Paradoxes in Paradise: Neoliberalism in Alberta's Developmental Disability Field

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2016 Paradoxes in Paradise: Neoliberalism in Alberta's Developmental Disability Field

Sonpal-Valias, Nilima

Sonpal-Valias, N. (2016). Paradoxes in Paradise: Neoliberalism in Alberta's Developmental Disability Field (Unpublished doctoral thesis). University of Calgary, Calgary, AB. doi:10.11575/PRISM/27252 http://hdl.handle.net/11023/3046 doctoral thesis

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Paradoxes in Paradise:

Neoliberalism in Alberta’s Developmental Disability Field

Nilima Sonpal-Valias

A THESIS

SUBMITTED TO THE FACULTY OF GRADUATE STUDIES

IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE

DEGREE OF DOCTOR OF PHILOSOPHY

GRADUATE PROGRAM IN SOCIOLOGY

CALGARY, ALBERTA

JUNE, 2016

This research examines the manifestation of neoliberal reforms and their institutionalising processes and effects in the field of services for adults with developmental disabilities in Alberta. The goal is to contribute to emerging understandings of how neoliberalism shapes the environmental context and characteristics of nonprofit human service organizations. A longitudinal embedded single-case study design and historical research approach are used. The study is grounded in a social constructivist perspective, guided by a theoretical framework integrating organizational and historical institutionalism with resource dependence theory. To understand the origins of the institutional arrangements existing at the start of the reforms, the evolution of the field is traced from 1905 to the 1990s. Four critical junctures are identified during this period, associated with: the eugenics movement; the deinstitutionalization and normalization movements; the social model of disability; and the onset of neoliberalism. The thesis identifies the broader socio-cultural, economic and political contexts in which the developments occurred. Neoliberal reforms, which intensified when the Klein government came into power in 1992, manifested in Alberta’s developmental disability field in four main ways: program cutbacks and limitations; a new structure for program delivery; increased family and individual responsibility; and managerial techniques for scrutiny and accountability. The thesis reveals poignant differences in the unfolding of the reforms, the identity and role of central actors, the levels and forms of acceptance, resistance, and entrepreneurship exhibited by various actors to shape institutional changes, and the nature and extent of change achieved. Organizations demonstrated isomorphic properties and tendencies expected in a highly institutionalised context, but their responses were diverse, structured by their histories, cultures and sense of self-identity, professional biases, and perceptions of dependencies. Even in a province much touted for neoliberalism, the reforms did not roll out coherently, and only partially achieved the benchmark principles of neoliberal government. Neoliberalism’s inherent paradoxes, a multiplex institutional context, and the creative agencies of strategic actors are implicated in the contradictory and experimental nature of the outcomes.

ii Acknowledgements

An endeavour such as this is rarely accomplished without significant funding, supervisory, professional, and family support. Funding toward this research was generously provided by Social Sciences and Humanities Research Council of Canada Doctoral Fellowship (2012-14), Izaak Walton Killam Memorial Scholarships (2013-14), University of Calgary Queen Elizabeth II Doctoral Scholarships (2010-12), and the Department of Sociology’s Graduate Research Scholarship (2015). I thank Dr. Tom Langford for introducing me to the neoliberalism literature and for just the right amount of supervision throughout this journey. Thank you for being there when I needed you, and for trusting me to muddle along in my own way the rest of the time. Thank you also to supervisory committee members, Dr. Keith Seel and Dr. Christopher Smith, for your constructive criticisms to earlier drafts, and to examiners, Dr. Trevor Harrison and Dr. David Este, for your insightful questions at the thesis defence. This project would have been impossible without the research participants. Thank you for sharing with me your perspectives and for allowing me to publicly identify you. To Elaine Yost of Options Rehabilitations Inc., Ryan Geake of Calgary SCOPE Society, and Joan Lee of Vecova Centre for Disability Services and Research, thank you for giving me access to your organizations, and for your unswerving leadership in the field. I thank my brother Nikhil Sonpal for planting the idea to leave my well-paying and fulfilling executive position to return to graduate school, and I thank my sweet and loving mother Bhanumati Sonpal for being the wonderful person she is. To my husband and best friend Wlad Franco-Valias, I cannot thank you enough for unconditionally supporting me in all my crazy goals. You are my strength and I am your biggest fan. Finally, to my father Kirtikumar Sonpal, my grandmother Savitagauri Sonpal, and my grandfather Manilal Sonpal: I could not have done what I did, or been who I am, without your blessings. Your love is felt every day.

iii Table of Contents Abstract ...... ii Acknowledgements ...... iii Table of Contents ...... iv List of Tables ...... viii List of Boxes and Figures ...... ix List of Abbreviations ...... x

CHAPTER ONE: INTRODUCTION ...... 1 1.1 Context and Motivation for the Study ...... 1 1.1.1 Defining nonprofit organizations, the sector, and human services ...... 5 1.2 Research Goal, Questions, and Approach ...... 6 1.3 Overview of Chapters ...... 10

CHAPTER TWO: CANADA’S NONPROFIT SECTOR, NEOLIBERALISM AND THEORETICAL FRAMEWORK ...... 14 2.1 Part One: The Canadian Nonprofit Sector and Neoliberalism ...... 16 2.1.1 Scope and significance of the sector ...... 16 2.1.2 Historical evolution ...... 17 2.1.3 Neoliberalism in the Canadian nonprofit sector ...... 20 2.1.4 Neoliberalism’s heterogeneity and contextual-specificity ...... 29 2.1.5 Conclusion ...... 34 2.2 Part Two: Understanding Nonprofit Human Service Organizations ...... 35 2.2.1 Distinguishing attributes of human service organizations ...... 36 2.2.2 A selected review of theoretical approaches ...... 39 2.2.3 Resource dependence theory ...... 42 2.2.4 Organizational institutionalism ...... 45 2.2.5 Historical institutionalism ...... 50 2.2.6 Conclusion ...... 54 2.3 Part Three: Research Questions and Theoretical Framework ...... 54 2.3.1 Comparing resource dependence and institutional perspectives ...... 56 2.3.2 Theoretical framework ...... 59 2.3.3 Analytic activities ...... 65 2.4 Concluding Remarks ...... 66

CHAPTER THREE: RESEARCH APPROACH AND METHODS ...... 68 3.1 Epistemological Orientation and Researcher Role ...... 69 3.2 Rationale for Case Study Approach ...... 71 3.3 Rationale for Selecting Alberta’s Developmental disability field ...... 73 3.4 Summary of Research Design and Logic ...... 75 3.5 Phase One: Historical Research ...... 77 3.5.1 Key informant interviews ...... 78 3.5.2 Document reviews ...... 82 3.5.3 Quantitative trends ...... 85

iv 3.6 Phase Two: Organizational Responses ...... 85 3.6.1 Organization selection strategy ...... 85 3.6.2 Data collection and management protocol ...... 88 3.6.3 Document reviews ...... 89 3.6.4 Interviews ...... 90 3.6.5 Quantitative trends ...... 91 3.7 Ethical and Political Considerations ...... 91 3.7.1 Voluntary and informed consent ...... 92 3.7.2 Protection of privacy and confidentiality ...... 93 3.7.3 Corporate sponsorship ...... 97 3.8 Researcher Position ...... 98 3.8.1 Prior views on neoliberalism ...... 99 3.8.2 Relationship with interview participants ...... 99 3.8.3 Employment history at Vecova ...... 101 3.9 Steps to Maximize Research Quality ...... 102 3.9.1 Trustworthiness and authenticity (validity) ...... 103 3.9.2 Dependability (reliability) ...... 105 3.9.3 Generalizability ...... 106 3.10 Scope and Limits ...... 106 3.11 Concluding Remarks ...... 108

CHAPTER FOUR: HISTORICAL EVOLUTION OF DEVELOPMENTAL DISABILITY SERVICES IN ALBERTA: 1905 TO 1992 ...... 110 4.1 Historical Review ...... 111 4.1.1 1905 to 1940s: Asylums and sterilization for the feeble-minded ...... 111 4.1.2 1950s to 1960s: Deinstitutionalization and the birth of community agencies ...... 120 4.1.3 The 1970s: Prosperity and progressive views of disability ...... 129 4.1.4 1980s to 1992: A bust for the economy and the onset of neoliberalism ...... 136 4.1.5 Summary ...... 146 4.2 Analytic Synthesis ...... 147 4.3 Concluding Remarks ...... 150

CHAPTER FIVE: KLEIN REFORMS, REINFORCEMENT AND ENTRENCHMENT ...... 151 5.1 1993 to 1996: Cutbacks and the Beginning of Reforms ...... 151 5.2 1997 to 2006: Reinvestment and the Reinforcement of Reforms ...... 155 5.3 Contextual and Institutional Forces Behind the Reforms ...... 159 5.3.1 The role of ideas ...... 160 5.4 Post-Klein: Entrenchment of Neoliberalism and Signs of a Shift ...... 165 5.4.1 Stelmach 2007 to 2011: Search for efficiencies and a plan to end homelessness ...... 165 5.4.2 Redford 2011 to 2014: Results-based budgeting and a Social Policy Framework ...... 166 5.4.3 Recent developments: History in the making ...... 168 5.5 Concluding Remarks ...... 170

v CHAPTER SIX: PROGRAM CUTBACKS AND NEOLIBERALISM’S PENETRATING REACH ...... 172 6.1 Introduction ...... 172 6.1.1 Description of organizations ...... 174 6.2 1992: The Institutional Legacy ...... 178 6.3 Cutbacks and Constant Constraints: The Paradox of Scarcity Amidst Plenty ...... 182 6.4 Neoliberalism’s Penetrating Reach ...... 187 6.4.1 Workforce 2010: A partnership where some were more equal than others ..187 6.4.2 Vecova’s transformation from a research institute to a service provider ...... 192 6.4.3 Defining developmental disability ...... 197 6.5 Concluding Remarks ...... 202

CHAPTER SEVEN: COMMUNITY GOVERNANCE ON GOVERNMENT’S TERMS ...... 204 7.1 Birth of a Program with Great Potential ...... 205 7.2 Paradoxes, Inherent Tensions, and Misalignments ...... 210 7.2.1 The paradox of governance without authority ...... 211 7.2.2 Inherent tensions in structural configuration ...... 213 7.2.3 Conflicting normative orientations ...... 216 7.2.4 Reigning in a system perceived to be out of control ...... 219 7.2.5 From community governance to community engagement ...... 224 7.3 The Loss of Legitimacy ...... 225 7.4 Organizational Responses: The Role of Organizational Culture and Identity ...... 227 7.5 Concluding Remarks ...... 235

CHAPTER EIGHT: INCREASING CITIZEN RESPONSIBILITY ...... 238 8.1 From Paternalism to Partnership...... 240 8.1.1 Changes in formal statements ...... 240 8.1.2 Capacity-building initiatives and mechanisms for involvement ...... 246 8.2 Responsible Families: Individualised Funding and Family Managed Supports ....247 8.3 Responsible Individuals: Employment First Strategy ...... 254 8.4 Concluding Remarks ...... 260

CHAPTER NINE: TECHNOMANAGERIALISM AND SCRUTINY ...... 261 9.1 The Rise of Technomanagerialism ...... 262 9.1.1 Accountability tools and processes as rational myths ...... 264 9.1.2 Ceremonial conformity and decoupling ...... 270 9.1.3 Shifts in loci and circuits of power ...... 272 9.2 Does For-Profit vs. Nonprofit Status Make a Difference? ...... 276 9.3 Concluding Remarks ...... 279

CHAPTER TEN: CONCLUSION ...... 280 10.1 Summary ...... 281 10.2 To What Extent Has Alberta’s Developmental Disability Field Been “Neoliberalized”? ...... 283 10.2.1 Catalytic government ...... 287 10.2.2 Community-owned government ...... 288

vi 10.2.3 Decentralized government ...... 289 10.2.4 Competitive and customer-driven government ...... 290 10.2.5 Mission-driven and results-oriented government ...... 291 10.2.6 Anticipatory government ...... 292 10.2.7 Enterprising and market-oriented government ...... 292 10.2.8 Conclusion ...... 294 10.3 How Have Neoliberalism’s Manifestations Shaped Organizations? ...... 296 10.4 Implications for Nonprofit Sector Policy and Practice ...... 297 10.5 Summary of the Dissertation’s Main Contributions ...... 299 10.5.1 Empirical contributions ...... 299 10.5.2 Theoretical, analytical and methodological contributions ...... 300 10.6 Final Words ...... 301

BIBLIOGRAPHY ...... 303

APPENDIX A: RECRUITMENT INVITATIONS AND ANNOUNCEMENTS ...... 344 A.1. Phase One Invitation to Participate ...... 344 A.2. Phase Two Invitation to Participate ...... 345 A.3. Phase Two Participation Announcement ...... 346

APPENDIX B: INTERVIEW GUIDES ...... 347 B.1. Phase One Interview guide for government representatives ...... 347 B.2. Phase One Interview guide for nonprofit and disability sector leaders ...... 348 B.3. Phase Two Interview guide for case study participants ...... 349

APPENDIX C: PARTICIPANT INFORMATION ...... 350 C.1. Phase One Participants ...... 350 C.2. Phase Two Organizational Sites ...... 354

APPENDIX D: CONSENT FORMS ...... 357 D.1. Phase One Consent Form (extract) ...... 357 D.2. Phase Two Organizational Participation Consent Form (extract) ...... 358 D.3. Phase Two Individual Consent Form (extract) ...... 360

APPENDIX E: CHRONOLOGY OF KEY DEVELOPMENTS ...... 361

APPENDIX F: ALBERTA PREMIERS AND MINISTERS FOR DEVELOPMENTAL DISABILITY SERVICES ...... 371

vii List of Tables

Table 2.1 Comparison of Organizational Institutionalism, Historical Institutionalism and Resource Dependence Theory ...... 57 Table 3.1 Research Logic ...... 76 Table 3.2 Summary of Data Collection Activities, Sources and Timeframe ...... 77 Table 4.1 Environmental and Institutional Contexts of the Evolution of Services to Albertans with Developmental Disabilities ...... 148 Table 5.1 Types of Ideas and their Effects on Policy Making ...... 161 Table 7.1 Organizational Response Strategies to Institutional Pressures ...... 228 Table 8.1 Formal Statements of Ministries or Programs Responsible for Services for Adults with Developmental Disabilities 1993/94 to 2015/16 ...... 245 Table 10.1 Reforms in the Developmental Disability Field Assessed Against Neoliberalism’s Governance Principles ...... 284

viii List of Boxes and Figures

Box 5.1 Principles of an Entrepreneurial Government ...... 153 Box 6.1 Workforce 2010: Vision, Goal and Objectives ...... 188 Box 7.1 PDD Community Governance Act - Preamble ...... 207 Box 8.1 Services for the Handicapped Program: Goals, Principles and Objectives 1972/73 to 1977/78 ...... 241 Box 8.2 Social Services Program Review 1983/84: Goal and Assessment Criteria ... 242 Box 8.3 Family and Social Services: Statement of Mandate, Mission and Basic Principles 1988/89 to 1992/93 ...... 243

Figure 2.1 Location of Research in Literature ...... 14 Figure 2.2 Theoretical Framework ...... 60 Figure 4.1 Annual Expenditures for Institutional and Community-Based Services for Albertans with Developmental Disabilities 1970/71 to 1992/93 ...... 140 Figure 4.2 Caseload Distribution in Institutions vs. Community-based Services for Adults with Developmental Disabilities in Alberta ...... 141 Figure 4.3 Institutional Shifts in Services for Adults with Developmental Disabilities in Alberta 1905 to 1992...... 149 Figure 5.1 Annual Expenditures in Health, Education and Social Services in Alberta from 1992/93 to 2012/13 ...... 157 Figure 6.1 Annual Expenditures in SPD/PDD Program Compared to Rest of the Programs in Social Services 1992/93 to 2013/14 ...... 182 Figure 6.2 Annual Expenditures in SPD/PDD Program and Average Cost Per Client 1992/93 to 2013/14 ...... 184 Figure 7.1 PDD Program Structure 1998-2006 and 2006-2014 ...... 214

ix List of Abbreviations AACL Alberta Association for Community Living (renamed Inclusion Alberta in 2015) AARC Alberta Association of Rehabilitation Centres (renamed ACDS in 2006) ACDS Alberta Council of Disability Services (previously AARC) AISH Assured Income for the Severely Handicapped, program AUPE Alberta Union of Provincial Employees CACL Canadian Association for Community Living (previously CARC and CAMR) CAMR Canadian Association for the Mentally Retarded (renamed CACL in 1985) CARC Canadian Association for Retarded Children (renamed CAMR in 1969) CCD Council of Canadians with Disabilities (previously Coalition of Provincial Organizations of the Handicapped) CET Creating Excellence Together Standards CMHA Canadian Mental Health Association (previously CNCMH) CNCMH Canadian National Committee for Mental Hygiene (renamed CMHA) FCSS Alberta Family and Community Social Services, ministry FMS Family Managed Supports FSS Alberta Family and Social Services, ministry HCS Alberta Handicapped Children’s Services, program HSD Alberta Health and Social Development, ministry IF Individualized Funding, funding option PC Progressive Conservative Party of Alberta PCSPD Premier’s Council on the Status of Persons with Disabilities PDD Alberta Persons with Developmental Disabilities Board, program PSS Alberta Preventive Social Services, program PTS Provincial Training School SC Social Credit League of Alberta (renamed Alberta Social Credit Party) SCS Alberta Seniors and Community Supports, ministry SFH Alberta Services for the Handicapped, program SPD Alberta Services for Persons with Disabilities, program SS Alberta Social Services, ministry SSCH Alberta Social Services and Community Health, ministry UFA United Farmers of Alberta VRDP Vocational Rehabilitation for Disabled Persons, federal program VRRI The Vocational and Rehabilitation Research Institute (renamed Vecova Centre for Disability Services and Research in 2011)

CHAPTER ONE: INTRODUCTION

Governments are defeated, prevailing ideologies change, and any number of exogenous events can affect government fiscal balances. Institutions, however, are long enduring. Even though the reforms were precipitated by the perception of a fiscal crisis, we have little doubt that the changes introduced by the Klein government have indelibly changed the institutional landscape in Alberta for some time to come. (Bruce, Kneebone, and McKenzie 1997:12)

1.1 Context and Motivation for the Study In December 1992, Ralph Phillip Klein won the leadership of the Progressive Conservative (PC) Party of Alberta and became the province’s 12th premier. His leadership win and the subsequent re-election of the PC Party in June 1993 set the stage for a dramatic shift in Alberta’s fiscal and social policy, and in the structure and role of its public sector. The Klein Revolution, as the media dubbed it (Lisac 1995), consisted of severely cutting spending to balance the budget and eliminate the provincial debt while encouraging corporate investment by creating a competitive tax regime, and promoting privatization and liberalisation. The breadth, depth and speed of the Klein reforms made Alberta the “poster child” of how to remake government upon neoliberal principles and practices (Harrison and Laxer 1995; Finkel 2006:293). It was during the midst of these changes, in 1997, that I began working as a junior researcher at The Vocational and Rehabilitation Research Institute (VRRI, renamed Vecova Centre for Disability Services and Research in 2011), one of the oldest and largest community-based charitable organizations funded by the provincial government to serve adults with developmental disabilities in Calgary.1 Over the next few years, as I took on roles of greater responsibility,2 I saw the government relying increasingly on the private (primarily nonprofit but also for-profit) sector for service delivery to adults with

1 There is an ongoing debate in the literature whether people-first (people with disabilities) or adjective-first (disabled people) language should be used; I have chosen to use the former since it is how self-advocates with developmental disabilities in Alberta currently refer to themselves. In the historical review of services in Chapter Four, I adopt terms that were in usage during the time under discussion. 2 I held the position of Director of Research from 2003 to 2010. The methodological implications of my privileged position as an “insider” to the field of research are discussed in Chapter Three.

1 developmental disabilities while at the same time decreasing the support provided to the organizations to do so and increasing scrutiny over their practices. Like my peers, I was struck by these changes which, from our vantage point, seemed to be guided primarily by an agenda to cut costs and increase financial accountability, with little apparent concern for their impact on the people who depended on government supports, the organizations who provided the services, or the potential long-term social costs of these seemingly short-sighted measures. We witnessed the developmental disability field and its community-based organizations being shaped in what we felt were profound ways by this increasingly close yet seemingly tenuous relationship with government and by the changing expectations of our service recipients, volunteers, private donors, and the public at large. We engaged with our peers within and outside the organization to make sense of our increasingly confusing and incessantly evolving landscape, both for ourselves and for the people who looked to us for direction and leadership. In many instances, we joined other service providers and advocacy groups to attempt to influence the changes in our environment by participating in various consultation mechanisms or through political activism, while others watched from the sidelines. As a sociologist situated in and deeply passionate about the nonprofit sector, my observations during the Klein era and its aftermath made me highly curious about the many ways in which the reforms were changing the environment in which we operated and what implications they might have for the characteristics and activities of developmental disability service organizations and nonprofit human services in general. I also wondered why different organizations seemed to be responding to these changes in different ways even though we were all in the same policy environment. In 2010, I left VRRI to pursue doctoral studies to grapple with these broad questions in a more balanced and scholarly manner. While the intensity of the Klein revolution might have made Alberta’s experience notably acute, the province was not alone in experiencing neoliberalism’s effects. Neoliberal ideas—characterized by a pro-market ideology, policies to reduce social spending and privatize state-owned services, and a governance mode focused on administrative efficiency and accountability (Steger and Roy 2010:11)—began sweeping

2 across western economies in the 1980s (Harvey 2005:3). By the end of the 1990s, they were part of the ethos of most of Canada’s major political parties (Finkel 2006:285).3 Neoliberalism’s expressions, however, are neither monolithic nor homogeneous. As Chapter Two will show, they come in “different hues and multiple variations” (Steger and Roy 2010:xi), are historically contextual, socio-politically shaped (Pierson 1996), and reflect local strengths and structural differences (Jenson and Phillips 2000). They also seem to unfold through experimental and reflexive learning, rather than in planned and coherent ways (Clarke 2004, 2010; Brodie 2010). Canadian accounts of neoliberalism’s effects on the nonprofit sector are still emerging. The dominant evidenced-based view from the nascent Canadian literature is that neoliberalism’s manifestations have significantly altered the political economy of the sector (Evans and Shields 1998:2), reshaped the focus, autonomy and creativity of organizations and their workers (Rekart 1993; Jenson and Phillips 2000; Baines 2004a, Baines 2004b), and changed how work is resourced, organized and accounted for (Dart and Zimmerman 2000; Brown and Trout 2003; Phillips and Levasseur 2004; Evans, Richmond, and Shields 2005; Gibson, O’Donnell, and Rideout 2007). The collective result of these shifts is evident in the large proportions of organizations, especially smaller agencies, that report severe challenges in fulfilling their mandates and objectives (Statistics Canada 2005:48; Lasby and Barr 2014:4). In contrast to the dominant view, there is a “more aspirational than evidentiary” (Phillips 2016:3) view which originates in the broader literature and which sees in neoliberal regimes a historic opportunity for the sector to forge a fresh relationship with the state (Pal 1997), generate social capital and solidarity (Putnam 1993, 2000), empower citizens (Korten 1990:120-128; Fisher 1993; Howell and Pearce 2001:33-36), and exhibit creative potential (Bode 2006:354-356). To better understand this complex and evolving landscape, a number of valuable studies have been undertaken since the 2000s (e.g., Banting 2000; Brock and Banting

3 Alberta’s Progressive Conservative party swung sharply to the right under Ralph Klein in 1993. The federal Liberals had their proponent in Paul Martin Jr. (finance minister 1993-2002). Ontario’s Progressive Conservative government elected in 1995 under Mike Harris followed suit, as did British Columbia’s Liberal Party led by Gordon Campbell in 2001. Some provincial New Democratic regimes and Quebec’s Parti Québécois are considered partial exceptions to this trend (Finkel 2006:285).

2001, 2003; Brock 2003).4 In addition, federal initiatives have sought to document the sector’s scope and economic dimensions.5 As well, there is a concentrated body of literature on intersectoral (nonprofit/government) relationships which is focused on charities regulations or federal-level forums or mechanisms (e.g., Laforest and Orsini 2005; Elson 2007, 2011a; Phillips 2010; Laforest 2011), or macro-level analyses of shifts in specific domains such as family policy (e.g., Brodie 2010). Notwithstanding these useful and growing contributions, extant knowledge of Canadian nonprofit organizations is largely descriptive, focused on practical concerns, and atheoretical (McKechnie, Newton and Hall 2000; Brock 2003:1; Seel 2006:48). Even though neoliberal restructuring has been occurring in the Canadian nonprofit sector for three decades, we have highly fragmented pictures of both the sector and of specific manifestations of neoliberalism within the particularities of the Canadian socio-political landscape. Furthermore, we have a theoretically underdeveloped understanding of the processes by which neoliberal reforms unfold in specific policy domains or sites, the role of organizational and individual actors in the process, and the consequences of the reform process for the organizations, their institutional contexts, and the citizens they serve. In the Canadian developmental disability policy arena, the literature is important, but small. Most of it is focused at the federal level and on disability policy generally (e.g., Dunn 2003; Enns and Neufeldt 2003; Neufeldt 2003; McColl and Jongbloed 2006) rather than developmental disability policy specifically. Most Canadian works are conducted by or for government departments and are of a practical, administrative or descriptive nature. Scholarly investigations in Alberta’s developmental disability policy domain have been highly specific (e.g., Malacrida [2006, 2015] on life at Michener Centre; and Grekul [2002, 2004, 2011] on the history of the eugenics program), or have focused on identifying issues of importance (e.g., Brad [2005] in education, and Clark, Seel, and Clark [2009] in transition from youth to adult services) rather than extending theoretical understandings. Very little has been written from a historical perspective, and other than

4 Funded by a multi-year national grants program from the Kahanoff Foundation (Banting 2000:ix). 5 For example, through the National Survey of Nonprofit and Voluntary Organizations (Statistics Canada 2005), the Satellite Account of Nonprofit Institutions and Volunteering (Statistics Canada 2009), and the multi-national Johns Hopkins Comparative Nonprofit Sector Project (Hall et al. 2005).

4 the exceptions noted above, much of it originates from or is about specific organizations (e.g., Sanders and Piotto [1997] on the Developmental Disabilities Resource Centre, or Alberta SSCH [1985b] on Michener Centre); “only in very rare circumstances is there an examination in any depth of cumulative developments” (Neufeldt and Enns 2003:19). Thus, this research seeks to fill the theoretical and empirical gaps in the Canadian literatures on neoliberal reforms and the nonprofit sector, and on the developmental disability field. I provide some basic definitions related to the nonprofit sector next, and then state this research’s goals and primary questions.

1.1.1 Defining nonprofit organizations, the sector, and human services In Canada, the nonprofit and voluntary sector consists of entities that meet all of the following criteria: institutionalized to some extent (formally incorporated and registered, or existing informally); not-for-profit and non-profit distributing (not existing primarily to generate profit and not returning any profit to owners or directors); non- governmental; self-governing (having control over organizational activities); and voluntary (membership and contribution of time and money are not required by law or as a condition of citizenship; and at least some roles within the organization are performed by individuals without pay). The definition includes hospitals, universities and colleges but not entities considered to be public sector agencies such as public schools and school boards (Statistics Canada 2009:43). There are over 161,000 such organizations across the nation, employing over two million people and representing about 7% of the national gross domestic product (Statistics Canada 2005:8). The sector is variedly referred to as the nonprofit and voluntary sector, nonprofit sector, or the not-for-profit sector.6 For simplicity, I use the term nonprofit sector. This is because all nonprofit and voluntary organizations have a voluntary component to varying degrees, ranging from using volunteers only to serve on their board of directors to being operated entirely by volunteers. In contrast, the nonprofit characteristic is a constant: if it

6 Academics also use the terms third sector, independent sector, nonmarket institutions, and social economy, to refer to the broad (and vague) space of civil society, located between the formal arenas of the state and the market and the informal arena of families and households (Steinberg and Powell 2006:3-4).

5 exists, the entity is considered to belong to the nonprofit sector; if it does not, the entity is precluded from the sector regardless of its volunteerism component.7 Canadian nonprofits are defined under the Income Tax Act (RSC 1985, c 1 [5th Supp.]) as clubs, societies or associations “organized and operated exclusively for social welfare, civic improvement, pleasure, recreation or any other purpose except profit,” and are tax-exempt (Canada Customs and Revenue Agency 2001:2). Most nonprofits are governed at the provincial level, under legislations such as Alberta’s Societies Act (RSA 2000, c S-14). Nonprofits engaged exclusively in charitable purposes may apply for registered charity status to Canada Revenue Agency (CRA) which governs all registered charities in Canada and allows them to issue donors with receipts to claim tax credits. Charitable purposes are determined by case law, and generally include relief of poverty, advancement of education or religion, or other activities deemed by the courts to provide public benefit (CRA 2009). About 56% of nonprofits in Canada are registered charities (Statistics Canada 2005:15). Nonprofit human service organizations are nonprofits that provide direct social services (such as income, material, emotional, psychological or personal development supports) to people. Many nonprofit human services are registered charities. Organizations providing services to people with developmental disabilities are an example of human service organizations. They are the focus of this research.

1.2 Research Goal, Questions, and Approach The goal of this research is to contribute to our emerging understanding of the ways in which neoliberal regimes shape the institutional contexts and characteristics of Canada’s nonprofit human service organizations. The aim is to address the scholarly lacunae in knowledge of Canada’s nonprofit sector in contemporary contexts, and as importantly, to generate insight to aid policy makers, public administrators and sector leaders maximize the vibrant potential and role of the sector in the nation’s social fabric.

7 With the increasing convergence and blurring of the boundaries between market and civil society—as nonprofits establish for-profit subsidiaries (social enterprises) and for-profits are created with the goal to distribute all after-tax profit to charity (e.g., the company Newman’s Own)—the sector is more accurately an artificial construct rather than a well-defined empirical reality (Kramer 2000:3-6).

The research is situated in the field of services for adults with developmental disabilities in Alberta, which provides a well-defined and institutionally-rich locus for analysing the manifestation of neoliberal reforms and their institutionalising processes and effects in a specific policy domain.8 Based on the literature and guided by a theoretical framework integrating insights from resource dependence theory, organizational institutionalism and historical institutionalism, the broad goal of the research was translated into the following specific questions:  What are the historical socio-political, economic and cultural origins of the institutional elements and arrangements that were present in the field of services for adults with developmental disabilities in Alberta at the start of the Klein reforms in the 1990s? 9 (Chapter Four)  What were the main general elements of the Klein reforms? Why were the reforms a critical juncture in the province’s institutional landscape and what made the transformation possible? (Chapter Five)  What were the key manifestations of the neoliberal reforms in Alberta’s developmental disability field? What salient contextual forces and actors shaped institutional developments and how did they do so? (Chapters Six through Nine)  How did publicly-funded developmental disability service organizations respond to the neoliberal reforms, and with what consequences? How can differences in organizational responses be explained? (Chapters Six through Nine)

The research was grounded in a constructivist epistemology.10 A longitudinal embedded single-case design (Yin 2009:50) was used to investigate changes over time in the field of services for adults with developmental disabilities in Alberta (the main case or unit of interest), and to explore differences within the field across three community- based service organizations (subunits) in perceptions of and responses to selected

8 The rationale for selecting the developmental disability field is provided in Chapter Three. 9 By institutional elements and arrangements, I mean the generally accepted beliefs, norms and customary practices, and their associated structures of informal rules, policies, regulations and laws that guide or sanction activities in a particular area. A more formal and precise definition is provide in Chapter Three. 10 The research’s epistemological stance and its implications for the research process and findings are discussed in Chapter Three.

7 developments.11 Methodologically, the developmental disability field was both an intrinsically valuable case (of interest in its own right) and an instrumental case (of interest in its potential to generate insights into neoliberal reforms and nonprofit human service organizations elsewhere) (Stake 2000:437). The field’s diversity of organizations made possible an exploratory analysis of differences in organizational responses within the same institutional environment. Resource dependence theory, organizational institutionalism and historical institutionalism provided the core concepts and insights for the research’s theoretical framework. Resource dependence theory suggests that organizational responses are shaped by an organization’s perceived dependencies on its external environment for political and economic resources, and the perceived uncertainty resulting from these power differentials. Organizations will attempt to manage these pressures through autonomy enhancing strategies, which, in turn, will influence their practices and characteristics. To understand the motivations for and constraints to an organization’s ability to enact strategic responses, it is important to examine its perceptions of its interdependencies in the external environment (Pfeffer and Salancik 1978). Organizational and historical institutionalism are part of the “neo-institutional” approach, but have different disciplinary origins, foci, and views of institutions. Both rest on the belief that individual (and, by extension, organizational) preferences and social outcomes are shaped by institutional arrangements which embody and transmit widely shared norms, values and beliefs (Greenwood, Oliver, Sahlin, and Suddaby 2008:4-5). Organizational institutionalism posits that organizational survival and success depend on the ability to demonstrate legitimacy, which is done by conforming to expectations emanating from the institutional context, even if such conformity is purely symbolic (Meyer and Rowan [1977] 1991). Relationships between institutional forces and organizations are best studied at the organizational field level (Scott 2008:181), which encompasses all “those organizations that, in the aggregate, constitute a recognized area of institutional life: key suppliers, resource and product consumers, regulatory

11 Although these organizations are, strictly speaking, subunits, I refer to them at various places in this document as “case study sites” since this is a more commonly encountered and understood term.

8 agencies, and other organizations that produce similar services or products” (DiMaggio and Powell [1983] 1991:64-65). Although institutional effects can structure organizations in an entire field to varying degrees through isomorphic processes (DiMaggio and Powell [1983] 1991), institutional contexts are complex. They contain multiple logics and conflicting forces which provide spaces where an organization can, individually or collectively, redefine or (co-)construct the institutional forces and logics in its field (Zucker 1988; Greenwood et al. 2008:14-17; Kraatz and Block 2008; Scott 2008:175- 177). The response enacted will depend at least in part on the organization’s identity, history, sense-making processes, capacity for strategic agency, and room for alternative formulations (Oliver 1991; Greenwood et al. 2008:16-18; Scott 2008:153-175). Unlike organizational institutionalists’ focus on organizations and their institutional environments, historical institutionalists study structures and relations of the state, and state policies (Hall and Taylor 1996:937). They view institutions as inherently historical, emerging from and sustained by broad socio-political contexts. Earlier choices are seen to constrain future ones through positive feedback and path dependent processes (Thelen 1999:387-396; Pierson 2000). While the earlier literature emphasised punctuated (exogenous shock) models of change, emerging research has focused on demonstrating transformative yet incremental change processes (Streek and Thelen 2005:3). Together, the three perspectives offer complementary tools and conceptual lenses to investigate the processes through which institutional changes emerge, reveal the institutional forces and power structures in which nonprofit human service organizations in neoliberal regimes are embedded, and examine the relationships between these organizations and their institutional environments. Using a longitudinal embedded case study design and a theoretical framework that integrates these three perspectives, this research was able to identify the confluence of contextual forces (critical junctures) in the history of the field of services to developmental disabilities in Alberta, reveal the processes through which neoliberal reforms unfolded in the field, analyse the role of critical actors in shaping these processes, and generate some preliminary insights to explain organizational differences in responses. The research’s contributions to the scholarly literature are summarised in the final chapter.

