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Follow-up Questions re: COVID-19 and Disability in Canada

After providing testimony on May 4th to HUMA, several follow-up questions were submitted by email from members of The Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities (HUMA).

Question: A recommendation from the Coalition Working Group is to protect the income of persons with disabilities. Many Canadians are facing a loss of income due to COVID-19. In your opinion, what challenges do persons with disabilities face in accessing emergency funding programs, such as the CERB?

From my perspective, there are two general types of challenges disabled Canadians face when accessing emergency programs like CERB. The first cluster consists of physical barriers that prevent application. Programs that rely upon paper application pose a litany of barriers for those with visual impairments and risk exposure in the process of mailing in documentation. At the same time, research indicates that the digital divide disproportionately hits the disabled population , for financial, technical, and cognitive limitations, meaning fully online systems will leave many unable to apply for help. This barrier is compounded by employment programs and libraries, often used for public Internet access, being closed by emergency orders.

This speaks to a broader access challenge that has been exacerbated by COVID-19 and I would strongly recommend that this and future governments take seriously the need to support Internet access for urban and rural disabled people.

While I have not personally heard of people struggling to accessing CERB using adaptive devices, like screen readers or voice-to-text software, web platforms are notoriously difficult to navigate for people with visual impairments as far too many web developers are under-educated or fully unaware of WCAG accessibility guidelines. It is critical that any application programs adhere to the highest level of web accessibility standard (WCAG 2.1 level AAA).

The second cluster of barriers are driven by policy schisms between the federal government, provincial governments and non-governmental organizations providing support for disabled people. In Ontario, there was early confusion about how CERB would function with the Ontario Disability Support Program (ODSP). The Ford government has since determined the CERB will be treated as income, meaning any money received through CERB will be deducted from monthly income supports provided by the province. Although not ideal, because of the additional paperwork of reporting income from one government body to another, this has provided access to those eligible with increased funds without risking medical, dental and vision benefits offered by ODSP. Each province is tackling this question differently, which has added another (potentially unnecessary) layer of “work” for constituency offices to untangle the bureaucracy and additional stress for those waiting to find out whether or not they are risking long term supports by taking the short term benefit.

A bigger challenge is posed for those unable to work and do not have the requisite earnings to qualify for CERB, leaving them to continue subsisting on below-LICO monthly income supports in an environment where food, housing and medical supply costs continue to creep higher while in-home care needs increase. This means that our most vulnerable disabled Canadians, those who are wholly dependent on the government to survive, are being left behind in the short term and could lead to reduced in-home sanitation and food quality. I would strongly encourage the federal government to consider disability support payments as “income” to qualify these individuals for CERB.

Question: Do you think persons with disabilities are more likely to face permanent job losses post-pandemic than the general population? Please explain.

Although not a perfect analogy, looking at the 2008 financial crisis, the working disabled population is likely to be disproportionately hit by the coming economic recession in both the short- and long-term . After the 2008 recession, disability employment rates lagged well behind their nondisabled peers. While research suggested this is driven by a variety of factors, but one anecdotal reason is that disabled people are often hired into front-line, secretarial/desk duties that were deemed non-mission critical during the crisis and, when rehiring these positions, were pushed out by nondisabled applications with more experience and/or education. Worse still, the disabled population bore the brunt of austerity measures following the crisis – something that could happen once again without careful planning.

Given the physical workplace impacts now and in the foreseeable future, it stands to reason that we will see a similar trend in the wake of this recession. Further, in my anecdotal experience, employers regularly look at me as an “expensive” employee who will require costly adaptive devices and renovations to physical spaces to be employed—this anxiety will surely be amplified, leaving disabled employees on the outside looking in, as profit margins shrink and businesses tighten belts over the next few years to weather consumer uncertainty.

While COVID-19 poses a horrifying bodily threat in the here and now, I am deeply concerned that the long-term economic costs for the disabled population could decimate recent employment gains brought on by provincial legislative changes (like the AODA or BC Accessibility Act) and increased access to post-secondary education.

Question: The federal government transfers monies to the provinces and territories through the Canada Health Transfer (CHT) and the Canada Social Transfer (CST). In British Columbia, the CHT and CST in 2020-2021 is projected to be around $7.6 billion. Recommendation 7 from the Coalition Working Group asks that transfers be earmarked for the healthcare needs of persons with disabilities. Do you think that some of these pre-existing funds should be earmarked for the care of persons with disabilities? Do you think that a new envelope of funding or a new transfer program should be established explicitly for the care of persons with disabilities?

I think this recommendation by the Coalition is an interesting policy solution to limit the rationing of health care supplies and services – if provinces are required to dedicate specific chunks of transfer funds to disabled people specifically it limits provincial governments from restricting medical access to disabled people in times of crisis, as the Ford government in Ontario contemplated in the early days of the pandemic.

