Human Resources Committee on April 18th, 2013

[Elisse Zack]

We've been talking for a long time about the development of a framework for a national episodic disabilities strategy for Canada. This tends to be one of the ways, like the mental health strategy or other similar kinds of strategies, that can start to outline a framework for how these kinds of communications might be able to work. We've got an outline of the type of framework and how the communication lines might work to begin to solve the communications issue. You're absolutely right about the number of jurisdictions. We would be very interested in working with the federal government to actually begin to build what a national episodic disabilities strategy in Canada would be.

[The Chair, Conservative, Ed Komarnicki]

Thank you very much for that.

We'll move to Madame Boutin-Sweet.

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

Thank you, Mr. Chair.

Thank you, ladies and gentlemen, for being here today.

Everyone knows there is a clear link between mental health and homelessness. That is obvious. The HPS, or the Homelessness Partnering Strategy, is the federal program aimed at combatting homelessness. In its last budget, the federal government made an excellent decision and renewed the program, but it adopted a new approach, known as Housing First. There is no doubt as to the importance of housing for those who are homeless.

What worries me a bit, however, is the fact that nowhere does the budget indicate whether the funding will be strictly limited to housing projects. There is no indication whether currently funded projects that are tied to housing but to other areas as well, such as mental health, will continue to receive support. I would like you to speak to the importance of continued HPS funding for projects that address housing and homelessness in addition to helping those who suffer from mental illnesses.

[The Chair, Conservative, Ed Komarnicki]

I might interject here that, really, it's not for you to anticipate what government may do. It's clearly hypothetical, whether you want to venture into that or not. But, generally, if you want to comment in those areas, I think it may be appropriate.

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

I would like to know what level of importance those kinds of projects are given when it comes to HPS funding.

[The Chair, Conservative, Ed Komarnicki]

I think it's fair to make comment about how it might be important with respect to the issue we're studying, but in terms of what the government might do, I don't think it's necessary for you to speculate on that.

Go ahead.

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

That's not my question.

[The Chair, Conservative, Ed Komarnicki]

Who wants to answer?

Go ahead, Mr. Levo.

[Aaron Levo]

I might begin by saying that certainly the Mental Health Commission of Canada, through our contributions to this particular issue, through the At Home/Chez Soi research project, was delighted to see the capitalization on the evidence that's been produced on housing first and this realignment through the HPS program.

To the chairman's point, we can't necessarily speculate on what would happen moving forward, but we have proactively offered our help and support through the networks we've created through that project, and certainly our own capacity to help and contribute in this area moving forward.

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

Forgive me for interrupting. My question was not about what you thought the government would do. I asked about the level of importance that should be given to projects that are not strictly housing-oriented, meaning they also involve a mental health component, for example.

[Aaron Levo]

Yes, it's a very important area, absolutely.

[Dr. Susan Eckerle Curwood]

From a research perspective, with regard to mental health housing, it's very important to speak not simply of housing, but of housing with supports. It's the combination of the right housing and the right supports for the person in the place and time where they're at with regard to their disability that makes it possible for the individual to succeed in housing. Housing is absolutely one of the most important social determinants of mental health. That it is there is absolutely integral to mental health recovery, but it has to be accompanied by proper mental health system supports.

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

Thank you. That was the point I wanted to have clarified.

I would now like to turn to the issue of wage subsidies, which can include both groups.

We have repeatedly heard from witnesses that employees with disabilities are highly productive, miss work less often and so on. So they offer employers significant advantages. Employers receive wage subsidies, but sometimes, they use those subsidies improperly. When the subsidy ends, so does the job.

You said that when a person with a disability finds a job, they lose certain benefits that their pay does not make up for. For that reason, I believe—and others have said the same—that the money should be given to the employees rather than to the employers, in an effort to offset what people with disabilities are losing in terms of program supports when they begin to earn wages. I'd like to hear your take on that.

[The Chair, Conservative, Ed Komarnicki]

We'll conclude with your responses to that.

Go ahead, Ms. Zack. I think you wanted to give a response.