1.3 Overview of Chapters Chapter Two is a three-part chapter. Part One begins by identifying the location of the research in the literature. It then provides the reader with the context for understanding Canada’s nonprofit sector by describing the sector’s scope, significance and historical evolution, before discussing how neoliberal reforms have impacted the sector’s organizations and role in civil society. The broader neoliberalism literature is then accessed, highlighting the heterogeneous, contextual and often-times contradictory nature of neoliberal reforms. Theoretical conceptualizations of neoliberalism as an incomplete cultural and political formation, and historical institutionalism’s theory of gradual transformative change are identified as particularly useful for investigating how neoliberal reforms unfold. Part Two draws on the nonprofit sector and human service organizations literatures to present the distinguishing features of nonprofit human service organizations and to review the major theoretical perspectives relevant to the study of these organizations. From these, organizational institutionalism and resource dependence perspectives are identified as most suitable for the present research. Engagement with the literature in Parts One and Two results in the development of the primary research questions. In Part Three, the theoretical framework for addressing these questions is developed, integrating historical institutionalism, organizational institutionalism, and resource dependence theory. Main concepts are defined and analytic activities identified. Chapter Three describes the research approach, starting with my epistemological orientation and how I view my role as a researcher in this project. The rationale for a case study approach and for selecting the field of services to people with developmental disabilities in Alberta are presented, followed by the overall logic for the investigation. The chapter then summarizes the research methods and analysis techniques. Reasons for the methodological choices, limitations and implications, and ethical and political considerations are discussed, and the scope and limits of the project are clarified. Chapter Four draws on primary and secondary sources to construct an overview of the evolution of disability policies and services for adults with developmental disabilities in Alberta from the creation of the province in 1905 to the start of the Klein era in the early 1990s. The chapter identifies four critical junctures, each resulting in a

10 major transformation of the policy and service landscape. The junctures are associated with: (i) the eugenics movement (1920s); (ii) the deinstitutionalization and normalization movements (1950s and 1960s); (iii) the social and rights models of disability (1970s); and (iv) the onset of neoliberalism (1980s). The analysis identifies the contextual forces and institutional elements supporting each juncture. Chapter Five provides an overview of the general transformations that took place in the province’s public sector while Ralph Klein was premier of Alberta from 1993 to 2006, and a brief review of developments from 2007 to the historic downfall of the ruling Progressive Conservatives to the left-of-centre New Democrats in 2015. An institutionalist lens is applied to analyse the contextual factors that made the Klein reforms possible, and to explore the interplay of ideational forces that made the reforms widely acceptable to the populace. The review reveals an overarching trend towards the entrenchment of neoliberalism in the province’s institutional landscape, but also finds examples of developments that suggest the beginnings of a possible progressive shift in the province’s social policy arena. The chapter provides the necessary backdrop for understanding the political economic context in which neoliberal reforms unfolded in the field of services for adults with developmental disabilities. Chapters Six through Nine each discusses one of four empirically identified themes: (i) the imposition of program cutbacks and limitations; (ii) the creation of a regional community governance board structure for program delivery; (iii) the increasing of individual and family responsibility; and (iv) the implementation of technomanagerial tools and processes. The themes reflect a particular facet of the manifestation of neoliberal policy goals or governance prescriptions in the developmental disability field from the start of the Klein reforms in the 1990s to the time of the research in the early to mid-2010s. Each chapter unpacks how one specific facet unfolded, and analyses the role of salient actors and factors in shaping the institutional developments. Where appropriate, focused examples are used to provide deeper insight to the narrative and analysis, and similarities and differences in organizational responses and outcomes are analysed. Chapter Six begins with a brief overview of findings for Chapters Six to Nine and an introduction to the three case study organizations, before discussing the first of the

11 neoliberal reforms: the imposition of cutbacks and limitations on the scope of the program of supports for adults with developmental disabilities. The chapter shows the link between the program cuts and the province’s dire economic straits during the early years, but also reveals an ideological motive as funding constraints continued despite significant improvements in the economy. Three examples illustrate the pervasive and penetrating reach of neoliberalism’s institutionalising effects at the field level, organizational level, and individual level. The analysis demonstrates some of the many contradictions and paradoxes inherent in the neoliberal project. Chapter Seven describes and analyses the promising birth and the turbulent life of the Persons with Developmental Disabilities regional community boards structure implemented during the Klein reforms to provide the program of supports and services for adults with developmental disabilities. The analysis reveals how, even in the presence of overwhelming institutionalising currents, creative entrepreneurs can experiment with the building blocks strewn around in the policy landscape to generate innovative responses within neoliberalism’s complex contours. The chapter then analyses how misalignments in institutional elements and neoliberalism’s inherent fault-lines led to chronic tensions in the program. Organizational differences in responses to the tensions in the field are traced to unique organizational identities, cultures and professional logics. Chapter Eight provides two very different examples of initiatives to increase citizen responsibility. The first example begins by explaining how families’ desire to have access to more funding and greater control over its management led to a loophole being turned into the widely-accessed Individualised Funding (IF) option a few years before the Klein era. The story reveals that IF almost died during the 1990s before its resurrection in the mid-2000s as the Family Managed Supports (FMS) option when families framed it in ways that were attractive to neoliberal ideological aims to infuse market characteristics into human service arenas. The analysis shows how the existence of multiple logics due to the co-presence of old and new institutional elements created gaps where endogenous change could occur. It also shows how shared beliefs led to both parties, families and government, embracing FMS. The next example analyses the Employment First Strategy (EFS), a Redford initiative to increase workforce participation

12 by adults with developmental disabilities. Unlike the IF example, in which the experimentation by creative entrepreneurs resulted in a popular initiative, the experiment with EFS began with a bit of a misstep from the government, resulting in an outcry from families, self-advocates and service providers. The initiative needed corrective action before it became more palatable to the community. Together, the two examples reveal the variations in outcomes even within the same social policy domain as neoliberal reforms attempt to move control from the public to the private realm. They also support the arguments of those who view neoliberalism’s foray into social policy as an experimental and reflexive process requiring active and ongoing work. Chapter Nine focuses on the implementation of technomanagerial tools and processes characteristic of neoliberalism’s new public management mode of governance which serve to increase government’s scrutiny and control over service providers. The chapter describes the significant burdens and constraints that these approaches impose on service organizations, and exposes them as rationalised myths, achieving neither organizational efficiency nor improved program outcomes. The analysis shows the ceremonial conformity of organizations to these demands, reveals the multiple and paradoxical ways in which they rearranged the loci and circuits of power in the field, and illuminates how the approaches and tools themselves are conduits of systemic power. Chapter Ten presents a brief summary of the research, followed by a final analysis to conclude the extent to which Alberta’s developmental disability field has been “neoliberalized.” It then summarises how neoliberalism has shaped nonprofit human service organizations in the field, and identifies a number of implications for policy and practice for sector leaders that arise out of the empirical findings from this study. The dissertation’s main contributions are listed before some closing comments made.

CHAPTER TWO: CANADA’S NONPROFIT SECTOR, NEOLIBERALISM AND THEORETICAL FRAMEWORK

Abandon the urge to simplify everything, to look for formulas and easy answers, and begin to think multidimensionally, to glory in the mystery and paradoxes of life, not to be dismayed by the multitude of causes and consequences that are inherent in each experience—to appreciate the fact that life is complex. (Peck 1993:14)

This research is located at the intersection of five overlapping literatures: (i) neoliberalism; (ii) nonprofit sector (specifically, Canadian nonprofit sector); (iii) social policy (specifically, Canadian developmental disability policy); (iv) institutional change; and (v) sociology of organizations (specifically, human services) (see Figure 2.1).

Figure 2.1 Location of Research in Literature

Neoliberalism

Social Nonprofit Policy Sector

Institutional Organizations Change

The scholarship in each of these literatures is vast and diverse; however, it is also highly fragmented within two areas core to the present research, i.e., the literatures on Canadian nonprofit sector and Canadian developmental disability policy. In light of the vastness of any of the five literatures in which the present study can locate itself, and the relatively underdeveloped literature in two of the core areas, this three-part chapter takes a slightly different approach to a “traditional” literature review (Roberts 2010:85-87). Instead of aiming for a comprehensive synthesis and critique, the focus is on judiciously selecting and presenting the empirical and theoretical information that is most useful to understand the broad context of the research and its subsequent direction.

Part One begins by describing the scope, significance and historical evolution of Canada’s nonprofit sector. The intent is to generate an appreciation of the sector’s unique evolution, its strong and complex relationship with the state, and its deep embeddedness in the institutional context. The presentation serves to emphasise that the present research is focused on the Canadian experience, since much of what we know about the nonprofit sector and about neoliberalism arise out of a predominantly American or otherwise international literature, and this thesis aims to fill that gap. When the review reaches the period of welfare state restructuring, the focus narrows to synthesizing the emerging literature on how neoliberal reforms in Canada have impacted the sector.12 With the historical review completed, the broader neoliberalism literature is accessed. From this, the overwhelming observation that neoliberal manifestations unfold in heterogeneous, contextually-contingent, and often-times contradictory ways is highlighted. Theoretical conceptualizations of neoliberalism as an incomplete and ongoing cultural and political formation, and historical institutionalism’s theory of gradual transformative change are identified as useful perspectives for investigating how neoliberal reforms unfold. Part Two focuses on the nonprofit sector and human service organizations literatures. First, the distinguishing features of nonprofit and human service organizations are presented since these provide insights into the most salient aspects of their institutional relationships. Next, the major perspectives in each literature are discussed, and from this repertoire, organizational institutionalism and resource dependence perspectives are selected and added to historical institutionalism as the three most suitable theoretical approaches for the present research. Part Three presents the thesis’ specific research questions, which arise from my engagement with the literature. This is followed by the theoretical framework, which integrates resource dependence theory, historical institutionalism and organizational institutionalism. The rationale for creating an integrated theoretical framework is provided, and convergences and divergences of the three theoretical perspectives are

12 For the same reason that the empirical findings of the neoliberal reforms are woven into a historical review of the nonprofit sector rather than being discussed on their own (i.e., to facilitate a greater understanding of the context of the reforms), relevant contributions from the disability scholarship in the Canadian social policy literature are woven into the historical review of the developmental disability field presented in Chapter Four.

15 discussed to justify combining them in a single framework. Main concepts in the theoretical framework are defined and analytic activities are identified.

2.1 Part One: The Canadian Nonprofit Sector and Neoliberalism

2.1.1 Scope and significance of the sector Canada’s nonprofit sector is proportionally the second largest in the world (Hall et al. 2005:9).13 It consists of over 161,000 organizations employing over two million people,14 and ranges from small groups with annual revenues under $30,000 to large institutions such as hospitals and post-secondary institutions. In 2007, it represented 7% of the national gross domestic product (GDP), and in 2006 (the last year for which industry comparisons were reported for the sector), its GDP outpaced that of industries generally regarded as significant national contributors such as the mining, oil and gas extraction industry or the retail trade industry (Statistics Canada 2009:9-11).15 The sector’s dominant role is to deliver human services. In Canada, 74% of the sector’s workers (paid and volunteers) are engaged in service activities, 10% higher than the international average (Hall et al. 2005:11). They provide essential services and benefits in almost every aspect of life including religion, health, education and social services, arts and culture, politics, sports and recreation (Statistics Canada 2005:8-12). The sector is also a significant vehicle for advocacy, expressive, and associative functions, and is a vital site for citizen engagement. Virtually all organizations are governed by volunteer boards, and more than half run entirely on volunteer contributions. The sector benefits from over two billion hours of volunteer time, equivalent to more than one million fulltime jobs, and receives over $8 billion in individual gifts and

13 Measured by the size of its workforce (paid staff and volunteers) relative to the size of the country’s economically active population, compared to 36 countries included in the landmark Johns Hopkins Comparative Nonprofit Sector Project. 14 These are organizations that are non-governmental, non-profit distributing, self-governing, voluntary, and formally incorporated or registered. Grass-roots organizations or citizens’ groups not formally incorporated or registered, and registered charities such as school boards, public libraries and public schools, which are seen as public sector agencies, are not included in this count (Statistics Canada 2005:8). 15 The last nonprofit sector economic data released by Statistics Canada was in December 2010 for information from 2007 (Statistics Canada 2013). The Satellite Account of Non-profit Institutions and Volunteering was terminated in 2008 as part of the federal government’s plan to achieve budgetary savings targets (Statistics Canada 2012b).

16 donations (Statistics Canada 2005:10). Close to 85% of the population aged 15 and over donate money to the sector, and almost half volunteer their time (Hall et al. 2009:9-10). Of the total revenues reported by Canadian nonprofit organizations, 49% is from provincial (40%), federal (7%) or municipal (2%) governments, primarily as grants and contributions (31% of total revenues) (Statistics Canada 2005:23). Registered charities (56% of nonprofits) and social services (12% of nonprofits) rely heavily on state funding: 54% and 66% of their total revenues, respectively, are from government (pp. 27-28). The close relationship between Canada’s nonprofit sector, government and citizen support has been described as a unique amalgam between the welfare partnership model and the Anglo Saxon model of civil society development (Hall et al. 2005:20). The former—exhibited by welfare states such as Belgium, France and Germany—is characterized by a large nonprofit sector workforce, more paid staff than volunteers, a strong focus on the provision of social welfare services, and extensive state support. At the same time, Canada—like the United Kingdom, United States and Australia—exhibits a strong volunteer presence and private philanthropic support. This unique combination of features is attributed to the historical evolution of Canada’s nonprofit sector.

2.1.2 Historical evolution During pre-Confederation, structures and processes for charitable activities took shape based on the traditions, practices, attitudes and ideologies of the early European settlers (Hall et al. 2005:24; Elson 2007:36). Primarily, three colonially-rooted ideologies shaped Canada’s social services (Guest 1997:18-19): (i) liberalism, with its values of individualism and liberty, common among those drawn to frontier societies; (ii) toryism, with its collectivist sensibilities originating in the feudal heritage of the French, and its ideas of social hierarchy and privilege held by British Loyalists and migrants; and (iii) socialism, which combined tory collectivism with liberal egalitarianism to create the notion of equality of condition through collective action. In Lower Canada, reflecting French norms, charitable work was performed largely by the Catholic Church funded by private donations and state subsidies. Subsequent immigrant groups adopted this practice and established their own societies and foundations (Guest 1997:15). In Atlantic Canada, British and Loyalist migrants drew

17 on principles from the 1601 Elizabethan Poor Law to deal with poverty and related problems.16 Local parishes and municipalities, where these existed, provided care and relief to the poor and the destitute; elsewhere, families, community members, charities, or the provincial government administered poor-relief. Since local authorities often had little capacity due to sparse populations, services were typically contracted out to local charities rather than being delivered by the state (Guest 1997:13). In Upper Canada, the government rejected the Poor Law,17 and initially left poor-relief to individuals, families and private charities; as urbanization’s negative social outcomes increased, it was forced to fund charities (Guest 1997:14-15). The seeds of a mixed social economy, thus, were sown, and a public-private contract regime that was to become much more dominant in the post-welfare state a century later started to take shape (Valverde 1995). Following Confederation in 1867, the provinces became responsible for health, education and social welfare.18 Governments assumed direct responsibility for prisons, asylums and schools, and let religious institutions, charities and volunteers take care of the sick, elderly, disabled and poor. State oversight of and contributions to private charities were relatively minimal in those early days (Valverde 1995:40; Guest 1997:16). Charities typically exhibited moral approaches in their practices, providing greater formal support and sympathy to the “honest or deserving poor” (Finkel 2006:34). The 20th century brought rapid industrialization, the social gospel movement,19 and unemployment and social unrest from World War I, forcing the state to get more involved in providing social, education and health services (Finkel 2006:89-90). The approach to service delivery remained fragmented (Hall et al. 2005:24), but private and public welfare became more intertwined. Legislative developments created a permanent

16 The Act for the Relief of the Poor (commonly referred to as the “Elizabethan Poor Law”) and The Statute of Charitable Uses (“Statute of Elizabeth”), were enacted in England in 1601 by Elizabeth I in the wake of political and religious turmoil to relieve the Crown of its moral burden of care for the poor and the destitute, reinstate public confidence in charitable giving, and devolve these responsibilities to local authorities (Guest 1997:11; Seel 2006:5-6). 17 It has been speculated that this might have been in response to public opposition to greater taxation and as a gesture to allow local (rather than central) governments decide on local matters (Guest 1997:14). 18 Under the British North America Act (1867, 30-31 Vict., c.3 [UK]). 19 The movement arose from a sub-group of Protestant Christians who viewed state-supported social reform as a necessary step toward individual moral reform to combat poverty and ignorance (Finkel 2006:85).

18 tax-mediated relationship between the federal government and charitable organizations.20 Federal and provincial governments subsidized nonprofits to help administer public programs (Valverde 1995), and implemented regulatory mechanisms to increasingly control nonprofit sector activities (Elson 2007:36). The establishment of the welfare state in the aftermath of the Depression and World War II resulted in unprecedented growth in the sector (Elson 2007:47). The blueprint for social welfare expansion in Canada was the Marsh report, Canada’s answer to a series of reports by Beveridge in the United Kingdom which was instrumental in arguing for a national health service, family allowance and unemployment insurance in that country (Guest 1997:109). Although Beveridge also proposed that individual voluntary action and voluntary organizations should be adequately supported to round off a welfare society, this recommendation was largely ignored by Marsh who assumed that social services in the Canadian welfare state would be delivered by the government (Elson 2011c:170). However, given Canada’s mixed welfare economy and federal and provincial government reluctance to invest any more than necessary in public social services, the Canadian governmental response was to supplement and fund services already provided by nonprofits rather than to duplicate or nationalise them (p.171). From the 1960s to 1980s, thus, state funding to nonprofit agencies rose rapidly (Hall et al. 2005:23), as did private charitable donations due to rising public affluence (Elson 2007:47). Consequently, both the public and the nonprofit sectors grew alongside each other to address community needs. As nonprofits became highly dependent on state funding, however, intersectoral relations became increasingly complex and negative, the legislative and regulatory context grew stifling, and concerns about the sector’s capacity to be an effective agent of the welfare state began to surface (Hall et al. 2005:23).21 These issues were just the tip of the iceberg once economic growth began slowing in the 1980s.

20 Specifically, the Income War Tax Act (1917), War Charities Act (1917) and subsequent amendments. 21 Resulting, for example, in (less than successful) national attempts such as the National Advisory Council on Voluntary Action (established in 1974) and the Voluntary Sector Roundtable (established in the 1990s) to recommend improvements to inter-sectoral relationships and enhance sector capacity.

2.1.3 Neoliberalism in the Canadian nonprofit sector As governments struggled with high unemployment, inflation, and deficits and debts associated with the economic slowdown, traditional conservatives and neoliberals argued that the culprit was the welfare state. Its expansion and interference in civil society were blamed for creating an economic crisis, hiking taxation to stifling levels, curbing market vitality, undermining initiative, and fostering dependency (Finkel 2006:286, 333). Neoliberalism is best conceptualized as consisting of three dimensions: (i) an ideology, (ii) a policy package, and (iii) a mode of governance (Steger and Roy 2010:11). Although it manifests in different ways, neoliberalism’s core ideology is founded on the principle that individual initiative, market-based competition and the free flow of global goods, services and capital are necessary for a better world (p. 12).22 Neoliberalism’s agenda is to create public policy and structures that reflect this ideology (Mudge 2008:718). As a policy package, neoliberalism promotes deregulation of the economy, liberalization of trade and industry, and privatization of state agencies. Policy measures include cuts to business taxes, anti-unionization, global movement of capital, reductions in social services and welfare programs, and government downsizing (Steger and Roy 2010:14). As a mode of governance, neoliberalism borrows values and techniques from the business world. Operationalized within government as “new public management,” neoliberalism uses quantitative targets, measurable outcomes, and market-oriented behavior to increase administrative efficiency, effectiveness and accountability (Osborne and Gaebler 1992). Success in the public realm for neoliberals is defined more in monetary terms than in the pursuit of public good (Steger and Roy 2010:12-13). For neoliberals, the only solution to the 1980s fiscal crisis was welfare state retrenchment, a return to free market principles, and the enhancement of individual responsibility. The neoliberal shift is summed up well by Mik-Meyer and Villadsen:

22 The term “neoliberal” is sometimes used interchangeably with “neoconservative.” Although both promote free markets and liberal attitudes towards corporate activity, neoconservatives support minimal government intrusion, except to enhance public security (through, for example, military intervention and tough law enforcement), and to promote traditional social and moral values (Steger and Roy 2010:22-23).

[Neoliberalism] involves not only a shift in power structures (from state to market) and responsibilities (from public to private domains), but also concerns who the citizen is fundamentally imagined to be and which obligations are considered legitimate in relation to citizenship. … [This] means that citizens are increasingly held responsible for their own situation (2013:4). By the 1990s, all major federal political parties and many provincial regimes in Canada espoused neoliberalism’s ideas to varying degrees.23 The federal Reform Party, founded in 1987, and Alberta’s PC Party, under Premier Klein from 1992 to 2006, were among its most notable proponents (Finkel 2006:285). With mass media and well- financed, corporate-controlled think-tanks perpetuating its views, and public benefits such as low inflation and interest rates ensuing, neoliberalism’s principles became palatable to and supported by many Canadians (p. 332). As a result, they became “incorporated into the common-sense way many of us interpret, live in, and understand the world” (Harvey 2005:3). Neoliberalism’s agenda to diminish the role of the state while providing freer rein to markets and individual initiative has significantly altered the political economy of the nonprofit sector (Evans and Shields 1998:2). The most fundamental change occurred in the sector’s contracting relationships with the government. Shifting from grant-based agreements, this critical juncture resulted in forcing organizations to compete for time- limited and project-specific funding, restricted provisions for infrastructure or administrative costs, and increased financial accountability (Elson 2008). As well, the new contract regime mandates collaborations and partnerships between organizations which often compete for the same resources and which may have incompatible social values and philosophies (Rekart 1993; Brown and Trout 2003; Hall et al. 2003:14-16; Scott 2003:4; Phillips and Levasseur 2004; Elson 2011a:110-111). Nonprofits contracted to deliver public services are expected to make up for government shortfalls by generating revenues through fundraising or entrepreneurial activities. The diversion of effort toward these activities often leads to mission drift, increased demands on staff, or a drop in the quantity or quality of service delivery (Dart

23 Neoliberalism tends to be associated with the political right, however, as the Canadian experience and Mudge’s (2008) examples from other countries show, there is no neat divide along the political spectrum with respect to its acceptance.

21 and Zimmerman 2000; Tindale and MacLachlan 2001; Brown and Troutt 2003). Revenue shortfalls result in staff layoffs, reduced capacity to recruit, train and manage volunteers, high administrative burdens, and uncertainties in planning for the future (Evans and Shields 1998:9; Hall et al. 2005:25-26; Elson 2011a:110-111; Calgary Chamber of Voluntary Organizations 2015). The contract regime’s new rules of engagement are often rationalized by the rhetoric of partnership, evoking images of power sharing and joint responsibility, and notions of “empowerment, flexibility, collaboration, consultation, proactivity, efficiency and a service orientation” (Wright and Rodal 1997:266). In reality, in most cases, the minister retains policy-making powers, bureaucrats control program design and allocation decisions, and external partners (for-profit or nonprofit) inherit the responsibility to implement within allocated budgets and program parameters (Evans and Shields 1998:23). Within this rather unequal relationship, nonprofit organizations have willingly engaged with government to develop and refine mechanisms for their own accountability and transparency, for example, through national and provincial forums such as the Voluntary Sector Initiative and the Alberta Nonprofit/Voluntary Sector Initiative.24 The complex web of relationships between the nonprofit and government sectors has spread its net to the market sector. The commercialization of the nonprofit sector has gone hand in hand with the marketization of public services, with for-profits allowed to compete for service delivery in many areas previously dominated by nonprofits (Evans and Shields 1998:11). Already blurred sectoral boundaries have become hazier and more porous with pressures to collaborate across sectors. Instead of enhancing effectiveness, organizations report that mandatory collaborations are complex and time-consuming to sustain, forces them to re-channel or stretch already strained resources (Phillips and Graham 2000; Hall et al. 2003:13), and are more likely to address government’s agenda than to benefit local constituents (Mitchell, Longo, and Vodden 2001). The net effect of these changes is that many publicly-funded nonprofit human services have been reporting severe challenges in the past decade in fulfilling their

24 There is a fairly substantial literature around the Voluntary Sector Initiative with respect to its origins, characteristics and outcomes; it is not included here due to its peripheral relevance to the thesis topic.

22 mandates and organizational objectives, thus preventing the sector from fully realizing its potential.25 In 2003, significant proportions of nonprofits reported difficulty in a variety of areas: planning for the future (60%), recruiting volunteers (58%) or board members (53%), obtaining funding from individual donors (54%), responding to increasing demands for services or products (46%), competing for revenue (45%), adapting to change (43%), and participating in public policy development (39%) (Statistics Canada 2005:48). Registered charities, which rely more on government revenues (54% of their total revenues) and gifts and donations (18%) than do other nonprofit and voluntary organizations (p. 28), were more likely to report capacity issues (p. 52). Despite 34% growth in real (inflation-adjusted) total revenues from 2000 to 2008 (3.7% annual growth) (Spyker 2011:5), 49% of registered charities surveyed in 2013 reported difficulty fulfilling their missions, and 26% felt their very existence was at risk. Smaller charities were more likely to feel stressed than larger ones (Lasby and Barr 2014:4). Nonprofit sector managers have responded to these challenges using external and internal strategies (Hall et al. 2003:14-29). External strategies include: developing new contacts and relationships with funders; pursuing wider varieties of revenue sources; collaborating with others for service delivery and administrative services; and educating funders and the general public about administrative costs. Internal strategies include efficiency improvement initiatives such as: retraining staff, revising procedures, and reconfiguring systems to meet changing reporting requirements; and recruiting, training and retaining staff and volunteers with specialized skills. Although nonprofit leaders are aware of the strategies they need to implement to effectively meet their mission goals, most feel highly challenged to do so. If nonprofit human service organizations are so vital to neoliberal regimes, why have Canadian governments not taken a more active interest in supporting and enhancing their capacity? One reason could be that, since these shifts have taken place in an

25 In addition to the landmark Statistics Canada (2005) study which is cited in the rest of the paragraph, Imagine Canada (http://www.imaginecanada.ca/) has conducted annual surveys of Canadian charities since 2010. In Alberta, the Calgary Chamber of Voluntary Organizations (http://www.calgarycvo. org/) has published reports since 2005 of issues and challenges in that province. The Statistics Canada (2005) report is cited here because it is based on a much larger and representative sample than the other surveys, and because the issues expressed have remained largely the same.

23 environment starkly lacking a coherent policy framework, they have resulted in a patchwork of federal, provincial and local initiatives (M. Hall et al 2005:28), each only partially able to address the problem as seen from its vantage points. Another reason could be that, because Canada’s mixed welfare economy is not a product of neoliberal reforms but has deeper, historical roots, its problems are not within neoliberal sightlines in Canada for requiring a solution.26 Phillips (2010) argues that the historical view in Canadian civil society that the purpose of charities is to provide services supported primarily by private philanthropy, has resulted in a stance towards the nonprofit sector of “active neglect” (p. 65). In Phillips’ view, this has resulted in the “near invisibility of the third sector in public policy” (p. 66) at least at the federal level, other than with respect to government’s role to promote philanthropy (via tax incentives) and ensure charities are honest (via regulatory oversight). Governments appear to simply assume that nonprofits will keep on going, tightening their collective belts as needed, but continuing to deliver services, and those that do not deliver services (but conduct research, are engaged in advocacy, or support the work of other civil society organizations) are probably dispensable anyway unless citizens and corporations step up with donations to support their work. ... The notions of this sector as fundamental to citizenship and democracy, as community builder and social innovator, or as a force in economic developments are largely absent from public discourse (Phillips 2010:65-66). While Phillips’ analysis is accurate, individual and corporate philanthropy are a relatively small source of funding for the sector, accounting for less than 15% of total revenues (Statistics Canada 2005:23). Moreover, although the vast majority of Canadians believe in the importance of charities (93%), trust them (79%), and believe they are effective at helping people (91%), (Lasby and Barr 2013), the sector has experienced a transformation in patterns of volunteerism and philanthropy over the past decade (Turcotte 2015). There has been a drop in the percentage of Canadians volunteering (46% in 2004; 44% in 2013) and in the total average hours of volunteering (168 hours in 2004; 154 in 2013) (Turcotte 2015:4). The percentage of Canadians aged 15 and over who donate has also dropped (85% in 2004; 82% in 2013), however, the average amount per

26 In USA, for example, the Bush administration made a concerted effort to enhance the capacity of faith- based and community organizations to provide federally-funded social services, and the Obama administration created a fund to foster social innovation in community-based nonprofit organizations.

24 donor has increased ($469 in 2004; $531 in 2013, controlled for inflation) (p. 10). Those who give lots tend to give the most. In 2013, the top 25% of donors contributed 84% of all donations (82% in 2004), while the top 10% of donors gave 66% of all donations (p. 12). Brock (2003:7) worries that with fewer and more selective people sustaining the sector, its reliance on the state is likely to increase rather than decrease (Brock 2003:7). Corporate trends in giving are also changing, with more corporations experiencing donor- fatigue, becoming more strategic in their donation choices, and tending to give to larger organizations and risk-free causes (Hall et al. 2009:15). The charity model also means that nonprofits are expected to focus on service provision, and not waste much time meddling in policy advocacy (Phillips 2010:69). Advocacy functions involve giving voice to community interests and issues, protecting human rights, and bringing unaddressed social problems and possible solutions to public attention (Hall et al. 2005:11). The sector’s function to catalyse policy development has become more necessary as downsizing has decreased government’s internal policy capacity (Laforest 2001:10; Hall et al. 2005:29). However, neoliberalism’s service- focused demands have severely diminished the sector’s advocacy capacities (Evans and Shields 2000:11; Hall et al. 2005:29). Unlike the 1970s and 1980s, when the federal government funded a large variety of national voluntary organizations for policy activities, by the 1990s, these same groups were seen as “special interests” for criticising welfare state restructuring, and their voices were severely curtailed by withdrawing funding (Laforest 2001:9). Project-based funding also reduced advocacy capacity either because such activities were no longer funded, or because the funding terms explicitly forbid or limited them (Evans and Shields 2000:11; Hall et al. 2005:29). Further constraints on policy advocacy were imposed by the Income Tax Act and CRA’s regulatory interpretations, which limit advocacy or non-partisan political activity spending by registered charities at 10-20% (depending on annual income in previous year) of their total income in the reporting year (CRA 2003). Many nonprofits are reluctant to engage in advocacy due to fear of negative repercussions for their

25 organization (Pross and Webb 2003:106).27 In 2004/05, charities spent on average a paltry 0.017% of their revenues on advocacy (Elson 2011a:81-82). The advocacy chill (real or perceived) decreases the capacity of organizations to be a voice for their communities (Pross and Webb 2003:110; Evans, Richmond, and Shields 2005:83), or forces them to expand their scope of services in order to acquire non-governmental revenue to support their advocacy work (Pal 1997:110). There are also infrastructure constraints both within the sector and, to some extent, in intersectoral mechanisms connecting the nonprofit sector to federal and provincial governments (Phillips 2010, 2012). Within the sector, most small and medium- sized organizations have little interest or capacity to engage in policy discussions (Phillips 2010:69), and umbrella organizations have difficulty amassing widespread or deep-rooted support due to the diversity and divided interests of the sector (Phillips 2010:69; 2012:168). Between the nonprofit and government sectors, there is unevenness in the mechanisms for dialogue. Intersectoral forums such as the federal Voluntary Sector Initiative, while making important advances, ultimately produced little change before being terminated by the Harper government in 2006 (Phillips 2010:66). There might be more hope at the provincial level, however, as several provinces have established intersectoral mechanisms in the past decade. They are generally non-formal and non- binding in nature and tend to be more organized on the government side of the table than on the nonprofit sector side; their long-term consequences and capacity to be effective voices for the nonprofit sector remains to be seen (Elson 2011b). In addition to advocacy, nonprofit organizations are “vehicles through which an enormous variety of other sentiments and impulses—artistic, spiritual, cultural, occupational, social, and recreational—find expression;” these are reflected in the wide range of organizations from opera companies to book clubs (Hall et al. 2005:11). They

27 In 2012, the Harper government provided CRA with $8million over two years (later increased to $13.4 million over five years) to establish a political-activity audit program (Beeby 2014), argued by some to be targeted at groups questioning the conservative government’s policies (Hayhoe 2014:247). In January 2016, the newly elected Liberals announced the closure of the program, once the reviews already underway were completed, in light of the finding that charities had shown substantial compliance with the rules related to involvement in political activities. According to this source, some 54 audits (30 already completed and 24 underway) would eventually be completed under this program (Canada 2016).

26 are also sites for fostering community, building bonds of trust and reciprocity, and generating social capital; these associative functions are argued to be critical for social cohesion and democratic participation (Tocqueville 1840/2004; Putnam 1993). In contrast to the dominant evidence in the Canadian literature of the challenges ensuing from neoliberal-inspired reforms for nonprofit human service organizations, some in the broader literature argue that the sector’s increasing presence in neoliberal landscapes puts it on the verge of a historic opportunity to rekindle local autonomy and community connections. Thinkers of neo-Tocquevillian persuasions view the growth in voluntary associations as enhancing opportunities for the generation of social capital, solidarity and cohesion (e.g., Putnam 1993, 2000), while others who embrace more Gramscian perspectives see the potential for civil society to mobilize citizens for social action, empowerment and systemic change (e.g., Korten 1990:120-128; Fisher 1993; Howell and Pearce 2001:33-36). The Canadian evidence to support these aspirational views is still very much nascent and unable to provide a firm answer. The ability of organizations to cultivate political capacities and social capital, moreover, depends on the extent that such sites embody democratic values and provide opportunities to practice them. Generally, publicly-funded human services tend to be highly formalized and professionalized, and as such, provide little opportunity for participatory governance and democratic socialization (Clemens 2006:210). These opportunities are likely to further diminish as service delivery becomes more integrated and systems-based, as seems to be the case, for example, in services to persons with disabilities in Alberta (Seel 2016) and human services in Saskatchewan (Garcea and DeSantis 2016). Although some authors (e.g., McKnight 1995) denounce the role of professionalized services in care provision and instead argue for mobilizing the power latent in neighborhoods and communities to support marginalized individuals, such aspirations are more idealistic than realistic. Service delivery, associative functions and advocacy functions, however, are not mutually exclusive. A number of Alberta’s disability service providers use terms such as “building capacity,” “enriching communities,” “meaningful inclusion,” and “community presence” in their goals or mission statements. Fostering advocacy, providing supportive

27 environments for clients to learn social skills and build trusting relationships, and creating social capital, are integral parts of the service-provision work aspired to by these organizations. Thus, notwithstanding the dominance of their role as service providers, nonprofit organizations are potentially “as much about participation as provision; as much about citizenship as service” (Nowland-Freeman 1996:4). These vital characteristics, which make communities inclusive and vibrant, have been brought into sharp relief by the institutional shifts being shaped by neoliberal ideologies of the role of the state, its obligations to society, and the ways in which these are to be fulfilled. On the one hand, neoliberalism has significantly amplified the role of nonprofit organizations in delivering public services on behalf (or instead) of government, and, to a lesser extent, in undertaking expressive and associative functions to prepare individuals to address social problems that were once accepted as the purview of government. On the other hand, the sector’s advocacy role and associative capacities have diminished, arguably at the very time that these seem to be most needed (Hall et al. 2005:11, 29). Pal (1997) posits a more nuanced view of the neoliberal shifts, arguing that they show evidence of distinct and contradictory dimensions which, taken together, will result in a realignment between the state and civil society. (1) The most visible dynamic is that of disengagement, which consists of the deliberate withdrawal of funding from nonprofit organizations via budget-motivated cutbacks to program expenditures, or, the withdrawal of legitimacy, particularly from advocacy groups, by publicly challenging their agendas or eliminating their supports. It also includes attacks on public sector unions. (2) Re- engagement consists of amplifying the role of some types of nonprofit organizations to fill the gaps left by the shrinking government, specifically, those to whom services provision can be downloaded, and those who foster volunteerism and the development of social capital. It also includes inviting nonprofit (and business) organizations to participate in policy roundtables as government’s own capacity for policy development shrinks, or as a way to gain support for potentially unpopular policy decisions. (3) Displacement refers to the change in the site of government-nonprofit interactions. This includes the rising prominence of courts in deciding on policy matters (e.g., Charter-

28 focused challenges to legislation),28 the use of international venues by nonprofit organizations for pursuing domestic issues (e.g., environmental or human rights policy), and the shift in interaction between nonprofits and governments from federal to provincial levels as provinces get increasing discretion over social policy matters (e.g., with the implementation of the Canada Health and Social Transfer). This somewhat more nuanced view aligns with those of many scholars (discussed next) who have commented on neoliberalism’s contradictions and contextual-specificity.

2.1.4 Neoliberalism’s heterogeneity and contextual-specificity Notwithstanding its characterization as a hegemonic discourse (Harvey 2003:3), an important feature of neoliberalism is that its doctrine “comes in different hues and multiple variations” (Steger and Roy 2010:xi). In other words, even though its proponents share a core belief in the power of free markets and individual initiative, neoliberalism is not a “monolithic beast” (Brennan 2009:354). First, as some have pointed out, it has inherent tensions due to its roots in different intellectual, political and bureaucratic spheres (Mudge 2008), or its reflection of both free-market libertarian and neoconservative moral authoritarian stances (Peck 2004:403). Second, neoliberalism’s motivations and manifestations are dynamic and heterogeneous: its ideological bases, political stances, policy expressions, and governance outcomes have been shown to take differing forms and proceed in differing ways over time and place depending on local socio-political contexts, institutional legacies and the varying considerations of policy actors (e.g., Pierson 1996; Jenson and Phillips 2000; Campbell and Pedersen 2001a; Harvey 2005:70; Bode 2006; Kus 2006; Ong 2006; Atkinson, Béland, Marchildon, McNutt, Phillips, and Rasmussen 2013:124). In addition, neoliberalism’s reform efforts have been shown to be partial (Connell, Fawcett and Meagher 2009:335). It is not clear that they achieve their own stated goals of increased efficiency or better service quality (e.g., Carruthers, Babb and Halliday 2001; Western, 2001; Newman and Lawler 2009), or that they are entirely successful in replacing other norms or rationalities. For example,

28 Although Canadian charities have only sometimes used the courts to rule on policy matters, the Canadian Charter of Rights has often been at the core of high-profile policy-related court challenges e.g., by women’s groups on abortion, sexual assault, and childcare issues. The history of litigation in the United States, however, shows that courts are a widely accepted tool for achieving public policy change (Owens 2014).

29 regardless of changed structural conditions or bureaucratic procedures, teachers (Brennan 2009), social workers, and other direct care workers in many sites continued to be guided by their professional ethos (Sawyer, Green, Moran and Brett 2009) or social justice orientations (Baines 2015) rather than efficiency-focused prescriptions. Individually or collectively, in diverse ways and to varying degrees, individuals have displayed resistance to neoliberalism’s market logics and practices, and exhibited the agency to negotiate and reshape the structural conditions imposed on them. Conceptualizations of neoliberalism from cultural perspectives (e.g., Clarke 2004, 2008; Kingfisher and Maskovsky 2008; Morgen and Gonzales 2008) and analyses of neoliberal shifts from various institutional perspectives (e.g., the edited collections in: Campbell and Pedersen [2001] using diverse institutional perspectives; Streek and Thelen [2005] applying historical institutionalism; and Meyer and Rowan [2006] using organizational institutionalism, to cite just a few) have provided useful insights into understanding neoliberalism’s heterogeneity and unevenness. Scholars from a cultural perspective urge that neoliberalism be conceptualized as an incomplete cultural and political formation (Kingfisher and Maskovsky 2008:120)— that is, as an “articulated ensemble” (Clarke 2004:38) of meanings and practices that requires active and continuous work to forge new shared meanings—rather than seeing it “as a thing that acts in the world” (p. 118). This characterization of neoliberalism as an ongoing process is also evident in Brodie’s (2010) conceptualization of neoliberalism as “a contested political rationality [particular way of seeing political problems and ways to solve them] that weaves foundational commitments to market logics, individualization, economic calculations of efficiency, and multiple sites of authority into new public policies and regulatory fields and onto existing ones” (Brodie 2010:1588). The active work underlying this is done through what Clarke proposes is: ... a double process of articulation and assemblage: first, the articulation of things into neoliberalism’s repertoire; second, the articulation of elements from neoliberalism’s repertoire into specific/local assemblages or constellations as part of political and governmental projects to remake particular places. And finally, articulation always implies the possibility of re-articulation—the attachment of words, symbols, practices, policies, and so on to alternative voices, vocabularies, imaginaries, and projects. (Clarke 2008:144-145)

Drawing upon Ong’s view of neoliberalism as a “mobile assemblage” of “techniques of governing that can be decontextualized from their original sources and recontextualized” in new spaces (Ong 2006:13), Clarke argues that neoliberalism’s diverse and partial manifestations can be understood in the immense, ongoing, messy, and sometimes failed, political work that occurs in these processes of dis-articulation, articulation, and re-articulation (2008:138, 144). The cultural perspective makes visible the sites and mechanisms through which change processes occur, that is, in the work that actors who are committed to a particular view of the world do to hitch their views into existing institutional arrangements (e.g., “public policies and regulatory fields” [Brodie 2010:1588]), and thereby bring about change. It recognises that change is an endogenous process (not a “thing that acts in the world” [Clarke 2004:118]) that occurs within the constraints of a particular institutional context (hence needing “dis-articulation and re-articulation”). Attention to institutional context is, as expected, front and centre in institutionalist perspectives of neoliberal shifts. Neoliberalism’s multi-faceted nature, empirically- demonstrated contextual-specificity, and its aim to transform institutional structures and their normative and cognitive underpinnings has rendered it particularly suitable for analysis from (neo-)institutional perspectives (Campbell and Pedersen 2001a:5). Institutionalism rests on the belief that human preferences, behaviour, and outcomes (organizational, social or political) arise in a social context, and are shaped by structures and patterns that are stable and enduring (Hall and Taylor 1996: 937). While institutional perspectives have a long history in the social sciences, with formulations being developed in each disciplinary area between 1880 and the mid-20th century (Scott 2008:16), their (“old”) notions of human activity as highly embedded in cultural and structural contexts were supplanted in the post-WWII era of high modernity and progress by views of individuals as rational, empowered actors. When institutional thinking re-emerged in the 1970s with a more active view of individual behaviour, it was sufficiently fresh to be labelled “new” (Meyer 2008:791).29

29 For a review, of how the “old” and “new” institutionalisms differ, see DiMaggio and Powell (1991), Hall and Taylor (1996), Peters (2000, 2005), or Scott (2008b:Ch.1).

