The Effect of COVID-19 and People with Disabilities in Ontario and Alberta

This week in MHS 601 I paired up with Brogan Gordon from Alberta Canada to compare Ontario and Alberta's vulnerable population of those living with disabilities. The pandemic has been hard on everyone but those living with disabilities have had an especially hard time.

People living with disabilities in Canada and Ontario face discrimination and inequities in most parts of their life. Those living with a disabilities face unemployment or underemployment, high rates of poverty and barriers to accessing services (Public Service Affiliation of Canada 2020). Often someone with a disability is overlooked for primary care services because the focus of assessments is on their disability itself. This leads to higher rates of emergency room visits for unmet healthcare needs (Lofters et. al., 2016). The Ontario Disability Support Program 1997 provides those living with disabilities a program that:

1. Provides income and employment support to eligible persons with disabilities

2. Recognizes that government, communities, families, and individuals share responsibilities for providing such support

3. Effectively serves persons with disabilities who need assistance and,

4. Is accountable to taxpayers of Ontario 1997, c 25, Sched B, s. 1.

In Ontario, a person with a disability is described as:

1. A person has a sustained physical or mental impairment that is continuous or recurrent and is expected to last 1 year or more

2. The direct or cumulative effect of the impairment on the persons ability to attend to his or her personal care, function in the community, and function in the work place, results in the substantial restriction in one or more of these activities of daily living and,

3. The impairment and its likely duration and the restriction in the personal activities of daily living has been verified by a person with the prescribed qualification. 1997, c. 25, Sched. B, s. 4 (1)

Ontario has lots of support programs in place for people living with disabilities including:

1. Income support

2. Employment support and networks

3. Tax credits

4. Ontario disability benefits

With the current pandemic of COVID-19, our vulnerable populations such as people living with disabilities have faced many challenges. More that one third of people in Ontario living with disabilities have been faced with job loss both permanent and temporary (Public Service Affiliation of Canada 2020). With job loss comes loss of income, this has results in over half the participants of the study being left with not enough income to purchase the necessities of living or personal protective equipment. Ontario emergency response planning for the COVID-19 pandemic largely failed the vulnerable population for those with disabilities. It is reported that most people living with disabilities also suffer from mental health disabilities as well. Since most people in Ontario that are faced with a disability are receiving Ontario disability support program (ODSP) they did not qualify for the larger benefit those without disabilities qualified for. Those without disability, when faced with job loss were offered income support by the Canadian emergency response benefit. Ontarians with disabilities were offered a one-time payment of $600 but this was not enough to substitute their full income. During the pandemic, mental health issues have risen dramatically leaving an already vulnerable population in a more vulnerable state. The federal government passed an Accessible Canada Act in 2019 that aims to make federal services, regulated services, and workplaces accessible and inclusive (Public Service Affiliation of Canada 2020). With these changes there are big hopes that the gap in inequitable distribution of healthcare will lessen but the changes have yet to be seen.

Like Ontario, Alberta has a variety of supports for individuals with disabilities. Some of these supports (adapted from the Government of Alberta website) are listed below:

• Alberta Brain Injury Initiative (ABII) – helps adults with acquired brain injury to live, work and participate in their communities

• Community Access for People in Continuing Care (CAPCC) – helps adult Albertans in facility-based continuing care engage with their communities to reduce social and cultural isolation

• Family Support for Children with Disabilities (FSCD) – works with eligible families to provide support and services based on each child and family’s needs

• Persons with Developmental Disabilities (PDD) – helps adults with developmental disabilities get services to live as independently as possible in their community

• Assured Income for the Severely Handicapped (AISH) – provides financial and health benefits for eligible Albertans with a permanent medical condition that prevents them from earning a living

According to the Alberta Human Rights Commission (n. d.), a disability can be defined as either physical or mental. The following definitions are taken directly from the Alberta Human Rights Commission website.

Physical disability is defined in the Act as any degree of physical disability, infirmity, malformation or disfigurement that is caused by bodily injury, birth defect or illness. This includes, but is not limited to, epilepsy; paralysis; amputation; lack of physical coordination; visual, hearing and speech impediments; and physical reliance on a guide dog, service dog, or wheelchair or other remedial appliance or device.

Mental disability is defined in the Act as any mental disorder, developmental disorder or learning disorder, regardless of the cause or duration of the disorder.

