First, the Minister of Community Services says: “the report stating these changes have hurt people is totally erroneous. That’s totally wrong.” That claim is unfounded.
Our analysis was based on interviews with community-based service providers, including health-care workers, social workers, and legal-aid workers. It reflects their experiences. While we could not interview government workers — despite trying to do so — the government has offered no data that would refute what we heard.
People are indeed being denied special-needs allowances by caseworkers based on policy changes. The policy manual is pretty clear in explicitly excluding a long list of items, and it specifically says that “regardless of recommendations regarding their medical necessity” many items and services will not be considered. Are these caseworkers keeping track of these denials and do they know their impact? The 5 clients who have managed to appeal had no real legal basis to do so. Prior to the 2011 changes, caseworkers, the Director, and the Appeal Board could make exceptions if an item or service was deemed “essential” or if there was proof that this item or service would “alleviate pain or suffering.”
Second, the Minister went on to make a more egregious claim, noting that if the current system was actually doing harm, “There would have been an outcry from Nova Scotians.” But no public outcry provoked the policy changes in the first place.
Should good governments not do the right thing, especially for people who do not have a voice at the table, for people unable to create an uproar? The people who are being denied special needs are our most marginalized, people for whom having a telephone itself is considered a ‘special need.’ Struggling to meet their daily needs, they are unlikely to call their MLAs. And service workers are, for the most part, funded by government, and many feel too vulnerable to speak out. Though many have. Our analysis is an outcry. How many more do we need?
When it made changes in 2011, the government said the system needed improvement. Indisputably, they made a dysfunctional system even more dysfunctional and unfair. Previously, there was one part of the system that was geared to accommodating extenuating circumstances for people with chronic health conditions and disabilities. Now any accommodation is even more arbitrary.
Community-based service providers try to meet the needs of their clients despite the system. What they and recipients themselves say, though, are sometimes shocking. Imagine somebody who has severe mental illness and is recovering from cancer being told that she might have access to additional help if she were dying. But for now, she is out of luck.
It is heart-wrenching to hear about a woman whose been told her breast cancer is back and is spreading, but who has refused treatment because it was so awful to cope with chemo and radiation while living in poverty the first time, so that she cannot face going through it again. She recently had her special needs diet allowance cancelled.
However secure we might feel, we are all vulnerable. Note that many people report being one or two paycheques away from being unable to pay their bills. Personal debt loads are increasing. Nova Scotia continues to have Canada’s second-lowest average incomes; with incomes stagnating over the past two decades, Nova Scotians are struggling to keep up with rising housing costs, let alone energy and food costs. Many Nova Scotians face high unemployment rates in their communities and, when out-of-work, are struggling to navigate an increasingly inaccessible Employment Insurance system.
Think: what if you developed a chronic illness and could not work, lost your job or your business, did not qualify for EI, or were downsized and ran out of EI before finding paid work? Where could you turn? The system of last resort, the punitive income-assistance system, provides support that is well below any measure of poverty or low-income. That means it fails to provide enough money to meet basic needs, let alone any other needs essential to maintaining health or dignity. Researchers at Mount St. Vincent University have reported annually since 2003 that those on income assistance cannot afford to eat a minimally nutritious diet.
What are we to make of a system in which physicians are frustrated by their inability to help patients get what they have diagnosed as essential for health? They see firsthand how poverty is a disease, and our income- assistance system is part of the problem.
This specific policy highlights not just a problematic income-assistance system and the absence of an adequate social safety net. It also reveals gaps in other programs and services, especially in our “universal health-care system,” as well as in a public-education system that falls short in addressing the needs of our youngest and most vulnerable community members.
(Should we really expect a parent to continue the work of a trained speech language pathologist over the summer months? For children with severe language deficiencies this is an unacceptable oversight and will undoubtedly result in loss of progress and possible long-term damage.)
This research highlights what we need in order to help those who face multiple barriers to even consider gainful employment, but who deserve to live without pain and suffering, in dignity, and with some quality-of-life. It is unacceptable to compare this group of people to anybody else in our society.
It is unacceptable to suggest that abuse of the system required the changes that were made.(Nevermind, that the minister equated those wanting medical marijuana with setting up grow-ops! listen here) The system is all about exclusion, making sure that those in need get access to minimal amounts of assistance after they have submitted mounds of evidence. Nobody aims to grow up to ‘live on the system.’ Nobody in the system wants to be there, in a place with very few options for healthy living, a place with little privacy, but with ample struggle for adequate food and shelter. Special needs allowances are, moreover, available to anybody demonstrating a need and not just for those on income assistance.
At the least, we need to remove barriers to special-needs allowances, as outlined in our report. Those changes can be made and will make a difference. The original cases that the government cited as reason for the changes only cost $40,000 over 10 years! The exclusions are not only harmful but cost inefficient; they will undoubtedly cost more in public health-care costs.
Furthermore, there is an urgent need to transform the way we support all of those living in poverty. We must mend, not expand the gaping holes in our social safety net. It is the right thing to do for people falling through them on hard times and for our society as a whole.
Christine Saulnier is the Director of CCPA-Nova Scotia. This blog post was written based on a report co-authored with Sara Wuite and Stella Lord. A version of this blog was published as an op-ed in the Chronicle Herald.