If the old institutionalism had seen people and groups as rather naturally embedded in broad cultural and structural contexts, the new institutionalisms . . . see the social environment as affecting the behaviors and practices and ideas of people and groups now conceived as bounded, purposive and sovereign actors. (Meyer 2008:792) Neo-institutional30 perspectives arise in a diverse literature which has given rise to different variants, each interested in a different problematic and based on different philosophical underpinnings to posit their theories of how institutional contexts shape human behaviour. They include: rational choice institutionalists from economics (e.g., North 1990); historical institutionalists from political science (e.g., Steinmo, Thelen, and Longstreth 1992; Thelen 1999; Streek and Thelen 2005); and organizational (or sociological) institutionalists from sociology (e.g., Powell and DiMaggio 1991; Scott 1995, 2008b).31 Their stances and approaches have resulted in different ways of understanding the forces and mechanisms underlying neoliberal processes, for example, as interest-based struggles of rational actors, historically-shaped political conflicts and path-dependent trajectories, shared beliefs and cultural scripts, or processes of diffusion, imitation or learning (Campbell and Pedersen 2001a:8-14; Amenta and Ramsey 2010).32 Of these perspectives, historical institutionalism takes a decidedly temporal approach in its analysis of the evolution of state structures and policies and of the role of power asymmetries in shaping these. As such, it lends itself particularly well for longitudinal investigations, such as the present study, interested in tracing how specific policy fields have evolved over a period of time. A series of recent works from historical institutionalists have paid particular attention to conceptualising and studying the gradually transformative ways in which neoliberal reforms unfold (e.g., Deeg 2005; Hacker 2005; Streek and Thelen 2005). Historical institutionalism has also been fruitfully applied to analyse critical junctures and policy shifts in government and nonprofit sector

30 Henceforth referred to simply as institutional rather than neo-institutional. 31 Campbell and Pedersen (2001) also identify discursive institutionalism, which is concerned with how institutions are transformed by how actors interpret changes in discursive structures. Amenta and Ramsey (2010) add political institutionalism, which looks at the role of political systems and parties. 32 Organizational and historical institutionalism are discussed in greater depth later as they form an integral part of the theoretical approach of this thesis.

32 relations in Canada at national and provincial levels (Elson 2008, 2011b).33 For these reasons, historical institutionalism is included in the theoretical framework for the present study, and is discussed in further detail under Section 2.2. In sum, neoliberalism’s internal contradictions plus contextually-specific institutional legacies and factors to articulate with plus the myriad ways actors may understand and respond to these shifts all mean that every instance of neoliberal reforms will be novel. This has led to the characterization of neoliberal projects as complex “experiments” (Peck 2004:393; Ong 2006:19; Clarke 2008:144; Brodie 2010:1561), stemming from processes that include trial-and-error, ongoing learning, and policy feedback (Campbell and Pedersen 2001:11). In addition, they have been described as “reflexive” (Brodie 2010:1567) as they undergo various iterations of articulations, dis- articulations, and re-articulations (Clarke 2008:144). In short, rather than seeing neoliberalism as a static monolithic concept, a homogeneous manifestation, or as having a core essence from which divergences can be measured, it is analytically more useful to think of it in the plural as neoliberalisms (Mudge 2008:724; Steger and Roy 2010:xi) or varieties of neoliberal models (Peck 2004:393) containing individual projects of neoliberalization (Clarke 2008:139), each an evolving experiment with a commitment to market logics, individualization, and economic calculations of efficiency, unfolding in locally-specific and often messy, unpredictable and sometimes failed ways as actors contest to reconfigure old or new principles, practices, discourses and meanings into new forms to promote their own interests and values. The local-specificity or contextuality of neoliberal projects, however, does not negate efforts to understand the large-scale historical project of neoliberalism since each case of neoliberalization, though unique, “remakes the relationship between the part (an actually existing neoliberal case) and the whole (the abstraction we might provisionally term neoliberalism-in-general)” (Peck 2004:395).

33 Historical institutionalism may be considered a specialized subset of more encompassing approaches such as historical sociology. The latter has been successfully used to trace the emergence of subjects as broad as particular societies (e.g., Harrison and Friesen [2010] on the growth and development of Canadian society) and as narrow as neoliberalism’s shaping of a specific policy arena (e.g., Pinto’s [2010] research on disability policy in Portugal). Historical sociologists, however, do not explicitly focus on making visible institutional elements or arrangements, although their analyses may well include such factors.

2.1.5 Conclusion The historical review of the Canadian nonprofit sector shows that it is deeply embedded in its institutional environment, shaped by the values and traditions of its colonial roots, federal-provincial arrangements, and a long and complex relationship with the state and citizens. Government–nonprofit sector relations date back to the 1600s, are multi-faceted, dynamic and symbiotic, and include a changing smorgasbord of statutes, regulations, policies and practices which, over time, have defined the role and scope of the sector, the conditions under which nonprofit organizations can provide publicly- funded services or advocate for public policy, and the terms under which they can access charitable status and related privileges (Elson 2011). The neoliberal turn since the 1980s has further shaped the sector’s political economy, shifted its relationships with government and civil society firmly towards a market-centric model, and reshaped what the organizations do and how they do it. The implications for the present research are that, to understand how neoliberal shifts have shaped the field of services to people with developmental disabilities in Alberta and the nonprofit organizations who provide these services, one needs to analyse (i) the contemporary political, legal, and cultural forces in the environmental context of the organizations, and (ii) the historical developments that have led to current institutional elements and arrangements. In addition, since the most fundamental relationship that enables these organizations to function revolves around the resources they get from the state (and to a lesser extent from its donors and volunteers), the investigation needs to analyse (iii) this resource-based aspect of their relationship. Further to this, the neoliberal literature suggests that it is imperative to situate particular emergences of neoliberalism within the specific historical, socio-political, cultural and institutional contexts in which they take root and unfold; in other words, to empirically investigate “who does what, by what means, to what ends and with what institutionalizing effects” (Kingfisher and Maskovsky 2008:121). It is also important to show how such specific instances of reform connect with the wider aims and discourses of neoliberalism writ large (Peck 2004:396). One particularly appropriate theoretical perspective identified from the neoliberal and institutional change literature for

34 investigating the manifestations of the reforms in Alberta is historical institutionalism. It will be discussed in further detail later in this chapter. Part Two focuses on the most useful theoretical approaches to understand the organizational behaviours of developmental disability service providers embedded in neoliberal contexts. It begins with a summary of the key attributes of nonprofit human service organizations so the reader understands the rationale for the theories selected.

2.2 Part Two: Understanding Nonprofit Human Service Organizations Nonprofit organizations are, in a sense, a hybrid of business enterprise and government, and different from both. . . . The net effect is to produce a pattern of behaviour in the nonprofit organization that differs from the behavior of the other two. (James 1987:35)

The very premise of defining a sector based on its non-distributive aspect—as the nonprofit sector is—makes explicit that there is a fundamental difference between nonprofit and for-profit organizations with respect to why they exist, the way they are organized, how they behave, and what roles they play, all without denying that there is a great diversity of organizations within the boundaries of the nonprofit sector (Steinberg and Powell 2006:9). While they share many characteristics with public agencies and for- profit firms (Young and Steinberg 1995:19-20)—such as having goals which they strive to achieve through the work of individuals organized in structures reflecting the flow of tasks or control, being controlled by the laws and regulations of the land(s) in which they operate, and being accountable to their stakeholders for their operations and outcomes— nonprofit organizations, specifically nonprofit human service organizations, have some fundamental characteristics that make them particularly embedded in and sensitive to their environmental contexts. Chapter One (Section 1.1.1) identified the formal criteria and definitions that nonprofit organizations in Canada need to meet, the legislation that governs them, and the limits to the activities that such legislation allows them to engage in; meanwhile, Chapter Two (Section 2.1) discussed the many ways in which the evolving institutional context in which they are embedded shapes their role and capacities. In this Part, I present some key attributes identified in the human service literature that set this particular sub-set of

35 nonprofit organizations apart from others.34 I then discuss theoretical perspectives from the nonprofit and human services literature that are best suited to understanding their behaviour in relation to their environmental context.

2.2.1 Distinguishing attributes of human service organizations Human service organizations work on people, aiming to transform them based on the organization’s vision of what is good or desirable. This fundamental and defining characteristic results in them having distinct attributes (Hasenfeld 2010:Ch.2). First, since they are viewed as engaging in moral work (their work is seen as being guided by moral values underpinning the change they wish to create in their clients), they must constantly seek and maintain legitimacy for what they do. Relatedly, they must use socially sanctioned service technologies (professional practices and tools). Second, since human service technologies generally suffer from indeterminacy, organizations and workers have considerable discretion in practice. Finally, since the predominant labour in human service organizations is care work, they tend to be gendered workplaces, employing large proportions of women. The consequences of each of these is discussed next. Human service organizations are viewed as engaging in “moral work” (Hasenfeld 2010:12) since every action that the organization takes on its client reflects a judgement about the individual, from affixing a particular socially-constructed label or diagnostic category on the client (e.g., “special needs,” “high/low functioning,” or “complex needs”), to the types and amounts of resources provided (e.g., an individual labelled as having “complex needs” will likely be assigned a more skilled worker than an individual assessed as having lower support needs), to the goals they help them to achieve (e.g., to be gainfully employed, to quit smoking, etc.). The values underpinning these judgements and work have to be seen as consistent with the values and rules of the broader society which permits and justifies the organization to have access to the private lives of its clients, and specifies what it is allowed to do for them, for what purposes, and in what manner (Hasenfeld 2010:12). Human service organizations, thus, must constantly seek legitimacy for what they do by

34 Human service organizations may be for-profit or nonprofit. While their specific auspices subject them to slightly different institutional contexts, the attributes presented pertain to all human service organizations.

36 referring to and adopting the rules and values of their stakeholders, which typically include law and policy makers, bureaucrats and regulatory agencies, professional associations, peer organizations, social movements, staff, volunteers, donors, clients, and client advocates (p. 15). Since each of these sources usually has diverse interests and ideologies, the institutional environment of human service organizations is heterogeneous and turbulent, with multiple and conflicting logics (Scott 2008:59-62). Maintaining legitimacy, thus, requires constant work. It also results in a cycle of legitimacy crises. When the social problem that the organization seeks to address remains unresolved and its underlying assumptions become questioned, or when another logic ascends (e.g., the social vs. the medical model of disability), the organization is forced to articulate a new perspective or reframe the issue to re-establish legitimacy. Since there is no simple solution to solving complex human problems and the institutional environments of human service organizations are fraught with turbulence and multiple logics, a cycle of legitimacy crises is created (Hasenfeld 2010:15). The state of “chronic crisis” that many human service organizations find themselves in is often attributed to fiscal uncertainties. While these may be real, typically most human services experience relatively small fluctuations in funding levels from year to year (Grønbjerg 1993). Rather, it is the need to periodically reaffirm the consonance of the organization’s mission with changing and conflicting institutional logics in order to justify its quest for resources and shore up its legitimacy that generates an aura of crisis. (Hasenfeld 2010:15) Legitimacy also shapes the service technologies that human service organizations can use: they must be socially approved and sanctioned. Although the efficacy of the technologies may be well-founded, the ones that gain legitimacy are those endorsed by powerful groups such as regulatory and certifying bodies, funders, scholars, and professional associations. A key characteristic of many human service technologies, however, is their indeterminacy. A multitude of factors can intervene to make service outcomes unpredictable, including competing demands from stakeholders, resource constraints, staff expertise and values, and client attributes (Hasenfeld 2010:17-18; Smith 2010). Technological indeterminacy gives organizations and workers considerable discretion in client-worker relations (Hasenfeld 2010:21-23; Sosin 2010). Defined as “the ability of organizational actors to act independently from the demands of authorities” (Sosin 2010:381), discretion may take the shape of workers or organizations eschewing

37 policies (e.g., turning away eligible clients), subverting policies (e.g., convincing clients to forego benefits), or supplementing policies (e.g., helping clients build the evidence to enhance their eligibility). The potential for discretion is highest in a heterogeneous institutional environment, in multiple environments with conflicting logics, or when standards and policies are open to interpretation (Sosin 2010:390). Although discretion can enable workers or organizations to overcome overly rigid or unfair regulations, it also gives them the power to promote unequal treatment or, worse, abuse clients for personal gain (Hasenfeld 2010:22). Consequently, human service organizations are surrounded by a number of safeguards such as training and socialization practices, standardized policies and procedures, monitoring and supervision systems, regulations, accreditation standards, and auditing and reporting systems. As a result, these organizations tend to be bureaucratically rigid, engage in excessive record keeping, and mandate some degree of professional distancing between workers and clients (p. 23). Another central characteristic of human service organizations is care work, which is generally provided by female workers since women are culturally viewed as ideal for such work (England 2005). Human service organizations, thus, are gendered workplaces with women predominating in direct service positions, and men typically filling administrative or authoritative positions (Hasenfeld 2010:27). In services for adults with developmental disabilities in Alberta, 83% of the workforce is female (Sonpal-Valias 2005:17). Concomitant to them being gendered workplaces, human service organizations have, on average, lower wages compared to places where care work does not predominate (England, Budig and Folbre 2002). Reasons for the wage gap include discrimination against women, cultural devaluation of care work and many of its clients, and the difficulty demonstrating the efficacy of such work. Cultural devaluation also means that human service organizations tend to be underfunded (Hasenfeld 2010:27). Stress among direct care workers is not uncommon as they attempt to work with inadequate resources in an environment where there is an inherent conflict between the values of empathy, nurturance and cooperation that a female workforce typically brings and the norms of competition and efficiency that typically characterise publicly-funded organizations in neoliberal regimes (Baines 2004a:275-278).

In sum, human service organizations are intrinsically linked with their cultural, economic and legal-political environments. The institutional context plays a critical role in the way the organizations are structured, the goals they engage in, the service technologies they adopt, the people they employ, and the practices that take place in client-worker encounters. At every point in an organization’s history and in each of its activities, its choices are shaped by the diverse interests of the organization and its workers, and the institutional contexts in which they are located. A key driver in these choices is to seek and maintain legitimacy. For human service organizations in the nonprofit sector, these institutional contexts and legitimacy requirements are further layered with those that pertain to the sector, such as, definitions of the types of work they can legally engage in, their obligations to citizens and donors, and so on. In the next section, I discuss the theoretical approaches at the intersection of the nonprofit, human services and organizational literatures that take into account this “thick” relationship between nonprofit human service organizations and their institutional contexts.

2.2.2 A selected review of theoretical approaches Theoretical advancements in the nonprofit sector literature are rich in diversity, but still in an emergent stage (Anheier and Salamon 2006:90). They include: (i) economic theories, which focus on attempts to provide supply and demand explanations for why nonprofits exist in free market economies and what roles they perform (e.g., Weisbrod 1975, 1977; Hansmann 1980; Young 1983; James 1987; Salamon 1987; Ben-Ner and Van Hoomissen 1991; Rose-Ackerman 1996; Ben-Ner and Gui 2003; Steinberg 2006); (ii) political theories, which focus on nonprofits as site for developing democratic values and skills, constituting citizen identities, choices and preferences, and translating private concerns to public issues (e.g., Tocqueville 1840/2004; Putnam 1993; Etzioni 1993; Clemens 2006); and (iii) sociological approaches that examine the role of groups, social structures and institutions in shaping the origins, behaviours, and outcomes of the sector. These sociological approaches include macro sociological perspectives that attempt to explain global convergence in the growth and characteristics of nonprofits (e.g., Boli and Thomas 1997), regime models that analyse national-level patterns (e.g., Salamon and Anheier 1998), and institutional perspectives that attempt to explain cross-national (and

39 local) variations in nonprofit sectors by examining how political, legal, and cultural contexts shape the sector and its organizations (e.g., DiMaggio and Powell [1983]1991, Hasenfeld and Powell 2004, and Meyer and Rowan 2006 using organizational institutionalism; and Elson 2008, 2011a, 2011b using historical institutionalism to explain the evolution of government-nonprofit relations in Canada). In general, economic theories have dominated the nonprofit sector literature. However, although they are well established and parsimonious, tests of some of their models have shown mixed results (Anheier and Salamon 2006:104-105).35 A more fundamental weakness is that economic reasoning is based on a clear division between public goods and services (to be provided by the public sector) and private goods and services (to be provided by the market/for-profit sector). Nonprofit human services typically provide “quasi-public” goods or services; which sector best provides these is ultimately a political rather than an economic consideration (Anheier 2005:120). Based exclusively on observations in Western capitalist economies, economic theories have failed to pay attention to how political considerations and the broader social contexts in which they arise influence the emergence, scope and characteristics of nonprofit organizations. Realizations of the sector’s extensive heterogeneity, multi- dimensionality, and dynamic nature across diverse political economies (Boris and Steurle 2006) have led to much interest in explaining how nonprofits are shaped by broad global factors or local societal systems and institutions. In contrast to economic theories, thus, institutional perspectives have provided a necessary corrective by inserting the role of the state and society into understandings of the nonprofit sector and its organizations (Smith and Grønbjerg 2006:233-235). Institutional theories have a long history and dominant role in the human services literature (Garrow and Hasenfeld 2010:42). Numerous early studies using organizational institutionalism, in particular, were based on public and nonprofit human services due to the deep embeddedness of these organizations in their institutional contexts (Meyer and

35 The three-failures framework, for example, which posits an inverse relationship between government social-welfare spending and the size and scope of the nonprofit sector, fails to explain why mixed economies such as Canada and the USA have showed largely synchronous growth in both sectors in the last half of the 20th century.

Rowan [1977] 1991:53). It is also the dominant approach in organizational sociology (Greenwood et al. 2008:2). Its focus on the cognitive and normative underpinnings of organizational behaviours and institutional processes, and on activities to achieve legitimacy, have added considerably to understandings of human service organizations (Garrow and Hasenfeld 2010:42). Organizational institutionalism is included in the theoretical framework for this research, and discussed in more detail later in this chapter. Another perspective that has made a major contribution to the human services literature is the political economy perspective, specifically, resource dependence theory. As noted at the end of Part One, nonprofit organizations are highly dependent on their external environment (funders, donors and volunteers) for resources, and these relationships have been changing in significant ways in the last two decades. Resource dependence theory suggests that organizational responses are shaped by these relations and power differentials, and that organizational attempts to manage these perceived pressures influence their practices and characteristics. To understand organizational responses and characteristics, it is important to examine its interdependencies with the external environment (Pfeffer and Salancik 1978). Resource dependence theory, thus, is well suited to analyse how developmental disability organizations in neoliberal contexts respond to and have been shaped by these relationships. It is, therefore, the third and final theoretical perspective that, together with organizational and historical institutionalism rounds off the theoretical framework for this research, and is discussed further later. Other perspectives that take into account the relationship between human service organizations and their institutional environment include (Garrow 2010:45-50): (i) critical theory, which aims to uncover systems of domination within organizations; and (ii) postmodernist approaches, which deconstruct organizational structures and practices to reveal how they are shaped by power and culture. Both approaches have made important contributions, but their primary aims and conceptual tools are not specifically targeted to investigate organizational characteristics and behaviour. In conclusion, the review of the nonprofit sector and human service organizations literature identified two theoretical perspectives, resource dependence theory and organizational institutionalism, that might provide useful insights into understanding how

41 the neoliberal shifts have shaped the institutional environment and the characteristics of developmental disability service organizations. In addition, the neoliberalism and institutional change literature identified historical institutionalism as a valuable approach for understanding the contextually-specific processes by which the institutional changes associated with neoliberal reforms unfold. Each of these theoretical approaches is discussed in turn next, beginning with resource dependence theory because it has the most narrowly-focused lens compared to the institutional theories. Table 2.2 (end of Part Two) summarises the main similarities and differences across these three approaches.

2.2.3 Resource dependence theory The review in Part One highlighted how neoliberal reforms have significantly restructured the political economy of nonprofit organizations by changing the terms of the funding relationships, opening up public services delivery to for-profit providers in some areas, increasing competition, and forcing underfunded organizations to seek alternate revenues through commercial activities. Additionally, Part Two noted that human service organizations must constantly seek and maintain legitimacy due to the moral nature of their work. Resource dependence theory (RDT) is one of the most influential theories in the human services and the organizational literatures; it focuses on this vital need of organizations for both economic resources (financial, human and other material resources for the production of goods or delivery of services) and political resources (legitimacy and power) to survive (Garrow and Hasenfeld 2010:39). RDT’s central thesis is that an organization’s survival depends on its ability to acquire and maintain political or economic resources (Pfeffer and Salancik 1978). Since many of these resources must be acquired from the environment, behaviour must be understood in relation to the organization’s context. The essential aspect of the context is the network of interdependencies that the organization has with other organizations or interest groups. When the environment changes, the organization must change its activities to manage these dependencies and uncertainties in order to survive. The more an organization perceives that it depends on others, and the greater its uncertainty about the actions of those organizations or groups, the more power these external elements will have on the organization’s internal structures, practices and activities.

Pfeffer and Salancik (2003) identify three levels of the environment, only one of which is the “real” environment as far as organizational behaviour is concerned: To understand how the environment of an organization affects organizations, it is useful to distinguish three levels of the environment. On one level, the environment consists of the entire system of interconnected individuals and organizations who are related to one another and to a focal organization through the organization's transactions. The next level is the set of individuals and organizations with whom this organization directly interacts. It is on this level that the organization can experience its environment. The environment comprised of organizations transacting with the focal organization is, however, not the environment that determines organizational action, for this environment, in order to affect action, must be observed and registered. Observation, attention, and perception are active processes which must occur for events to exist in the experience of any social actor. Thus, the third level of the organization's environment can be characterized as the level of the organization's perception and representation of the environment—its enacted environment. (Ch.4, emphasis added) 36 In other words, “[o]rganizational environments are not given realities; they are created through a process of attention and interpretation” (Pfeffer and Salancik 2003). What an organization knows about its environment depends on how it learns about it, how much attention it pays to what it learns, what it selects as important out of this, and how it interprets this information to make sense of its environment. The organization’s knowledge, thus, is local, specific, and constructed. In this sense, RDT’s ontology may be described as relativist, which Guba and Lincoln (1994) define as follows: Realities are apprehendable in the form of multiple, intangible mental constructions, socially and experientially based, local and specific in nature (although elements are often shared among many individuals and even cultures), and dependent for their form and content on the individual persons or groups holding the constructions. Constructions are not more or less “true,” in any absolute sense, but simply more or less informed and/or sophisticated. Constructions are alterable, as are their associated “realities.” (pp. 110-111) The authors concede that it is possible that organizations may misread dependencies, demands and uncertainties. Their view of organizations, thus, is one of a coalition of bounded rational actors (individuals or groups), able to act strategically to meet their varying interests, but with incomplete knowledge of all possibilities. Based on

36 Ebook; page number not applicable. Pfeffer, Jeffrey, and Gerald R. Salancik. 2003. Books24x7. http://common.books24x7.com.ezproxy. lib.ucalgary.ca/toc.aspx?bookid=7346. Accessed April 20 2016).

43 its perceptions, the organization decides what action to take. It is important to note here that RDT makes an important distinction between organizational behaviours and outcomes: although important aspects of the environment may affect an organization’s outcomes (including success or failure), if these aspects are invisible (unknown) to the organization, they are not considered in determining the organization’s actions. Organizational behaviour, according to RDT, depends on its known environment. Organizations will attempt to manage perceived dependencies and uncertainties by implementing strategies to enhance their autonomy (Pfeffer and Salancik 1978:26-27). Publicly-funded human service organizations, for example, respond to underfunding by engaging in political advocacy, seeking supplemental or alternative funding, collaborating with other providers, “creaming” (selecting the easiest) clients, implementing more efficient financial and personnel management systems, using unpaid or low-paid staff, and changing the composition of their boards to manage the financial pressures created by the contracting environment (Kramer and Grossman 1987:46-48). Each strategy that an organization implements to enhance its autonomy changes organizational practices and creates new dependencies and relations of power. These new relationships may be outside the organization, but may also be inside the organization, created by shaping new structures of authority and actors’ capacities to control access to external resources or information. Internally, organizational actors or units that secure the most difficult and sought after resources (Astley and Sachdeva 1984) or are in specialty positions that cannot be easily substituted (Lachman 1989:249) acquire power relative to other internal groups or units; these interdependencies further reinforce power differentials. For example, university departments with large external grants and graduate programs were more likely to be represented on university research boards and on all committees, and more able to use their power in the allocation of graduate fellowships – a resource that was considered scarce and critical (Salancik and Pfeffer 1974:462-468). RDT provides useful insights for understanding the behaviours of developmental disability service organizations given their high degree of dependence on their external environment for material and political resources. The assertion that organizations enact

44 strategies to reduce environmental dependencies has held up well in over 30 years of research using this theory on firms (Hillman, Withers and Collins 2009). However, the environmental context of organizations (firms or nonprofit) does not consist of just shifting networks of interdependencies. It is also replete with professional norms, moral values, cultural prescriptions, and taken-for-granted beliefs that also guide behaviour. By focusing on actors’ strategic (interest-focused), rational- choice capacity, the theory overlooks the constraining potential of these other—perhaps more powerful—factors that may conflict with strategic considerations or even make it impossible to conceive such alternatives. In contrast, organizational institutionalism and historical institutionalism explicitly focus on these forces for their analyses. Oliver (1991), for example showed how integrating RDT with OI significantly expanded the theoretical scope of understanding how both strategic and institutional factors shape organizational responses. Institutional perspectives are discussed next.

2.2.4 Organizational institutionalism Organizational institutionalism (OI) is the dominant approach in organizational sociology (Greenwood et al. 2008:2). Its core ideas are drawn widely from cognitive psychology (specifically, from March, Simon and Cyert), cultural theory (specifically, the semiotic functions of culture), phenomenology (from Schutz), ethnomethodology (from Garfinkel), Berger and Luckman’s conception of reality as a social construction, Gidden’s notion of structuration, and Bourdieu’s constructs of field and habitus.37 OI’s social constructivist persuasions are evident in its distinct view of institutional contexts, and its view of the process of institutionalization. OI views the organization’s institutional environment as consisting of normative and cultural-cognitive concepts and processes such as common beliefs, routines, moral templates and cognitive scripts that provide shared cultural frames and become taken for granted. Formal rules and procedures (which may include regulatory frameworks of professional agencies and the state) may be considered part of the institutional environment, as long as they can be

37 For more details on how these schools and approaches influenced new institutional approaches to organizational analysis, see DiMaggio and Powell (1991:11-27) and Scott (2008:36-41).

45 shown to “embody, enact or transmit societal norms and values” (Greenwood at al. 2008:5). Greenwood et al. provide their understanding of institutions as: more-or-less taken-for-granted repetitive social behaviour that is underpinned by normative systems and cognitive understandings that give meaning to social exchange and thus enable self-reproducing social order. Institutions are characterised by lack of overt enforcement, their survival resting upon ‘relatively self-activating social processes’ (Jepperson 1991:145). (Greenwood et al. 2008:4-5, emphasis in original) OI views institutions as sources of interpretive scripts and terms through which individual self-identities and preferences are created, meaning is formed, and behaviours are enacted which, in turn, reinforce the cultural conventions embodied in the institution. In this way, institutionalized practices achieve “a rule-like status in social thought and action” (DiMaggio and Powell 1991:9); they are widely followed, undebated, and exhibit permanence (Tolbert and Zucker 1983:25). Institutionalised acts are perceived as objective and exterior aspects of social reality by those who share a common understanding of them; in this sense, the divide between culture and structure dissolves since the two are seen as mutually constituted (Hall and Taylor 1996:947). Rational and strategic action are possible in this model, but are institutionally constituted, with individual behaviour guided not just by a “logic of instrumentality” or “social appropriateness” (Hall and Taylor 1996:949), but by “orthodoxy” (Scott 2008:51). As Zucker ([1977] 1991) explains: For highly institutionalized acts, it is sufficient for one person simply to tell another that this is how things are done. Each individual is motivated to comply because otherwise his actions and those of others in the system cannot be understood (Schutz 1962; Berger and Luckmann 1967); the fundamental process is one in which the moral becomes factual. (p. 83) The institutional perspective stands in opposition to classical views of organizations as rational instruments (Weber 1920/1947:329-341; Scott and Davis 2007:35-36). Instead, OI views organizational structures and processes as being constituted by prescriptions emanating from the organization’s institutional context, rather than just being products of its technical environment (Meyer and Rowan [1977] 1991; Zucker [1977] 1991; DiMaggio and Powell [1983] 1991). Early OI theorists focused on explaining why organizations appeared to have similar formal structures. The foundational argument (Meyer and Rowan [1977] 1991) was that organizations in

46 modern societies exist in highly institutionalized contexts replete with widespread but untested beliefs of rational means to achieve desired social ends. 38 These beliefs, which the authors label “rationalized myths,” arise from laws and regulations, professional ideologies and standards, industry norms, or practices followed by powerful or successful organizations. Since success and survival depend on achieving external legitimacy, organizations adopt and uphold these misperceptions even if they have no demonstrated benefit to, and may even hinder, the efficient accomplishment of the organization’s goals. Organizations deal with this conflict through “ceremonial conformity,” making symbolic changes in the organization’s formal structure, while loosening (“decoupling”) the degree of alignment and integration between it and the actual behaviours that constitute daily work activities. Organizations respond in similar ways in highly institutionalised contexts because the misperceptions are widespread and largely undisputed. The responses thus, result in isomorphism by structuring organizations in the entire “field” through coercive, mimetic or normative processes (DiMaggio and Powell [1983] 1991). A field is defined as “those organizations that, in the aggregate, constitute a recognized area of institutional life: key suppliers, resource and product consumers, regulatory agencies, and other organizations that produce similar services or products” (DiMaggio and Powell 1991:64-65). It creates an important level of analysis that goes beyond the common notion of an industry, bringing into the fold entities that can all impact the performance of the core organization, and which all share common regulatory, normative, and cultural-cognitive frameworks. The structure and behaviour of organizations cannot be understood without reference to the characteristics of the field in which they are located (Scott 2008:86). In contrast to the early interest in isomorphic structuration activities, later theorists came to recognise institutions as contested terrains, “rife with conflict, contradiction, and ambiguity” (DiMaggio and Powell 1991:28), negotiated and co- constructed by increasingly agentic organizational actors (Greenwood et al. 2008:16, 19). One view of institutional contradiction (DiMaggio and Powell 1991:29-30) rests on the structural argument that institutions are composed of networks of interrelated elements

38 Interestingly, in this landmark paper Meyer and Rowan did not formally define institutional context.

47 which may be mutually supportive or antagonistic. Depending on the nature and extent of alignment between these elements, institutions may be resilient, mutable, or fatally unstable in the face of change (Zucker 1988). A more symbolic view is that society is simultaneously comprised of several institutional orders, each with its own logic of material practices and symbolic constructions to make sense of the social world (e.g., the “social” versus the “medical” model of disability). When contradictory orders get pitted against each other, institutional entrepreneurs can rearrange institutional building blocks to create new meanings and practices (Friedland and Alford 1991). In both formulations, change occurs in a world replete with institutions, circumscribing the possibilities that new institutions can take (Hall and Taylor 1996:953).39 In the institutional logics perspective, for example, the creation of new logics depends on the range of cultural schema available in the institutional environment, and on the capacity of institutional entrepreneurs to mobilize the power necessary to dismantle prevailing logics (Garrow and Hasenfeld 2010:43). Institutional terrains, thus, both constrain and enable actors to enact diverse responses based on a number of field or organizational factors. Responses may range, for example, from passive strategies such as acquiescence or compromise, to active resistance through avoidance and defiance, to outright manipulation (Oliver 1991:151- 159). Field factors may include the historical context of the field, complexity of the resource environment, contradictory pressures due to overlapping jurisdictions, professional diversity (Powell 1991:194-197), or government willingness to negotiate and compromise (Paradis and Cummings 1986). Organizational factors may include structural aspects such as board interlocks (Davis and Greve 1997), nature and context of institutional pressures (Oliver 1991), organizational histories and identities (Glynn 2008), or sensemaking processes (Weick 1995; Zilber 2008). With its potential to tie together macro (state level) forces and meso (field and organizational level) factors to micro phenomena (preferences and behaviours of individual actors) (Greenwood et al. 2008:4), OI is an analytically powerful approach for

39 This is similar to historical institutionalism’s notion of “path dependency,” although the sources of constraint are theorized very differently by the two perspectives.

48 understanding the characteristics and responses of developmental disability services in relation to their institutional contexts. In addition, its focus on making visible how beliefs and cultural templates become structurally sedimented makes it suitable for uncovering the processes underlying neoliberalism which cultural theorists conceptualise as a cultural and political formation (Kingfisher and Maskovsky 2008:120; Clarke 2004:38). OI has been successfully applied in political science (where it is referred to as sociological institutionalism) to explain how legitimacy concerns result in isomorphism in state organizations (e.g., Meyer et al. 1977; 1992) and policies (e.g., Soysal 1994), as well as how differences in cultural conceptions shape policy formation (e.g., Dobbin 1994). The theory’s most critical limitation is, not surprisingly, its lack of clear definition of institutions, and of the difficulty operationalizing institutional aspects. An underspecified definition, on the other hand, enables application of the theory to multiple levels, settings and topics (Greenwood et al. 2008:32), and makes it easier to interface with other perspectives—for example, RDT (as demonstrated by Oliver 1991) and identity theory (Glynn 2008) to name just two—thereby increasing the potential to sharpen the understanding of how institutional processes are related to individual-level behaviours that result in organizational phenomena. Another problem is that although OI conceptualizes institutions as social and cultural constructions (therefore suggesting an interpretivist or a constructivist epistemology), the actual construction processes that underpin them are, for the most part, assumed rather than empirically tested. Most OI studies use quantitative approaches to examine, for example, the adoption of new organizational forms or practices rather than using interpretive approaches to understand how cognitive frameworks shifted to enable these changes to occur (Hinings and Tolbert 2008:484). Similarly, while OI acknowledges that interests emerge within particular historical contexts (DiMaggio and Powell 1991:7, 10), with few exceptions (Tolbert and Zucker 1983; Dobbin 1994), theorists have paid relatively little attention to the role of history in shaping organizations (Hinings and Tolbert 2008:484). In contrast, historical institutionalism, discussed next, explicitly focuses on the historical processes underlying institutional change, specifically in state structures and policies.

2.2.5 Historical institutionalism Unlike RDT and OI, which focus on organizational behaviours, historical institutionalism (HI) is interested in state structures and policies (Hall and Taylor 1996:937-938). HI defines institutions, by and large, as “the formal or informal procedures, routines, norms and conventions embedded in the organizational structure of the polity or political economy” (Hall and Taylor 1996:938). HI views institutions as legacies of concrete historical processes, emerging from and sustained by a larger social and political context, and shaping actors’ interests, identities, powers, and strategies. HI’s task is to identify the temporal factors and power asymmetries that influence institutional development and operation. HI rejects OI’s view of institutions as culturally-shared scripts, arguing that this obscures the presence and role of conflicts among groups (Thelen 1999:387).40 Instead, HI posits that institutions “represent socially sanctioned, that is, collectively enforced expectations with respect to the behaviour of specific categories of actors or to the performance of certain activities. Typically they involve mutually related rights and obligations for actors” (Streek and Thelen 2005:9; emphasis in original). While individuals are capable of strategic action, they are expected to conform to institutional requirements, which are enforceable by a third party (p. 10). Path dependency and positive feedback are core concepts in HI. Choices made early in an institution’s life are seen to have a greater, ongoing and deterministic impact over it than later choices, constraining future possibilities and being self-reinforcing (Pierson 2000). Explanatory mechanisms for path dependency include notions of sunken costs and increasing returns (Pierson 2000), vested interests (Mahoney 2000:516-518), coordinating effects of institutional logics (Deeg 2005:172), and the potential for institutional arrangements to create and reinforce power discrepancies (Thelen 1999:391- 394). While institutions are persistent by definition, it does not necessarily follow that they are static or immutable. Institutions are located in ever-changing contexts. Thus,

40 Although considerations of conflict had largely been missing in earlier (pre-1990s) OI research (DiMaggio and Powell 1991:30,31), some authors had started to address how power and interests shape organizational fields, e.g., Brint and Karabel (1991), Galaskiewicz (1991) and DiMaggio (1991).

