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© 2019 THE INCLUSION BLOG. ALL RIGHTS RESERVED.

Part 3: The Hidden Cost of Not Supporting People

This is part 3 in a series about professionalizing the wages of DSW’s.  If you missed Part 1 and 2, I’ve summarized them below.  If you did read them, skip down to Part 3.

Part 1 – Professionalizing wages is important.  With stable supports people can leverage their supports towards long term goals of independence, social inclusion, and employment.  It’s not a want, it’s a need.

Part 2 – Reduce the overwhelming demand.  Step 1 – Make applications for supports transparent and cohesive.  Step 2 – Provide top-notch support to natural support structures.  Step 3 – Support choice and flexibility in how funds are spent.  Give people control over the resources allocated to them so they can make the choices that are most relevant and impactful to their situation.  This allows people to leverage their personal resources alongside those of the government.

Part 3 – Expose the hidden costs of our current system.

Where do people get support if;

  1. A) their natural supports are no longer able to support them, &
  2. B) community living is not yet an option?*

If natural supports and CL’s aren’t available, most people supported end up living in health related institutions such as hospitals, seniors facilities, nursing homes, long term care facilities, and personal care homes.  Roughly 12,000 Canadians at any given time are living in these aforementioned facilities instead of in the community.

A report in 2007 said that an average hospital stay lasts 7 days and costs roughly $7000.00 per person.  Adjusted for inflation that means it costs almost $8000.00 per person today.  That’s $96 million a week and just under $5 billion a year.  Now that’s a rough estimate.  Not every person is living in a hospital.  Most live in personal care homes which are less expensive.  But even a conservative estimate of $4 billion, is a lot of money.  That’s funding that we’re already spending on people supported but not towards direct support or community living.  Nursing home’s aren’t suited to people with disabilities as they are designed for increasing dependance, not supporting independence.  And are less cost effective than a person living in the community.

There are other associated costs that are more difficult to calculate.  If people supported are living in nursing homes then seniors don’t have access to those beds.  That contributes to hospitals needing to house waiting seniors longer.  And in turn, full hospital beds contribute to increased ER wait times.  That doesn’t include the lost economic impact of people not participating in their communities.  Things like taxes paid on their home or visiting local businesses.

There is another outcome that is much darker than living in a healthcare facility.

It’s estimated that roughly 16% of homeless people in Canada live with an intellectual disability, 55% have a serious health condition, and 63% have more than one.  Homelessness is a very serious issue affecting Canadians.  The indirect cost of homelessness is calculated at roughly $24 billion dollars per year.  That includes shelters, police and prison costs, health care, and lost productivity.

It’s impossible to tell how much of those costs apply directly to people living with disabilities.  Looking at the statistics it’s fair to assume that it’s not an insignificant portion.  Which again, is more tax dollars Canadians are spending on people with disabilities that aren’t going towards CL’s, professionalizing the industry, and improving the resources available to people who require support.

When talking about hidden costs it’s important to remember that this is different than talking about reallocating funds.  Even if we were to reallocate monies spent, it wouldn’t necessarily mean a reduction in healthcare spending.  This is more about demonstrating how we already spend our funding and explore if there are better opportunities available to us.  This is a powerful way to discuss how professionalized supports can support other government resources and reduce the impact on our strained social services.

For example, Medicine Hat is well on its way to ending homelessness by using a housing first model.  This means that regardless of a homeless person’s situation, they place them in a home of their own.  No requirements to be drug free, pay rent, etc.  Participants in the program don’t have to meet any specific requirements other than that they are homeless.

To most people this sounds counter intuitive.  However according to estimates done by the Alberta Ministry of Human Services, a chronically homeless person can cost the government $100,000 per year.  Medicine Hats housing first program costs an average of $35,000 or less per person, per year.  So far the program has been wildly successful, long term outcomes for participants are significantly better, and the city is set to announce the end of homelessness by the end of the year.

Medicine Hat homelessness doesn’t directly relate to supports but it does demonstrate how limited resources can be spent more efficiently and produce better outcomes.  If we had professional supports who had a long term career investment in the field, it seems likely to me that we’d have a better support system.  More people would find the supports that are right for them instead of being homeless or burdening our strained healthcare system unnecessarily.

This article is far from being a perfect academic study of the pro’s and con’s of the situation.  But it is clear to me that we do invest substantially in people with disabilities.  The question is, are we really doing the best that is possible with the money that is being spent?  Is there a better way?  I strongly believe that community based person centered support is the way to go.  Long term investment in professionalizing the industry would lead to better outcomes first and most importantly for people supported, but also for society as a whole.

Next article I’ll be talking about corporate support.  How private industry can indirectly support professionalizing wages for DSW’s.
*Outside the disability community not many people know how long it can take to get supports in place.  Especially in an emergency or unexpected situation.  Finding the right home, making it accessible, with the right staff takes time.  Planning supports is not something that should happen overnight but should happen gradually, with the person supported.  Having professionalized DSW’s would help as supports wouldn’t change multiple times through the process.


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  1. Yet another excellent example of how support up front often costs less than dealing with the results of a lack of support later. Thanks for helping get those facts out into the open!

    • Thanks Chris. Not my most technical piece but it does put certain metrics into perspective. People still have to have their needs met. If one system isn’t taking them on, another one elsewhere surely is and much less efficiently. What’s worst is the cost to people. All of those people not getting their needs met, and their families alongside them. Impossible to measure the true cost of stress.