Here's an idea: Pull together a panel of average citizens and ask THEM to take a look at health care and what they think needs to be done. The Globe's Andre Picard summarizes here what the group of 28 Ontarians recommended as part of the Citizens' Reference Panel on Health Services.
If you like your information full-on, read the full report here. It's 44 pages, but there's also a one-page summary. 
Nothing world-shaking in the panel's findings, but that's the point. It doesn't take shiny new equipment, expensive new drugs and an influx of even more health-care professionals to fix much of what ails the "health" system - it just takes common sense and policy-makers brave enough to get beyond the individual interests of the big players.
Note the recommendation to end the fee-for-service pay system for doctors. Yes, please - the incentives are all wrong in that system, resulting in high costs to taxpayers with no assurances that all that spending is actually resulting in a healthier population. Governments are all about "outcomes" these days - why should the medical system be exempt?

Just bite the bullet, government - developmental disability is for life

I can feel for governments on issues like health spending, which has no top limit to its growth. As long as there are people desperate to stay alive and clever entrepreneurs eager to capitalize on that, no amount of money will ever be “enough.”

So yes, let’s have a heart for the plight of government in trying to manage that challenging issue. But that’s no excuse for why they’re not better at managing other costs that are far more predictable year over year.

The crazy stuff going on right now for people with developmental disabilities in B.C. is a fitting example.

Yes, there are cost pressures on that front, too: double-digit growth in autism diagnoses in Canada; expanded services on reduced budgets; more private-sector interests finding ways to turn a profit in the delivery of social services.

But allowing for all of that, the big costs for a funding body like Community Living B.C. still ought to be relatively predictable over the long term.

When it comes to a lifetime condition like developmental disability, you can budget with assurance knowing that the people needing services and support today will still need them tomorrow. The number of babies born with developmental disabilities every year is also stable enough to be built into the spending plan.

And unlike the health system, caps on care are common for developmental-disability services, restricting the number of people who can access support.

In contrast to our all-you-can-eat health system, there are multiple tests to take, professional assessments to acquire, hurdles to overcome and “analyst” scrutiny to bear before anyone gets CLBC funding. It all adds up to more budgetary certainty.  

Yet here we are again, acting like the cost of caring for British Columbians with developmental disability has caught us by surprise.  Here we are again, trying to downgrade the housing support and work opportunities for people who we know with certainty can’t manage without them.

B.C. looked progressive back in the 1980s when it shut down the big institutions - Glendale, Tranquille, Woodlands - where “the retarded” had been locked away. But the years haven’t been kind to the chronically underfunded community system that developed as a replacement for institutional care.

The creation of CLBC in 2005 was supposed to improve things. The Crown corporation was conceived as a parent-driven initiative that would finally put people with developmental disabilities and their families first in establishing spending priorities.

Not quite. The TC reported this week on the concerns of group-home operators facing a 19 per cent jump in B.C.’s minimum wage this year. Some overnight staff at the homes earn minimum wage, and agencies are wondering where they’ll find the money.

Not from CLBC. The Crown corporation told agencies to cut client services if it comes to that.

“We would encourage your members to continue to explore new and more cost-effective ways to meet individuals’ disability-related needs,” wrote the CLBC’s Doug Woollard in a letter last month to the Community Living Agencies Network, which had raised the issue.  

Much has changed for the better for people with developmental disabilities in the last 30 years, mind you.

The level of integration in our school system now would have been a distant dream in the days when I was in elementary school and the mentally handicapped kids were hidden away in the basement.

In terms of employment, the best that any of those kids could hope for back then was a seat in a sheltered workshop, where they’d maybe make a few dollars a week. Now, there’s the possibility of getting a real job - for real money - at the growing number of community-minded businesses stepping up to do their part.

But those gains are worthless if government waffles on its commitment to people’s basic needs. The closure of group homes this year is destabilizing decades of effort to create those homes and bring a little certainty into people’s lives. Recent cuts to work programs and job training are just plain cruel.