Research shows that individuals with disabilities are a vulnerable group who experience discrimination and marginalization. They experience barriers in accessing and receiving high-quality healthcare and their health outcomes are often poorer than their neurotypical or able-bodied counterparts (World Health Organization & World Bank, 2011). Individuals with disabilities also experience other barriers which may directly or indirectly impact their health and wellness. For example, individuals with disabilities are more likely to make less money. According to Wall (2017), 23% of individuals in Canada with a disability were considered low income, compared with only 9% of people without a disability. Khuller and Chokshi (2018) state that low income contributes to poor health, which in turn makes it harder to work to earn more income. Thus, individuals with disabilities experience a variety of barriers to good health. In Alberta, since the start of the COVID-19 pandemic, some barriers have become quite clear.

For example, Albertans who receive AISH funding receive $1685 in monthly payments. They are allowed to work to supplement their income, provided they earn no more than $1072/month from other sources. If they earn more than $1072 from other sources, their AISH payments will be cut proportionally. At the start of the pandemic many individuals lost their jobs. However, recipients of AISH who lost their jobs were unable to apply for CERB to receive any additional income. Instead, they were only allowed their AISH payments ($1685) while other Albertans were eligible to receive $2000/month in CERB. Advocates and individuals with disabilities questioned why the government felt that $2000/month was the minimum income people needed to live, while paying individuals with disabilities who were unable to work significantly less both before and during the pandemic.

On a more positive note, the Government of Alberta adjusted other existing policies (such as FSCD and PDD policies) to ensure they were meeting the needs of Albertans with disabilities during the pandemic (Government of Alberta, 2021). One important example is allowing personal support workers to enter the homes of, and work closely with, individuals with disabilities. Requiring personal support workers to socially distance themselves from the families and individuals they support would have significantly limited their ability to provide needed care to individuals with disabilities. The Government of Alberta also created a reference guide on COVID-19 for people with disabilities which provides information on how to stay safe and limit the spread of the virus.

Nationally, the pandemic has been challenging for many individuals with disabilities.

Persons with disabilities face unique and heightened challenges and vulnerabilities in a time of pandemic, including equality of access to health care and supports, access to information and communications, mental health and social isolation and employment and income supports.

GOVERNMENT OF CANADA (2021)

Advocacy groups have urged both the national government and provincial governments to address the unique vulnerabilities that individuals with disabilities and their families experience (Inclusion Alberta, 2020). For example, healthcare systems should evaluate triage protocols to ensure that individuals with disabilities are not denied care (in cases where healthcare systems are overburdened) on the basis of their disability alone. In addition, governments should work to provide needed financial assistance to individuals with disabilities and their families. Both Alberta and Ontario already have supports and policies in place relating to individuals with disabilities. It is the responsibility of these provinces to continue to adapt these supports and policies to meet the changing needs of individuals with disabilities during the pandemic.

References:

Alberta Human Rights Commission. (n. d.). Mental or physical disabilities and discrimination. https://www.albertahumanrights.ab.ca/publications/bulletins_sheets_booklets/sheets/protected_grounds/Pages/mental_or_physical_disabilities.aspx

Government of Alberta. (2021). COVID-19 information for disability service providers. https://www.alberta.ca/covid-19-information-for-disability-service-providers.aspx

Government of Alberta. (2021). Supports for people with disabilities. https://www.alberta.ca/supports-for-people-with-disabilities.aspx

Government of Canada. (2021). COVID-19 and people with disabilities in Canada

Inclusion Alberta. (2020). COVID-19 Recommendations from Disability-Related Organizations in Canada. https://inclusionalberta.org/news/2020/03/25/news/covid-19-recommendations-from-disability-related-organizations-in-canada/

Khuller, D., & Chokshi, D. A. (2018, October 4). Health, Income, & Poverty: Where We Are & What Could Help. Health Affairs. https://www.healthaffairs.org/do/10.1377/hpb20180817.901935/full/

Lofters, A., Guilcher, S., Maulkhan, N., Milligan, J., & Lee, J. (2016). Patients living with disabilities: The need for high-quality primary care. Canadian family physician Medecin de famille canadien, 62(8), e457–e464.

Ontario (2020) Ontario Disability Support Program Act 1997, Retrieved from: https://www.ontario.ca/laws/statute/97o25b

Public Service Affiliation of Canada (2020) Pandemic is Increasing Inequities for People with Disabilities, Retrieved from: http://psacunion.ca/international-day-of-persons-with-disabilities

Wall, K. (2017). Low income among persons with a disability in Canada. Statistics Canada. https://www150.statcan.gc.ca/n1/pub/75-006-x/2017001/article/54854-eng.htm

World Health Organization & World Bank. (2011). World Report on Disability 2011. https://www.who.int/teams/noncommunicable-diseases/disability-and-rehabilitation/world-report-on-disability