At the same time, I am inherently nervous about us versus them paradigms that enforce a hard line between “disabled” and “nondisabled” in part because this division is extremely hard to demarcate. Where would this line be drawn? How do we determine a health care user who is “disabled” versus one that is not? If COVID-19 causes long-term impairments (such as reduced lung function) are not all patients proto-disabled people?

For this reason, I am more supportive of human rights-based directives that outlaws eugenic rationing of care and services along lines of impairment and prognosis. I also would strongly support the establishment of programs to explicitly support disabled people, not just in times of crisis but in perpetuity. Disability is fundamentally experienced differently from coast to coast to coast, in large part because of limited resources, and anything the federal government can do to reduce these impairment effects the better for our country’s oft afterthought citizens.

Question: The Coalition Working Group’s third recommendation concerns the provision of PPE in long-term care homes and the screening of support staff and caregivers. In your opinion, would the provincial and territorial governments be best placed to act on such a recommendation? What do you think the role of the federal government should be in this regard?

This is an important (and, admittedly, a bit unwieldy) question that has some quick fixes and some long-term systemic changes that can be brought to bear. Perhaps a naïve patriot, I believe that Canada works best when all levels of government are working together and leveraging their strengths to solve different parts of the problem. Long Term Care facilities are complex structures guided by reems of policy and funding structures that vary from province-to-province and, as such, on-the-ground solutions are likely best led by provincial and territorial governments as they are simply better informed and better connected to the grassroots deployments of services and support.

At the same time, I think the federal government has a role to play in this problem. To start, the federal government could support provinces in developing best practices on screening and sanitation as new research emerges. Further, the federal government should continue efforts to procure and distribute vital PPE supplies, especially from international vendors, so that provinces are not left negotiating deals in competition with each other. Going forward, the federal government could also play a role in facilitating inter-province supply redistribution as different provinces may need higher volumes of supplies at different times as hot spots pop up periodically. Finally, the federal government could offer increased financial support to Canadian businesses temporarily retooling to produce PPE and sanitizer supplies to reduce dependency on unpredictable international supplies.

Question: The Coalition Working Group recommends establishing a Citizen’s Task Force that includes persons with disabilities, their families and allied organizations to inform a future disability-inclusive emergency response plan. Which body do you think this task force should report to, and how should such a task force interface with the federal government’s COVID-19 Disability Advisory Group (CDAG)? In your opinion, how would a Citizen’s Task Force inform government planning around emergency situations? Please explain.

While I was not a part of the Coalition Working Group, I would argue the formation of the CDAG is a short-term response to this recommendation and is beginning to open channels of communication between the federal government and the disabled population and disability stakeholders.

Post-pandemic, I would strongly support the evolution of CDAG into just this sort of task force to solidify disability-inclusive emergency response plans. The work of this group most logically falls under the purview of the Accessible Canada Act, leaving them to report to the Minister of Employment, Workforce Development and Disability Inclusion. Having said that, something this important and with an urgent need for provincial and territorial coordination could be argued to fit better under the purview of the Minister of Intergovernmental Affairs.

Question: In your opinion, what needs of persons with disabilities are not currently being met by the federal government? Please explain.

I think throughout my opening remarks, question response and within this document I have hit on some of the main priorities that should guide future government intervention, namely:

  • Push forward legislation to outlaw eugenic-inspired medical care and supply rationing in Canada
  • Increased support in accessing PPE, both from an affordability and acquisition perspective
  • Increased support for provincial health care systems to train and hire more support staff to reduce burn out and cross-contamination caused by PSWs working in multiple facilities
  • Increase financial support to those dependent on financial support programs who now struggle with increased care and supply costs
  • Develop financial supports for employers converting workplaces to be accessible, both in terms of physical alteration/construction and the purchase of adaptive devices

References

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Richards, James, and Kate Sang. 2019. “The Intersection of Disability and In-Work Poverty in an Advanced Industrial Nation: The Lived Experience of Multiple Disadvantage in a Post-Financial Crisis UK.” Economic and Industrial Democracy 40 (3): 636–59. https://doi.org/10.1177/0143831X17750474.

Smythe, Susan. 2015. “Where Is Canada’s Digital Inclusion Strategy?” Policy Note. July 23, 2015. https://www.policynote.ca/where-is-canadas-digital-inclusion-strategy/.

Turcotte, Martin. 2014. “Persons with Disabilities and Employment.” Stats Canada. December 3, 2014. https://www150.statcan.gc.ca/n1/pub/75-006-x/2014001/article/14115-eng.htm.

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By Jeffrey Preston

Born with a rare neuromuscular myopathy, Jeff has spent his life dedicated to advocating for himself and others with disabilities. With a PhD in Media Studies from Western University, Jeff's research focuses on the representation of disability in popular and digital culture. Jeff is currently an Assistant Professor of Disability Studies at King's University College @ Western University in London, ON.