Introduction
March of Dimes Canada is pleased to present its Pre-Budget Submission to the Government of Nova Scotia for fiscal year 2024-25. As a charitable service provider and key stakeholder in delivering an array of services for people with disabilities and their families, caregivers and friends, March of Dimes Canada welcomes the opportunity to deliver insights into how we can build a more equitable and inclusive province. In developing this submission, March of Dimes Canada has listened to the priorities communicated to us by our community of service users and stakeholders.
About March of Dimes Canada
Founded over 70 years ago, March of Dimes Canada is a national charity committed to championing equity, empowering ability, and creating real change that will help people living with disabilities across the country unlock the richness of their lives. As a leading service provider, resource, and advocate, we are paving the way for people living with disabilities to experience full and meaningful lives in an inclusive world.
March of Dimes Canada delivers services under three core program areas:
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Community Support Services delivers services to people with disabilities which enable them to live in their community and remain in their own homes, including attendant care services, supportive housing and other supports, including brain injury services and our best-in-class After Stroke program. Our services are designed to ensure service users feel empowered, healthy, and equipped, through tackling daily living, social, institutional, and navigational barriers.
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Skills Development and Employment Services provides comprehensive support through a range of services to assist people with disabilities achieve their employment goals and employers achieve their workforce needs. This includes SkillingUp, our free digital skills training program, which gives people with disabilities the skills and self-confidence to be successful in careers that require digital skills, and community programs designed to unlock the potential of children, youth, and adults with disabilities by empowering them to learn, grow, and achieve in an inclusive Canada.
Summary of Recommendations
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Recommendation 1: Support for People with Disabilities including Brain Injury
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Recommendation 2: Support for Stroke Survivors and their Families
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Recommendation 3: Work Towards an Effective Canada Disability Benefit
Recommendation 1: Support for People with a Disability
We ask that the government of Nova Scotia prioritize care at home and in the community to enable Nova Scotians with disabilities including brain injury to have independence, dignity, and choice, by adopting a home-first approach, addressing the health human resources crisis, and investing in supportive housing programs.
Both traumatic and non-traumatic brain injury is a prevalent issue in Nova Scotia. There are approximately 17,000 brain injuries that occur each year.
With these high rates of brain injury combined with an aging population who are at increased risk of falls and complicated medical statuses, the risk of Nova Scotians suffering a brain injury and requiring some degree of supportive housing option will only increase. If supportive housing options are not provided, current homeless rates will rise and pressures on existing homeless support systems will be overburdened. Supportive housing involves cooperation between low-income housing providers and service providers such as March of Dimes Canada to provide staffing solutions to provide individualized supports to clients. These services are scaled to individual need and can include medication administration, self-care/hygiene support, and support with accessing community services (including recreation and employment).
It has been identified that approximately 50% of people who experience homelessness have some form of brain injury. Homelessness is a serious and complex issue. People who experience homelessness are more likely to experience food insecurity, addiction, limited access to housing, discrimination, and various forms interpersonal and intimate partner violence.
With this high rate of brain injury among homeless populations, there is a critical need to provide and strengthen specialized services and support to individuals living with brain injury transitioning from the health and shelter systems to permanent housing to ensure long-term success.
As a community support organization, March of Dimes Canada provides brain injury services across the country, providing supportive housing, case management, day programs and outreach services to individuals living with the effects of a brain injury.
We ask that the relevant departments work together to determine the appropriate increase to supportive housing and services in the province and implement that increase.
Recommendation 2: Support for Stroke Survivors and their Families
We ask that the government of Nova Scotia support stroke survivors by complementing and deepening community support services with investment in After Stroke programs that are personalized to meet the needs of stroke survivors and their families.
More than 1,700 Nova Scotians experience stroke each year and many thousands live with the effects of stroke in our province. With advancements in medical care, the survival rate for stroke has increased dramatically, and more people are surviving stroke than ever before. However, as more people survive a stroke, stroke has become one of the leading causes of adult disability in Canada. Today, more than 878,000 Canadians live with the wide-ranging, disabling effects of stroke. Two-thirds of stroke survivors leave hospital with a disability, such as aphasia and communication challenges or debilitating fatigue. Stroke impacts people of every age and every aspect of their life, from physical health to mental health, family life, financial, and social and community participation.
March of Dimes Canada’s After Stroke program was created in collaboration with stroke experts and people with living experience of stroke to directly fill the gap. Guided by living experience and evidence-based design, the After Stroke program provides world-class stroke support and is based on Stroke Best Practice Recommendations.
Our After Stroke Coordinators fill the gap by giving stroke survivors and their families a seamless transition from hospital to home and community. After Stroke puts stroke survivors and their families at the centre of care, helping them meet their personal recovery goals and connecting them to community supports through in-hospital support, coordination and community navigation, personalized planning and goal setting, emotional support, stroke-focused education and training, and peer support.
We recommend that the province consider partnering with March of Dimes Canada to deliver and strengthen these much-needed services to stroke survivors and their families.
Recommendation 3: Working Towards an Effective Canada Disability Benefit
As a service provider, March of Dimes Canada plays a key role in supporting people with disabilities in accessing the full scope of financial security benefits available to them, such as the Disability Support Program, the Disability Tax Credit (DTC), the Registered Disability Savings Plan (RDSP) and the Seniors Home Safety Tax Credit, as well as employment services and supports for employers to hire people with disabilities. We are committed to focusing on financial security and will continue working with our service users, their families, and caregivers, and with community stakeholders to build this foundation of dignity and independence for all people with disabilities in Nova Scotia.
People with disabilities in Canada are three times as likely to live in poverty than those without.1 Current Disability Support program rates do not enable recipients to move beyond deep poverty – especially as the affordability crisis persists.
To ensure Nova Scotians with disabilities can thrive rather than simply surviving, the federal government’s incoming Canada Disability Benefit (CDB) must supplement existing Nova Scotia benefits, bringing Disability Support Program recipients’ income above the poverty line. While March of Dimes Canada is advocating federally that the CDB must be designed as non-taxable income, it is essential that all provinces and territories work to proactively identify and mitigate any impacts on existing benefits and programs.
To that end, we are proposing that the Honourable Minister Johns and Honourable Minister Boudreau place the CDB in Nova Scotia’s policy directive on exempt income sources related to eligibility for disability income support. In addition to preserving Disability Support Program eligibility, there must be no claw backs to other benefits such as dental or prescription drug coverage, housing and transportation supports, and other funded benefits, programs, and services once the CDB is implemented.
With regards to private disability insurance coverage, we are asking the federal government to enter a Memorandum of Understanding (MoU) with the Canadian Life & Health Insurance Association (CLHIA) which ensures all private insurance providers in Canada categorize the CDB as a supplemental benefit with no impact on the insurance providers' determination of the eligible applicant's private insurance income benefits. We ask that the Honourable MacMaster work with the federal government and private insurance regulators to ensure that any required legislative, regulatory or policy amendments are completed to enshrine the requirements in the MoU in law.
