Introduction
March of Dimes Canada is pleased to present its Pre-Budget Submission to the Government of Alberta 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 Alberta. 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’re 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 two core program areas:
-
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.
-
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.
In Alberta, March of Dimes Canada currently provides supportive housing services in the Edmonton area and maintains over 200 employees. There are also virtual service programs available to Albertans, including our Tech4good and HiTech programs (in partnership with Telus), which support people with disabilities with skill development for learning technology.
Summary of Recommendations
-
Recommendation 1: Increase access to supportive living options for Albertans with Brain Injury.
-
Recommendation 2: Support stroke survivors by complementing and deepening brain injury community support services with investment in the After Stroke program.
-
Recommendation 3: Work towards an effective Canada Disability Benefit
Recommendation 1: Increase access to supportive living options for Albertans with Brain Injury
Both traumatic and non-traumatic brain injury is a prevalent issue in Alberta. Approximately 5000 people every year in Alberta, according to Government of Alberta reporting, suffer some sort of head injury1. Examples of non-traumatic brain injuries can include aneurisms, brain tumours, cerebral edemas, encephalitis, stroke and many others. Traumatic brain injuries include falls, motor vehicle injuries, sport injuries, and intimate partner violence. With these high rates of brain injury combined with an ageing population who are at increased risk of falls and complicated medical statuses, the risk of Albertans 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 by individual need, and can include (but are not limited to) medication administration, self-care/hygiene support, and support with accessing community services (including recreation and employment.
The rise in homelessness rates in Alberta has a direct link to brain injury rates. Collecting and identifying accurate statistics around the actual impact of homelessness is difficult to identify due to under-reporting people who are homeless often don’t go to a doctor, have experienced mistrust within the medical system and are sometimes unable to secure medical identification. This can result in over-hospitalization of people experiencing homelessness due to climatic conditions, psychological strain, and exposure to communicable disease that create and lead to a range of chronic and acute health problems, including injury from cold, tuberculosis, skin diseases, cardio-respiratory disease, nutritional deficiencies, sleep deprivation, musculoskeletal pain, and dental trouble2. Proving supportive housing options for individuals who are homeless creates consistent access to medical treatment, drug rehabilitation, and food security.
It has been identified that approximately 50% of people who experience homelessness have some form of brain injury. These brain injuries be caused by any number of incidents, including (but not limited to) an increased risk of falling, overdose, or violence. 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 o provide and strengthen specialized services and support to individuals living with brain injury transitioning from the health and shelter systems to permanent housing in order to ensure long-term success and decrease risk to emergency shelter employees, emergency responders, and physical property. By supporting a transition to a permanent housing solution out of hospitals and shelters, we can decrease the likelihood of individuals returning to the health or shelters system and becoming unhoused again.
We ask that the Honourable Nate Horner, Honourable Adriana LeGrange and Honourable Minister Jason Nixon work together to determine the appropriate increase to supportive housing and supportive housing services in the province and implement that increase.
Recommendation 2: Support stroke survivors by complementing and deepening brain injury community support services with investment in the After Stroke program.
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. Increasingly, we are seeing that a growing population amongst brain injury survivors are those impacted by stroke.
More than 9,000 people in Alberta experience a stroke each year. 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. Nearly 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.
Recognizing this increased need, we applaud the Ministry of Health for working to Improve choice for Albertans in healthcare, and fostering an environment that welcomes innovation and incentivizes the best patient care.
Tailor-made for stroke survivors’ needs
As a response to the increasing needs of stroke survivors after their hospital and rehab stays, 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. This support centres on March of Dimes Canada’s After Stroke Coordinators, who serve and support stroke survivors in person as system navigators at a time when the health and rehabilitation systems are new and overwhelming to survivors and their families and caregivers. 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.
With the goal of closing gaps for stroke survivors – particularly those living in rural/remote communities – across the province, March of Dimes Canada is seeking new funding to complement and deepen our currently funded brain injury community support services with the After Stroke program, which is tailor-made for the needs of stroke survivors.
An essential community program for stroke survivors and their families and caregivers, the After Stroke program can, with public funding, be a sustainable and long-term support for the growing population of stroke survivors in Alberta, reducing the burden on existing funded brain injury services by providing support laser-focused on this specific population.
March of Dimes Canada can provide a connection to personalized support, education and participation opportunities, and access to other March of Dimes Canada services, as Albertans transition from hospital to their communities and/or age in place living with stroke.
We recommend that the province consider partnering with March of Dimes Canada to deliver and strengthen these much-needed services, or issue a RFP for service providers (to which March of Dimes Canada would be very pleased to respond).
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 Assured Income for the Severely Handicapped (AISH), 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 Alberta.
People with disabilities in Canada are three times as likely to live in poverty than those without3. Current AISH rates do not enable recipients to move beyond deep poverty, especially as the affordability crisis persists, even with Alberta’s leading disability income support rates.
To ensure Albertans with disabilities can thrive rather than simply surviving, the federal government’s incoming Canada Disability Benefit (CDB) must supplement existing Alberta benefits, bringing AISH 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 Jason Nixon and the Honorable Nate Horner place the CDB in Alberta’s policy directive on exempt income sources related to eligibility for disability income support. In addition to preserving AISH 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 Nate Horner 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.
