worries about costs.
But it's ridiculous to say that someone who needs seven hours a day of support, for his own well-being and the protection of the community, is suddenly fine to make his own way in life because he turns 19.
We are just throwing those people away, to land in their parents' basements, in jail or on the streets.
The court ruling could mean an end to that waste. All government has to do is accept it.
Footnote: It is not good to turn 19 in B.C. if you have problems. Children in care are also generally abandoned by the system on their birthday, sent packing from their last foster home, often with few skills, emotional issues and no money. It is cruel, and a formula for disaster.


Dawn Steele said...

Thanks for highlighting this, Paul.

Ironically, one of the key justifications for including children's services under the CLBC mandate against the advice of most experts and many families, was that it would integrate adult and children's services, thus providing a smooth transition to adult services and stopping the "black hole" that families confronted when their children turned 19.

Neil and others like him should of course continue to be supported, and this is a great victory for families. But, just as we feared, this will mean less and less money available for early intervention services for new children entering the system--dollars that can make an enormous difference in the eventual lifetime costs of support, and in the long term sustainability of community living.

I and others have argued from the outset of restructuring that the fundamental reason for key problems in community living--waitlists, the "black hole" at 19, exclusion of those with IQ >70, a focus on crisis services, etc--was underfunding, not structure.

But of course TPTB didn't want to hear that, especially while in budget-cutting mode. So we've wasted hundreds of millions creating this new structure that has solved none of the same old problems. Things will continue to go from bad to worse until we can find the political will to do it right, and to accept that even if we don't do it for them, we should do it out of self-interest.

transformation said...

Thanks you for noting this issue that impacts hundreds of B.C. families and communities every day.

If CLBC appeals or the government legislates IQ, then cabinet will either have to make the conscious decision to cut these folks loose and let the criminal justice system serve them by default after victims have been created, or assign responsibility to a Ministry (or authority) to provide proactive supports that will assist individuals and families to 'live good lives in good communities'. When people have severe physical or nerurological limitations in their ability to manage their behavior or care for themselves, we can either choose to help or abandon them, but each choice has a price.

Lisa said...

I am a former foster child and current child advocate (in the USA).

When I "aged out" of foster care in the 80's, I was 16 years old. I didn't know how to cook, drive or budget.

When I did know was that, if I failed in the adult world, I would be homeless. There was no safety net for me.

I was one of the lucky ones. I started college at age 16 (unusual, I know, but school was always my anchor in the midst of the unpredictability of foster care).

I made it through college and graduate school. Now, I am even married with two stepchildren:

But, the other children who grew up with me haven't been so lucky. I volunteered at unwed pregnancy shelters and saw their name. I searched the criminal databases, and saw their charges.

I was homeless for two weeks as I initially struggled to adjust to the adult world. Some of my former friends from foster care didn't make it out there at all.

Change can be made, but we need to advocate for it. Please visit my blog sometime:

dave22 said...

Wow!!! Well written blog about the pragmatic challenges facing the "over 19" young adults! Clearly these young people need our continued support. Clearly CLBCs budget was not set with the intent to provide support for this goup of people. CLEARLY our Minister and Provincial Governement needs to rethink the funding formula so as to allow CLBC to continue to offer support for our young adults. Cutting them off is not a viable option... the Minister should know better.