50 institutional persistence and reproduction are seen to be dynamic processes in which disruption to feedback mechanisms create possibilities for evolution. Understanding how institutions evolve and change requires analysing their differing ideational and material foundations, and the processes and mechanisms through which they are reproduced and sustained. Analysing these contextual conditions also helps to unravel why overarching trends have different local consequences (Thelen 1999:399). HI’s epistemology, consequently, is firmly grounded in interpretivism, and is strongly reflected in the inductive, context-specific methods they use such as process tracing and case comparisons (Hall and Taylor 1996:954). In HI’s earlier conceptualizations, institutional change was viewed as resulting largely from punctuated processes, where exogenously precipitated critical junctures (e.g., war, economic crisis) radically interrupt otherwise uneventful periods of continuity (Hall and Taylor 1996:942). Recent literature suggests that neoliberal reforms occur endogenously within the constraints of the very institutions that they are reforming, in incremental ways, and resulting in gradual institutional transformation (Deeg 2005; Hacker 2005; Streek and Thelen 2005:3-4). Streek and Thelen (2005:9) argue that this new type of reform, which they call advanced liberalization, is better captured by distinguishing the processes of change (abrupt or incremental) from the results of change (continuity or transformation). Doing so makes it possible to conceptualize gradual transformation as change that results in institutional discontinuity, but through incremental, endogenous processes.41 One way that historical institutionalists study change processes is by viewing institutions as structuring individual behaviour through “relations of authority, obligation, and enforcement,” that is, as a social regime (Streek and Thelen 2005:11): By regime we mean a set of rules stipulating expected behavior and ‘ruling out’ behavior deemed to be undesirable. A regime is legitimate in the sense and to the extent that the expectations it represents are enforced by the society in which it is embedded. Regimes involve rule makers and rule takers, the former setting and modifying, often in conflict and competition, the rules which the latter are

41 In this thesis, I use the term “critical juncture” to refer to either mode of transformation, where there is evidence of a conjuncture of forces initiating abrupt change or processes of gradual transformation.

expected to comply. … [R]elations and interactions between the two are crucial for the content and the evolution of the regime as such. … [cont.] Conceiving of institutions as regimes not only makes them eminently accessible to empirical research as it translates institutional relations into relations between identifiable social actors. Even more importantly … it is only if we can distinguish analytically between the rules and their implementation or ‘enactment’—and, by extension, if we can identify the gaps between the two that are due to, or open up opportunities for, strategic action on the part of actors— that we can capture important features of incremental endogenous change. (Streek and Thelen 2005:13) The gap between an institution’s idealised set of rules and the actual reality of the behaviour under it may be present for a number of reasons including: inherent ambiguity of rules, variation due to the contexts in which they are interpreted, unintended consequences, and deliberate circumventing (Streek and Thelen 2005:14-16).42 At least five broad modes of gradual institutional transformation have been identified, occurring in the ambiguities and gaps that either exist by design or emerge over time between formal institutions and their actual everyday implementation or enforcement: displacement (new, or previously subordinate, institutions and associated logics slowly discredit or push aside traditionally dominant arrangements, e.g., Deeg 2005); layering (new elements become attached to existing seemingly unassailable institutions, gradually changing their structure and status via differential growth, e.g., Hacker 2005); drift (slippage in institutional practices due to neglect in the face of changing circumstances, e.g., Hacker 2005); conversion (redeployment of existing institutions to new goals via redirection or reinterpretation, e.g., Palier 2005); and exhaustion (withering away of institutions via depletion, e.g., Trampusch 2005). Conceptualizing institutional change as arising from either exogenous or endogenous sources, and occurring in abrupt or gradually transformative ways significantly expands HI’s capacity to provide a more nuanced understanding of institutional change processes. HI is particularly appropriate for analysing how Alberta’s developmental disability policies and structures have evolved over time and during the neoliberal era. By focusing on questions of timing and temporality, HI enhances the realism of its analyses

42 Compare this with OI’s concept of decoupling between formal organizational structure and the actual implementation of everyday work.

52 and creates a strong foundation for making causal claims (Hall and Taylor 1996:954). Although HI does not concern itself with questions of institutional impacts on organizational characteristics and processes per se, its view of institutions as products of broad historical contexts, its explicit interest in the outcomes of historical processes (continuity or change), its attention to the role of power in shaping individual behaviours and institutional outcomes, and the analytical tools it offers complement OI’s relative neglect of these considerations. There are also many points of similarities between the two schools. Both view institutions as arising in broader social contexts, and both have a complex view of the mutually-constitutive relationship between individuals and their institutional context. Their views of institutions as works-in-progress that exist only to the extent that they are reproduced through routinized enactments, and as multiplex environments with inherent contradictions and tensions, make them eminently suitable for investigating how the various institutional elements of neoliberal regimes shape the activities of nonprofit human service organizations, and how the latter reinforce and perpetuate institutional rationales and ideologies. Their concepts related to the gaps or discrepancies between formal structure and actual behaviour can usefully reveal sites of tensions and variations in organizational perceptions and responses, and open up possibilities of sources for resistance to seemingly pervasive institutionalizing forces. For nonprofit scholars in general and for the present research in particular, the vital contribution of both OI and HI is that the prevalence and vitality of the sector are not simply products of exogenous individual choices, but of how these choices are shaped by political, legal, and cultural contexts. Institutional perspectives suggest that a complex array of institutions and their interrelationships are at play, at any given time and historically, in shaping the characteristics of the field of services to persons with developmental disabilities as a whole, and its nonprofit service provider organizations. The theoretical challenge is to determine which specific forces are critical in the field as a whole or in a specific organization’s environment, and to elucidate the processes by which they shape people’s preferences and choices (Smith and Grønbjerg 2006:236-237).

2.2.6 Conclusion The review of theoretical approaches in the nonprofit sector and human service organizations literature shows that no single theory or perspective is adequate to address (i) how developmental disability service organizations have been shaped by the institutional changes brought about by neoliberal shifts in their environment; and (ii) the historical processes by which these institutional changes have come about. The review also showed that there is a fundamental and complex relationship between nonprofit human service organizations and their environment for material resources and legitimacy. As such, organizational behaviour has to be understood with these in mind. Three perspectives, RDT, OI and HI, offer complementary lenses and conceptual tools that, if used together, would be better able to address these needs. Part Three presents the specific research questions arising from the literature review, and the integrated theoretical framework that is used to address them.

2.3 Part Three: Research Questions and Theoretical Framework [There is an] increasing recognition among scholars that institutions and institutional change are more complex than any paradigm portrays by itself and that it is time to begin exploring how paradigms complement and connect with each other in ways that might eventually generate new insights, if not a new problematic, for analysing institutions. (Campbell and Pedersen 2001:2)

Based on engaging with the literature, the broad goal of the research was translated into the following specific questions for this study:  What are the historical socio-political, economic and cultural origins of the institutional elements and arrangements that were present in the field of services for adults with developmental disabilities in Alberta at the start of the Klein reforms in the 1990s? (Chapter Four)  What were the main general elements of the Klein reforms? Why were the reforms a critical juncture in the province’s institutional landscape and what made the transformation possible? (Chapter Five)  What were the key manifestations of the neoliberal reforms in Alberta’s developmental disability field? What salient contextual forces and actors shaped institutional developments and how did they do so? (Chapters Six through Nine)

 How did publicly-funded developmental disability service organizations respond to the neoliberal reforms, and with what consequences? How can differences in organizational responses be explained? (Chapters Six through Nine)

The literature highly recommends integrative approaches given: the diversity of the nonprofit sector (Kramer 2000; Anheier and Salamon 2006:103; Steinberg 2006); the complexity of organizational environments in general (Hillman, Withers and Collins 2009) and the deep embeddedness of human service organizations in particular (Garrow and Hasenfeld 2008:50); the complexity of institutional processes in general, and the multiple contours and manifestations of neoliberalism in particular (Campbell and Pedersen 2001:2-3; Kus 2006). An integrative approach provides a richer theoretical span and a wider methodological scope than a single perspective, thereby promising a more nuanced understanding of the complex world and activities of nonprofit human service organizations in neoliberal regimes. Blended approaches have been successfully demonstrated by others who have combined these perspectives to suit their empirical purposes and advance theoretical understandings (e.g., Oliver 1991; Campbell [1998] 2001; Hay 2001; see also Hall and Taylor 1996:955-957 and Thelen 1991:370-371). Based on these recommendations and the prior successes of blended approaches, a theoretical framework for this research was developed integrating resource dependence theory (RDT), organizational institutionalism (OI), and historical institutionalism (HI). These perspectives were selected based on the conclusion from the literature review that understanding how neoliberal shifts have shaped developmental disability service organizations requires attending to the institutional contexts in which the organizations are embedded, the historical developments that have shaped these contexts, and how organizations are shaped by their need for resources. The review suggested that, from the extant theoretical perspectives available, RDT, OI and HI would be well suited to address these requirements (see Parts One and Two above). The framework aims to leverage the synergy between these perspectives due to their common assumptions and epistemological stance, while harnessing the strengths proffered by their divergent foci, and their complementary insights, conceptual lenses and tools. Before presenting the theoretical framework, RDT, OI and HI are compared to show that there are sufficient

55 commonalities in their fundamental assumptions to justify integrating them into a single framework, and that their divergences help to expand the empirical and theoretical reach of the study. Next, a diagram of the integrated framework is presented, identifying the various levels of analysis that it encompasses, and defining the main concepts. The chapter ends with a summary of the various ways in which the three perspectives are blended in the four main analytic activities conducted to address the research questions.

2.3.1 Comparing resource dependence and institutional perspectives The commonalities and distinctions of RDT, OI and HI on various points relevant to the current investigation are summarised in Table 2.1 (next page). All three perspectives are interested in how the environmental context shapes individual choices and behaviours, and how contexts persist or evolve. They share fundamental assumptions that: (i) individuals are capable of strategic action, but their choices and behaviours are constrained by contextual factors (Pfeffer and Salancik 1978:43; DiMaggio and Powell 1991:10; Hall and Taylor 1996:937); (ii) these contexts are socially constructed and reproduced by the contextually constrained ongoing interpretations and actions of individuals (Pfeffer and Salancik 1978:26-27, 63; DiMaggio and Powell 1991:11; Hall and Taylor 1996:941); and (iii) environmental contexts contain interconnected elements, with sometimes conflicting logics or demands, from which change can originate (Pfeffer and Salancik 1978:93-94; DiMaggio and Powell [1983] 1991:65; DiMaggio and Powell 1991:28-30; Thelen 1999:396; Streek and Thelen 2005:14-16). The perspectives share a constructivist philosophy, evident in their assumptions about environmental contexts. These fundamental convergences highlight the compatibilities across the perspectives, and justify their use in a single study. Their divergences provide opportunities to expand the theoretical and methodological reach of an investigation. These divergences originate primarily in: (i) their problematic foci; (ii) their definitions of environmental context; (iii) the degree of strategic agency and rationality they assign to individuals; and (iv) their analytic tools.

Table 2.1 Comparison of Organizational Institutionalism, Historical Institutionalism and Resource Dependence Theory Organizational Historical Resource Dependence Institutionalism Institutionalism Theory Convergences Common Environmental contexts: assumptions  shape individual choices and behaviours,  are socially constructed through individual interpretation and actions,  contain numerous elements with conflicting logics and expectations. Individuals:  must respond to contextual demands to pursue their interests,  capable of strategic action, but preferences/choices are structured by context. Ontology Relativist (constructivist paradigm) Epistemology Interpretivist/constructivist Main question How does the environmental context shape choices and behaviours, and with what consequences? Divergences Foci Field and organizational State structures, policies, Strategic responses of level changes conventions organizations Views of Institutional environment Task environment environmental Normative, cultural- Normative, enforced. Economic, political context cognitive. Shared norms, Historically-specific resources. Exchange meanings, beliefs provide procedures, routines, norms networks create cognitive scripts, moral in state products and dependencies, power frameworks. structures. difference, uncertainty. Durable, but changeable Dynamic Reproduced out of habit or Durable due to sunk costs, Ever-changing due to inability to conceive elite interests, but capable of ongoing activities to alternatives, but multiple change through shock or reshape networks of logics provide space for re- incremental processes. interdependencies. interpretation and creation. Organizations Guided by cultural frames. Have differential access to Bounded rational. Seek to and Seek legitimacy. Can power and decision enhance autonomy and individuals create new meanings in structures. Elites act to reduce power differentials spaces with misaligned maintain status quo. and uncertainty via elements or conflicting strategic adaptation. logics. Methodologies Diverse (mostly Comparative. Historical. Diverse (mostly or analytic quantitative) methods. Context-specific process quantitative) methods. tools tracing. Notion of critical junctures. Note: The institutional perspectives have significant internal debates and sub-variations; the table is, necessarily, a highly concise summary of a complex literature, and describes predominant stances and tendencies.

First, OI and RDT seek to explain the behaviour of formal organizations (Pfeffer and Salancik 1978; DiMaggio and Powell 1991), while HI focuses on analysing historical developments in institutions and how the structures and products of the state and the political economy shape capacities for action, policy making and institution building (Hall and Taylor 1996). Combining the perspectives enables one to analyse the historical changes in the institutional contexts of the field of services to people with developmental disabilities and the relationship between neoliberal shifts and organizational responses. Second, each perspective defines environmental context differently. OI and HI have a broad concept of institutional context, defining it, respectively, in cultural- cognitive (Scott 2008:57) or regulative-normative terms (Hall and Taylor 1996:938; Streek and Thelen 2005:9). RDT has a narrower focus, defining it in terms of resource relationships in the organization’s task environment,43 although RDT does address how an organization can change normative and regulatory controls in the environment to serve its own interests (Pfeffer and Salancik 1978:2, 147-152, 188-191). Combining the three perspectives allows for a much broader definition of institutional context. Third, although all three perspectives view individuals as capable of contextually- bound strategic action, RDT imbues them with more agentic capacities (Oliver 1991:149). Consequently, the context in RDT is much more dynamic than in OI and HI, with self-interested organizations making frequent strategic (albeit contextually constrained) adjustments to perceived environmental demands and pressures, and by so doing, creating new structures of relationships in their efforts to achieve stability and predictability (Oliver 1991:149). The environmental context in OI and HI is changeable but relatively durable, reproduced via isomorphic and cultural transmission processes (DiMaggio and Powell [1983] 1991; Zucker [1977] 1991), or path dependencies shaped by historical legacies (Hall and Taylor 1996:941; Pierson 2000). Power differentials play a central motivating role in RDT (Pfeffer and Salancik 1978), figure prominently in HI (Thelen 1999:391-394), but have been relatively neglected in OI (DiMaggio and Powell

43 Task environment refers to an organization’s relations of exchange relevant to the supply of inputs and disposition of outputs (Scott and Davis 2007:125).

1991:30). Combining these perspectives provides a greater repertoire of possible explanations when confronted with institutional change in the empirical setting. Finally, HI’s distinct historical focus and tools (e.g., its notion of critical junctures and the use of process tracing) expands the methodological capacity of the research. These divergences are harnessed as potential strengths in the present research.

2.3.2 Theoretical framework Figure 2.2 below illustrates the theoretical framework. It depicts the theorised relationships between the developmental disability field (all individuals, groups, organizations, and entities associated with the delivery of publicly-funded services for adults with developmental disabilities in Alberta), the field’s institutional context, and the socio-historical context. The downward arrows (thick, left-side) are theorised to typically exert more force than the upward arrows (thin, right-side). The framework encompasses multiple levels:  the macro level which consists of broad global, societal and historical contexts;  the supra-meso level where institutional forces such as federal or provincial legislation, policies and structures exist;  the meso (field) level where service organizations and related groups within a specific policy domain exist and interact, and where norms and values are shaped;  the sub-meso (intra-organizational) level where organizational goals, structures, and culture exist, and shape behaviours and preferences of organizational actors;  the micro (individual) level where individual actors perceive and make sense of their social settings, develop preferences, and enact their behaviours.

Figure 2.2 Theoretical Framework

Broad Social and Historical Contexts MACRO (Local, National and Global)

Institutional Context Regulative, normative, cultural-cognitive elements, SUPRA-MESO and their associated activities and resources. Relations of exchange, and their associated perceptions of dependence, power differentials and uncertainties.

Developmental disability field

Regulatory agencies, funders and donors Professional schools MESO Other governing bodies

SUB-MESO Service Provider Organizations

Actors MICRO Workforce, clients, families, advocacy groups

Organizational field is a main level of analysis in this research. It is defined as “those organizations that, in the aggregate, constitute a recognized area of institutional life: key suppliers, resource and product consumers, regulatory agencies, and other organizations that produce similar services or products” (DiMaggio and Powell [1983] 1991:64-65). It encompasses entities that can impact the performance of the focal organization, and which all (mostly) share common regulatory, normative, and cultural- cognitive frameworks (Scott 2008:86).44 For a collection of organizations to be considered a field, they need to have undergone the process of structuration. Highly structured fields are those which have a high degree of interaction among the organizations, sharply defined structures and patterns of domination or coalition, a large amount of information that must be processed, and an awareness among participants that “they are involved in a common enterprise” (DiMaggio and Powell [1983] 1991:65). Structured fields are more likely to be susceptible to (and to demonstrate) isomorphism (having similar organizational structures and range of activities). They are also more likely to use similar institutional logics (ways in which they theorise and organise their material practices and the symbols they use to make sense of their social world), and to have clearer field boundaries (Scott 2008:191). The structure and behaviour of organizations cannot be properly understood without “seeing it in the context of the larger action and meaning system in which it participates” (Scott 2008:209), that is, at the level of the field. The field gives us conceptual access to all the relevant actors in a specified social arena, the relational systems and processes through which they interact, the governance systems which consist of the regulatory and normative arrangements which control their activities, and the cultural-cognitive systems which underpin the frames they use to make sense of the events that occur to them and the logics they use to guide their actions. Attending to the ongoing activities of individuals and organizational actors in the field makes visible the processes by which the institutional arrangements in a field are sustained or changed.

44 The concept continues to evolve in the literature, and is “at one and the same time, widely accepted and hotly contested” (Scott 2008:181). For the purposes of the thesis, the definition provided here is adequate.

In this research, the developmental disability field is defined as all individuals, groups, organizations, and entities associated with the delivery of publicly-funded services for adults with developmental disabilities in Alberta. This includes service provider organizations, clients (service-recipients)45 and their allies (families and other key supporters or advocates), various levels of government (as producers of legislation, policies, programs, standards, or funding),46 bureaucrats, other funders and donors interested in the aims of developmental disability service organizations, accreditation and regulatory bodies that set and monitor standards of professional practices, professional schools that train individuals for the field’s workforce), and the workforce (managerial, frontline, and support services). Institutional context is a fundamental construct in this theoretical framework. This research adopts an omnibus conception of institutions (encompassing various strands of institutional approaches) as “comprised of regulative, normative and cultural- cognitive elements that, together with associated activities and resources, provide stability and meaning to social life” (Scott 2008:48), integrated with RDT’s focus on relationships of exchange, and their associated resource dependencies, and perceptions of power differentials and uncertainties (Pfeffer and Salancik 1978:68). Although on the face of it relations of interdependence between a focal organization and another entity are presumably more transient than regulatory, normative or cultural-cognitive forces, two arguments can be made to counter this. First, some relationships of exchange are of a very long duration, for example, the relationships between primarily publicly-funded developmental disability service organizations and government, or between the organizations and their client populations. Second, these enduring relationships are not shaped simply by the nature of what they exchange (provision of funding, bestowing of

45 During the time of the study, Alberta had about 10,000 adults with developmental disabilities receiving provincially-funded supports, and about 180 provincially-funded service provider organizations supporting adults with developmental disabilities. Source: http://www.humanservices.alberta.ca/disability-services/ pdd-by-numbers.html. 46 The most important role is played by the provincial government, and to some extent by the federal government (e.g., as signatory to international declarations regarding disability rights, or as the funder for national income support programs for people with disabilities), however, municipal governments also play a role (e.g., providing transportation programs and subsidies, setting accessibility standards, ensuring availability of low income housing, etc.).

62 legitimacy, or the delivery of goods and services) but are also heavily institutionally structured due to the human service work of the organizations (e.g., by regulatory and professional frameworks, public’s normative expectations, and views about appropriate service technologies). For nonprofit human service organizations, thus, such relationships of exchange are both durable and an essential aspect of their institutional context. Institutional contexts are viewed as originating in and being sustained by broader social and historical contexts, and by the ongoing and recurrent activities of individuals within these contexts. At any given time, a complex array of institutions and their elements are assumed to be at play, operating in independent or interdependent ways to reinforce or counter each other to shape choices and behaviours. When the elements are misaligned, spaces and possibilities for institutional change are likely to open up. Regulative elements in this framework are conceptualized as including formal rules (e.g., legislations, regulations, policies), monitoring and sanctioning activities, and their associated and perhaps unwritten codes of conduct. 47 Their objectives may be to control activities, or to confer special powers or benefits (e.g., a licence to operate a business, or to register as a charity and gain tax advantages) (Scott 2008:52). Regulative elements involve what is considered legal: what one must do, or is allowed to do. Normative elements refer to values and norms. Values are expressions of a desired state (ends); norms specify standards of conduct (means). Collectively, they “introduce a prescriptive, evaluative, and obligatory dimension into social life” (Scott 2008:54). They may be formally stated (e.g., in accreditation standards or professional codes of conduct) or exist informally in routines and conventional behaviours (Hall and Taylor 1996:938). They are backed by social (rather than legal) sanctions; they are enforced by the collective expectations of other salient actors (e.g., peer organizations) who share similar values and beliefs (Thelen 1999:387; Streek and Thelen 2005:9). However, because they derive from shared beliefs, norms and values are internalized; their conformity is typically self-motivated rather than externally induced. Normative

47 It should be emphasized that regulative, normative and cultural-cognitive elements are analytic rather than empirical distinctions. Rules and regulations, for example, usually derive their legitimacy from normative underpinnings, which in turn rest on beliefs and worldviews shared by at least some collective group. In empirical settings, thus, they may coexist, intermingle, or as is often the case, blur into each other.

63 elements involve what is considered appropriate: what one should strive for, or what one is supposed to do. Cultural-cognitive elements include shared beliefs, conceptions, symbols (words, signs, gestures), and frames through which meaning is socially constructed. Cognitive refers to an individual’s internal (mental) processes that create symbolic representations of the world in response to received stimuli, while culture refers to the shared external (social) frameworks that shape the internal interpretive processes (Scott 2008:57). Cultural-cognitive elements exist at deeper levels than regulative or normative elements, and typically underpin the latter two. They get reinforced by everyone performing according to shared schemas and behavioural scripts, and gradually turn into undebated practices and become objectified, for example, as “rationalized myths” (Tolbert and Zucker 1983:25; DiMaggio and Powell 1991:9). Cultural-cognitive elements involve what is considered obvious and taken for granted: what one sees as the natural or only conceivable thing to do, or accepts unquestionably as “that’s just how we do this.” Relations of exchange are the interconnections between a focal organization and other parties with whom it exchanges material resources or support. The relations of exchange that have the greatest bearing are those in which there is a perceived power differential, i.e., where the focal organization feels a sense of dependence on the other party, and perceives the latter as having some level of control over its behaviour or survival. These relations are most likely to be those where the resource in question is critical to the focal organization’s operations and difficult to obtain from other sources, the other party has a great deal of control over how it allocates the resource and has the capacity to make demands over the focal organization, and the other party has some means of assessing the organization’s activities to judge the extent to which the demands imposed on it are met (Pfeffer and Salancik 1978:44-45). Individuals and organizations are viewed as capable of strategic action, constrained to varying degrees by contextual factors (Pfeffer and Salancik 1978:43; DiMaggio and Powell 1991:10; Hall and Taylor 1996:937). It is assumed that, at any given time, their choices and behaviours will involve some degree of self-interested calculation combined with some degree of orientation to socially constructed and shared

64 systems of beliefs, norms and values, and perceptions arising out of relations of exchange and dependence. Choices and behaviours may originate from a relatively self-centred stance of “what’s in my best interest (given what I’m allowed) to do in this situation?,” to a more normative orientation of “what do others expect me to do in this situation?,” to a more taken-for-granted position of “I’m only doing what anyone would do in this situation.” It is expected (but not assumed) that, in addition to institutional contexts, past choices and outcomes will shape decisions. A mutually (but not equally) constitutive relationship is envisioned between individuals (and organizations) and their institutional context, that is, that individual and organizational behaviour is largely shaped by the institutional contexts in which they find themselves, but also that the institutional context can be shaped by, and be a product of, the ongoing activities of these actors, albeit within the constraints imposed by extant institutional arrangements.

2.3.3 Analytic activities Four main analytic activities were undertaken to address the research questions: 1. Historical evolution of the developmental disability field in Alberta. At the macro level, the emergence and evolution of the salient institutional forces (as conceptualized using a blended definition from OI and RDT) were traced in the field of developmental disability services in Alberta from the creation of the province in 1905 to the start of the Klein reforms in the 1990s. HI’s notion of critical junctures was used to identify the most prominent historical shifts and link them to changes in the broad political, socio-economic, and cultural contexts. HI’s notions of path dependence and sunken costs sensitized the analysis to the possibility that, regardless of changes in broader socio-economic and political contexts, institutional evolution may be constrained by prior institutional arrangements. (Chapter Four) 2. The Klein reforms as a critical juncture. Also at the macro level, Campbell’s ([1998] 2001) typology integrating HI’s insights with the cultural-cognitive lens of OI was deployed to show why the Klein reforms constituted a critical juncture shaping the future institutional environment, and how the confluence of material and ideational forces made this transformation possible. Integrating OI with HI in

an analysis of institutional change processes directed attention to the way policymakers think about the rules and standards within their institutional context and the discourses they employ to guide and justify their actions. (Chapter Five) 3. Manifestation of neoliberal reforms in the developmental disability field. The empirical research identified four main ways in which neoliberal reforms manifested in the developmental disability field. Each is discussed and analysed separately, interspersed with focused examples to highlight particular processes or outcomes. All three perspectives were drawn upon for the analysis, which was conducted at both the meso (field or inter-organizational) level and the micro (intra-organizational or individual) level, depending on the topic being examined. (Chapters Six through Nine) 4. Comparison of organizational responses: An important part of the analysis included theorizing similarities and differences in organizational responses to the institutional changes in the field. While the field was the primary level and unit of analysis, three developmental disability service organizations constituted embedded units of analysis, and were treated as “comparative case study sites” for this research. The analysis consisted of blending insight from RDT and OI to shed light on the institutional sources motivating and guiding organizational behaviours and strategic responses. (Chapters Six through Nine) In addition, to conclude the thesis, a final overarching analysis consisted of taking a broad look at the extent of neoliberalization of the field. For this, the ten objectives identified as characterizing neoliberal modes of governance (Osborne and Gaebler 1992) were used as a heuristic frame to structure the analysis.

2.4 Concluding Remarks The typical efforts of most leaders of nonprofit human service organizations to the many challenges (and opportunities) characterizing the shifts in the political economy since the 1990s focus on attempts to improve internal efficiencies, diversify revenue streams, and strengthen external relationships in order to mitigate uncertainty and enhance survivability. These strategies, perforce, are directed and operate at the intra- and inter-organizational levels. The historical review of the Canadian nonprofit sector

66 showed, however, the deep embeddedness of the organizations in a supra-organizational environment which consists of a changing and often conflicting smorgasbord of legal- political, economic and regulatory demands. Human service organizations, in particular, are susceptible to normative and cultural forces towards which they need to orient and reorient their behavioural choices and activities in order to garner the material and political resources necessary for survival. The review also showed that history matters, for at least two important reasons. First, current institutional contexts of Canadian nonprofit human service organizations are products of historical processes and forces. Second, neoliberal reforms aim to change institutional contexts, and—like other institutional change processes—are best understood by examining the specific historical, socio-political, and cultural contexts in which they take root and unfold. Based on the review of the nonprofit sector and human service organizations literature, three theoretical perspectives were identified that offer the most promise for the purposes of the current research, and an integrated theoretical framework was developed to guide the multi-level and wide ranging examination undertaken by the present research. In the next chapter, the research approach and methods are described.

CHAPTER THREE: RESEARCH APPROACH AND METHODS

Research is not helped by making it appear value free. It is better to give the reader a good look at the researcher. Often, it is better to leave on the wrappings of advocacy that remind the reader: Beware. Qualitative research does not dismiss invalidity of description and encourage advocacy. It recognises that invalidities and advocacies are ever present and turns away from the goal as well as the presumption of sanitization. (Stake 1995:95)

The goal of this research is to contribute to emerging understandings of the ways in which neoliberal regimes shape the institutional contexts and characteristics of nonprofit human service organizations in Canada. As with many qualitative case studies, this research was prompted by the need to make sense of something encountered in real life (Merriam 1988:44). The research was motivated by my observations of the changes originating from the Klein reforms in the field of services to people with developmental disabilities in Alberta where I worked from 1997 to 2010. My need to make sense of these changes and their implications for community-based organizations led me to the scholarly literature. Here, I found that understandings of the impact of neoliberal reforms on nonprofit human services were still emerging, and also that neoliberalism did not manifest in uniform ways. I also learned that very little was documented about the field of services to people with developmental disabilities in Alberta in general. Therefore, for pragmatic and scholarly reasons (which I elaborate below) I decided to locate my research in this field and to use a case study approach to address the research goal. In this chapter, I summarise the research approach and methods. I first state my epistemological stance and how I view my role as a researcher since these guide all my research decisions. I then explain the methodology: why I chose to do a case study, my rationale for locating the research in Alberta’s developmental disability field, and the overall logic for this multi-level investigation. For each phase, I describe data collection methods, activities and sources, the ways in which the data were organized and analysed, and the reasons for my choices. I discuss ethical and political considerations, and steps to maximize research quality. I end by clarifying the scope and limits of the project.

3.1 Epistemological Orientation and Researcher Role My research is grounded in a constructivist epistemology. By this I mean that, like many qualitative researchers, I believe that our understanding of the world is constructed based on the “concepts, models, and schemes [that we invent] to make sense of experience, and we continually test and modify these constructions in the light of new experience” (Schwandt 2000:197).48 These constructions arise in the sociocultural and historical settings in which the experiences take place, and are shaped by our personal histories, life circumstances, interests and biases. In contrast to positivist (or post- positivist) views that empirical reality can be accurately captured either fully (for positivist) or imperfectly and probabilistically (for post-positivists) (Lincoln and Guba 2000:168), constructivists hold that there can be no unmediated, direct grasp of the empirical world. All knowledge thus is local, specific, subjective and impermanent. Constructivists, therefore, are ontological relativists (Schwandt 2000:197-198). That is not to say that there is no real world “out there;” objects and people exist, events and activities occur, time passes. In the developmental disability field, laws and regulations govern activities, resources are allocated, contracts are signed, services are provided, people are employed, clients are supported, and endless reports are produced. These are empirically real. Even ontological relativists must approach these facts with realism. How we make sense of these facts—how and why the facts came about, what their social meaning is (a contract as a signed piece of paper vs. a contract as a legally binding instrument)—is a socially mediated process, resulting in a constructed knowledge of the social world. Moreover, these “[c]onstructions are not more or less “true,” in any absolute sense, but simply more or less informed and/or sophisticated” (Guba and Lincoln 1994:111). We may choose to respect all constructions or perspectives, but they are not all equally important; those “less informed and/or sophisticated” are less useful socially or for research purposes (Stake 1995:102-103).

48 There appears to be neither a single description of constructivism, nor a consistent use of terminology, with terms like constructivism, constructionism, social constructionism and so on used in different ways. As well, there are many positions ranging from weak to radical on the spectrum (Schwandt 2008:208). What I describe in this section reflects what I believe; the terminology itself is not relevant.

Ontologically, this research has two levels of “reality” for me to confront. One relates to the simple historical facts in the field of developmental disability services: what happened, when, where, who was involved, etc. These are fairly straightforward to verify. They can be easily judged by “those who know” whether I got them right. The other level of “reality” relates to the interpretations made and the perceptions held by people about these facts, what they mean(t) to those involved. It is at this level that my epistemological orientation as a constructivist becomes most relevant. As a researcher, my task is to make sense (construct knowledge) out of how others make/made sense (construct/constructed knowledge) of the world, to understand what accounts are consistent, what accounts are different and why that might be so, and what accounts (because they are more informed and developed) might be more useful in my [re]construction of their knowledge into a yet more informed, and hopefully more sophisticated, understanding of the world. A constructivist epistemology, like any other, has implications for the methodological choices consistent with its worldview. Appropriate choices are those that are typically part of the wide range of qualitative approaches (such as case studies, in- depth interviews, ethnographies, participant observation, historical analyses, and so on) that bring the researcher into (literally or through media such as texts, videos, etc.) the world that interests them and where the researcher can attempt “to make sense of, or to interpret, phenomena in terms of the meanings that people bring to them” (Denzin and Lincoln 2000:3). The methodological choices I made, the rationales underlying these choices, and their implications are discussed in further detail in this chapter in the specific areas where they arise in the research process. A constructivist epistemology also has implications for the criteria for judging the goodness or quality of such research. While these have grown over time and depend on the specific “variety” of one’s constructivist position and research aims, authenticity and trustworthiness remain central (Lincoln and Guba 2000:178-182). Towards the end of the chapter, I describe further what is meant by these terms, and the general steps I took to achieve them. In addition to epistemological orientation, the research is also shaped by what I saw as my role in this research project. Stake (1995:91-99) identifies a number of roles such as teacher, participant observer, interviewer, evaluator, advocate and so on that a

70 researcher plays while doing their research; each has implications for how the research is done. At one level, my role was that of a doctoral student attempting to do good, useful research by applying the various techniques of my discipline in ways that strived to meet scholarly criteria of quality. At another level, equally important to me, was my commitment to my role as an advocate, for the developmental disability sector as well as the nonprofit sector more generally. I disclosed in the introduction to the thesis that the research was motivated by my professional experience in and my passion for the nonprofit sector, and that I hope the research will help provide insights to create an environment that maximizes the vibrancy of the sector. Thus, while striving for academic rigour throughout the research process, I also try to make visible through my analysis insights that may help generate a better understanding of how to improve the potential of the sector. I do not see these activities as being in tension; nevertheless I discuss more fully in Section 3.8 the steps I took to make sure that my views do not distort or threaten the quality of my investigation or the integrity of my interpretations.

3.2 Rationale for Case Study Approach The research used a longitudinal embedded single-case design (Yin 2008:50). The primary focus was to research Alberta’s developmental disability field, which constituted the main level and unit of analysis. Within this overarching single-case, comparisons were made across three organizations to explore potential differences in how they made sense of, or enacted responses to, institutional changes. The organizations were treated— and are sometimes referred to in this document—as “case study” sites, but they are technically subunits of analysis embedded within a single case, or, as Stake (2008:447) calls them, “cases within the case.” Case study research excels at generating rich, holistic and context-specific accounts. It can result in insights and understandings that can help structure future research, and thereby advance scholarly knowledge (Merriam 1988:32). A case study can also provide insight into the likely experiences of other nonprofit organizations in similar contexts (Berg 2009:330). A case study approach is particularly useful when ‘“how’ or ‘why’ questions are being posed, … and the focus is on a contemporary phenomenon within a real-life context” (Yin 2009:2). Defined as “a method involving systematically

71 gathering enough information about a particular person, social setting, event, or group to permit the researcher to effectively understand how the subject operates or functions” (Berg 2009:317), it is ideal for “researching relationships, behaviours, attitudes, motivations, and stressors in organizational settings” (p. 331), and for understanding how people, groups or organizations “frame what they see and hear, how they perceive and interpret this information, and how they interpret their own actions and go about solving problems and interacting with others” (p. 319).49 Case study research has been criticised that it cannot be used to make formal generalizations or contribute to theory building. When Stake (2000) says, “Single or a few cases are a poor representation of a population of cases and questionable grounds for advancing grand generalization” (p. 448), he is making the point that criticisms about generalizability are grounded in assumptions based on positivist research such as experimental or correlational designs. Flyvbjerg (2006) argues that such criticisms arise out of the overvaluation of general, context-independent knowledge over concrete, practical, context-dependent knowledge, and the privileging of formal generalizations over “the force of example” (p. 228). On the contrary, he argues, case study research is ideal for generalization which uses the falsification test (a case study’s in-depth examination can reveal the one black swan lurking among the many white swans, and thus force the revision of the proposition that all swans are white). For qualitative research, thus, the notion of generalization needs to be reframed (Merriam 1988:174). Two such reconceptualizations include the notion of naturalistic generalization (Stake 1994:85-88; 2000:442), and reader (or user) generalizability (Merriam 1988:177; Stake 2000:442-443). Naturalistic (vs. propositional ) generalization refers to the idea that people arrive at many conclusions through their own experiences or through vicarious experiences arising from engaging with thickly constructed accounts, such as those produced by many case studies. A single case provides insights and implications for other cases; it also adds to the repertoire of knowledge from other cases, thus providing an opportunity to modify existing generalizations, and thereby refine

49 I disagree with Berg’s use of the word “method” to define a case study, however, his description is otherwise useful. Stake (2000) is more accurate when he reminds us that a case study is “a choice of what is to be studied. By whatever methods, we choose to study the case” (p. 435, emphasis added)

72 theory (Stake 1994:85-88; 2000:442). A single case is also valuable to practitioners and policy makers because it extends knowledge of human experiences in complex settings, and can lead to refined expectations and action options (Stake 2000:448). The idea of reader generalizability recognises that the transferability of any study ultimately depends on whether the reader thinks the study applies to their needs and what they learn from it. The rich, thick descriptions that case studies typically provide make it easier for readers to see if the findings apply to their situation (Merriam 1988:177). The concept of reader generalizability is consistent with the idea that knowledge is constructed and that, in addition to the case researcher, “the reader, too, will add and subtract, invent and shape— reconstructing the knowledge in ways that leave it differently connected and more likely to be personally useful” (Stake 2000:442-443). Depending on how one views generalizability, thus, a single case can be useful for providing insights and implications for other situations that may share some similarities with it. It can also be useful for extending (being one more empirical example to build on) or revising established theories (being the lone black swan). The richness of information that a case study yields, besides being useful in its own right, also makes it easier by others to judge if the learnings from it may be applied elsewhere. These considerations were among those factored in to the decision for conducting the present research in the field of developmental disability services.

