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Towards an Integrated Funding Model

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Towards an Integrated Funding Model Challenges to be addressed Persisting low basic incomes of people with disabilities Significant income difference even where ... – PowerPoint PPT presentation

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Title: Towards an Integrated Funding Model


1
Towards an Integrated Funding Model
2
Challenges to be addressed
  • Persisting low basic incomes of people with
    disabilities
  • Significant income difference even where working
  • Major need for personal supports and for cost
    offset
  • Involvement of families in providing informal
    support, and the direct costs and opportunity
    costs
  • Disincentives to employment bcs of support system
  • Need to strengthen community capacity for
    inclusion
  • Government fiscal limitations
  • Intergovernmental relations

3
Persisting low basic incomes (SLID)
  • Income difference of 7,600 per year
  • 9,400 if LTD
  • Below after tax LICO
  • w/disabilities 25
  • LTD 29
  • w/o disabilities 11

4
Persisting low basic incomes -- major
unemployment (SLID)
  • Employed all year
  • 26 w/disabilities
  • 19 LTD
  • 58 w/o disabilities
  • NILF all year
  • w/disabilities 54
  • LTD 65
  • w/o disabilities 17

5
Earnings difference if working all year (SLID)
  • Earnings difference of 5,800 per year (employed
    all year)
  • 7,200 if LTD
  • Below after tax LICO (earners)
  • with disabilities 9
  • LTD 11
  • w/o disabilities 6

6
Major need for personal supports (HALS)
  • 53 of all adults need help with one or more
    everyday activities
  • pay out of pocket - not reimbursed
  • 25 of helped - okay
  • 39 of more needed

7
Major need for personal supports (HALS)
  • 35 of all adults need aids / devices for
    mobility, seeing, hearing, speaking
  • Gap between need and usage

8
Need for cost offset (HALS)
  • 36 of all adults have non-reimbursed costs for
    various disability supports

9
Need for cost offset (HALS)
  • Cost a reason why supports not more widely used

10
Need for cost offset -- equity according to
ability to pay? (HALS)
  • The 36 of all adults who have non-reimbursed
    costs for various disability supports doesnt
    vary much by income level
  • But its harder to pay when poorer

11
Need for cost offset -- equity according to
gender? (HALS)
  • Differences in the extent to which men and women
    pay for disability supports and are not
    reimbursed
  • Regardless of family income status, women are
    more likely to pay

12
Disincentives to employment because of system
design (HALS)
  • People not in the labour force
  • 12 concerned about losing disability supports if
    employed
  • 20 concerned about losing disability income if
    employed

13
Family members provide most support (HALS)
  • Nearly half of people needing support for
    everyday activities are helped by family members
    only

14
Family members providing support -- opportunity
costs (HALS)
  • Family incomes are lower where family members
    provide support with everyday activities

15
Need to strengthen community capacity for
inclusion (HALS)
  • Reasons why people arent doing more of the
    community activities that they want

16
Towards Solutions
17
Integrated model would...
18
Low basic incomes
  • Measures to increase employment
  • job accommodation funding and incentives / info
    to employers
  • greater encouragement for employers to use
    present tax system
  • human capital exemptions
  • Better basic income support

19
Income gap even if working
  • Refundable tax credit that recognizes difficult
    to itemize additional costs of disability
    advanced quarterly / monthly
  • Or other provincial or federal income program to
    deliver the same
  • Not only for people who are employed
  • Not subject to claw backs

20
General financial assistance to families who
provide disability support
  • Refundable tax credit where providing direct
    support available regardless of age of person
    supported and their labour-force status
  • Or other provincial or federal program to do the
    same
  • Not subject to claw backs

21
Disability Support Program
  • Aims ensure access to disability supports
  • for citizenship and inclusion
  • to help overcome barriers to carrying out
    activities of daily living, and to social and
    economic participation (incl. political and
    cultural) -- barriers directly associated with a
    disabling condition

22
Disability Support Program
  • Disability Support
  • a good or service used to help a person overcome
    barriers associated with a disabling condition
  • no fixed set of goods and services
  • program would focus on supports that attach to
    individuals (but not exclusively)

23
Examples of disability supports
  • Human assistance for direct instruction, care,
    therapy (non-institutional) or assistance
  • Planning and counselling
  • Social development around individuals
  • Technological supports
  • Medications and health-related supplies
  • Environmental adaptations
  • Information and referral
  • Other

24
Program Principles
  • Accessibility
  • Equity
  • Adequacy
  • Portability
  • Responsiveness and consumer control
  • Public responsibility

25
Conditions of access -- need for disability
support
  • Presence of need for a disability support would
    be the sole criterion
  • Not criteria such as
  • income level age employability cause or
    category of disability attachment to training,
    work or rehabilitation residency
  • Not a welfare-based program

26
Conditions of access -- disability
  • Inclusive definition of disability
  • hearing seeing speaking / being understood
    mobility flexibility / agility pain
    respiration general cognition - intellectual
    disability specific learning disability memory
    / confusion emotional / psychiatric other

27
Program Administration
28
Program Administration
29
Equity in financing individuals
  • Disability support cost unit price x number of
    units needed
  • Consistent and transparent pricing scheme for
    typically needed items and services price quotes
    for less typical items and services
  • Peer review of units of service requested

30
Strengthen community capacity for inclusion --
mix of options
  • Community-based
  • Non-profit
  • For profit

31
Strengthen community capacity for inclusion --
key functions
  • Core capacity
  • core coverage of disability administration,
    training and office costs portion of service
    cost to provider
  • conditional grants periodic review
  • publicly subsidized user fees a major but not the
    only source of agency income
  • generic services (e.g., homemakers, counselling)
    eligible to increase generic capacity
  • Forecasting and planning

32
Strengthen community capacity for inclusion --
core financing
  • Enable community services to
  • review and recommend individual claims
  • assist with individual planning, contracting and
    logistics
  • provide direct services to people with
    disabilities (specialized and generic)
  • provide counselling on disability issues
  • consult with employers and others on inclusion /
    accommodations

33
Strengthen community capacity for inclusion --
forecasting
  • Enable community services to
  • research patterns in use of supports
  • forecast emerging demand for support
  • document approaches that work well and not so
    well
  • devise innovative support options on a
    demonstration basis
  • participate in policy process

34
Intergovernmental aspects
  • Intergovernmental accord
  • Guiding principles and objectives
  • Provincial scope to design and administer program
    consistent with regional needs and guiding
    principles
  • Reinvestment agreement new federal funding not
    used to reduce provincial contribution
  • Positive profiles for payers

35
Conclusion an integrated model would seek to...
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