Everybody has to be prepared to give up something in a recession, I suppose. But should that include secure housing, social connection and job training for a few thousand extremely vulnerable people who we know won’t make it in this world without our help?

People with developmental disabilities need a lifetime of support. It’s frustrating, inefficient and sad that government still resists that reality.

CLBC execs clean up as services dwindle

*Note: Here's further news coverage from October after Rick Mowles was fired, and another follow from Nov. 4 detailing Mowles' $345,000 severance package

While browsing the Community Living BC Web site for information about cuts to services, I found myself comparing compensation paid to CLBC executives since the Crown corporation was started in 2005-2006. Very, very interesting.
CEO Rick Mowles has seen a 59 per cent increase in his annual compensation over the four fiscal years from 2005-06 to 2009-10, pushing him to almost $231,000. Doug Woollard, vice-president of operations and the man most often mentioned in stories about more service cuts at CLBC, has seen his compensation climb 57 per cent in that same period, to almost $176,000.
Wow.
Meanwhile, the money for contracted services for people with developmental disabilities - the raison d'etre of CLBC - fell $5 million in the 2009-10 fiscal year compared to the previous year. (Can't do comparisons back to 2006, as funded services have changed.) I guess we now know why the CLBC bosses get the big bucks.
See the figures for yourself here. You'll need to go into each year's financial statements to do the comparison.


*June 23: Heard from CLBC communications and I just want to underline that the increases above are for total compensation - salary, incentive, pension, and a category called "all other compensation."
CLBC says Rick Mowles hasn't had a salary increase since 2005. But when I take his partial-year salary from fiscal-year 2006 and calculate it as a full year for comparison's sake, I still come out with his salary increasing from $138,660 to $195,000 by 2009-10, so the "zero salary increase" doesn't square with the numbers in CLBC's financials.
But at least Mowles didn't take the $21,500 incentive this year that he got in 2008-09. That has been discontinued as of the most recent fiscal year. That paid the CEO up to 15 per cent additional on top of his salary if he hit his performance targets in any given year.
Only the incentive to the CEO was discontinued. Other CLBC executives continue to receive that. Doug Woollard, Richard Hunter (VP of corporate services) and Carol Goozh (VP of policy and program development) each got more than $13,780 in performance incentives in the last fiscal year, and an additional $10,700 or so in the "all other compensation" category.
And here's what those incentive measurements are, from the CLBC Web site:

Incentive Plan Performance Measurement 
CLBC’s CEO and NEOs incentive plan performance targets and measures are captured in the organization’s Operational Plan which is derived from the Strategic and Service Plan initiatives. All three documents are accessible to the public on CLBC’s web site. The main categories within the Operational Plan are as follows:
1. Transformation and Organizational Development
2.  Community Supports and Services
3.  Services for Children
4.  Safeguards
5.  Policy/Program Development
6. Community Involvement and Partnerships
7. Governance, Financial & Information Management
8. Communication
Operational goals within each category are assigned to CLBC executives and performance measures are assigned to each operational goal.  The executive’s progress towards the achievement of stated goals is regularly monitored throughout the year and assessed at fiscal year-end.  The annual review provides the basis for the performance incentive calculation.

Nice to have the Ontario Appeal Court calling prosecutors on their guff about the constitutional rights of sex workers in the landmark case that's before the courts right now. The judges cut through the blah-blah-blah and just got down to the bare facts - that Canadian laws around prostitution aren't just shutting sex workers out from constitutional protection, but are actively making the work much more dangerous than it needs to be.
With two sex-work-related court cases progressing toward the Supreme Court of Canada right now, those of us who support the decriminalization of the adult, consensual sex industry are feeling stirrings of hope. However, I'm a little fearful that the federal government's response to a pro-decriminalization court ruling could be to declare sex work illegal, which will improve nothing and possibly make the situation even worse for workers.

If anyone's still wondering whether things are going well in the psychiatric facilities here in Victoria, this ought to set them straight. Terrific TC opinion piece from a psych-ward survivor, who writes in my favourite style: Straight-up.