3.3 Rationale for Selecting Alberta’s Developmental disability field The decision to investigate the field of services for adults with developmental disabilities in Alberta was driven by pragmatic and scholarly considerations. Pragmatically, I have over 13 years of professional experience in disability services. It was while working in this field that I became aware of the institutional demands under which nonprofit human service organizations operate, and curious about their effects on organizational characteristics, capacities and outcomes. As a field “insider,” I have contacts that helped me access research resources with relative ease, and first-hand knowledge that gave me added insight in interpreting the data collected.50 Picking a case

50 The implications of this insider position are discussed in greater depth later in this chapter.

73 site that is “easy to get to and hospitable to our inquiry, perhaps for which a prospective informant can be identified and with actors willing to comment on certain draft materials” are valid criteria for case selection (Stake 1994:4). From a scholarly perspective, there is a very small body of knowledge of the developmental disability policy arena in Canada (see Chapter One), and even less written from a historical perspective: “only in very rare circumstances is there an examination in any depth of cumulative developments” (Neufeldt and Enns 2003:19). At the same time, Alberta’s developmental disability field is rich in the heterogeneity of forces embedded within it. There has been a swath of changes in policies and practices in the field since 1905, shaped by progressive shifts in societal views of people with disabilities rubbing up against counterforces such as the province’s historical tendency (until recently) to elect conservative governments, its volatile economy, and its citizens’ penchant for self- reliance and entrepreneurism (see Chapter Four). Collectively, these forces have created a multiplex institutional environment abundant in competing aims and logics, and a field with much diversity in the size, scope and approaches of the many community-based organizations providing services and supports. The institutional richness of the field provides an excellent opportunity for a case study of neoliberalism’s manifestations and developments in a specific policy arena. It meets Stake’s advice that a case should “maximize what we can learn. Given our purposes, which cases are likely to lead us to understandings, to assertions, perhaps even to modifying of generalizations” (1994:4). Methodologically, therefore, the field of services for adults with developmental disabilities in Alberta provided the benefit of being both an intrinsically valuable case (of primary interest in its own right) and an instrumental case (of secondary interest in its potential to generate insights into neoliberal reforms and nonprofit human service organizations elsewhere) (Stake 2000:437). Furthermore, the field’s organizational diversity provided the opportunity to make some exploratory comparisons to investigate differences in organizational responses within the same institutional environment. Stake (2000:439) cautions that it is generally not advisable to simultaneously do an intrinsic and an instrumental case study since the aims of each are different; he also concedes, though, that even those who do an intrinsic case study are always thinking

74 about how that case might teach us about some other class of things. I do not think the fact that the field of services for adults with developmental disabilities in Alberta was both intrinsically and instrumentally valuable compromised this research in any way because my focus was always overwhelmingly on understanding the case in its own right. I do, however, strongly believe that the insights generated from this case are potentially useful for extending our understanding of neoliberal reforms and nonprofit human services elsewhere; this potential should not be trivialised, or worse, ignored.

3.4 Summary of Research Design and Logic Once the decision was made to use a case study approach and the field of services for adults with developmental disabilities was confirmed to be interesting from a scholarly perspective, the next step was to link the primary research questions to the analytic activities required to answer them, and the specific methods needed to generate the appropriate data. Cunningham (1997) characterises this type of study as an intensive case study since its purpose is to develop an “intensive understanding of the events and practices of one person, group, or organization” (p. 402), or, in the present instance, a particular field of services in a specific policy domain. “The goal is to provide a history, description, or interpretation of unique and typical experiences and events ... based on an assortment of evidence from “within” the case ... from different viewpoints and time perspectives” (p. 402-403). Consistent with my epistemology, qualitative methods were used to gather the “assortment of evidence;” these are suited for investigating the unfolding of events or processes, and exploring how people structure and give meaning to their social realities (Berg 2009:8). Table 3.1 summarizes this research logic.

Table 3.1 Research Logic Analytic Levels and Research Questions   Methods Activities Phase One Historical evolution of the field What are the historical socio-political, (Macro level) Trace the economic and cultural origins of the evolution of the field from institutional elements and arrangements 1905 to the 1990s, linking key  that were present in the field of services  shifts in contextual forces and for adults with developmental institutional arrangements. disabilities in Alberta at the start of the Historical analysis Klein reforms in the 1990s? Document reviews Klein reforms overall What were the main general elements of (Macro level) Identify key the Klein reforms? Why were the elements and analyse why the  reforms a critical juncture in the  reforms were a critical province’s institutional landscape and juncture. what made the transformation possible? Neoliberalization in the developmental disability field (Meso and micro level) What were the key manifestations of the Key informant Examine how the reforms neoliberal reforms in Alberta’s interviews contributed to the developmental disability field? What   neoliberalization of the field, Researcher’s salient contextual forces and actors identifying key actors, roles experience shaped institutional developments and and institutionalising how did they do so? processes. Phase Two Differences in Organizational Responses How did publicly-funded Document reviews developmental disability service (Meso and micro level) Interviews organizations respond to the neoliberal   Compare three case study reforms, and with what consequences? Researcher’s sites (subunit analysis). How can differences in organizational experience responses be explained?

The research was conducted in two phases involving numerous data sources and participant groups. Table 3.2 summarizes the data collection activities, sources, and timeframes. The research methodology is described in detail in Sections 3.5 and 3.6.

Table 3.2 Summary of Data Collection Activities, Sources and Timeframe Method Sources Timeframe Phase One: Historical evolution of developmental disability field, and neoliberal reforms Interviews Purposively-selected sample of (actively employed or retired): Dec 2012 to 10 government representatives. Feb 2013 10 disability/nonprofit sector leaders.

Document Alberta government documents, annual ministry/departmental Mar to Jun Reviews reports, budgets, background policy papers, research and 2013 consultation reports, news releases. Statistics Canada data. Media As needed till reports. Organizational monographs. Scholarly literature. fall 2015 Phase Two: Comparison of organizational responses Study Sites 1. Calgary SCOPE Society (SCOPE) Jul 2013 to Apr 2. Optional Rehabilitation Services Inc. (Options) 2014 3. Vecova Centre for Disability Services and Research (Vecova)

Document Annual reports and financial statements, websites, T3010 forms, Reviews policy and procedure manuals, correspondence, internal documents about organizational direction and strategic changes.

Interviews Purposively-selected sample from pool identified by CEO/ED. SCOPE (total identified: 11) Options (total identified: 12) 3 senior leaders (management) 3 senior leaders (management) 2 program or area managers 5 area managers or facilitators Vecova (total identified: 24) 7 senior leaders (management and board, past or present) 3 area managers, mid-managers or professional staff 5 frontline staff (practitioners or team leaders)

3.5 Phase One: Historical Research The objectives for Phase One were to (i) trace the historical evolution of the institutional context of Alberta’s field of services for adults with developmental disabilities from 1905 to the present; (ii) identify the main elements of the Klein reforms which began in the mid-1990s; and (iii) elucidate how neoliberal shifts since the mid- 1990s had shaped the field. These objectives were achieved by using historical analysis (Singleton and Straits 2005:364). Data collection involved (i) conducting open-ended interviews (for individuals’ perspectives based on their personal experiences from at least the mid-1990s to the present, and (ii) reviewing primary and secondary historical sources and scholarly literature (for the period 1905 to present).

Historical research allows the use of a variety of methods “informed by a theory or theories that provide a set of parameters that focus on asking about history as it unfolds, particularly the relationship between people, events, phenomena, and the historical situations that create history.” It differs from a simple description of historical events or chronologies in that it provides a theoretically-informed account systematically linking how events, people or ideas of the past have shaped the present (Berg 2009:297).

3.5.1 Key informant interviews Interviewing individuals with firsthand knowledge of past events (obtaining oral histories) is a common way to supplement information from historical documents. The latter, especially if produced by official agencies or organizations, are more likely to “reflect only front-stage information. Facts critical for understanding research questions or hypotheses may have been combed out … However, the real-life experiences and memories of people cannot so easily be omitted, edited, erased, shredded, or swept away” (Berg 2009:311). Interviews are the main way to find out what is “in and on someone’s mind” (Merriam 1988:72), their feelings, past behaviours, how they made/make sense of the world, and their knowledge of the historical facts of interest to the researcher. In and through this dialogue, the researcher constructs her own knowledge and understanding. Because people define their worlds and structure their memories in unique ways, open- ended, conversational interviews are better at allowing the researcher “to respond to the emerging worldview of the respondent, and to new ideas on the topic” (p. 74). One difficulty with oral histories is locating individuals with firsthand information on the research’s subject matter (Berg 2009:310). For this research, the aim was to purposively select currently-employed or retired individuals known to have firsthand experience in the development or implementation of the Klein and subsequent reforms in the developmental disability field based on their senior positions in government, intermediary, or service delivery organizations. Since the time period of interest was only 20 or so years ago; sufficient key informants were easily located. An initial sample of 29 potential respondents was identified based on my professional knowledge (19) and suggestions from the thesis supervisory committee

(10);51 an additional 24 individuals were suggested by respondents who provided me their phone numbers or emails and, in some cases, introduced me to the suggested person. Purposive and referral sampling are acceptable strategies where the aim is to gain a deep understanding of the problem rather than to generalize the findings to a broader population (Singleton and Straits 2005:133). Potential respondents were contacted for interviews if there was a high degree of certainty (based on knowledge of the individual’s employment position and activities) that they would be well-informed about the reforms, or able to provide a perspective to augment information already gathered. In the interest of time and cost, the sample was restricted to Calgary, Red Deer, and Edmonton. Recruitment began in November 2012 by emailing 14 of the 19 originally identified potential respondents who were already personally known to me (see Appendix A1 for the formal invitation to participate). Interviews took place between December 2012 and February 2013. A total of 24 individuals were contacted (14 government representatives, 10 disability field or nonprofit sector leaders). Twenty interviews were completed (10 government representatives, 10 disability/nonprofit sector leaders).52 Three government representatives did not respond and one was interested in participating but was out of the country for an extended period. By the time the twentieth interview was completed, I felt that plenty of information and diversity of perspectives had been gathered. Although one can always think of people who might add yet another or a richer perspective, the additional time needed could not justify further interviews. All respondents agreed to be identified as having participated in the research (see Appendix C1 for names and a brief self-provided biography). Many also agreed to have their contributions publicly cited by name (see Appendix D1 for an extract of the consent form); however, for each quote reproduced in this document, I used my judgement about whether to name the source (see Section 3.7 for more details on ethical considerations). A number of respondents had held positions in both government and in community-based

51 Dr. Keith Seel and Dr. Christopher Smith both have extensive experience and contacts in the nonprofit sector; Dr. Seel has deep personal and professional ties in the developmental disability field. I thank them both for the leads they provided, and also for their participation as interview respondents. 52 There was no methodologically-driven need or deliberate effort to interview equal numbers of government and non-government respondents; this was merely a coincidence.

79 services during their careers; they were categorised according to the positions they held at the time of the interview or at the time of retirement.53 Some respondents were also family members of individuals with developmental disabilities and were able to share their perspectives from both their professional and personal experiences. The interviews were open-ended and conversational, however I had a list of predetermined questions to guide the issues or topics to be explored. Two questionnaires were prepared, one for government representatives and the other for the disability sector or the nonprofit sector leaders (see Appendices B1 and B2 respectively). The questions were essentially the same in both questionnaires, but with a slight different in focus to acknowledge the different employment areas of the respondents. Respondents were emailed the consent form and interview guide ahead of the scheduled interview so they could prepare if they so desired. Although I had this list of predetermined questions, I worked from the assumption that I did not know what topic any particular respondent might choose to focus on or what they would share about it. As long as the information shared shed light on the research topic at large, I was comfortable generating questions appropriate to the situation. In some cases, I used information gathered from earlier interviews to generate questions for later interviews. This was done both as triangulation strategy (to validate or verify previously obtained information) and as a means to further explore a new and potentially interesting topic or perspective. Given this flexibility, the actual interviews were all closer to the unstandardized than the semi-standardized point on the continuum (Merriam 1988:74; Berg 2009:106-107). They allowed me to ask questions informed by the research’s theoretical framework, permit comparisons across interviews, and “to pursue areas spontaneously initiated by the interviewee” (Berg 2009:109). As Merriam (1988:76) states: Thus the interviewer/respondent interaction is a complex phenomenon. Both parties bring biases, predispositions, and attitudes that colour the interaction and the data elicited. (p. 76)

53 The purpose of categorization was simply to provide a quick guide to the respondent’s scope and focus of experience to round out the breadth of perspectives obtained. There was no intent to formally compare one group’s perspectives with the other’s.

Interviews were conducted at a location of respondents’ choice (typically their workplace), and lasted from 1.25 to 3 hours, averaging 1.75 hours. All interviews were digitally recorded and transcribed within a few days. Some respondents also gave me copies of internal documents such as private correspondences, memos or newsletters that I otherwise would not have access to easily or at all. Relevant documents were scanned as PDF files. Transcription files and PDFs were imported into NVivo and systematically coded using, first, directed content analysis (according to themes derived from the research’s theoretical framework and questions), and then inductive analysis (according to themes emerging from the data) (Berg 2009:341). Once thus organized, the data were interpreted based on my interpretation of what was actually said (manifest content) and its underlying meaning (latent content) to construct ideas about patterns and unique perspectives (Berg 2009:343-344). The interpretive process drew upon my own experience in the field and knowledge of the respondents to derive insights. The interplay of experience, induction and deduction enabled the development of categories and the generation of insights that were clearly linked to the data (p. 347-348). “From this perspective, content analysis is not a reductionist, positivist approach. Rather, it is a passport for listening to the words of the text and understanding better the perspective(s) of the producer of these words” (p. 343). Triggered insights were jotted as notes in NVivo in case they may prove useful later (p. 355). All analyses were conducted after Phase Two data collection was completed. The most serious limitation of interviews that rely on retrospective data is recall bias, where individuals may not recall events or may recall them incorrectly (Bryman, Bell and Teevan 2012:167). A participant not being able to recall an event was not an issue. The aim was to obtain the informant’s perspective on developments that “really stand out in [their] mind” (Appendices B1 and B2). After respondents had shared their views on the topics most salient to them, I prompted them to talk about some other topic that I felt they may have a unique or informed perspective on. If the individual did not have a good recollection of this subject, I moved on to another topic. The problem of individuals not being able to recall an event accurately was mitigated for the most part through triangulation (see also Section 3.9 on steps taken to maximize research quality),

81 by checking the information for factual accuracy against that of other informants who talked about it. Regardless of factual accuracy, what was important for me was to understand the informant’s perspectives and feelings about a topic; if these had changed over time, it was important to understand from their perspective why that had happened.

3.5.2 Document reviews In addition to key informant interviews, multiple primary and secondary document sources were accessed to trace the evolution of the institutional context of Alberta’s services for adults with developmental disabilities. Reviewing available documents is a common and sometimes the only way to conduct historical research, or study larger (macro and meso level) social units, processes and contexts (Singleton and Straits 2005:355-356). The review was mostly conducted between March and June 2013, although any relevant documents that came to my attention kept being added to the dataset as late as fall 2015. The documents included:  Government of Alberta website and publications (current programs and services, associated legislations, regulations, policies, and announcements; annual reports of relevant ministries, departments or agencies; current and archived budgets, financial reports and economic summaries; relevant background papers on changes in administrative structures, legislations, regulations, policies or practices; research reports; and current and archived news releases);  Statistics Canada tables for historical demographic and economic data;  historical monographs published by or about long-serving organizations;  scholarly publications and media reports related to Alberta’s developmental disability history, eugenics program, disability services, and Klein reforms; and  websites of Legislative Assembly of Alberta and Provincial Archives of Alberta.

The original plan was to trace the history from 1980 onwards to establish the institutional arrangements one decade prior to, during, and after the Klein reforms. However, it quickly became apparent from the key informant interviews that a number of significant disability policy and structural changes had been implemented in the 1970s, which in turn were influenced by ground-breaking ideological shifts related to the American civil rights movement and European disability rights movements in the 1960s.

At this point, I decided to trace the history all the way to 1905, the year that Alberta was incorporated. This served to be a worthwhile decision because it has resulted in a contextual understanding of Alberta’s developmental disability programs and services that covers the lifespan of the province—a project not undertaken before, and one that can provide a future foundation for constructing a deeper history and analysis. First, all documents were chronologically organized and perused for reports of key developments in government structures, regulations, policies, protocols and funding decisions, or activities related to the developmental disability field. Relevant information was systematically entered into two tables; (i) 1905/06-1992/93, ending prior to the start of the Klein era; and (ii) 1993/94-2015/16, by the fiscal year in which changes were reported54 (see Appendix E for a much edited summary of developments).55 Second, an overview was compiled in the tables for each decade, summarizing: key developments; political, economic and social context; forces that appeared to have shaped government’s approach to disability programs and services; and names of main government leaders during the decade and their political affiliations. The tables served as organizing structures, and launching points for the information discussed in Chapters Four and Five. One limitation of document reviews is finding and procuring required information (Merriam 1988:106; Singleton and Straits 2005:358). Fortunately, information about the province’s structures, regulations, programs and policies could be reconstructed via publicly-available government documents. It was more difficult to know the context and (official and unofficial) rationales for the origins of these institutional elements, unless these (at least official) rationales were included in the documents. I supplemented the review of official documents with information from interviews, scholarly publications and media reports, recognising full well that they too would have selective foci, biases, and perspectives. Notwithstanding, the judicial use of secondary sources is acceptable “to get general information about the setting of the historical period under investigation” (Singleton and Straits 2005:368).

54 Fiscal rather than calendar years were used because government annual reports and financial summaries (which were a significant source of the data) are organized in fiscal years. 55 Collectively, the two tables spanned close to 40 pages (in 9 point font). Due to the size, they are not appended to this thesis, but are available separately upon request for anyone interested in reviewing them.

Another issue with using documents is establishing their veracity, that is, determining whether a document was actually created by the purported author, and where, when and how (Merriam 1998:106-108; Singleton and Straits 2005:360; Berg 2009:303-306). The historical materials used were official, public, or scholarly, so there was no reason to suspect their authenticity. A related issue is that of quality, that is, whether the information is accurate, complete, and reliable. To the extent that one of the aims was to establish what government structures, regulations and processes existed, there was no reason to doubt that the account in the official documents was false. The information may have been incomplete, however, depending on the level of detail provided; government annual reports produced in the past two decades tend to have more detail than those from earlier years, perhaps reflecting increasing standards and expectations for accountability. Since the main focus of this research is on developments since the 1990s, the amount of information available was sufficient. The reliability of the information was verified by corroborating it with at least one more source. For example, to examine changes in the province’s overall fiscal situation and developmental disability program expenditures, the amounts provided in the annual report for the focal fiscal year were compared to those reported for the subsequent year (annual reports provide current and previous year’s financial data). Population estimates in the provincial documents were verified against Statistics Canada’s demographic data. Qualitative information was also verified to the extent possible by comparing it to that reported in scholarly publications and organizational monographs. Despite these efforts, the caveat remains that all forms of communication are contextual and purposive, created with a specific audience, rationale and goal in mind (Merriam 1998:106; George and Bennett 2005:99-100). Documents intended for external audiences are likely to be crafted in ways that are self-serving for the producers. Both the accuracy and the author’s probable intent were borne in mind to identify information that was likely to be have particular political biases or goals, and to sift the facts from the rhetoric.56

56 The rhetoric itself is also used in some parts of the analysis as an indicator, for example, of how government views or frames its goals or views in certain policy domains.

3.5.3 Quantitative trends Trends in the province’s fiscal position, developmental disability program data, and other relevant quantitative variables were entered into Excel spreadsheets for the past 30 years or so, with key political or policy development points flagged. The data were derived from provincial reports and Statistics Canada tables. Knowledge of the context in which policy developments are occurring is important because it often contains aspects that policymakers are sensitive to, responding to, or in some ways trying to influence; it provides another layer of insight into policymakers’ perceptions and decisions (George and Bennett 2005:97). In so far as policy decisions are made tangible and reflected in financial decisions, trends in financial and economic data can provide an effective overview of the chronological relationship between the two. Much of this information provided the basis for some of the discussion in Chapters Four through Seven.

3.6 Phase Two: Organizational Responses The objective for Phase Two was to garner a deeper understanding of similarities and differences in organizational responses to shed further light on understanding the primary topic of interest, that is, the institutionalization in the field. This was achieved by purposively-selecting three community-based publicly-funded service organizations to serve as embedded units of analysis within the overarching single-case analysis of the institutional changes in the developmental disability field (Yin 2009:53). While comparing different organizations makes the research more interesting, compelling and robust than investigating a single organization’s experience (Berg 2009:326; Yin 2009:60-62), the focus in this study was primarily on understanding institutional effects in the field in general than on doing any formal within-case comparative study.

3.6.1 Organization selection strategy The organizations were purposively-selected using maximum variation sampling (Patton 1990:172). Also known as sampling for heterogeneity (Singleton and Straits 2005:133), this strategy involves constructing a sample by choosing units that differ along theoretically relevant criteria. It was decided that selecting three organizations would be practical in terms of time and cost, and would yield sufficient variability for the purposes of this study. Maximum variation sampling is a useful strategy where the

85 objectives are to: (i) obtain rich, in-depth information from a small number of units; (ii) investigate the uniqueness of each unit; and (iii) identify common patterns across units that point to shared aspects and core elements (Patton 1990:172). The selection process began by, first, delimiting the sample of organizations based on certain criteria and considerations. The first criterion was that all organizations had to have been in existence since at least 1993 so that their experiences could be traced from the start of the Klein reforms. Second, they all had to be located in the Calgary region to avoid the time and cost of out-of-town travel. Third, they had to be supportive of the research and trusting of me as the researcher so that I could have maximum access for research purposes. With around 40 organizations serving adults with developmental disabilities in Calgary, and given my professional knowledge and connections in the field, I had no doubt that I could find three organizations to fulfil these requirements. Next, the organizations selected from this population had to be sufficiently different on potentially theoretically relevant aspects such as their origins and rationales for why they were established, their organizational cultures and service delivery approaches, the types and range of services they offered, and the ways in which they tended to react to changes in the field. I knew from my experience working in the field that mid-sized and larger organizations were more likely to be actively involved in field level activities and to enact a potentially wider range of responses to institutional changes than smaller, less-resourced ones. It made sense, therefore to focus my selection efforts on the former organizations. Selecting organizations with prior knowledge of their relevance for a particular theoretical framework allows for a stronger research design than randomly selecting a few organizations in the hope that they vary on the independent and dependent variables of interest (George and Bennett 2005:24). Based on these considerations, the following organizations were selected: (1) Calgary SCOPE Society (SCOPE); (2) Optional Rehabilitation Services Inc. (Options); and (3) Vecova Centre for Disability Services and Research (Vecova) (see Appendix C2 for main facts about each organization; a further description is provided in Chapter Six). The organizations satisfy the methodological requirements, are well-known to me, and are led by individuals with whom I have positive professional relationships. The selection

86 was validated via informal conversations with a number of (active and retired) leaders in the field who confirmed that the organizations differed on theoretically relevant aspects.57 All three organizations are frontline service providers to adults with developmental disabilities in Calgary and have been in operation since the mid-1980s, well before the start of the Klein reforms. Vecova and SCOPE are registered nonprofit charities, while Options is a private business. Including a for-profit organization was intended to expand the potential to investigate whether nonprofits and for-profits in the developmental disability field experience different institutional pressures, and with what consequences. As it turned out (and the reader will see this in the later chapters), although Options enacted somewhat different responses than the other two organizations, the differences did not seem to be related to their for-profit status. Nonetheless, the organization was a valuable participant in the research and led to other insights. The organizations differ in their geneses and core values. Vecova was established in 1969 as a research institute of the University of Calgary and has a dual mandate for service provision (originally for demonstration purposes) and applied research. SCOPE was started in 1983 by disability professionals, and is known for its strong social justice focus and support for self-advocacy.58 Options was founded in 1986 by a parent and has a very family-focused approach. These differences suggested that, though operating in the same field and likely facing similar isomorphic pressures, each organization might perceive and interpret institutional pressures differently, and enact different responses. This was, indeed, borne out by the research.

57 The original plan was to select organizations during summer 2013 via a peer-nomination screening survey using pre-defined, theoretically-guided criteria. However, announcements by the government in spring 2013 of $42 million in budget cuts and changes in contracting processes created considerable anxiety and turbulence among organizations (CBC News 2013), suggesting that organizations would have little appetite for responding to a research survey at that time. To avoid seriously delaying the project, the peer-nomination approach was cancelled. 58 In the developmental disability field, self-advocacy is the term used for people with developmental disabilities knowing their rights and responsibilities, speaking up for themselves, and having control over their own affairs rather than having these decided by other (nondisabled) individuals. The term ‘allies’ is used for nondisabled individuals who promote self-advocacy and who assist individuals with disabilities to obtain information and make decisions related to their own affairs.

3.6.2 Data collection and management protocol The organizations formally agreed by summer 2013 to participate as research sites (see Appendix A2 for a copy of the invitation to participate, and Appendix D2 for an extract of the organizational participation consent form). Data collection consisted of document reviews and interviews with individuals at various levels of each organization, lasted from July 2013 to April 2014, and was conducted as opportunities presented at each organization: Vecova (July 2013 to January 2014); Options (October 2013 to January 2014); SCOPE (October 2013 to April 2014). The objective was to obtain a detailed chronology of and explanations for changes in each organization’s formal and informal characteristics, main activities, financial status, relations with stakeholders and the broader community, perceptions of opportunities or pressures, and the potential link between organizational shifts and the institutional contexts. A study protocol—“a standardized agenda for the investigator’s line of inquiry”— was established to guide the investigation and maximize the likelihood that the same recruitment, data collection, analyses and research management processes were followed for all sites (Yin 2009:79). A study protocol helps the researcher to collect comparable information across sites,59 and stay on target by facilitating the efficient collection of information and reducing the requirement for return visits (p. 90). The study protocol for this research consisted of (in order): 1. getting consent from each leader for their organization to participate in the research (Appendix D2); 2. providing a template to each organization that they could customize and use should they wish to announce their participation in the study to their stakeholders or other external parties (Appendix A3); 3. having the organization’s leader identify a primary contact (themselves or designate) that I could contact for research-related support or inquiries;

59 A study protocol is especially important in a positivist study where reliability is an essential component to maximize the potential to access the same “stable reality,” but this is not the issue in a study with a relativist ontology. A standard study protocol, however, has the benefit, regardless of the study’s paradigmatic perspective, that a systematic process is followed and nothing important gets left out. Following a study protocol suit my methodical style.

4. providing a list to the organization’s leader (or designate) of the types of documents needed for the research; 5. reviewing the documents and developing a site database (see Section 3.6.3); 6. conducting interviews with individuals at various levels of the organization, as identified by members of the senior leadership team (see Section 3.6.4); 7. transcribing the interviews; and 8. systematically analysing the data after all data collection was completed.

3.6.3 Document reviews Each organization was asked to provide current and archived documents related to its primary activities, processes, and formal changes from the time of incorporation to the present, for example: annual reports, strategic plans, audited financial statements, board minutes, internal correspondences, policy and procedures manuals. Also reviewed were each organization’s website, and where available, T3010 annual filings to CRA.60 Annual reports are efficient sources for learning about organizational direction and shifts in mission, activities, funding sources, major stakeholders, and financial health. Annual reports and websites are an organization’s public face: their look and language represent the image the organization wishes to portray to external audiences (Stanton, Stanton and Pires 2004). They are part of the repertoire of “ceremonies” used by organizations to demonstrate legitimacy (Meyer and Rowan [1977] 1991). Significant shifts in organizational direction or self-portrayal were flagged to follow up on during subsequent interviews. Policy and procedure manuals also provide insight into the organization’s activities and formal direction for how these activities are to be conducted. As nonprofit organizations, Vecova and SCOPE are required to produce publicly-available annual reports, but as a private business, Options is not. Instead, Options gave me copies of a number of their annual contract reports submitted to government; I used these to chart changes in the organization’s activities, size and financial status. For all organizations, I also relied on interviews with senior leaders for information on organizational genesis, culture, structure, institutional pressures, and evolution.

60 Websites and T3010 reports are in the public domain. The organization’s permission was not required to review these.

For each organization, I listed the documents requested, when and by whom they were given to me, and the date they were returned. The documents were chronologically sorted and relevant information was recorded in my research notes. Permission was requested to scan into a PDF file any document with relevant information too large to condense into research notes.61 A chronological table was developed for each organization, listing all key developments and shifts, and the data sources. In addition, I jotted other details, and my own observations or thoughts in a site note file. The tables and the notes served as launching pads for identifying topics to pursue in the interviews. The chronological tables, site notes, interview transcripts and PDF files collectively form the site database. Having a formal, presentable database which stores all the research evidence enhances the research’s validity (Yin 2009:119). The limitations of reviewing existing documents to reconstruct organizational histories is the same as that identified in Section 3.5.2, that is, knowing what documents might be relevant and being able to access to them. Although the organizations were very cooperative in providing access to archived documents, in some cases, such documents simply did not (or were not known to) exist, or would have been too difficult to locate.62 Despite these limitations, enough information was gathered from the document review to construct the historical evolution of each organization and identify key shifts that could be corroborated and augmented through the interviews.

3.6.4 Interviews Formal interviews were held with people at various levels of each organization to get diverse perspectives or information unique to certain positions.63 Each leader was requested to provide a list of potential respondents, with their position and work email. Since each leader provided a list of more people than needed, I purposively-selected

61 Very few document needed to be copied, and my requests for copying documents were always granted. 62 For example, Options had financial records going back only to 1997. SCOPE was in the midst of moving offices, and their archives were in somewhat of a disarray. Vecova, which has a tendency to keep all historical records (I know this from having worked there), produced the most archival information of the three organizations, but it too, did not have the manpower to locate some items I thought might be interesting to review. Nonetheless, more than sufficient information was collected for this research. 63 Because the focus was to understand relationships between the environment and the formal and informal structures and processes of service organizations, rather than how service delivery itself was affected with respect to client-worker relation, data collection did not include families or clients.

90 individuals based on their organizational position: senior leadership and mid-managerial positions were prioritized for selection since they would be most likely to know about organizational shifts and their rationales and outcomes; only a few frontline staff were interviewed, since their work allowed them little time for activities outside of direct client support. Selected individuals were emailed and requested to reply to me in confidence if they were interested in participating; no one declined. Table 3.2 above summarises the total number of potential respondents and the interview sample for each organization. As in Phase One, the interviews ranged somewhere between semi-structured and unstructured (Merriam 1988:74; Berg 2009:106-107), with the interview schedule serving as a conversational guide (see Appendix B3 for the interview guide, and Appendix D3 for an extract of the consent form). Interviews were conducted in person in a private office at each site during work time.64 They lasted from 40 min to 2.25 hours, and were digitally recorded. Transcriptions were imported into NVivo and thematically coded using the same approach as in Phase One (see Section 3.5.1). The interviews were important sources of new and supplementary information, and corroborated (triangulated) previously gathered information about the organization.

3.6.5 Quantitative trends Quantitative information from annual financial reports was entered into an Excel spreadsheet for each organization, and changes over time were graphically displayed. On each chart, key institutional developments and organizational shifts were overlaid. However, the charts did not reveal any notable patterns, and this information is not reproduced or commented on in this thesis.

3.7 Ethical and Political Considerations The research methodology was approved by The University of Calgary Conjoint Faculties Research Ethics Board (CFREB) in August 2012, and meets the requirements of the Tri-Council Policy Statement (2nd ed., Interagency Secretariat on Research Ethics 2010, hereafter referred to as TCPS2) on the ethical conduct of research involving

64 The sites included the organization’s main administrative location and satellite locations, e.g., places where the organization’s day programs or residential services were provided. The political and ethical issues arising out of such “corporate sponsorship” of research are discussed in the Section 3.7.

91 humans. Mason (1996:31) challenges researchers to go beyond professional codes of ethical practice and to engage in an ongoing and critical reflection of the moral, ethical and political implications of their decisions by asking “difficult questions” at all stages of the research process. Below, I discuss three main ethical and political considerations that bear on this research: voluntary and informed consent; protection of privacy; and corporate sponsorship of research.

3.7.1 Voluntary and informed consent TCPS2 requires that consent for research participation is voluntary, informed and ongoing. All participants who contributed to this research did so voluntarily, with an understanding of: the purpose of the research; what their participation entailed; the type of information that would be collected, how it would be stored, and what would be done with it; and how they could withdraw their (own or organization’s) participation if they so desired. Participants were told there would be no foreseeable risks or direct personal benefits as a result of their participation. All this information was provided on the consent form emailed to each selected individual a few days prior to data collection, giving them reasonable time to review and consider their decision to participate. Three versions of consent forms were used, all based on a single template provided by CFREB:65 (i) consent to participate in Phase One key informant interviews (Appendix D1); (ii) consent for the organization to participate as a case study site (Appendix D2); and (iii) consent for the individual member of the organization to participate in an interview (Appendix D3). The three consent procedures differed slightly, as described further below. In general, all individuals were requested to review the consent form, and print two copies prior to the meeting. At the meeting, key points were summarised and repeated verbally, and any questions were clarified before requesting the individuals to sign the form to indicate their informed consent. Verbal consent from each participant was obtained to digitally record the interview. Only one person (in Phase One) declined to have the interview digitally recorded, but permitted me to take notes instead. Participants were told that, their consent notwithstanding, they could flag any specific

65 Latest version is available at: http://wcm.ucalgary.ca/research/files/research/cfrebconsentformtemplate _sept2013.docx

92 information they had provided (or were going to provide) that they did not wish to be used in the research (i.e., for the information to be “off the record”). This gave them the choice to contribute to the research, while allowing them the flexibility to omit certain information from the dataset. In some cases, participants asked me to switch off my recorder before sharing what they perceived to be sensitive information; when the conversation topic changed, I asked for permission before resuming the recording. Aside from this common procedure, I developed some slight differences in how participants could partially or completely withdraw their involvement. TCPS2 requires consent to be “ongoing,” that is, “carries through to the end of participants’ involvement in the project” (p. 33). For interviews, the participant’s involvement was deemed to have ended when the interview ended; for the site studies, the organization’s involvement was deemed to have ended when the last data collection activity was completed on site (i.e., not including accessing publicly-available data about the organization after completing all on-site data collection activities). To give participants sufficient time to reflect on their contribution, I went beyond the requirements stipulated in TCPS2. Specifically, all interview participants (Phases One and Two) had up to seven calendar days from the date of the interview to inform me if they wanted any specific, or all of, the information they had provided to be removed from the study database. For the organizational studies, each signing leader could specify on the consent form which specific data collection activities (other than access to publicly-available data) I was allowed to undertake at their organization, and had seven calendar days from the last day of data collection on site to notify me of their decision to terminate their organization’s participation. No data collection activities were undertaken at the organization’s site until the leader had signed the organizational participation consent form. Phase Two participants were told that if their organization’s leader ended the organization’s participation in the research, all information, even if it was voluntarily provided by the individual, would be destroyed. None of the organizations or participants withdrew their consent.

3.7.2 Protection of privacy and confidentiality Privacy and confidentiality in this research relate to safeguarding the identifiability of participants, recognizing that the disclosure of individuals’ expressed

93 opinions (in the case of the interviews) or of an organization’s information as gleaned from its records or interviews (in the case of the case studies), may result in potential reputational harm to the participants (TCPS2:55). A number of processes were used to respect the privacy and confidentiality of participating individuals and organizations.66 Key informants interviewed in Phase One were asked if they wished to have their contribution “public and cited by name” or “public but cited anonymously.” An important strength of digitally-recording and transcribing interviews is having a verbatim record of the conversation in which the participants have shared (or co-constructed) with the researcher their perspectives. Being able to cite these extracts lends support to the researcher’s claims, and also enhances the richness of the data presented. Participants’ consent to publicly cite them (anonymously or by name) was a necessary condition of participation. Given that the individuals interviewed were leaders in the field, I also felt the research would gain credibility if they agreed to be identified as participants in the project, even if they wanted their information to be cited anonymously. All 20 individuals agreed to be identified as research participants, and upon request, provided brief biographies (Appendix C1). Ten of them also agreed to be cited by name in any quotes used in this dissertation and other dissemination products. Each participant, regardless of whether they consented to be cited by name or anonymously, was assigned a unique code. The participant code list was stored in a password-protected electronic file on my home computer, separate from my password- protected laptop on which the research data was stored. All data (transcriptions, interview notes, documents provided, email correspondence, etc.) related to a participant were saved as electronic files with the same code. Digital recordings or handwritten notes were destroyed immediately after transcription, no paper copies of documents were retained, and any identifying information in the data was removed. These measures ensured that confidentiality was assured even if data security was compromised in some way. Some participants agreed to be cited by name if they were allowed to review the quoted information ahead of time. I emailed them their specific quotes and the context in which they appear, and requested them to email me within two weeks their consent to cite

66 The issue of safeguarding organizational reputations is discussed in Section 3.7.3.

94 them by name, or to identify any specific quotes which they wished to have cited anonymously. All these individuals gave me their consent to cite them publicly, although some took a bit longer than two weeks due to their busy schedules. Even if individuals had consented to be cited publicly by name, I only did so if, in my judgement, the quote would not harm their reputation in any way; otherwise, I cited them anonymously. This was the ethical response in my view to the trust they had placed in me. In most cases, cited participants are described in the body of the text in general, unidentifiable terms, but with sufficient information to contextualise the discussion (e.g., “a government official who played a key role in developing this policy”). All citations labeled “ personal interview” refer to data obtained from interviews conducted from December 2012 to February 2014 as part of the research for this thesis. When a respondent is cited anonymously, the quote is labeled with their unique code (e.g., “P1G14, personal interview” refers to a quote from respondent P1G14); this notation allows me to refer back to the original interview transcript if necessary. The case study organizations could choose to be identified or remain anonymous. Given that the selected organizations have unique features and are well known in the field, I cautioned the leaders that it would be difficult for me to guarantee anonymity, and that to do so might strip the research of potentially relevant and interesting findings. Whether or not they were influenced by this caution, all organizational leaders chose to make public their participation in the study (see Appendix C2). Organizational leaders were requested to block or remove any sensitive or personal information (e.g., about the organization’s clients) from any documents that I was given access to. In the few instances where personal information was inadvertently left visible, I simply ignored it. I also stated my preference to conduct the document review on site in a space where the documents could be left securely during the review period. Vecova provided me with a private office space for the duration of data collection, and Options made their boardroom available. For both places, document review was conducted on site; any documents I brought home for review were done so with the organization’s permission and returned within a few days. SCOPE was in the midst of a move at the time of data collection, and allowed me to take home whatever I

95 needed and return it when done. To ensure the security of any documents taken offsite, I stored and reviewed them at home rather than in my shared office on campus. No paper copies of any documents that are not publicly-accessible were retained; some documents were electronically scanned and entered into the research database, and were subject to the same security measures as the rest of the research data. Organizational leaders were also requested to identify a pool of potential participants at various levels from which I could select individuals to interview. Although participant anonymity was impossible given this recruitment process, it was a justifiable limitation to maintain the trust of the organizational leader that I was not talking to individuals within the organization “behind their back.” It was also an efficient way to locate individuals potentially most knowledgeable about the history and activities of the organization. Individuals whom I purposively selected to interview from this pool (see Section 3.6.4 for selection process) were emailed and requested to reply in confidence if they wished to participate. They were told that, even though they had been suggested by their organization’s leader, they were not obligated to participate. If they chose to participate, they were told that any information they shared would be kept confidential, and if cited, would be done so anonymously. They were also given the choice of being interviewed on-site during work hours or off-site after work hours; all participants chose to be interviewed on-site during work hours (see Section 3.7.3 for issues related to corporate sponsorship of research). Interviews were digitally recorded with permission, recordings and notes were destroyed after transcribing, identifying information was deleted, and each file was assigned a secure and unique code. In this and other dissemination products, respondents are identified either by their code, or in general terms (e.g., “a senior manager at SCOPE”) to contextualise the information. All data were stored and analysed on my password-protected laptop in my home office. Periodically created backup files were stored on password-protected devices. No one else had access to the data.67 Signed consent forms were stored securely in my home

67 Participants had been told as part of the formal consent process that the only other person who would have access to the data, if needed, was the thesis supervisor Dr. Langford. Even if he were to access the raw data, identifiable information has been removed, and the participant’s identity can only be re-linked to the data if he were to also request access to the participant code list.