[Elisse Zack]

It would be interesting to try some demonstration projects. Since it's such a complex issue, you asked how we find out what works. Rather than starting with big things, can we start with small demonstration projects that explore different ways of working? Definitely it's a disincentive for somebody with many health problems to return to work and potentially lose all the extended benefits if they go back to it, or go to a job that doesn't include any benefits at all.

Both for MP McColeman and for you, I think it's the same issue: How do we start looking at these issues in small, manageable ways? One way may be to take a couple of workplaces and try it out, try out a new model. I agree with having it perhaps shared or having people continue to receive their health benefits from some kind of third party during the period of time when they return to work, to see what happens and whether that actually increases the number of people who are returning to work?

[The Chair, Conservative, Ed Komarnicki]

Thank you, Ms. Zack.

I think we have a comment by Ms. Eckerle Curwood. Go ahead.

[Dr. Susan Eckerle Curwood]

I think it's really essential to look at what the wage subsidy is attached to. For instance, to go back to your interest in housing, we know that a best practice in mental health housing is to have the supports attached not to the housing unit but to the individual. So they are not a feature of the housing unit, but if the individual changes housing, they maintain their support. I think it would be very interesting to consider what would happen if the wage subsidy were handled in the same way, so that it was attached to the individual rather than to the job or the position.

[The Chair, Conservative, Ed Komarnicki]

Thank you for that intervention.

Go ahead, Ms. Leitch.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Thank you very much, everyone, for taking some time to present to our panel today.

I have two sets of questions.

First, you may or may not know that the Government of Canada has significantly invested in the opportunities fund for persons with disabilities. It's a substantive funding mechanism. It is a wage subsidy. It's attached to an individual—just so you're aware, Ms. Curwood. I would like to get your opinion on how that has worked in the past, what things we might do to improve it in order to improve the attachment to the workplace of individuals who have a disability—because obviously it's a program that has been announced and is funded. We want to make it as effective as possible.

There is that as well as the enabling accessibility fund. There was mention in the budget for both those programs. Funding was augmented, but we also want to enhance workplace attachment. What are your thoughts on the contributions and the direction of those two substantive programs that aid persons with disabilities? Where should they be focused? Or maybe you think they're doing a great job in some of the things they're doing. We'd like to know about that, too, so we don't change what we're doing well.

[Dr. Susan Eckerle Curwood]

I think one of the best things happening right now is that there is a focus on training and education with regard specifically to the mental health disability population. One of the things we have to consider is when that disability first manifests, when the first onset is. With certain mental illnesses, particularly with schizophrenia, a lot of times the first onset happens at that point of young adulthood, right around the ages of 18 to 24 when the usual life course trajectory is for a person to be engaging in those training opportunities that are going to prepare them for that very initial attachment to the workforce.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

That is exactly what the opportunities fund does. That's what it targets.

[Dr. Susan Eckerle Curwood]

Yes, and that's what I'm really saying is so important to our population. If we were to lose those people at that point, then we'd really lose, in some cases, a lifetime of vocational trajectory, of career building, etc. So for this particular population, that intervention in the training and providing that access is so critical.

[The Chair, Conservative, Ed Komarnicki]

Ms. Zack, do you have a brief comment?

[Elisse Zack]

Yes. I would like to commend the government on both those programs. They are excellent. The portion of the opportunities fund that we have used...we don't provide direct service, but we know they've worked very well in assisting people to get into the workforce and to help find jobs for those job development programs. Those are excellent. We have used a fair bit of the portion that is for training and education of employers because that is a critical gap right now, especially where episodic disabilities are involved.

The work we have done a lot of, and that we all need to be doing more of, is with the component of the opportunities fund that is about educating employers about the issues and specific needs of people with episodic illnesses. It's excellent to get people into the workforce, but when they have to go in and out, that's when some of those other programs have to kick in. From the education part of it, it's absolutely great, as well as for job accommodation and letting employers know about opportunities for how they can accommodate people with episodic disabilities without necessarily having a huge cost to their business or organization. It's about both those programs. At the same time, increasing awareness is a major problem right now. It's a major issue, specifically on episodic disabilities.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

The second question I have....

Do I have a little time?