CASE UPDATE - ANNUAL REPORT 2010-2011

BETWEEN A ROCK AND A HARD PLACE – CHILDREN WITH SPECIAL NEEDS


In his 2005 report, Between a Rock and a Hard Place, the Ombudsman found that as many as 150 families had been forced to surrender their parental rights to children’s aid societies (CASs) in order to get residential care for their severely disabled children. He found that the Ministry of Children and Youth Services had failed these families in a manner that was “unjust, oppressive and wrong” and recommended the Ministry immediately restore custody rights and ensure funding was provided for residential placements outside of the child welfare system. 

In response to the Ombudsman’s recommendations, the Ministry provided additional funding for the care of children with severe needs and returned 65 children to their parents’ custody. It did not agree, however, to remove its moratorium on special-needs agreements. Instead, it committed to better co-ordinating special-needs services for families in need. 
Despite this, complaints to the Ombudsman about services and treatment for children with severe special needs have continued to increase over the past few years. In 2010-2011, there were 44 such complaints – up from 39 in 2009-2010 and 24 the previous year. Although not all of these cases involved parents who had reached the point of turning their children over to CAS care, most raised real concerns about the availability of services for these children. 
Some examples:
•    The mother of a 15-year old girl with developmental disabilities, mental health and gender identity issues, contacted the Ombudsman after she had signed a temporary care agreement with the CAS that placed her daughter in a group home. She feared she would have to give up custody of her daughter to the CAS so it would continue to fund the group home placement. She had been told by her community’s service co-ordination agency that her daughter did not meet the criteria for complex special needs funding. After Ombudsman staff asked the Ministry to review the case, the funding for the girl’s placement was taken over by the local service co-ordination agency.
•    A family who adopted a 13-year-old boy with special needs complained to the Ombudsman that they felt pressured to enter into a temporary care agreement with their local CAS when the special-needs agreement set up to fund the boy’s residential placement had expired. In response to the inquiries of Ombudsman staff, the CAS extended the special-needs agreement and the Ministry confirmed it would fund the placement in the event that the CAS did not renew the agreement. 
•    The mother of a 15-year-old boy with special needs complained to the Ombudsman that her local child welfare agency told her repeatedly that she would have to give up custody in order to keep him in a necessary residential placement. She had originally placed him in care voluntarily through a temporary care agreement on the understanding this would allow her to remain his legal guardian. She was later told this arrangement could only last a year, after which she would have to give up custody of the boy to continue his placement. After Ombudsman staff spoke to the Ministry, it confirmed that the boy qualified for group home placement and he was moved into another home a few days before the temporary agreement expired.
•    A retired grandmother who was the guardian of her 12-year-old grandson with special needs contacted the Ombudsman after the Ministry told her there were no available daytime treatment placements in the community.  She had been given guardianship after her daughter had passed away, leaving her grandson in CAS care. The boy’s psychiatrist also believed the case was urgent. In response to Ombudsman staff inquiries, the local service co-ordination agency found a suitable day program for the boy and provided in-home services and respite support for the grandmother. 
•    The father of a 17-year-old boy whose residential placement had been funded by a child welfare agency for 12 years contacted the Ombudsman when the agency decided the boy could be reintegrated into the community. The father said the boy had become extremely angry and withdrawn because the promised supports were not in place when returned to the family. Ombudsman staff worked with the Ministry and the local service co-ordination agency to assist the family with funding and a special support worker. 

One of the initiatives launched by the Ministry in 2009 was the implementation of an “early alert” system to identify families in crisis who may require supports such as a residential placement for a child with special needs. This was established to ensure parents would not have to relinquish custody in order to obtain residential services. However, we continue to hear from families who are in crisis and are already involved with CASs, even though there are no protection concerns, in order to get the financial and other support required for their child. The Ministry was unaware of the families’ situations in several of these cases. The Ombudsman has directed his staff to keep a close eye on these cases, particularly where the early alert system failed.
 
“Families go to their government for help and they’re told there’s no money – but they discover there could be help available if they turn their child over to the state. That is bureaucratic dysfunction at its worst.”
– Ombudsman André Marin, as quoted in the Ottawa Citizen, June 16, 2010

There has also been an emerging trend in cases involving the provision of special-needs services for children reaching age 18. The Ombudsman received 12 complaints from families who had funding for their child’s services slashed or cut off abruptly at age 18. These families fell through the cracks between the Ministry of Children and Youth Services and the Ministry of Community and Social Services, which handles adult developmental services. They were told that funding in the adult services sector was “discretionary” and there was no provincial mandate to care for the special needs of adults. Funding was also limited by the March 2009 freeze on the Ministry of Community and Social Services’ discretionary Special Services at Home program.

Although the Ministry of Community and Social Services has recently implemented a new standardized assessment tool for adult special needs cases, the complaints received by the Ombudsman indicate gaps in the availability of services for adults with special needs.
In one case, the single mother of an 18-year-old man contacted the Ombudsman after six months of trying to transition her son to adult services. Her funding had been cut by $15,000 a year. She and her son’s psychiatrist had told the Ministry of Community and Social Services the situation was urgent but were advised there was no money available because all of the Ministry’s resources had been allocated to the community and there was no provision for direct funding arrangements. The Ministry told Ombudsman staff that the man would have to go on a waiting list. The situation became serious when the mother became unwell and was concerned about her ability to continue to care for her son at home. As a result of Ombudsman staff inquiries with the Ministry and the Local Health Integration Network (LHIN), emergency funding was provided, plus increased funding for in-home care and personal support for the mother.

In another case, the Ministry terminated funding for respite services for the mother of a 20-year-old developmentally and physically disabled man when he turned 18. She was told her son would be placed on the adult services waiting list along with 124 others. The mother contacted the Ombudsman for help and her doctor later advised that she was unable to continue caring for her son. Ombudsman staff asked the Ministry to review the family’s needs and within days, it found a placement for the son in a local adult residential facility.

The Ombudsman continues to monitor this emerging and disturbing trend 
in complaints.