96 office. Consent has been received from all participants to retain the research data indefinitely for possible scholarly use, including the production of various dissemination products. When I no longer have any use for the data, signed consent forms will be shredded, electronic files will be deleted, and digital drives will be reformatted. These measures meet TCPS2’s requirements and guidelines.

3.7.3 Corporate sponsorship The participating organizations, in effect, became “corporate sponsors” of this research. This gave rise to two ethical and political considerations. First, the organizations demonstrated significant trust in me by allowing me access to their documents and members. As mentioned in Section 3.6.1, I am well known to and have a positive relationship with many people in all three organizations, and especially their respective leaders. As with individual interviews, this trust in me goes with my responsibility to ensure that the information gathered during the research is not used in ways that could potentially harm the interests or reputation of the participants. Unlike the individual interviews, however, there was little room to hide potentially negative information or analysis about an organization under the cloak of anonymity with only three participating organizations. A related issue is that these are organizations and people with whom I wish to continue to have positive relationships in the future. It is not in my interest to jeopardize this relationship by revealing them in a negative light. Given these ethical and strategic considerations, I had to resort to a heightened degree of sensitivity about what information or analysis I chose to share in this dissertation (and will in any future publications), and how I did so. Judicious decisions were made about what was included and what was not; only information or analyses that: (i) were relevant to the research questions, (ii) advanced understanding of the subject matter, and (iii) were not potentially harmful to the organization’s reputation were included. As with all of the findings, any claims that were made based on my analysis were supported by the evidence presented. I believe these choices balance the ethical considerations with the need to uphold research integrity. Second, as discussed in the previous section, I requested organizational leaders to identify the pool of individuals to interview. This was an efficient and trusting way to get

97 access to the potentially most knowledgeable individuals at various levels of the organization, however, some issues arise from this. One is the possibility that the organizational leaders only identified individuals who would portray the organization in the most positive light. Another is the possibility that, even if they did not do so, interviewees would feel obliged to portray the organization positively since the organization was supporting the research by allowing me to interview them and to do so during their work time. It is also possible that some people who participated, especially those from the lower ranks of the organizational hierarchy, may have done so out of a perceived sense of pressure. I attempted to mitigate the last issue, as mentioned previously, by assuring participants that their research involvement must be voluntary and that I would not be divulging the identity of either the participants or non-participants to anyone else. With respect to the issues regarding a potential bias in the sample, there was little I could do other than remind people that the interview was confidential and encourage them to share their perspectives as honestly and openly as they could. Judging from the variety of perspectives that were present in the data, though, there were very few participants who painted their respective organizations in only glowing terms. In the next section, I discuss how my own position bears on the research.

3.8 Researcher Position The notion of reflexivity challenges researchers to have a greater awareness of how their values, political positions, cultures, and social categories such as gender, race, class and location within power hierarchies permeate the research process and have implications for the knowledge generated (e.g., DeVault 1990; Hertz 1996; Bryman, Bell and Teevan 2012:15-16; Gentles et al. 2014). Even before this conversation gained momentum in the literature, Becker (1967) advised researchers to know “whose side are we on,” “use our theories and techniques impartially,” (p. 246) and make “clear the limits of what we have studied, marking the boundaries beyond which our findings cannot be safely applied” (p. 247). Below, I discuss three specific ways in which my positioning as a researcher who is both passionate about the nonprofit sector and has professional connections with some of the individuals and organizations in the field bears on the research: (i) my views about neoliberalism’s impact on nonprofit organizations based on

98 my observations before starting the research; (ii) my prior acquaintance with a number of the interview participants; and (iii) my employment for many years at Vecova, one of the organizations that participated as a study site.

3.8.1 Prior views on neoliberalism My observations of the reforms while working in the nonprofit sector made me apprehensive about the impact of neoliberal regimes on nonprofit human services, and motivated me to undertake research that could make a positive difference for the sector. Fully aware that I had a negative opinion of neoliberalism based on my observations and preliminary readings, I took a number of steps to ensure that this preconception did not bias or distort my investigation. First, I searched for literature that offered a theoretical or empirical counter-point to this negative perspective; these sources are included in the literature review in Chapter Two. Second, my research questions and goals reflect an open stance: instead of seeking to “expose” neoliberalism’s negative impact on disability services, my research genuinely seeks to understand how neoliberal reforms and other institutional pressures have shaped these organizations, and is undertaken with an openness to discover diverse consequences, positive, negative or neutral. Third, I designed the research to gather facts and perspectives from various sources, for example casting my net widely for the documents reviewed, and interviewing representatives from the nonprofit sector and government officials to understand policy processes from diverse perspectives. I believe these steps mitigated my original bias, maintained research integrity, and yet allowed me to be an advocate for the sector.

3.8.2 Relationship with interview participants An interviewee’s conception of the researcher plays an important role in whether they consent to participate in the research, and the extent to which any potential bias is introduced in the information they share (Berg 2009:131). The social context of the interview is intrinsic to understanding the data collected (p. 147). While employed at Vecova, I conducted a number of studies which I disseminated province-wide to policy makers and practitioners through invited talks, written reports,

99 industry periodicals and annual conferences.68 I also provided ad hoc consultations to many organizations and participated in various intersectoral forums. As a result, many research participants are well acquainted with me, my work, and my sympathetic views towards people with disabilities and disability service providers. In turn, I know many of these individuals and all of the site study organizations. Those who did not know me would have formed an initial perception of me through my introduction letter which stated the purpose of my research as aiming “to generate new insight into how social policy shapes organizational characteristics and impacts public service-delivery and outcomes” and “provide new understanding of how to enhance the long-term vitality and effectiveness of nonprofit human service organizations” (Appendix A1). Recruitment announcements distributed by study sites to their members also had a photo of me and a brief sentence about my experience in the nonprofit sector (Appendix A3). Most likely due to this history, people were very willing to participate in this research. They knew (or believed) that, as a field ‘insider,’ I shared many of their values and goals; the “common ground” necessary to establish trust and rapport for a positive research outcome (Berg 2009:130-131) already existed. Many acquaintances— nonprofit and government representatives, men and women, alike—greeted me with a hug rather than a formal handshake. Many also said that the research was “timely” and “necessary.” In general, all interviews were positive: the conversations flowed naturally and people appeared at ease sharing their perspectives; I knew tacitly through their verbal and nonverbal cues that I could trust what they were sharing with me (Berg 2009:133-134). However, there are two ethical considerations that arise from this high level of trust and prior acquaintance. On the one hand, some people confided in me information they might not have shared with someone less familiar. I knew they were inviting me into a private conversation when they asked me to turn off the recorder, or requested that the information be kept “strictly off the record,” or used statements such as, “I’m only telling you this,” or “This is strictly between you and me.” I thus came to know information that helped provide greater depth and background to the topic of conversation. But after the

68 The references are not cited here as they are not relevant; a list is available upon request.

100 interview ended, I had to pretend that I had never been privy to this information.69 I faced the difficult task of bracketing this knowledge while analysing the data (to somehow un- know what I did know), and also the regret that I could not use this information to generate a greater understanding in others. Despite the internal struggle, the ethical choice was obvious: to respect the person’s request for confidentiality and their trust in me, even if it meant not being able to tell a more complete story to others. On the other hand, precisely because I was viewed as an insider who was familiar with key people in the field, I was told by at least one interviewee that they could not share certain details with me: “I really can’t tell you more because you’d know some of these people. It wouldn’t be professional of me.” The ethical course of action was not to remind the interviewee that I had promised to keep their information confidential, but to respect their right to withhold any information and not pressure them to divulge it. In both situations, my position resulted in access to different information than might have been provided to a researcher not as well acquainted with the field. However, since the scope of the study is large and the above incidents were few, I believe there is little impact on the research findings as a whole.

3.8.3 Employment history at Vecova My employment at Vecova (or, VRRI as it was then called) from 1997 to 2010 bears on this study in three ways. First, when interviewing Vecova participants, I experienced the same insider-related situations as described above, that is, being trusted, being told information that was “between you and me,” and not being told some things because I might “know the people.” The ethical choices I made were as described above. Second, a number of Vecova interviewees assumed I knew what they were talking about given my history with the organization. This was evident from statements such as, “You know how it was when we went through [some organizational process],” or “You know what happened as well as I do.” Regardless of my knowledge, I wanted to learn about the topic from their standpoint. I encouraged them to share their perspective by saying something like, “I’m really interested in what your thoughts or experience are on

69 None of the information shared required legal or ethical disclosure to a third party.

101 that. Can you tell me more please?” As they did so, and if it was a topic which I was indeed familiar with, I had to listen without letting my own experience or judgments interfere with what they were saying. That meant not verbalizing my thoughts externally, but also silencing my thoughts internally so that I could listen as openly as I possibly could. I did not want the interviewee to get the sense that I might be disagreeing with or judging their responses. Another strategy I used to encourage interviewees to share their recollections or views was to say something like, “Let’s forget I used to work here. Tell me about [the topic] as if I’m just a researcher who knows nothing about it.” Through this act of role-taking, defined as “a conscious selection, from among one’s actual role repertory, of the role thought most appropriate to display to a particular respondent at the moment” (Gordon 1987:213, cited in Berg 2009:129), I was attempting to alter the interviewee’s reaction towards me as an ex-employee of Vecova in favour of me as simply a researcher; ethically, this is a legitimate strategy to circumvent avoidance tactics or elicit fuller information (Berg 2009:130). After the interview was over, however, I allowed my own knowledge of the topic to weave with the data to generate my interpretation, while still respecting the perspective that the respondent had shared. The third way in which my history at Vecova and in the developmental disability field as a whole bears on the research is that I bring to the research my own knowledge and experience as a data source in its own right. My perspective provides added insight to the analysis; in a constructivist study, the use of personal experience is not only legitimate but unavoidable—it is another “voice” in the data pool, respected in its own right, yet subjected as any other to testing if it is “more or less informed and/or sophisticated” than any other’s voice (Guba and Lincoln 1994:111).

3.9 Steps to Maximize Research Quality The quality of a research is typically judged by questions related to validity, reliability and generalizability. In constructivist inquiry and in case study approaches, these criteria are translated to trustworthiness and authenticity, dependability, and naturalistic or reader generalizability (Merriam 1988:Ch.10; Guba and Lincoln 1994:114; Stake 1995:87, 108). Here, I summarise the steps taken to achieve these.

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3.9.1 Trustworthiness and authenticity (validity) This research involved (i) constructing the history of developments in the field of services to people with developmental disabilities in Alberta from 1905 to the present to identify key institutional shifts and legacies, and (ii) understanding from the perspective of the organizations providing services in the field how institutional shifts beginning in the mid-1990s had impacted the field. In research that involves historical facts, trustworthiness and authenticity translate to accuracy. To ensure that the first activity produced information as accurate as possible, I reviewed multiple primary sources including over 150 Alberta government documents, and secondary sources including scholarly publications, and media reports. Where possible, information was triangulated across sources to maximize accuracy (see Section 3.5.2). The rest of the discussion in this section focuses on maximizing the quality of the research with respect to the second (and main) aim of the investigation. In constructivist case studies, trustworthiness and authenticity relate to whether the perspectives (constructions) of the participants are adequately represented, that is, that the researcher’s interpretations (reconstructions) are credible to the participants (Merriam 1988:168). Steps to enhance the quality of the research with respect to these considerations include: triangulation (using multiple methods, investigators, or data sources to confirm emerging findings); member checks (taking interpretations back to participants to ask them if they are plausible); conducting long-term investigations at the case site; peer examination (asking colleagues to comment on emerging findings); and participatory modes of research (Merriam 1988:169; Stake 1994:112-115). In this study, triangulation was conducted in various ways. Factual information from document reviews was verified by cross-checking with other documents or key informants for both the historical part of the research (Sections 3.5.2) and the organizational case studies (Section 3.6.3). Emerging findings from earlier interviews were verified by asking respondents in later interviews about the same topics or issues (Sections 3.5.1 and 3.6.4). Perspectives and interpretations were compared throughout the analysis process when the data were being coded, often times requiring re-coding or new codes being added as interpretations shifted and better understanding of the topic

103 emerged for me. I also knew from my own history in the field, if the views being expressed were commonly shared or unique; thus, I drew on my own memory as a source for triangulation. Diverse viewpoints were taken into account in constructing the interpretations. In the report of findings, perspectives are shared via illustrative quotes; convergent views are indicated with phrases such “a number of people felt that ..,” or “some were of the view that ...” and so on. Other perspectives were included wherever they added nuanced information or understanding of topics. Because of my close connections with a number of the people who participated in the interviews, I was able to occasionally conduct informal member checks throughout the time that I was analysing the data. I regularly play golf, for example, with one of the participants who was a senior executive in the field for many years. If I came up with a new interpretation on something, I would sometimes ask her or other such people in my network if they thought my interpretation was plausible. While these member checks were ad hoc and not systematic, they still served to validate my emerging understandings. In addition, some measure of member checking occurred incidentally when I sent excerpts of transcripts to the participants who had requested to see their quotes before they were publicly cited by name (see Section 3.7.2). I sent them their quotes with a brief summary of the contexts in which they appeared. Their consent to use their quote in the context in which it appeared indicated their implied approval that I had not misunderstood their perspective on that topic. Another, more rigorous, example of member checking was the reviews provided by Dr. Keith Seel and Dr. Christopher Smith. Both are members of my thesis supervisory committee and were also key informants in Phase One. Their comments to an earlier draft of the thesis were extremely valuable in readjusting some of my thinking on certain topics, or alerting me if I needed to provide more evidence to support my claims. Guba and Lincoln (1994:111) add that a trustworthy account is one which fairly represents the perspectives of all of the participants in the study, that no voice is marginalized. As mentioned previously, I took into consideration diverse viewpoints in constructing my interpretations. This was one of the main reasons for interviewing representatives from the service provider side of the developmental disability and

104 nonprofit sectors, as well as senior government bureaucrats who were involved in policy decisions. In that sense, I have confidence that I represented the diversity in the views adequately. However, there are many views that this study did not reach. For example, the research would have been far more comprehensive and interesting if it had included the views of Premier Klein and subsequent premiers, members of their cabinet, deputy ministers and so on, to directly get their perspectives on the reforms. The research would also have been richer if it had directly included the views of the people receiving supports in this field; their views are represented only indirectly via the voices of families and service provider advocates. These gaps are real, however, I do not believe that they compromise the quality of the study because my primary aim was to understand the unfolding of the neoliberal reforms from the perspectives of those closest to their intersection with the organizations providing services in the field.

3.9.2 Dependability (reliability) Dependability relates to whether outsiders with access to the same data as the researcher arrive at a similar understanding, or at least, can see how the researcher arrived at the results that she did (Merriam 1988:172). In addition to triangulation, techniques to enhance dependability include: (i) an explanation of the researcher’s assumptions and rationales for the methodological decisions made, her relationship to the group being studied, and the social context from which the data were gathered; and (ii) an audit trail, such that other researchers can use the original report as “an operating manual” (p. 173). In this study, I have clearly outlined: my theoretical framework (Section 2.3); my epistemological assumptions and self-assigned role (Section 3.1); my employment history in the sector; my prior biases and how these were addressed; and the implication of these for the research (Section 3.7.4). Relevant implications of the social context from which the data were gathered are included in Chapters Six through Nine wherever they are pertinent to understanding participants’ perspectives as a result of current events in their field. In addition, with respect to the audit trail, the data collection and management protocol describes the systematic process used to collect the data (Section 3.6.2), the coding strategy is described (Section 3.5.1), the systematic process for how chronologies were constructed is described (Sections 3.5.2 and 3.6.2), and there is a thorough database

105 that stores all the research evidence. Finally, the chapters reporting the findings have extensive quotes to support the claims made, or perhaps generate new interpretations by other readers. Which brings us to the topic of generalizability.

3.9.3 Generalizability Stake (1994:87) lists a number of techniques to help achieve naturalistic and reader generalization (see Section 3.2), such as: including information on matters that readers are familiar with so they can gauge the credibility of other matters; providing enough raw data so readers can assess the researcher’s interpretations and construct their own alternative interpretations; describing how triangulation was carried out; making available information about the researcher and other sources of input; providing the reader with reactions to the accounts from participants and other users of the study. Steps such as triangulation, making information about myself and the research sample known, and getting reactions from study participants have already been discussed above and will not be repeated here. Here, I address the point about including enough information and raw data that readers can judge the credibility of the report and construct their own generalizations. Among the most important advantages of this research was my ability to digitally-record and transcribe in-depth interviews, publicly name all Phase One key informants, cite by name a number of them within the body of the report, and publicly name the Phase Two case study sites. These advantages allowed me to share information that is credible and rich in content and texture. There is much here for others to extend their own knowledge or to assess if the findings apply to their situations. Attending to these issues has assisted in maximizing the quality of the research. Nonetheless, as any project, this one has the scope for which it is intended, and the limits beyond which it should not be applied.

3.10 Scope and Limits The scope of the research is about understanding how Alberta’s neoliberal reforms manifested in the field of services for adults with developmental disabilities in the province, and how the interplay of contextual forces and salient actors shaped institutional developments in the field. It is also about making sense of some of the differences in how publicly-funded service organizations in the field responded to the

106 reforms. The focus is on understanding the unfolding of the neoliberal reforms from the perspectives of those closest to their intersection with the organizations providing services in the field. To conduct the research, a historical analysis was undertaken on the evolution of developmental disability services and policies since the birth of the province to the time of the study, key informants were interviewed, and comparisons were conducted on three service provider organizations selected for their divergence on potentially theoretically important variables. The investigation was informed by a theoretical framework underpinned by a constructivist epistemology. The research methods and data sources were guided by the theoretical framework and epistemological assumptions, and by the pragmatic constraints inherent to a doctoral dissertation project. The scope and limits of the research ensue from these choices and circumstances, and this research must be read with that in mind. Three such limits are identified next. First, although the research constructed the history of developments in the developmental disability field in Alberta from 1905 to the present, the purpose of this was specifically to interpret from this the main institutional shifts and the historical socio- political, cultural and economic factors associated with them. I have attempted to ensure that the historical facts are accurate regarding what happened when, but the goal was not to produce, and the product of this investigation (Chapter Four) should not be read as, the history of the field. There are far too many gaps in this research for it to stand as that, even though the depth and extent of the investigation were sufficient for the aims of this project. Nonetheless, the information here should provide a good launching point for those interested in constructing a more comprehensive history of this policy domain. Second, while the research provides theoretical insights into the likely experiences of other nonprofit organizations in Alberta and in other similar neoliberal regimes, the fundamental assumptions—philosophically (that knowledge is constructed and is local and subjective) and theoretically (that neoliberal reforms are contextually- specific)— lead to the assertion that history and context matter. I do not believe that the nuances and details of the findings revealed by this study will be experienced in the same ways by other publicly-funded policy domains or in other neoliberal regimes. Similarly,

107 while the findings from the three Calgary organizations provide insights into the experiences of other developmental disability service organizations in Alberta, I do not believe that service providers in other parts of the province with different contexts (e.g., rural locations) necessarily had the same experiences or outcomes. To make such claims would violate and contradict the fundamental assumptions of this research. Nonetheless, this research makes valuable contributions. The insights gained from the detailed and rich investigation pursued by this research may be usefully and appropriately extended to produce a general understanding of the processes through which neoliberalism may unfold, what effects it may have on service organizations, their institutional environments and responses, and how these developments may be shaped by the various forces and actors in the field. In other words, the findings may be generalizable at a theoretical rather than at an empirical level (Mason 1996:153), and may be fruitfully applied at the level of broad strokes rather than specific details. Third, there are some topics that were simply beyond the scope of the present study, but which are well within the umbrella of this research’s subject matter. One such topic is how neoliberal reforms have differentially impacted adults with developmental disabilities receiving services and their families depending on traditional sociological variables such as gender, race/ethnicity, and class, or others such as location (urban/rural), fluency in English, and so on. Another topic is how workers of differential backgrounds (such as gender, race/ethnicity, educational level, tenure in the field, seniority, and so on) have experienced and responded to the reforms, and how they have impacted them in their own personal lives. These topics are important to understand more fully the deep and pervasive effects of neoliberalism and worthy of future research.

3.11 Concluding Remarks This research utilized a complex longitudinal embedded single-case study research design involving two phases, multiple methods and levels of analyses, and a number of sources and participant groups. There is a strong rationale for this complexity. It emanates from the breadth of the research and the multiple research questions needed to achieve this. It is also grounded in the literature’s recommendation for a longitudinal, multi-focal, and multi-level analysis sufficiently complex to investigate the diverse world

108 of nonprofit human service organizations in an institutional context that is historically- shaped, dynamic and heterogeneous. The design reflects the multi-faceted nature of social phenomena, and tries to achieve sociological clarity by incorporating this fact both into the research’s theoretical framework and its methodology. The complexity of the research and the breadth of its reach become evident in the next six chapters which address the research questions.

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CHAPTER FOUR: HISTORICAL EVOLUTION OF DEVELOPMENTAL DISABILITY SERVICES IN ALBERTA: 1905 TO 1992

Changes in disability policy over the last century have reflected shifts in views of disability and a questioning of processes and structures as new ways of conceptualizing issues have arisen. However, one policy paradigm never completely replaces another; rather, policies based on different views of disability coexist. (Jongbloed 2003:208)

This chapter traces with a broad, macro-level brush, the contextual forces that shaped the historical evolution of the field of services for adults with developmental disabilities from 1905 to 1992. The purpose is to analyse the institutional origins of the field’s policies, structures, and services that existed at the start of the Klein era, in preparation for a deeper study and analysis of the Klein reforms and their outcomes for nonprofit service delivery organizations in subsequent chapters.70 The information used is based almost entirely on Government of Alberta’s annual reports and ad hoc publications, and scholarly secondary sources. For developments after the 1980s, the secondary data are substantiated or augmented with information from primary interviews conducted in 2013 and 2014 with twenty government, nonprofit and disability sector leaders. The research and analytic effort invested in this chapter are deliberately limited since the historical review, while important to establish the institutional origins of the policies and structures that existed at the start of the Klein era, is secondary to the main goal of the research which is to analyse the impact of the Klein reforms. The chapter is organized as follows. The historical review is divided into four periods, each containing within its span what I consider to be a critical juncture in the cultural-cognitive and normative elements (the ideological and philosophical beliefs, and associated values and norms) underpinning and supporting services for adults with developmental disabilities, resulting eventually in a transformation of the disability policy and service landscape. Based on my analysis of the historical developments, I identify these critical junctures to be associated with: (i) the eugenics movement (1920s);

70 See Appendix E for a chronology of key developments in the field and Appendix F for a list of governing premiers and ministers responsible for services to people with developmental disabilities since 1905.

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(ii) the deinstitutionalization and normalization movements (1950s and 1960s); (iii) the social and rights models of disability (1970s); and (iv) the onset of neoliberalism (1980s). For each period, the narrative describing the evolution of policies and services is interwoven with the analysis of the contextual and institutional forces associated with the transformation. After the historical review, the analysis is synthesised by identifying the contextual forces and institutional elements supporting each critical juncture (Table 4.1), and arraying them along a timeline to make explicit temporal progressions (Figure 4.3).

4.1 Historical Review

4.1.1 1905 to 1940s: Asylums and sterilization for the feeble-minded When the Province of Alberta was established on September 1, 1905, there were no organized services for Albertans with developmental disabilities. Most people were cared for at home by their families, and those who were deemed by the courts to be “dangerous lunatics” were sent for permanent incarceration at government expense to the Insane Asylum in Brandon, Manitoba, a practice put in place by the Dominion government for the lands that constituted the Northwest territories (Alberta Social Services and Community Health [SSCH] 1985b:2). No attempt was made to separate individuals with developmental disabilities (referred to as “mental defectives” or “feeble- minded”) from people with mental illness (“lunatics” or “insane”).71 The prevalent view was that both, like criminals, were dangerous and disruptive, and confinement and control were normal and appropriate for both their protection and that of society (Jongbloed 2003:205). The incarceration of persons who were “insane and dangerous to be at large” was legally permitted in the new province under the 1907 Insanity Act.72 In the first decade of the 20th century, Alberta’s population surged from 73,000 in 1901 to 374,000 in 1911 (Statistics Canada 2011) as the federal government actively promoted immigration. The new settlers, who were predominantly Anglo-Saxon

71 Repugnant as it is to me, I use the labels that were historically in use; doing so paints a more accurate picture of the prevalent societal values and views towards disability, and reflects how these have evolved over time. I also do away with using quotation marks for these labels, except perhaps when first introducing them. In no way does this construe my acceptance of such terminology. 72 An Act Respecting Insane Persons, SA 1907, c 7. Available at: http://www.ourfutureourpast.ca/law/ page.aspx?id=2898095. Accessed May 20, 2015.

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Protestants from Ontario, United States, and Britain, joined a wide variety of Indigenous groups, largely confined to reserves scattered across the province, a nascent working class associated with rail transportation, coal mining, construction and small-scale manufacturing, and an already established class of ranchers who were predominantly rich Englishmen and English Canadians from the east. The new agricultural settlers together with the ranchers soon played a strong role in the province’s cultural, social and political realms, and their values of self-reliance, entrepreneurship and respect for authority dominated (Whitcomb 2005:16-18). The railway sped up transportation, new technology improved agricultural production, more migrants arrived from Europe, and Canada became the world’s second largest wheat producer. As wheat prices soared, Alberta experienced one of its many economic booms (p. 21). The rapid population growth and the cost of paying the Dominion Government for the care of inmates in Brandon forced the need for a local asylum, resulting in the Provincial Hospital for the Insane at Ponoka in 1911. Based on the best American asylums and modelled on progressive techniques of “moral care”73—a philosophy espoused by Duncan Marshall, the Liberal minister for public health services— the Ponoka Hospital “was meant to bring Alberta into the forefront of treatment for the insane and feeble-minded” at half the operating cost than the province was paying the Brandon asylum (LaJeunesse 2002:27). However, with the population rising rapidly, the hospital’s capacity was surpassed before construction was completed. The new Liberal premier, Arthur Sifton, faced with a total public debt74 of $29 million when taking office

73 In contrast to earlier Bedlamic models which consisted of cruel punishment, constant restraint and inhumane conditions, moral care rested on beliefs originating in the late 1700s in France and 1830s in England that kind treatment, tranquil surroundings, and (relatively) small institutions were more conducive to treatment. Although a number of asylums were built in North America with this vision in mind, most failed at putting the philosophy into practice (LaJeunesse 2002:17-19; Neufeldt and Enns 2003:30). 74 Government financial reporting methods and standards have varied over time. Until 1923, the public accounts of Alberta had no balance sheets (Hanson [1952] 2003:355). Thus, net financial assets/debt (financial assets [cash or cash equivalent, not including capital assets] minus financial liabilities), an important figure reported in contemporary public financial statements (Canadian Institute of Chartered Accountants 2003:24), cannot be readily calculated. Instead, I have provided the next best measure available in Hanson ([1952] 2003), the total public debt, for years until 1923. Throughout this document, I attempt to clarify in footnotes, to the best of my understanding as a non-accountant, these various financial measures wherever I have cited them. What is more relevant for the purpose of this thesis, however, is not so much how a figure is calculated, but its effect on public perceptions, political debates, or policy decisions at the time in question.

112 in 1911 (Hanson [1952] 2003:45), decided it would be more economical to abandon Marshall’s vision and keep expanding the site rather than build smaller facilities.75 By 1915, over 500 residents lived in a place built for half as many (LaJeunesse 2002:31). In 1919, two important developments occurred: (i) construction of a legal definition of a mentally defective person, and (ii) recognition that people with mental illness and people with developmental disabilities require different policy responses and interventions. These developments manifested in the Mental Defectives Act.76 The Act defined a mentally defective person as “any person afflicted with a mental deficiency from birth, or from an early age, so pronounced that he is incapable of managing himself or his affairs, and who is not classified as an insane person.” It permitted the placement of such persons in institutions designated for them. In 1919, under Liberal premier Charles Stewart, the South Edmonton Home for Mental Defectives was established as the first residential training institute for children with developmental disabilities (Alberta SSCH 1985b:2), and in 1920, construction was announced for the Home and Training School for Mental Defectives in Oliver to accommodate up to 1,500 of the most feeble-minded so they would “no longer be a menace to society” (LaJeunesse 2002:31). When the United Farmers of Alberta (UFA) under premier Herbert Greenfield came into power in 1921 with the provincial population at 588,000 (Statistics Canada 2011), a government review concluded that the Oliver facility should house the most ill of Ponoka’s insane inmates. Idiots and imbeciles, including those from the Edmonton Home, were to be relocated to Red Deer to a facility once used for World War I veterans with post-traumatic stress disorder (Alberta SSCH 1985b:2).77 The government viewed the move as an efficient plan to separate people with mental illnesses from people with developmental disabilities, segregate both from society, and make a new facility unnecessary for a few years; the economic consideration outweighed any regard for the impact on families as people got shuffled about the province (LaJeunesse 2002:32).

75 By 1913, Alberta’s total public debt of $56 million was the second highest per capita in Canada (Hanson [1952] 2003:306), due largely to expensive railway guarantees and costs for telephone lines (p. 45). 76 An Act Respecting Mentally Defective Persons, SA 1919, c 21. Available at: http://www.ourfutureourpast. ca/law/page.aspx?id=2902299. Accessed May 20, 2015. 77 Post-traumatic stress disorder was not recognized at the time. This determination was made by Alberta SSCH at a much later date.

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Originally built in 1913 by the Presbyterian Synod as the Alberta Ladies’ College, the Red Deer facility’s single building opened its doors in October 1923 as the Provincial Training School (PTS) for the residential care and training of mentally-defective children and young adults. In theory, the children were to be taught academic, vocational and personal skills, but there was a strong belief even when the school first opened that very few would ever return to the community due to their level of disabilities (Alberta SSCH 1985b:4); while some “higher-grade” individuals received training in vocational areas such as farm work, sewing and housekeeping, the work they did was on the institution’s grounds and for its needs. Activities were focused on how to keep the residents occupied through work or leisure within the confines of the institution, rather than to prepare them for life in the community (p. 5). As the only institution for people with developmental disabilities in Alberta for a long time, and one where few were expected to leave other than through death, it was inevitable that PTS would become overcrowded, and need frequent expansion.78 By 1977, when PTS was renamed Michener Centre,79 it comprised 66 buildings on over 300 acres of land, and had over 1,800 residents (Alberta SSCH 1985b:1, 30). Michener Centre, which housed as many as 2,300 individuals in the early 1970s, has the dubious reputation as the longest-standing residential institution in Alberta for people with developmental disabilities and as the site for a eugenics sterilization program that lasted longer than most others in the Western world (Grekul 2002:248). The establishment of facilities like the South Edmonton Home and PTS reflected a rise in the power of medical professionals and a shift in the societal view of disability from a law-and-order approach to a medical model. Medical professionals promoted their view of disability as an individual deficit that, like disease, could be diagnosed and potentially cured or controlled through medical intervention (Jongbloed 2003:205).80

78 Malacrida (2015:11-13) also identifies the advent of free and compulsory schooling and its use of standardized testing as an important contributor to the expansion of institutional facilities by making visible children who fell outside of the (arbitrarily decided) normal range of acceptable behaviours. 79 Named after Roland Michener, Red Deer resident and Governor-General of Canada from 1967 to 1974 (Alberta SSCH 1985b:23). 80 Oliver (1996:31) argues that “there is no such thing as the medical model of disability, there is instead, an individual model of disability of which medicalization is one significant component.” Withers (2012:5) agrees that while the medical model has an individual focus, it is distinct enough to warrant its own categorization, and also identifies the eugenic and charity models as distinct approaches to disability.

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The medical model is rooted in an emphasis on clinical diagnoses. It conceptualizes disability as the attribute of a person who is functionally limited and biologically inferior (Hahn, 1985) and represents the individual as a patient with special medical needs who deserves a charitable response in the form of provision of health services. Diagnostic categories are linked to programs aimed at improving functional capacity, and medical professionals become the gatekeepers to benefits. (Jongbloed 2003:205) The strongest example of the power of medical professionals over the lives of people with developmental disabilities was the eugenics program. The philosophy of improving human genetic traits through selective breeding had existed since the late 1800s. However, it was in the post-World War I period, when scientific and medical knowledge were seen as having answers to social problems, that eugenic ideas started getting especially warm reception by influential conservative elites and “progressive” social reformers (Grekul, Krahn and Odynak 2004:359), who considered it both economically beneficial and morally responsible to prevent feebleminded people — conflated as the mentally defective, the insane, undesirable immigrants, the poor, prostitutes, and criminals—from reproducing. These groups were thought to have defective genes that could be a threat to the purity and potential of the human (as in, white, upper- and middle-class) race; gender segregation via institutionalization, combined with the sterilization of those deemed unimproveable, was seen as necessary and effective (Radford 1991:453). 81 The first critical juncture in policies and services to people with developmental disabilities in Alberta, thus, appears to have occurred in the 1920s, resting on an intimate link between institutionalization, the medical model of disability, and the eugenics movement. The idea of segregating people with severe developmental disabilities into institutions was already well grounded in legislation and practice.82 The link between institutionalization and eugenics was formalized in 1928 when, despite opposition from political opponents and the media, premier John Brownlee’s UFA enacted Alberta’s

81 During this time, close to 30 American states passed sterilization laws (Grekul, Krahn and Odynak 2004:359). 82 Alberta was not unique in this. There is a large literature on mental asylums that large custodial institutions elsewhere in Canada, United States and Britain for people with mental disabilities or mental illness, even though they may originally have been established based on other philosophical considerations, were transformed by pressure from the eugenics movement (Radford 1991:450).

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Sexual Sterilization Act.83 The Act allowed for the sterilization of mentally defective people, upon authorization by the Alberta Eugenics Board and consent from the individual, family or guardian, or the provincial minister of health (Grekul 2002:4), and gave institutions the important role of identifying those who should be sterilised (p. 105). Radford proposes that “specialized custodial institutions for the mentally deficient were essentially manifestations of eugenically-driven social policy” (1991:450), while Malacrida makes a strong argument that “although training and education were the given reason for the existence of [Michener], in fact, eugenic concerns played a central role in establishing and sustaining the institution” (2015:4). A number of contextual factors made Alberta a particularly fertile ground for eugenic ideas to take hold. Economically, the province faced a total public debt of $92 million in 1920 (Hanson [1952] 2003:67), and premier Stewart’s Liberal government had floated the idea of raising taxes (p.89). Socially, labor unrest was high as war veterans returned and contributed to rising urban unemployment, and there was much hostility against immigrants from “enemy” nations who were willing to work for low pay (Whitcomb 2005:33). Culturally, many influential middle-class social reformists such as Nellie McClung and Judge Emily Murphy—who led the fight for women’s suffrage and prohibition (which had both classist and racist elements)—were strong proponents of sterilization to improve the white race and reduce the tax burden “through the weeding out of undesirable strains” (Grekul, Krahn and Odynak 2004:362). In 1922, a year after the provincial Liberals were displaced by the more populist and socially conservative UFA, the Canadian National Committee for Mental Hygiene (CNCMH, renamed Canadian Mental Health Association [CMHA]) added to the eugenic chatter in the province by reporting that “the recent wave of Slavic immigrants suffered from high levels of feeblemindedness.” The United Farm Women of Alberta again aggressively lobbied the government for a study to implement sterilization (Grekul 2002:249). These factors, combined with Alberta’s radical (as in, anti-Eastern Canada) tendency, made politicians more willing to go all out to implement sterilization while other provinces

83 The Sexual Sterilization Act, SA 1928, c 37. Available at: http://www.ourfutureourpast.ca/law/ page.aspx?id=2906151. Accessed May 25, 2015.

116 merely flirted with such programs (Grekul, Krahn and Odynak 2004:378).84 With respect to people with developmental disabilities, the regulatory and facility infrastructure was already in place, with the Insanity Act and Mental Defectives Act permitting the identification and incarceration of such persons, and places like PTS to house them. By the time premier John Brownlee, an urban lawyer sympathetic to the grievances of farmers but naturally cautious and economically conservative, took office in 1925, the total public debt had reached $137 million (Hanson [1952] 2003:93), and the Great Depression was around the corner. The depression hit the prairie provinces particularly hard, coinciding with one of the worst droughts in history and falling grain prices (Whitcomb 2005:42). Municipal governments were overwhelmed as farmers flocked to the cities to seek work. Unemployment jumped to over 25%, and as much as 20% of the population was on welfare at some point during the decade. Despite Brownlee’s efforts, between 1929/30 and 1935/36, the province’s total outstanding debt85 grew by $45 million. Alberta had, on average, the highest net interest86 charges relative to current revenue among all the provinces, absorbing a dangerously high proportion of between one-third to more than one-half of the current revenues annually (Hanson [1952] 2003:131). In 1932/33, the province introduced a personal income tax in the attempt to meet rising welfare and agricultural relief costs (p. 120). Spending on mental institutions during the first half of the 1930s remained fairly constant as government funding was directed preferentially toward relief costs (Hanson [1952] 2003:152). However, demand for PTS’ services continued to grow. At the beginning of the decade, PTS had a waiting list of 727 (Alberta SSCH 1985b:5), and a report indicated that “[a]t a conservative estimate, there are 5,600 defectives (i.e., idiots, morons and imbeciles) in the province of whom possibly 1,200 should receive instruction” (p. 6). With intense overcrowding, children with diverse disabilities were

84 British Columbia was the only other province in Canada with such legislation. Despite having similar size populations, about ten times as many people in Alberta were sterilized as in British Columbia (Grekul, Krahn and Odynak 2004:358). 85 As reported by Hanson ([1952] 2003), the total outstanding debt refers to the total sum of money owed to external lenders (i.e., not including government’s internal obligations such as pension liabilities) minus the money put aside to eventually help pay these debts (sinking funds). 86 Net interest is the interest paid out for debts minus any interest earned on investments.

117 often grouped together, reducing the ability of the staff to properly meet their individual needs. It wasn’t until the end of the decade that the facility was expanded further. Meanwhile, the official record suggests that the residents remained relatively untouched by the famine and depression which beset the rest of the province (p. 7). As the Brownlee government became increasingly conservative to meet the financial burdens of the depression, and Brownlee himself was caught up in a scandal, rural Albertans became thoroughly disillusioned with the UFA. Promoting monetary reform as the cure-all for depression woes, the Social Credit League of Alberta (SC, later known as the Alberta Social Credit Party), with its charismatic leader William Aberhart at the helm, filled this political gap and overthrew the UFA in 1935 (Whitcomb 2005:48). Class warfare and religious fervour were at their height during the 1930s. The conservative elites and the well-to-do viewed the poor and unemployed as lazy and threatening, rather than as victims of the depression (Whitcomb 2005:43). People with developmental disabilities continued to be viewed as a genetic threat and a drain on public coffers, and their sterilization was not seen as proceeding quickly and efficiently enough since obtaining consent was proving to be very difficult. In 1937, under the SC regime, the Sexual Sterilization Act was amended to permit the sterilization of people with developmental disabilities without consent, and broadened to recommend sterilization for “individuals ‘incapable of intelligent parenthood’” (Grekul, Krahn and Odynak 2004:363).87 Medical professionals, along with Alberta’s socially conservative political and social elites, played a central role in perpetuating eugenic ideology, aiding in its implementation, and increasing the scope and powers of the Eugenics Board. In 1935/36, when the SCs assumed power, Alberta’s net outstanding debt was $172 million (Hanson [1952] 2003:133). On March 31 1936, lacking sufficient cash reserves and refusing the terms of a loan from the federal government, the government defaulted on its debt payments (p. 171). It subsequently passed an order-in-council to reduce the interest rate payable on bonds and savings certificates by 50% (p. 172), and cancel the redemption of bonds except in the case of personal emergency (Mansell

87 The Sexual Sterilization Act Amendment Act, 1937, SA 1936 (2nd session), c 47. Available at http://www.ourfutureourpast.ca/law/page.aspx?id=2968369. Accessed May 25, 2015.

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1997:19). In August 1935, the government had already suspended the payment of savings certificates (Hanson [1952] 2003:207). These highly controversial events were followed by a series of negotiations and disputes between the government and its bondholders, culminating in 1945 in a debt reorganization program supported by the federal government (pp. 180-183). During these precarious times, notwithstanding some of their early left-wing ideas, the SCs implemented a series of cautious, orthodox budgets tending to both reduce and overestimate expenditures while underestimating revenues (p. 189). Collectively, these activities resulted in a mirage of overall surpluses every year from 1937/38 until the debt was reorganized in 1945 (p. 187). The early SC movement was reformist and anti-establishment. Although it did not achieve its promise of monetary reforms, it made a number of improvements in health and education such as increasing the number of hospital beds, initiating maternity grants and financial support for needy polio and cancer patients, and improving teachers’ labour rights despite the province’s dire financial straits (Finkel 1989:43). After a few years in power, the authoritarian premier Aberhart revealed his more, pro-corporate economy- minded side until his death in 1943 (p. 71). Aberhart’s successor, Premier Ernest Manning, held views more aligned with those of big business than with farmers, workers and low-income earners. As the party’s left-leaning rank-and-file members were driven away, the SC government lurched decisively and permanently to the right (p. 85). In the 1940s, the economy surged. Alberta joined in the effort for World War II as a major training and supply centre for Alaskan airbases (Whitcomb 2005:49); agricultural production improved and diversified, and crop prices rose, resulting in unprecedented prosperity for the province’s farmers (Hanson [1952] 2003:159); and the discovery of oil in Leduc in 1947 set off one of the greatest resource booms in Canadian history (Whitcomb 2005:54). By 1950/51, the province’s net debt88 was effectively reduced to zero, with oil and gas providing 31% of the total provincial revenues, a vast amount of cash and investment reserves, and a significant reduction in outstanding debt due to the 1945 debt reorganization program (Hanson [1952] 2003:218).

88 As reported by Hanson (2003:216, 218), net debt in this case refers to total liabilities minus total of all assets (financial and capital assets). This is the same as a “consolidated balance sheet bottom line.”

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The war was an economic boon for the province, but it presented significant challenges for PTS. With people being recruited for the war effort, staff turnover reached 80% in 1945, and financial constraints limited any serious progress or innovation in services (Alberta SSCH 1985b:9). Although federal transfers helped with some facility and service expansions (Hanson [1952] 2003:200), overcrowding resulted in the 270- some residents receiving little more than basic care (Alberta SSCH 1985b:8). By the end of the 1940s, Alberta’s eugenics program was well established, with rates comparable to American states with the highest rates (Grekul, Krahn and Odynak 2004:377). From 1929 to 1948, 1,129 men (40%) and women (60%) were sterilized (Grekul 2002:108); 55% of these individuals were labeled “mentally defective” (Grekul, Krahn and Odynak 2004:368). The availability of intelligence testing made possible the diagnosis of intellectual disability. It also contributed to the institutionalization and potential sterilization of many misdiagnosed individuals since the tests were inaccurate and culturally biased (Malacrida 2015:21). Grekul (2002:122-124) notes that in her representative sample of cases presented to the Eugenics Board as “mentally defective” from 1929 to 1972, no IQs were reported for 11%, 9% had scores of 70 or higher (and would not be considered mentally disabled by current standards), and 34% had scores with large variances. These findings call into question the scientific basis of the Board’s decision processes. The Board’s powers increased even further in the 1950s and 1960s.

4.1.2 1950s to 1960s: Deinstitutionalization and the birth of community agencies The post-war years were a turning point in daily life and social attitudes. Mechanization on farms drove people to urban centres for employment and a more attractive lifestyle. Alberta’s population grew from 940,000 (urban 48%) in 1951, to 1.3 million (urban 63%) in 1961, to 1.6 million (urban 73%) in 1971 (Statistics Canada 2011). There was increased use of technology, and cars provided new social freedoms. At the same time, the province displayed rather contradictory attitudes, exhibiting a tendency towards general liberalization and increasing support for women’s rights, while harbouring negative sentiments and discriminating against religious groups such as the Mennonites and Hutterites who refused to bear arms during the war, and people originating from “enemy nations” such as Germany, Japan or Italy (Whitcomb 2005:53).

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The economy continued to boom, but for reasons other than the wartime activities. A string of major oil discoveries following in the steps of Leduc created a surge in foreign investment in emerging oil-related services and industries such as the petrochemicals sector, and a boom in construction and housing in response to the province’s rapid population growth (Mansell 1997:20). By 1956/57, the province reported net assets89 of $253 million and annual revenues of $250 million, with about half of the latter coming from the petroleum sector (p. 21). The Manning government encouraged private investment to support economic diversification, in principle, but provided these ventures with little or no direct financial aid (Finkel 1989:117). The surging economy enabled the government to maintain the confidence of the financial community and the middle-class urban elite by keeping taxes relatively low and producing generally balanced budgets (Mansell 1997:21). It also allowed the SCs to put in place enviable health, education and welfare programs, making the government seem rather progressive at first glance (Whitcomb 2005:53-54). Alberta had, at that time, a generous universal supplement for pensioners over 70 years old, and free health treatment for old-age pensioners, the blind, and recipients of mothers’ allowance (Finkel 1989:122- 123). The amount of social spending appears less impressive, however, if one takes into account the province’s significantly higher revenues per capita compared to the Canadian average (p. 122).90 As well, as Finkel (1989) put it, the spending was “less proof of ‘big government’ than of ‘rich government’” (p. 139), and unlike traditional socialists, for whom welfare programs are a means for wealth redistribution, the SC’s rationale was based on the economic benefits of added purchasing power (p. 88). Manning’s ideological position “simply didn’t allow for much collectivist meddling in the economy” (Finkel 1989:117). Consistent with his fundamentalist evangelical view that salvation could only be attained through solitary human struggle, he eschewed collective interference in the individual’s right to attain grace (p. 137),

89 Net assets equal total financial (cash and cash equivalent) assets plus capital assets. 90 For example, Finkel (1989:122) reports that in 1957, Alberta had the highest per capita spending on education at $90 (50% higher) compared to the Canadian average of $60; Alberta’s per capita revenues in the previous year, however, were $225 (80% higher) compared to the Canadian average of $125. Alberta’s spending on education as a proportion of its overall budget, therefore, was below the national average.

121 supported the preservation of the “free-enterprise way of life” (p. 164), and adopted a conservative, moralistic approach to government policies (p. 145). This ideological position translated into a strident anti-socialist paranoia (p. 98), stingy treatment of the poor and unemployed (p. 101), severe restriction of labour rights and union activity (pp. 84, 109, 111), curtailment of civil liberties (p. 108), and a general antipathy towards citizens who found themselves marginalized by the booming economy (p. 118). The growing population, increasing wage gap, high cost of living and the unemployment of individuals lacking the skills needed in the post-war economy put severe pressures on municipal capital infrastructure and welfare budgets. Only after caving into political and public pressure did the Manning government release funds to the municipalities for these added costs. However, it only paid for a portion of, rather than the full amount of, the annual costs, claiming that the latter would undermine local responsibility (Finkel 1989:120-121). In many areas, it implemented partial user-fee systems, for example, to receive health, pharmaceutical and dental care (p. 123), and rationalized them in terms of enhancing individual responsibility (p. 137). When the federal government announced a free hospitalization scheme in 1958, Alberta’s insistence on user-fees “to prevent people from needlessly occupying hospital beds” was one of many points of conflict with the federal government (Finkel 1989:123). The conflict arose both from differences between Manning’s individualistic approach and the federal government’s collectivistic rationale for the establishment of a welfare state (p. 144), and Manning’s aversion to what he perceived as federal meddling in provincial matters. When a federal-provincial conference on mental retardation was announced in 1964, Alberta’s health minister objected that it was an intrusion into an area of provincial responsibility (p. 150). The governing party’s fundamentalist and moralistic views were acutely reflected in policies to individuals with developmental disabilities. The SCs antagonistic relationship with the federal government may also have slowed Alberta’s progress in the disability arena compared to developments nationally. After World War II the eugenics movement fell into disrepute due to its association with Nazi Germany (Withers 2012:25) and to scientific research refuting many of its initial claims (Harbour and Maulik 201:4). The Alberta Eugenics Board,

122 however, approved even more people for sterilization, and those at a younger age (Grekul 2002:160). In 1955, parents admitting their children to PTS were required to sign a form stating they understood that their child may be sterilized if the Board so advised. During the 1950s and 1960s, Alberta’s sterilization rates were among the highest in North America (Grekul, Krahn and Odynak 2004:377). By the time Premier Lougheed’s Progressive Conservative (PC) Party repealed the Act in 1972,91 the Board had reviewed 4,785 cases, taking 13 minutes per case on average, and approved 4,739 (99%) individuals for sterilization; of these, 2,834 (60%) were sterilized92 (Grekul 2011:18, 21). Alberta’s sterilization program for individuals with developmental disabilities is argued to have lasted as long as it did, despite the post-WWII rise in civil rights and social justice movements, because of a combination of factors (Grekul, Krahn and Odynak 2004:378-380). In addition to the province’s radical tendencies and influential figures pointed out earlier, there was an unusual degree of overlap between the religious and socially conservative political elites during the 36 years that the SCs governed the province. Both Premiers Aberhart and Manning were also highly authoritarian and indifferent to public criticism. “With political and religious leadership intertwined, it was unlikely that active opposition to government social programs, including involuntary sterilization, would emerge in the province” (Grekul, Krahn and Odynak 2004:378). The SCs also relied heavily on expert advice from medical professionals and, in the absence of a strong Catholic Church (which strongly opposed any form of birth control), a small and powerful community of doctors, psychiatrists, and social workers had a solid platform to promote a medicalized view of social problems. The logics underlying the eugenics ideology, thus, remained undebated and continued to perpetuate, achieving a “rule-like status” (DiMaggio and Powell 1991:9; Tolbert and Zucker 1983:25).

91 The Sexual Sterilization Repeal Act, 1972, SA 1972, c 87. Available at: http://www.ourfutureourpast.ca/ law/page.aspx?id=2930991. Accessed May 25, 2015. 92 About 40% of the individuals approved for sterilization were not sterilized for various reasons including lack of patient, parental or spouse consent or an indefinite delay in obtaining such consent. The 1937 amendment to the Sexual Sterilization Act was intended to remove such barriers at least for individuals deemed to be “mentally defective;” about 40% of the individuals for whom diagnostic information was recorded were labeled as having only a psychotic condition (most often schizophrenia) and not as being mentally defective or mentally deficient (Grekul 2004).

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Over time, the Eugenics Board became increasingly powerful, expanded its scope, and aided by little turnover, was able to remain unchallenged internally and externally. Between 1929 and 1965, for example, the Board was chaired by the same person, and over the 43 years of the Board’s existence, only 19 other individuals served as members (Grekul, Krahn and Odynak 2004:366). Similarly, for 44 years between 1925 and 1969, there were only three people who headed the ministry responsible for people with developmental disabilities. The medical professionals at residential institutions added to this positive feedback context (Pierson 2000) by identifying and recommending residents to the Board for sterilization. In effect, the system became a “well-oiled machine,” fixated on carrying out its mandate as efficiently as possible (Grekul 2011:17). Malacrida (2015) lucidly sums up this confluence of forces: Concerns about race purity, nationhood, and the social upheaval that accompanied settlement and industrialization were combined with the development of science, professional interests, and social improvement to create a climate of intolerance of difference, the entrenchment of surveillance, and social control, and the naturalization of incarcerating and sterilizing people found to be deficient. In Alberta, these concerns were exaggerated and protracted because of immigration trends and efforts at nation building. As well, these concerns and practices were permitted to flourish because of the closed institutional circle of mental health services in the province. This tight circle of professionals and legislators was able to create draconian laws that permitted relatively easy incarceration of individuals in the Michener Centre and also permitted a system of performing eugenic sterilizations virtually without accountability or, often, even consent. (pp. 29-30). The alignment between these various institutional elements appears to have made the eugenics program extremely resilient even in the face of significant changes in the socio-cultural environment. Sterilizing people with developmental disabilities without their consent, thus, became “an institutionalized practice” both in terms of the theoretical usage of the phrase (DiMaggio and Powell 1991:9) and in terms of it being perpetuated and supported by the residential facilities in which many people with developmental disabilities were forced to live their lives during this period. With healthy government coffers to draw from, the Manning government invested heavily in expanding the province’s institutions to accommodate a growing population. In 1957, Deerhome, a facility specifically for adults with developmental disabilities, was constructed on PTS grounds. Although there was some attempt in PTS at teaching skills

124 that could enable some of the children to potentially reintegrate into the community, Deerhome’s initial population of 335 residents was viewed as too disabled for eventual discharge. They engaged in domestic services to support the facility’s needs, and leisure and recreation (Alberta SSCH 1985b:11). The population at PTS (renamed Alberta School Hospital [ASH] in 1965) and its related facilities rose from 395 (PTS only) in 1950, to 1,567 in 1960 (including Deerhome), to a peak of 2,365 in 1969 (pp. 29-30).93 Overcrowding and short-staffing meant that, regardless of intent, residents did not receive the attention and training they needed to prepare for life in the community (p. 16). Meanwhile, the deinstitutionalization movement was making rapid strides at the federal level and in some other provinces,94 challenging existing segregationist policies and practices. Together with the normalization movement, it resulted in the second critical juncture in the developmental disability field in Alberta, occurring in the late 1950s to 1960s. Both movements gained their inspiration and strength from the post- WWII global consciousness for civil rights and other social justices. The deinstitutionalization movement in Canada was spurred by injured veterans returning from World War II, and victims of a polio epidemic in 1953 and their families. Averse to rehabilitation treatment provided in hospital-like facilities far from families (Jongbloed 2003:205), they spearheaded the creation of nonprofit organizations such as The Easter Seal societies,95 Edmonton Physically Disabled Association (renamed Goodwill Industries of Alberta),96 and the Canadian Paraplegic Association (CPA, renamed Spinal Cord Injury Canada) 97 to advocate for and provide community-based

93 The population count from 1962 to 1973 (last year reported) included Baker Memorial Pediatric Unit in Calgary (Alberta SSCH 1985b:29). 94 Saskatchewan, for example, enacted the first provincial law to fund community rehabilitation services for war veterans and other individuals with motor impairments in 1946, and was a forerunner in planning community supports for people with mental health needs as early as 1956 (Neufeldt 2003:40, 43). 95 Easter Seals Alberta. “About Us.” http://www.easterseals.ab.ca/Site/AboutUs.aspx. Accessed June 10, 2015. 96 Goodwill Industries of Alberta. “History.” http://www.goodwill.ab.ca/about/history/. Accessed June 10, 2015. 97 Spinal Cord Injury Alberta. “History Spinal Cord Injury (Alberta).” http://sci-ab.ca/about/cpahistory. Accessed June 10, 2015.

125 treatment and care for individuals with motor impairments.98 Similarly, organizations like the Canadian Mental Health Association (CMHA), which had become reinvigorated by the involvement of family members, advocated for community-based facilities and housing options for individuals with mental health needs (Neufeldt 2003:42).99 While these efforts raised public consciousness for community-based services for people with physical disabilities and mental health needs, it was the normalization concept which provided a solid foundation for the deinstitutionalization of individuals with developmental disabilities. Originating from ideas and demands expressed in the 1950s by Scandinavian parents, normalization meant “making available to the mentally retarded patterns and conditions of everyday life which are as close as possible to the norms and patterns of the mainstream of society” (Nirje [1969] 1994:19). Popularised in North America by Wolfensberger (1972) and the National Institute on Mental Retardation (renamed Roeher Institute),100 normalization means providing people with developmental disabilities with opportunities for accessing living supports, getting an education, working, having leisure activities and engaging in relationships in the same sorts of facilities and environments available to everyone else in society, and respecting their choices and desires. Its principles were readily adopted by parents advocating for the education rights of children with developmental disabilities (Dunn 2003:203). Thwarted by school boards, a number of parents organized segregated schools in their own homes or church basements. Alberta’s first such school was established in Calgary in 1958 by Christine Meikle, a concerned parent (Sanders and Piotto 1997).101 As the

98 CPA persuaded the Canadian government to develop North America’s first spinal cord rehabilitation centre in Toronto (Neufeldt and Enns 2003:39). CPA, Easter Seals and March of Dimes joined together in 1962 to create the Canadian Rehabilitation Council for the Disabled (CRCD), an advocacy organization that operated at the federal level (p. 41). 99 Ironically, it was the CMHA, when it was called CNCMH, that had advocated with much influence and success for the segregation and sterilization of the “feeble-minded” in the 1920s in Alberta. 100 The Roeher Institute was succeeded by the Institute for Research and Development on Inclusion and Society (IRIS). Source: IRIS. “Welcome to the New Home of IRIS!”. http://irisinstitute.ca/2012/02/01/ welcome-to-the-new-home-of-iris/. Accessed June 10, 2015. 101 Excerpt available at: http://www.ddrc.ca/index.php/aboutus/ourhistory. Accessed June 10, 2015. The eponymous school is still in operation as part of the Calgary Board of Education, and serves children with severe and complex needs.

126 children grew to adulthood, parent associations shifted their focus to lobby for employment opportunities and community living options (Neufeldt 2003:45).102 The institutional context at the federal level was primed for a nation-wide transformation in disability programs, with important building blocks and initiatives related to the rise in the welfare state coming into place. The 1957 Hospital Insurance and Diagnostic Act and the 1966 Medicare Care Act collectively led to the establishment of universal medicare, providing all Canadians, including those with disabilities, access to publicly-funded fundamental health care services. The 1961 Vocational Rehabilitation of Disabled Persons Act (VRDP) enabled the provinces to recover up to 50% of vocational training costs for individuals with disabilities, while the 1966 Canada Assistance Plan Act (CAP) provided similar cost-sharing for approved social programs, including disability supports (Jongbloed 2003:204-205).103 Concerted attention on cognitive disabilities came about in 1964 in response to parental pressure when the federal government organized a national conference to discuss the “mental retardation” file—a move criticised by the Manning government as an intrusion in provincial matters (Finkel 1989:150). Following the conference and as part of the Centennial Crusade, federal funds were provided in 1967 in partnership with CAMR to incite provincial governments to fund community-based services for individuals with developmental disabilities, and set up research and demonstration centres across Canada

102 Local associations lobbied for education and services, while provincial associations coordinated efforts across communities. In 1958, provincial associations formed the Canadian Association for Retarded Children (renamed in 1969 to the Canadian Association for the Mentally Retarded [CAMR] as the children became adults, and in 1985 to its present name, the Canadian Association for Community Living [CACL]). Source: CACL. “History.” http://www.cacl.ca/about-us/history. Accessed June 10, 2015. 103 CAP, a conditional federal-provincial cost-sharing arrangement introduced to encourage national standards in social programs (Canada Finance 2011), was an important funding source for the provinces. In Alberta, the largest percentage increase in welfare payments occurred between 1961 and 1966, when per capita welfare payments rose almost seven-fold as a result of the new program (Shedd 1997:251). At the time of writing, CAP had evolved into the block-funded Canada Health Transfer (CHT) and Canada Social Transfer (CST). In 2014/15, CHT and CST comprised over 11% of the province’s total revenue (Alberta Finance 2015:14), and 87% of the revenues for Human Services, the ministry responsible for the majority of the province’s social programs (Alberta Human Services 2015a:46).

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(Neufeldt 2003:47).104 With increased federal funding, provincial grants rapidly expanded for nonprofit group homes and sheltered workshops (p. 48). In 1969, Alberta commissioned a study to review services for individuals with mental health and cognitive issues. The Blair (1969) report was instrumental in developing a policy framework and guidelines for structuring community services under the Lougheed regime. Nonprofit sector growth in Alberta was also spurred by the Preventive Social Services Program (PSS, later renamed Alberta Family and Community Support Services [FCSS]), introduced in 1966 as part of broader welfare reform. Under the uniquely Albertan program, the province paid municipalities 80% of funding to identify and implement provincially approved preventive programs.105 Depending on their value orientations, local authorities used the funds to either deliver programs directly or funded nonprofit agencies to do so (Bella 1982:144).106 PSS aligned with the SC government’s goal to reduce welfare dependency over the long term (Bella 1982; Faid 2009:5), and its desire to increase municipal responsibility to counterbalance the increasing centralization of welfare activities by federal and provincial governments (Langford 2011:52). Although the SCs may have intended the program as “an alternative to the pernicious welfare state being created in other places in Canada” (p.55), many administrators with social work backgrounds saw the program instead as a means to strengthen social services and expand the welfare state (Bella 1982:144).107 Regardless of its intent, PSS strengthened the role of voluntarism and of nonprofit organizations in services traditionally provided by families, neighbours or churches (p. 151).

104 The Vocational and Rehabilitation Research Institute (now Vecova Centre for Disability Services and Research) in Calgary, a case study site for this thesis, was one of nine research and demonstration centres Canada-wide that resulted from CAMR’s national campaign. Another was the well-regarded NIMR (renamed Roeher Institute, and later IRIS) in Toronto. 105 CAP’s cost-sharing arrangement would reduce the province’s costs to only 30% of the total for some programs, one of the key reasons why the SCs proceeded with PSS (Harrison and Weber 2015:25). 106 Some jurisdictions such as Calgary, with a greater market ethos, encouraged the development of nonprofit and commercial social service agencies, while places such as Edmonton, with a more statist philosophy, strengthened the capacity of its municipal social services. 107 Langford (2011:55), for example, reports that PSS promoted the establishment of day cares throughout Alberta, even though the SCs were, in general, opposed to day cares because they encouraged women to work outside the home (p. 53).

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Theoretically, these developments collectively contributed to create a sufficient critical mass of institutional elements—the cultural-cognitive underpinnings of the deinstitutionalization and normalization movements, the role of parents in changing normative expectations, and the changes in the federal regulative environment—to prime the province’s context to displace the dominance of a residential facility-based model of service and make possible the emergence of community-based nonprofit disability services. It appears that the new institutional context, however, was not strong enough yet in Alberta to completely discredit deeply-ingrained sterilization practices or residential facilities. It had to contend with the Manning government’s and the social elites’ fundamentalist and moralistic views, their parochial approach to federal initiatives, and a powerful and close-knit circle of medical elites in charge of residential facilities and the Eugenics Board. Thus, even as the deinstitutionalization conversation led to serious advancements federally and in some other provinces,108 the progress in Alberta was much slower. However, community-based nonprofit advocacy and service organizations had started appearing on the landscape, and in this sense, a critical juncture had most certainly occurred, awaiting further diffusion of this service model.

4.1.3 The 1970s: Prosperity and progressive views of disability Building on the foundation prepared by the developments of the 1950s and 1960s, the 1970s brought more significant changes to Alberta’s developmental disability sector than any since the start of the century, within the context of a socio-cultural shift in the province’s population, a new PC government, provincial prosperity, and international changes in attitudes towards disability. The 1960s’ iconic political and socio-cultural changes together with the rise in Alberta’s increasingly diverse and managerial urban class made SC’s conservative, rural, religious values less palatable to the modern electorate. In 1971, less than three years after Manning retired from provincial politics, SC’s 36 years in power were brought to an end, with Peter Lougheed’s PCs winning the election on a broadly appealing platform to diversify the economy, regain decision-making control over the oil and gas sector, and

108 Saskatchewan had been planning community supports for people with mental health needs as early as 1956 (Neufeldt 2003:43).

129 improve social programs for seniors, people with mental health needs, people with disabilities and other vulnerable groups (Whitcomb 2005:56; Faid 2009:6). With the 1973 OPEC oil embargo, oil prices rose and Alberta’s GDP surged from $8 billion in 1970/71 to almost $50 billion in 1979/80, making it Canada’s richest province (Whitcomb 2005:57). A new royalty scheme further increased real per capita natural resource revenues109 from under $200 in 1971/72 to over $1,000 in 1979/80. Despite a series of tax reductions, the province ran annual surpluses from 1974 to 1984, giving the government a much needed opportunity to invest in capital and social projects, support private ventures, and save for the future (Mansell 1997:23-24). The Alberta Heritage Savings Trust Fund was established as a repository of surplus revenues, and for the first time since the province’s early days, the government bought companies and made massive investments to support diversification (Whitcomb 2005:59). The population grew from 1.6 million in 1971 to 2.2 million in 1981 (Statistics Canada 2011), and was increasingly well-educated, entrepreneurial, mobile, and economically-motivated. For the first time, Alberta had a significant number of non- European and non-Aboriginal residents, with half the foreign immigrants coming from developing nations (Whitcomb 2005:57). Like Albertans before them, the newcomers favoured private enterprise, respected market forces, and preferred a government that was rhetorically laissez-faire, but intervened to improve business conditions and smoothen boom-bust cycles (Mansell 1997:22). To meet the growing need for public services, overall real (inflation-adjusted) public spending per capita almost doubled between 1971 and 1979 (Mansell 1997:25, Fig.3). Nominal expenditures for SSCH grew from $90 million in 1970/71 to $475 million by 1979/80 due to restructuring (net increase in areas under ministerial responsibility), inflation (which accounted for almost 40% of the increased costs), and expanded programs and service coverage (resulting in staffing expansion from 1,500 to 8,000 people). The expenditures included the costs to

109 Real values are nominal values (the actual monetary amounts in the reporting year) adjusted for inflation so that year-over-year comparisons may be made without the confounding effect of inflation-related fluctuations. Per capita is the reported amount divided by the population estimate for that year (the population figure is typically an estimate on a given date, or an average for the year). Inflation and population estimates for locations in Canada may be obtained from Statistics Canada tables.

130 deinstitutionalize people with disabilities and establish community-based supports (Kinkaide 1987:20). Internationally, there were major shifts in conceptualizations of disability, building on the social consciousness groundwork laid in the 1950s and 1960s. British activists developed a social model of disability which conceptualized disability as the oppression created by the failure of society to respond to the functional limitations (impairments) of people with disabilities, and shifted the focus from fixing (rehabilitating or curing) the individual to changing the social environment (Jongbloed 2003:206). In North America, disability activists advocated for the rights of people with disabilities to be respected, have control over their lives, and access opportunities for full participation in society (Jongbloed 2003:206). These sociopolitical activities not only “changed the conversation about disability, but also presented a new framework in which disabled people could be united and organized” (Withers 2012:5). CACL’s nation-wide campaign to change public attitudes towards people with developmental disabilities, “Plan for the 70s,” played a significant role in refocusing federal and provincial policies from institutionalization to community-based supports, and galvanized parents and service-recipients to advocate for more active involvement in decision-making processes. The campaign also spurred the establishment of developmental disability self-advocacy organizations such as “People First,” parallel to other cross-disability self-advocacy groups such as the Coalition of Provincial Organizations of the Handicapped (renamed Council of Canadians with Disabilities [CCDS]) (Neufeldt 2003:50-51). The third critical juncture in services for adults with developmental disabilities, thus, can be said to have occurred in the 1970s. The social and rights models introduced new conceptualizations of disability and of the place of people with disabilities in society into an institutional landscape already primed by the developments of the 1950s and 1960s. Promoted by academics, a new crop of rehabilitation professionals, and increasingly influential parental advocacy groups, these views were reinforced and expanded by Wolfensberger’s (1972) landmark publication which translated the philosophical basis of deinstitutionalization and the normalization principle into a solid

131 strategy for community-based service models. Meanwhile, the milestone Blair (1969) report already contained guidelines for restructuring services into small, community- based treatment and training units. This confluence of forces occurred at a time when Alberta’s provincial context contained a new governing party reflecting the values of an increasingly diverse, educated, and urban population. The high degree of alignment in the cultural-cognitive elements in the province firmly established the widespread belief that individuals with disabilities had the right to participate in society and make decisions over their own lives. Moreover, with unprecedented economic prosperity, public funds were readily available to finance innovative and collaborative responses to facilitate rapid deinstitutionalization of individuals with developmental disabilities. In 1972 the Sexual Sterilization Act was repealed and the Eugenics Board finally disbanded.110 Services for the Handicapped (SFH) program was created, administratively separating people with developmental disabilities from those with mental health needs. SFH’s goal was “to meet the health and social service needs of the handicapped” by making it possible for them to lead lives as normal as possible in their own communities. Around the same time, Handicapped Children’s Services (HCS) was created to financially assist parents or guardians of children under 18 years (Alberta 2006a:565). SFH and HCS concentrated government’s focus on their respective populations, but were criticised for unintentionally creating “silo[s] of responsibility” and “disability specialists” rather than integrating disability policies, funding, and responsibilities across all public departments (MacFarlane 2009:14). There were also long-term implications of the different types and levels of supports available for children vs. adults, and the challenges posed by the transition process for individuals, families and agencies (Clark, Seel and Clark 2009). Parent, Dr. Keith Seel, elaborated on a concern that I know is shared by many parents of children with developmental disabilities: From age 3 onto 18, you get FSCD, that’s Family Supports for Children with Disabilities. This one is also a fairly affluent program, and you’ve got a bunch of options. If you’ve got some more special needs, like dual diagnosis and things like that, you can end up with supplementary funding. This funding is available for, say, roughly 12 years. . . . When you hit 18, the transition point is this

110 The Sexual Sterilization Repeal Act, 1972, SA 1972, c 87. http://www.ourfutureourpast.ca/law/ page.aspx?id=2930991. Accessed May 25, 2015.

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envelope is really problematic. When families arrive at PDD’s111 doorstep, [they have] multiple expectations. They’ve seen a luxury model with PUF [Alberta Education’s program unit funding]. They’ve seen a non-existent support model in the schools. They’ve seen the fear side of things in FSCD because you have to go through these multi-professional review teams that every year evaluates your contract and so each year, you have no idea if you’re going to get anything, and it creates a great deal of anxiety for families. So, they arrive at the doorstep of PDD with these expectations. Now, the night of the date of the child turning 18, things change. Up until that point, you’ve been dealing with children’s services and with children’s services’ mind-set, which is protective. So, I can have a lock on my child’s door because they tend to run, and that would be seen to be protective, but the moment they turn 18, now it’s unlawful confinement. Nothing has changed about the child, and there’s been no preparation in terms of the transition from one to the other, thoughtfully. Suddenly, everything changes, the supports change, the people change, everything changes in the individual’s life as they move into PDD. (Seel, personal interview) Despite these difficulties, SFH and HCS were critical first steps in the creation of structures to support deinstitutionalization. Other developments included innovations such as the 1976 Dependent Adults Act,112 and the 1979 Assured Income for the Severely Handicapped (AISH) program. The Dependent Adults Act enabled Courts to appoint a relative, friend, or the Public Guardian as a legal guardian of an individual unable to make personal decisions. AISH was the first social assistance program in Canada exclusively for people with disabilities unable to work, thus viewing and treating them differently from other welfare clients.113 Establishment of SFH led to rapid growth in community-based residential services, sheltered workshops, and training programs structured on a continuum-of- service model with clients moving through a series of programs towards increasing levels of independence. The proportion of SFH funding for community supports grew from 11% in 1972/73 to over 25% in 1979/80, while spending on institutions decreased from 89% to 71%; part of the latter was allocated to modernise existing facilities so they

111 Persons with Developmental Disabilities program for adults with developmental disabilities, successor to SPD, introduced in 1996/97. 112 The Dependent Adults Act, 1976, SA 1976, c. 63. http://www.ourfutureourpast.ca/law/page.aspx? id=2932920. Accessed June 10, 2015. 113 This distinction proved significant in the 1990s, when AISH escaped the cuts imposed on welfare programs by the Klein government (Faid 2009:6).

133 resembled more closely “normal” environments (Alberta Health and Social Development [HSD] 1973; Alberta SSCH 1980). During these times of service establishment and growth, there was significant collaboration between SFH staff in the six regional offices, community agencies and families to identify service needs, develop programs and special projects, train and support staff, and place clients in the community (Alberta HSD 1973). Families initiated forums to advocate for an increased range of supports and to co-create service standards (MacFarlane 2009:14). The newly created Alberta Association of Rehabilitation Centres (AARC, renamed Alberta Council of Disability Services [ACDS]) joined with SFH to co- sponsor training for vocational managers, resulting in a program of ongoing support to agency staff on program content, quality and administrative practices (Alberta SSCH 1976, 1977). Alberta Advanced Education funded post-secondary institutions to develop rehabilitation certificate, diploma and degree programs to train personnel for community- based services using a nationally recommended “career ladder” model based on a values- based, person-centred curriculum (Neufeldt and Egers 2003:312).114 As a result, a large cohort of graduates became available to support the expansion of service agencies.115 Elaine Yost, a parent, and President of Optional Rehabilitation Services (Options) described this period of optimism as follows, echoing the sentiments of many service providers who were part of the field in those days: As a sector, we had a purpose that was really focused on community. We saw ourselves as a community. Later, I think we became more focused on our own survival. I think there was a much different community spirit and a different response to the needs of individuals and their families. We had a vision of services that was very unique. Families were part of that, self-advocates, service providers were part of that. There was a different kind of leadership, and connection to people in post-secondary institutions who were very instrumental in helping us think about things and ask about things differently. It was honestly a very exciting time. (Yost, personal interview) With so much money and energy invested in developing a strong cadre of community-based services, it was surprising that the government continued to expand

114 The “career ladder” referred to about 70% of personnel receiving one- and two-year college diplomas, the remaining 30% being divided between various levels of specialization from bachelor’s to doctoral degree levels, and college diploma holders being able to proceed to more advanced education. 115 Red Deer College was the first in Alberta to graduate students with a diploma in rehabilitation in 1974.

134 residential facilities. The Centre for Care of the Mentally Handicapped (renamed Eric Cormack Centre) was opened in Edmonton, and major renovations and expansion were undertaken at PTS to create a multi-use public recreation complex, and a public residential subdivision which included 21 group homes. The changes at PTS, which re- opened as Michener Centre in 1977, addressed overcrowding, developed more normal physical environments for the residents, and reportedly dissolved the “physical and psychological boundaries between the institution and the city’s residential area” (Alberta SSCH 1985b:22). By the end of the 1970s, with community agencies being the preferred service option, there was no waiting list at Michener Centre and the resident population had dropped by 30% to 1,657 from a peak of 2,365 in 1969 (p. 29-30). The official version for the continued expansion of residential facilities was that they were needed to support people who were too old or whose disabilities were too severe to enable an easy transition to the community; locating them in purpose-built group homes on Michener grounds was considered a safer option (Alberta SSCH 1985b:24). In reality, it appears that the general public was simply not ready to welcome people with developmental disabilities or mental illnesses into their communities. There was also a powerful group of parents who believed institutional care was a better option for individuals who were severely disabled.116 Many of these parents were instrumental in improving supports from within by modernizing the physical environment, amenities and support model (Wingrove 2013b; Malacrida 2015:228).117 There were also political and economic considerations for maintaining and expanding the facilities. Institutions were often the largest employers in the rural communities where they tended to be located; politicians needed the support of the many people who economically benefited from the facilities (LaJeunesse 2002:147; Malacrida 2015:155). In some cases, the deinstitutionalization of some residents without properly planned community-supports in place reinforced views that residential facilities were

116 Among these was former premier Ernest Manning, whose oldest son Keith was a long-term resident of Michener Centre (Malacrida 2015:226). 117 The Society of Parents and Friends of Michener Centre had over 200 members at the time of writing. Most are family members or guardians of individuals in Michener Centre. Source: http:// humanservices. alberta.ca/disability-services/pdd-central-society-parents-friends.html. Accessed July 24, 2015.

135 necessary (LaJeunesse 2002:149). Arguably, keeping them operational also provided “a too-easy alternative in the form of reinstitutionalization when the will and resources to support community living fall short” (Malacrida 2015:231). During the 1970s, thus, there appeared to be contradictory and conflicting logics shaping policies and services to adults with disabilities in Alberta. On the one hand, there was the immense push towards deinstitutionalization, well-aligned with the widespread beliefs brought about by progressive movements and models of disability. On the other hand, there were makeover attempts to “normalize” institutional facilities so they could remain in operation. The landscape of contradictory logics became even more complex when the economy took a severe downturn in the 1980s.

4.1.4 1980s to 1992: A bust for the economy and the onset of neoliberalism The heady days of the 1970s were soon over. Oil prices fell in the early 1980s and again in 1986, grain prices tumbled in the mid-80s, there was a global recession, and inflation and interest rates were high (Mansell 1997:27). On the international scene, British Prime Minister Margaret Thatcher and American President Ronald Reagan were translating their particular visions of neoliberal ideas for small government into specific policies and programs (Steger and Roy 2010:21). Similar ideas were being echoed in Canada by pro-business groups such as the Fraser Institute and the National Citizens Coalition (Grekul 2012:177), and the newly-formed Reform Party of Canada led by Preston Manning, son of Alberta’s former premier Ernest Manning (Harrison 1995:52). Private sector investment declined, unemployment rose above the national average from 4% in 1980 to 12% in 1985, and welfare costs and caseloads increased dramatically (Kinkaide 1987:23; Mansell 1997:27-28). Canada’s first food bank opened in 1981 in Edmonton (Harrison and Weber 2015:26). As the government cut thousands of public sector jobs, and enacted laws to support private businesses and erode worker rights, the province witnessed the most militant decade in its history of labour relations (Gereluk 2012:173). The population grew by a very modest 14% from 2.2 million in 1981 to 2.5 million in 1991 (Statistics Canada 2011), and indeed from 1983 to 1987 there was net migration out of the province (Mansell 1997:28).

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To add salt to Alberta’s wounded economy, federal CAP payments118 declined substantially during the 1980s (Azim 1987:41) to curb dramatic increases in the federal deficit (Mansell 1997:41), and the Trudeau government’s National Energy Program increased federal transfers out of Alberta. The province’s total per capita revenue for 1986/87 was 25% less than in recent years, despite a series of tax increases. Meanwhile, per capita spending rose dramatically from 1981/82 to 1983/84 to meet commitments made in the 1970s, and stabilized close to these higher levels until 1986/87 (Mansell 1997:27-29). In 1985/86, the province announced a deficit of about $800 million after running mostly balanced or surplus budgets since 1972/73119 (Alberta Finance 2003:61; Mansell 1997:21). The following year, the deficit rose to an unprecedented $4 billion, and remained substantial from then until a surplus was achieved in 1994/95 (Alberta Finance 2003:61; Mansell 1997:30). Bad investments and loan guarantees to private sector projects to promote economic diversification led to a rapid buildup in provincial debt (Mansell 1997:25,34). In 1991/92, the government also announced a net financial debt120 of over $2 billion, compared to net financial assets of close to $12 billion in 1985/86 (Alberta Finance 2003:61). The economic slowdown of the 1980s set the stage for the ascendancy of neoliberal reforms in Alberta, and focused the government’s attention on combatting the deficits and rising public debt by targeting spending. Some scholars (e.g., Cooper and Neu 1995, Taft 1997) have cogently argued that government debts and deficits are not necessarily the inherent evils they are portrayed to be; that government’s ideologically shaped accounting choices determine how these figures are calculated and reported; and that in Alberta’s case, the deficit issue arose due to corporate giveaways such as low royalties and poor investment decisions more so than high expenditure levels. Others

118 See the importance of the Canada Assistance Plan (CAP) footnoted previously. 119 There was a deficit in 1982/83 of close to $800 million, followed by two consecutive years of surpluses (Alberta Finance 1997a:58; Mansell 1997:30). 120 Net financial assets/debt equal financial assets (cash or cash equivalent, not including capital assets) minus financial liabilities.

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(e.g., Drugge 1995; Parkland Institute 2002; Flanagan 2011)121 have pointed to the low tax regime as a major cause of the province’s fiscal status. Here, I merely wish to note that portrayals of debts and deficit—or the use to which these are put by political or other elites to construct policy responses—are not to be taken at face value; they are as socially constructed as the solutions enacted in response to them. In the socio-political context of the 1980s, debts and deficits were portrayed as problems to be resolved, and public programs were targeted as the culprits. The fourth critical juncture in services for adults with developmental disabilities in Alberta, thus, came about in the mid-1980s as these ideas entered into the mix of cultural schema available in the province’s institutional environment, and its policy prescriptions caught the imagination of the province’s politicians and public administrators. In 1983/84 SSCH embarked on major restructuring to increase efficiency and reduce costs (Kinkaide 1987:23).122 Reflecting the restructuring occurring in the corporate sector, the ministry reduced administrative and staffing costs through consolidation, automation, streamlining, and downsizing. In addition, it transferred some responsibilities to other departments, decentralized services via regionalization, reallocated funding to programs most in need, and intensified the privatization of certain social services by transferring the delivery of publicly-operated services to nonprofit agencies and for-profit firms (Alberta Social Services [SS] 1987). As was described in Section 4.1.3, privatization had already started in the late 1970s for services to people with developmental disabilities (Kinkaide 1987). Azim (1987:40) explains that privatization may be in response to a perceived need to restrain public spending (a purely pragmatic consideration), or based on the belief that market forces and mechanisms maximize the use and distribution of resources (an ideological consideration). It would appear that Alberta’s move to privatization was motivated by

121 Although the Parkland Institute (2002) report and Flanagan (2011) do not comment on the situation in the province’s fiscal policy decisions in the 1980s per se, the arguments presented regarding the PCs approach to taxation are equally relevant to the situation in the 1980s. 122 In 1986, the Department of Social Services and Health (previously Social Services and Community Health) was dissolved; responsibility for people with developmental disabilities was placed under a new Department of Social Services, renamed Family and Social Services in 1988 (Alberta 2006a).

138 both factors. Kinkaide (1987)123 frames privatization as the “revitalization of community enterprise,” and describes it as a vital strategy for realizing service delivery efficiencies and broadening individual, family and community responsibility for their own health and welfare (p. 28). Azim (1987:53), meanwhile, reports that privatization was in response to the government’s claims about electorate dissatisfaction with a rigid, over-bureaucratized social service delivery system, and “vague notions that Albertans are denied an opportunity for personal development within the social service field.” Privatization mechanisms included establishing boards to provide oversight (e.g., for the hospitals at Oliver and Ponoka), engaging in conditional grants and contracts with private organizations to deliver public services, and outsourcing administrative services such as research and clerical work (Kinkaide 1987:29). The benefits of privatization were seen as: reducing the growth of government by shifting its role from delivering services to developing standards and monitoring service quality; strengthening market forces, thereby increasing competition, strengthening service accountability, and increasing creativity, innovation and service quality; enhancing volunteerism and work opportunities in the non-public sector; and containing costs (p. 32). Funding reform, which was part of privatization, was supposed to ensure that service delivery was “maintained at prescribed quality and cost standards” (p. 33), although it quickly became apparent that the rapidity of the reforms made it difficult to maintain and monitor quality service provision. For persons with developmental disabilities, privatization served to deinstitutionalize services and deinstitutionalize individuals, moving both from the direct purview of the government to the care of the community. The growth in community- based services increased rapidly in the late 1970s and early 1980s as they became the major care providers. Figure 4.1 shows the real per capita expenditure for SFH, and the funding distribution between community-based services and institutions. Total annual funding increased significantly for the first decade of SFH’s existence before levelling off

123 Perry S. Kinkaide served in the Alberta Government from 1972 to 1986 in positions including Regional Coordinator and Regional Director of SFH, Director of Privatization and Funding Reform in SSCH, and Assistant Deputy Minister. Source for biography: http://abctech.ca/perry-kinkaide-ba-msc-phd-cmc- founder-past-president-and-director-of-public-policy. Accessed June 25, 2015.

139 in the first half of the 1980s.124 For the rest of the 1980s, as the economy worsened, total funding dropped, but increased overall for community-based services. From 1980/81 to1989/90, the proportion of grants to community agencies grew from 32% of SFH expenditures to 44%, while spending on institutions decreased from 64% to 51% (Alberta SSCH 1981; Alberta Family and Social Services [FSS] 1990).125

Figure 4.1 Annual Expenditures for Institutional and Community-Based Services for Albertans with Developmental Disabilities 1970/71 to 1992/93

Lougheed Getty $20

$18 $16 1972: SFH created $14 $12 $10 $8 $6 $4

$2 $ Real $ Per Capita 1972 (in dollars) $0 1970/1 1975/6 1980/1 1985/6 1990/1 Total Program Funding Community Services Institutions

Sources: Compiled from nominal values reported in Government of Alberta annual reports of ministry responsible for program, adjusted for provincial inflation (Statistics Canada CANSIM Table 326-0021) and population growth (Statistics Canada CANSIM Table 051-0001).

Figure 4.2 shows the caseload distribution in institutions and community-based services for individuals receiving SFH supports in 1972/73 (19% in community), 1980/81 (55% in community), and 1989/90 (77% in community (Alberta HSD 1973; Alberta SSCH 1981; Alberta FSS 1990). The high costs of institutions relative to community-

124 The funding spike for institutions from 1975 to 1978 was likely due to costs associated with the developments at Michener Centre. The spike in 1977/78 for community services may also be due to capital funds injected to encourage services to set-up. However, these are simply my speculations. 125 Totals do not add to 100%; the balance of funding is the proportion allocated to program support and oversight at provincial and regional levels.

140 based supports is partly reflected in the fact that, in 1989/90, although only 23% of individuals remained in institutions, they received 56% of total program funding.

Figure 4.2 Caseload Distribution in Institutions vs. Community-based Services for Adults with Developmental Disabilities in Alberta

8,000

Institutions

6,000 Community Services 1,440

4,000

2,042 SFH Caseload SFH 2,000 2,303

2,460 4,737 544 0 1972/73 1980/81 1989/90 Sources: Government of Alberta annual reports of ministry responsible for program.

In sum, the expansion of community-based services in the 1980s appears to have been a confluence of the shift in ideas arising from the deinstitutionalization and normalization movements, government’s need to reduce service costs, and its ideological leanings towards privatization. Privatization was also consistent with public support for greater involvement in public services. Stephen Golub, CEO of the Central Region PDD Board at the time of the interview, observed: The 1980s were full of structural changes. Preventative social work required people to be involved. “We need to distribute responsibility” was part of the whole push for decentralization. The decentralization represented probably a shift from the Social Credit “Ernest Manning knows best and every decision he makes in Edmonton affects all of the province,” which worked for a while. But as people in Alberta got younger, and as Peter Lougheed came in, he wanted to do something that was representative of a new style, a new feel. And a lot of Albertans did not want to wait until “Dad” told them what to do, they wanted to be more involved and take more personal responsibility and ownership, and maybe even personal initiative. So, the idea was, “Let’s distribute that.” (Golub, personal interview) Privatization also reflected the demands of families to have greater flexibility and control over services. When the government made available funding for families to

141 directly purchase (or, as it turned out, to create) services tailored to the unique needs of the individual or the family, the program had rapid uptake (see Chapter Eight). Entrepreneurial family members, and many government employees laid off as part of cost-cutting measures, took advantage of the funding by establishing not-for-profit and for-profit agencies based on their unique visions and philosophies of support or expertise. Golub explained further this confluence of events, and the role of families in particular: Privatization was also very much tied in with the processes to move people out from Michener. That was reflected in the Baker Centre plan as well, when they moved people out of Baker Centre into more community-based settings, served by people working for private agencies. It was probably a confluence of government seeing privatization as a good idea and families saying they did not want their children at Michener. So there was two things probably working together for a while. . . . A lot of the agencies we have in PDD right now were started by families who got together, with some support from government, back in the days when we had community development workers to help you and guide you through setting up a society, putting by-laws in place, having your meetings, hiring staff, setting up whatever you needed with policies and procedures and all those types of things, regulatory requirements, etc. We had staff who were focused just on doing that for quite a few years—[named a few individuals]— people like that, whom you probably know (Golub, personal interview). Another factor contributing to the rise in small agencies was a perception in government that the existing community-based organizations—many of which had become large agencies—were becoming either too powerful in the sense that they served a large enough caseload to challenge the government’s policy and funding decisions, or were perceived to provide services that did not fit with government’s vision of inclusion. There was, therefore, a conscious effort by the government to reduce this concentration of power by funding new, smaller agencies (MacFarlane 2009:18). MacFarlane’s views were echoed by a few other service providers. One individual had this to say: In the 80s, there was a fundamental shift. Some of the residential programs started to be tendered out. The perception was that “big was bad” and there was a swing to having families have more say, a swing to having more choice. …We saw a real upswing of small “mom and pop agencies,” or just a single person with two bedrooms in their home offering services. . . . There was a shift in thinking that large agencies were not inclusive, were not community-based, and not individualized service. (P1C11, personal interview) The expansion of community-based services occurred within a context of broader international and federal initiatives for increased public awareness and disability policy

142 advances. The United Nations declared 1981 the International Year of Disabled Persons and 1982-93 the International Decade of Disabled Persons. To support these, a federal committee undertook a comprehensive review of federal legislation pertaining to persons with disabilities, and produced the landmark Obstacles report (Canada 1981). Guided by the report’s 130 recommendations, from the early 1980s to the 1990s, federal and many provincial governments provided a leadership and coherence of focus not seen before or since. Legislative developments, such as the Canadian Charter of Rights and Freedoms (Constitution Act 1982), an amendment to the Canadian Human Rights Act (R.S.C., 1985, c.H-6) and the Employment Equity Act (S.C. 1995, c.44), positioned disability in a human rights framework. Meanwhile, structural developments, such as the creation of the Disabled Persons Secretariat and the Disabled Persons Participation Program within the Department of the Secretary of State, emphasized disability as a rights and citizenship issue and galvanized federal activities and funding (Neufeldt 2003:58-62). The flurry of federal activity spurred similar responses from the provinces (Neufeldt 2003:57). In Alberta, the government allocated $2 million to improve vocational services and facilities, including a grant to AARC to enhance its role in policy planning and development of vocational services (Alberta SSCH 1981). The Premier’s Council on the Status of Persons with Disabilities [PCSPD] was created to advise on cross-disability policy matters (Alberta SS 1988). Guidelines were developed to help design services “in accordance with the unique needs, strengths and personal choices of the individual” (Alberta SSCH 1986:26), resulting in the development of individual service plans with an emphasis on natural (vs. professional) supports, smaller group homes and supported independent living (vs. congregate care), community access options for leisure, and supported employment (vs. sheltered workshops). Despite these positive advancements, the rapid expansion of community-based services was criticised as having being carried out with no vision, overall plan, or proper structures and supports for quality and accountability (MacFarlane 2009:18). Service providers felt that many new agencies lacked the resources or expertise to provide quality services or be involved in developing system-wide solutions. There was also a perception that standards and policies were not uniformly applied, as noted by one of the service providers:

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The criteria were always changing and inconsistent across agencies. So you would hear what some other agency got and you were hearing something else from PDD. It was always changing, and inconsistent and subjective. (P1C12, personal interview). To improve accountability, AARC (now ACDS) was funded in 1985 to develop standards for vocational services (Alberta SSCH 1985a). The impetus came largely from AARC member agencies and from local service provider councils formed to advocate for better standards, funding clarity, and procedural transparency (MacFarlane 2009:18-19). A member of AARC and the Calgary Rehabilitation Service Provider Council recalled: We developed the accreditation and CET certification during those times, and we needed those things. That was good. It used to be very loose and out-there, so we did need some standards. It was a service provider initiative in partnership with PDD. 126 There were other accreditation bodies and various agencies used that, but there wasn’t anything specific for our field, so that initiative was the first. (P1C15, personal interview) In addition to insufficient standards, inadequate funding became an issue in the 1980s. The gap between public sector wages and those that community-based agencies were able to pay their staff became significant enough that the latter were unable to remain competitive with the former. Funding was increased for vocational services in 1981 after much lobbying (Alberta SSCH 1982). However, it was insufficient, and service provider councils once again lobbied hard in 1989 for wage increases; this was a pattern that would continue well into the future (MacFarlane 2009:18-19). Given the collaboration and support between SFH and services providers in the 1970s, it is surprising to see the friction evident in the above examples. From an institutional perspective, the friction may be understood as a potential misalignment between, on the one hand, the beliefs and normative bases underlying the activities of families and service providers, and on the other hand, government’s goals to encourage the establishment of community-based services in the 1970s versus its goals for accelerate privatization in the 1980s. The aims, values and expectations of families and service providers, which were directed by the normalization principle and the rights-based model of disabilities, remained unchanged between the 1970s and 1980s. When revenue was plentiful in the

126 Individuals often referred to SFH as PDD, though the latter was not established until the mid-1990s.

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1970s, government’s goals for deinstitutionalization were also aligned with these aims (see, for example, the guiding principles and objectives for SFH, reproduced in Box 8.1 in Chapter Eight). Once financial constraints set in during the 1980s, government’s goals were directed towards cutting spending; deinstitutionalization served as a convenient justification for accelerating privatization and a means to achieve these new fiscally- driven goals. A possible reason for the friction, thus, may be due to this divergence in goals, which in turn resulted in community’s expectations for adequate funding and standards of quality not meshing with government’s priorities to reduce costs. An important exception to the friction between government and community-based services was Claiming My Future (Brassard 1989). This seminal report, which shaped the direction of service philosophy and delivery, was produced by MLA Roy Brassard with significant input from community-based and academic rehabilitation professionals. Its key recommendations, supported by government and the broader developmental disability sector, included: viewing individuals with disabilities as citizens with rights; emphasising the value and role of individuals and families in setting policy and service directions; expanding the responsibility of other public departments to consider the needs of people with disabilities in their programming; providing funding to support family- and self-advocacy groups and resources; and developing specific legislation to ensure services for individuals with developmental disabilities. A senior bureaucrat suggested that Brassard (1989) was spurred by broader developments in the disability field, rather than originating per se in government’s philosophy for disability services: The Brassard Report was seminal. It came out of a changing ethos in Alberta around the idea of deinstitutionalization. There was a realization that we really needed to move people from Michener back into their family homes and communities. It wasn’t so much government policy as it was the influence of Nirje, who influenced Wolfensberger. He came up with his principles of normalization in Norway. Nirje visited Alberta too. . . . There were a few things that I think were happening at the time that were important. Rick Hansen went around the world in his wheelchair. That created the Premier’s Council for the Status of Persons with Disabilities. Gary McPhearson was a big part of that. The Alberta Disability Strategy came about in 1992, I think it was. I wouldn’t call it a policy. Rob Lougheed was the MLA who was charged with it. . . So all these circumstances led people’s thinking about change a little bit. I am not sure that we can say it was policy that led to these changes. (P1G13, personal interview)

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While Brassard (1989) may well have been the product of broader developments, it was the onset of neoliberal prescriptions in Alberta’s public sector that left an indelible mark on the province in the 1980s overall: unprecedented job losses in the private and public sectors, severe controls on collective bargaining rights (Gereluk 2013), accelerated privatization of support services and some human services (Kinkaide 1987), and cuts to public programs. After peaking in 1982/1983, real per capita expenditures generally dropped for the rest of the decade (Mansell 1997:25). During Getty’s tenure (1985/86 to 1992/92), Alberta had the tightest spending controls in all of Canada: nominal program spending grew by only 2.3%, significantly less than the 6.8% average growth for the federal and all other provincial governments (Taft 1997:16). Cost containment included cutting medicare, eliminating nursing positions, closing hospital beds and services, and freezing doctor’s fees. Education spending was frozen, student loans and welfare rates were reduced, and capital projects were halted. By 1991/92, the equivalent of 4,400 fulltime public sector jobs had been cut. Private sector subsidies intensified, and inflation drove up the carrying costs for funds borrowed to cover the growing debt (Taft 1997:Ch.4). Despite small tax increases and the spending controls, budget deficits continued and the debt kept growing (Mansell 1997:31). By 1992, the public lost faith in the Getty government’s ability to balance the provincial books (p. 62). In December, following a series of spectacular failures of government-backed businesses and deep public distrust and anger (Lisac 1995:Ch.3), Getty resigned and was replaced by Ralph Klein as the leader of the PC Party. The 1980s were just a prelude to the dramatic reforms that would be ushered in by the Klein government (Chapter Five).

4.1.5 Summary This chapter sketched the contextual forces that shaped the evolution of the field of services for adults with developmental disabilities in Alberta from 1905 to late 1992. Four main periods were identified, the first three characterised by a major shift in society’s ideological and philosophical beliefs about people with developmental disabilities, and the last by the onset of neoliberal ideology. Eventually, these resulted in transforming policies and service models. For each period, the province’s socio-political and economic environments, demographic context, and dominant cultural values were

146 described, and their role in helping, or hindering, the ideological shifts to gain a foothold in the province was discussed. The analysis, which was interwoven throughout the historical review, is synthesised in the next section.

4.2 Analytic Synthesis The historical analysis supports Jongbloed’s (2003:208) observation that, despite shifts in views of people with developmental disabilities over time, policy responses based on different cultural-cognitive underpinnings often coexist. It also supports institutionalist assertions that there is a complex array of institutions shaping the characteristics and outcomes of a field at any given time. Institutional scholars identify two theoretical challenges for empirical research: first, to identify the cultural frames that shape how a problem is seen and how its solution is defined (DiMaggio and Powell 1991:28), and second, to determine which forces and processes are the critical players shaping institutional developments (Smith and Grønbjerg 2006:236-237). I have attempted to address these challenges throughout the narrative in the historical review. This section synthesises the analysis. Table 4.1 below identifies the main contextual factors and forces, and the unique combination of elements prevalent in the institutional landscape for each period. Following it, Figure 4.3 presents a graphic timeline of the evolution in institutional elements and service models. Cultural-cognitive elements (sources of ideas, shared beliefs) are arrayed at the top, followed by normative elements (sources of professional ideologies, norms or standards), and then regulative elements (legislations, regulations, and policy activities).127 Dominant service models are arrayed below the timeline. Arrows identify (i) the onset of each element which played an important role in institutional change; and (ii) the implementation of a new service model. Critical junctures are highlighted by ovals representing the time span where there are three or more arrows aligned in the same vertical space, indicating the convergence of a critical mass of elements to instigate institutional transformation. Both Table 4.1 and Figure 4.3 are empirically derived from the evidence presented in the historical review.

127 Regulative, normative and cultural-cognitive elements are analytic rather than empirical distinctions. As is often the case, they intermingle or blur into each other. What is important is not the categorization of any element but what other elements are co-present, and whether they reinforce or counteract each other.

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Table 4.1 Environmental and Institutional Contexts of the Evolution of Services to Albertans with Developmental Disabilities

1905 to 1940s 1950s to 1960s 1970s 1980s to 1992 Asylums and Sterilization Birth of Community Services Period of Prosperity Recession and Privatization Eugenics Movement Deinstitutionalization Social and Rights Models of Disability Onset of Neoliberalism Environmental Contexts Historical Birth of Alberta. WW1. Rise in science and technology. OPEC oil embargo. Global recession. WW2. Thatcher/Reagan neoliberalism Political Liberal. UFA. SC. SC. (Authoritarian, PC. (relatively socially PC. Federal Reform (Traditionalist) conservative) progressive) Party (neoliberal) Economic Expansion. Depression/labour unrest. Post-war and oil boom. Foreign Surge in GDP, revenues, and public Recession. NEP. Federal transfers Post-war boom. Oil found in 1947. investment. Net assets. services. Canada’s richest province. decline. Deficits, and rising debt. Demographic Population boom. Conservative elite. Overlap between religious and political Increasingly urban, multicultural, diverse, Corporate layoffs. High White, Anglo-Saxon rural majority. elite. Population more urban than rural. well-educated, professional. unemployment. Cultural Self-reliance. Respect for authority. Civil rights and women’s movements. Socially progressive relative to previous Cost-conscious. Shift from shared values Social reform. Religious fervour. Rise Liberalization and awareness of social decades in the province. Open to to individual/local responsibility.

148 in respect for science and medicine. injustices. Growing social freedoms. innovation and largesse.

Institutional Contexts Cultural- Law and order model: people with Medical model. People with physical Social and rights models: disability Social and rights models. Medical cognitive disabilities a menace to society. disabilities promote rehabilitation and created by social oppression; people with model still present. Neoliberal Medical model. Feeble-mindedness a` community living. Normalization and disabilities have right to full participation ideology: small government, low threat to human race, hereditary, deinstitutionalization movement spread and respect. Medical model still present. taxes and spending cuts. subject to diagnosis and intervention. with parental advocacy. Normative Law and order, then science and Medical, psychiatry and rehabilitation Rehabilitation professionals, social Corporate and business logics medicine. Eugenics movement. professionals. Confinement, treatment, workers, parental and self-advocacy (efficiency, competitiveness, Confinement and control. sterilization. Start in demand for groups. Collaboratively developed accountability). Obstacles (1981) Treatment and/or sterilization. community supports. standards. Post-secondary training. Regulative Insanity Act, Mental Defectives Act, Federal initiatives (Medicare, VRDP, Blair report (1969). SFH created. Sexual IYDP. IDDP. Charter of Rights. Sexual Sterilization Act, Eugenics CAP, Centennial Crusade). Research and Sterilization Act repealed. Dependent Regionalization. Brassard (1989). Board funding for community supports. Adults Act. AISH. Service Large residential institutions Large residential institutions. Eugenics Community-based sheltered services. Surge in privatization. Rise in small models Eugenics program program at its height. Start of community- Institutions “normalized.” agencies Individualised funding based services and advocacy agencies. model. Normalized institutions.

Figure 4.3 Institutional Shifts in Services for Adults with Developmental Disabilities in Alberta 1905 to 1992

Law and order model Social and rights models Medical model of disability

Cultural Comm Living/Deinstitution. movement Neoliberalism

Eugenics movement

Normalization movement Self- advocates

Medical and psychiatry professionals

Parent advocates 1919 1907 1928 Sexual Sterilization Act (repealed 1972) Rehabilitation professionalization Normative Insanity Mental 149 Act Defectives

Act IYDP, IDDP, InstitutionalContext Federal initiatives Obstacles report 1961 VRDP 1966 CAP Brassard Centennial report Crusade Social Services

Blair Creation of SFH, restructuring and Regulative

report regionalization funding reform 1900s 1910s 1920s 1930s 1940s 1950s 1960s 1970s 1980s 1990-92

Congregate care and segregation in large residential institutions “Normalized” residential Institutions Eugenics Program Regionalized services

Models Community-based programs Segregated supports Integrated supports

Privatization Service

4.3 Concluding Remarks Since 1905, Alberta’s developmental disability field has been shaped not only by societal shifts in views towards disability, but also by the province’s unique combination of circumstances such as its history as a frontier land with a socially conservative and religious elite, its distance from and general distrust of Central Canada, its volatile resource economy, and its population that values entrepreneurship and self-reliance. Alberta’s disability policies have reflected these individualist and radical (as in, different from elsewhere) leanings. The latter is demonstrated in the long history of eugenics and institutionalization. It is also exemplified by the province’s more progressive innovations such as Canada’s earliest parent-run schools for children with disabilities, income support programs such as AISH, and legislations such as the Dependent Adults Act. Between 1905 and 1992, four critical junctures were identified where significant shifts in services to people with developmental disabilities occurred. The first three junctures arose from shifts in the relatively narrow cultural-cognitive context of societal views towards people with disabilities. The fourth arose from a much broader shift, in views about the role of government and its relationship with citizens. People with developmental disabilities just happened to be on the wide path that would be impacted by this neoliberal turn. Neoliberalism’s policy prescriptions related to the privatization of public services and the fostering of greater individual and community responsibility started gaining a foothold in Alberta’s public sector in the 1980s, catalysed by the province’s rapidly declining economic conditions, and the close connection between its political and business elites. By the time Klein came into power, the foundation for a massive transformation had been set.

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CHAPTER FIVE: KLEIN REFORMS, REINFORCEMENT AND ENTRENCHMENT

The Klein revolution was very much a revolution from within. The Progressive Conservative party came to power in 1971 determined to make Alberta prosperous by making the government bigger. That leadership reinvented itself in the early 1990s, and held on to power with a determination to make Alberta prosperous by making the government smaller. Smaller in some ways but not in others. (Lisac 1995:43)

This chapter provides an overview of the general transformations that took place in the province’s public sector and services during Ralph Klein’s tenure as premier of Alberta from 1993 to 2006, followed by a brief review of developments from 2007 to the historic downfall of the PCs to the left-of-centre New Democrats in May 2015.128 The information is based on government publications and secondary sources in the scholarly literature. The analysis of the Klein years is divided into two phases: (i) 1993 to 1996, the period of intense cutbacks and start of the reforms; and (ii) 1997 to 2006, the period of prosperity, reinvestment, and reinforcement of new techniques of governance. The broad contextual factors that made the transformations possible are identified, and the interplay of ideational forces is explored to explain why the reforms became widely accepted. The review of developments after 2007 reveals a general trend towards the entrenchment of neoliberalism in Alberta’s institutional landscape, but also finds examples that signify the beginnings of a possible shift in the province’s social policy arena in the last few years of the PC’s forty four consecutive years of being in power.

5.1 1993 to 1996: Cutbacks and the Beginning of Reforms When Ralph Klein became the premier of Alberta in December 1992, the province had been running a deficit for six years, was on its way to a net financial debt of over $2 billion, and had a net accumulated debt of $17.5 billion from zero in 1986/87

128 Small portions of this chapter (≈10% in total) were previously published in Sonpal-Valias, Sigurdson and Elson (2016); these portions constitute an insubstantial amount (about 8%) of the publication in total. Wherever excerpts from that source are used, they are properly cited. I am the sole researcher and author of the information presented in this chapter, unless cited otherwise.

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(Alberta Finance 2003:61).129 The economy was more diversified, but still heavily reliant on the petroleum industry. Oil and gas prices had not rebounded from the mid-1980s, and the corporate sector was still recovering from massive restructuring in the face of globalization’s competitive pressures. Almost $2.4 billion in private sector investments and guarantees had been written off by the government, and expenditure obligations kept spending levels high despite falling revenues (Mansell 1997:33-34). Federally, the Reform Party of Canada was echoing Margaret Thatcher’s and Ronald Reagan’s ideology and policies for small government. Reform’s bold plan to reduce the federal deficit through 10-15% cuts in program spending was garnering much support among Alberta’s business and political elites and causing a fundamental reconsideration of government’s role in society. Alberta’s 2.6 million residents, many personally impacted by corporate downsizing, favoured aggressive cuts to the province’s expenditures (pp. 44-45). The Klein government framed the fiscal situation as a crisis originating from a spending problem in social programs, particularly health care (Taft 1997:25-27).130 When the PC’s won the June 1993 provincial election on a platform to reduce the debt and eliminate the deficit in four years, the plan to address the fiscal situation intensified into a program that included deep spending cuts and widespread bureaucratic reforms to enhance administrative efficiency and accountability. Many of the latter were guided by new governance principles (Osborne and Gaebler 1992; see Box 5.1), which the Klein government used to educate bureaucrats for the reform activities (Lisac 1995:147).

129 Net financial assets/debt equal financial assets (cash or cash equivalent, not including capital assets) minus financial liabilities. Net accumulated debt is the total sum owed including long-term (aka unmatured) debts and other obligations such as pension payments, minus any reserve funds set aside for debt payment. 130 A number of scholars have argued that the fiscal position was bad, but not as terrible as was presented (e.g., Harrison and Laxer 1995:7; Mansell 1997:52), and that it may not have been as bad were it not for a historically low tax regime and ill-fated and risky business subsidies (McMillan and Warrack 1995).

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Box 5.1 Principles of an Entrepreneurial Government

Best-selling authors Osborne and Gaebler (1992) claim that a post-industrial, knowledge- based, global economy needs an anti-hierarchical, anti-bureaucratic, and entrepreneurial mode of governance which is characterised by ten principles: 1. Catalytic government, or “steering rather than rowing:” creating policy and policy- focused regulatory structures and mechanisms while leaving service delivery to private organizations. 2. Community-owned government, or “empowering rather than serving:” moving control from bureaucrats to individuals, families, neighborhoods and communities. 3. Competitive government, or “competition rather than monopolies:” injecting competition in the acquisition and delivery of public goods and services. 4. Mission-driven government, or “mission rather than rules:” replacing systems, regulations and activities that stifle creativity with those with clear missions and performance measures to ensure accountability. 5. Results-oriented government, or “outcomes rather than inputs:” tying funding to the achievement of clearly-defined outcomes and measures of quality. 6. Customer-driven government, or “meeting the needs of the customer rather than the bureaucracy:” providing citizen-focused, competitive programs for customers to choose from. 7. Enterprising government, or “earning rather than spending:” generating revenues from public services by training managers to think like entrepreneurs. 8. Anticipatory government, or “prevention rather than cure:” building foresight through long-term planning and budgeting, and cross-departmental/cross-regional approaches. 9. Decentralized government, or “participation and teamwork rather than hierarchy:” giving authority for decisions to be made collaboratively by those close to the problems. 10. Market-oriented government, or “leveraging change through the marketplace:” using the scope of the government to structure market-based incentives for change.

Key elements of the program for reforms included:131  Redefining the role of government by mandating all departments to determine which programs were essential and appropriately provided by government and which ones could be targeted for elimination or privatization (Kneebone and McKenzie 1997:182-183).  Downsizing government by decreasing the number of ministries and civil servants, and implementing rapid, deep, and broad cuts (Mansell 1997:56-58).

131 List is derived from Sonpal-Valias, Sigurdson and Elson (2016:76-77).

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 Improving financial management and controls by changing accounting, reporting, and budgeting processes, and strengthening the role of Treasury and standing policy committees in budgetary and business plan reviews (Boothe 1997).  Improving program accountability by introducing three-year business plans, performance measures, and spending targets, and expanding the role of standing policy committees to provide closer political oversight (Boothe 1997:224-226).  Decentralizing some aspects of decision making by restructuring school boards and health authorities, and pushing the actual implementation of budget cuts onto local authorities (Kneebone and McKenzie 1997:186-192).  Expanding public input processes through mechanisms such as province-wide round tables and other consultative means (Mansell 1997:51).132  Enacting legislation to guide fiscal decision making (Boothe 1997:221-224).133

In just the first year, the number of ministries was reduced from 26 to 16, and over 2,500 full-time positions were eliminated from a workforce of about 30,000 (Mansell 1997:48). All areas were asked to develop plans to cut spending by 20% over the three year period beginning in 1993/94 (p. 58).134 The reforms affected all ministries, but their size, implementation and implications differed. For example, between 1992/93 and 1995/96, real per capita spending decreased by 12.7% for Education, 16.0% for Health, and 28.2% for Family and Social Services (FSS), contributing to a total real per capita decrease of 23.6% (nominal 16.5%) (Bruce, Kneebone and McKenzie 1997:2). One reason for the differences is political consideration: the cuts in Education—a more politically sensitive area since it affects a larger proportion of the population and targets children—were relatively low (Kneebone and McKenzie 1997:195). The

132 It is arguable whether these mechanisms involved a true cross-section of Albertans, and to what extent government considered the input provided (Lisac 1995:82, 144). The budget round tables, however, did achieve government’s aims to educate the public about Alberta’s fiscal situation, and to gauge support for measures to deal with the deficit (Boothe 1997:219). 133 The legislation was, specifically: 1992 Deficit Elimination Act, requiring the deficit to be eliminated by 1996/97; 1999 Balanced Budget and Debt Retirement Act, requiring the elimination of the debt by fiscal year 2021/22; and the 1995 (rev.2000) Alberta Taxpayer Protection Act, requiring a referendum to introduce a sales tax. 134 Twenty percent in nominal terms, thus the cuts were actually higher in real per capita terms with inflation and population growth taken into account.

154 differences can also be attributed to a particular view of who was considered to be a “deserving” recipient of public funds. For example, expenditures for welfare recipients who were considered capable of working (and therefore not deserving of public funds) decreased severely by 35.9% between 1992/93 and 1995/96 (Shedd 1997:257),135 and were achieved mostly by tightening eligibility, reducing benefit amounts, and requiring recipients to enrol in employment training programs. In contrast, children and people with disabilities (who are not viewed as personally responsible for their poverty) were treated less harshly: between 1992/93 and 1995/96, child welfare saw a relatively low decrease of 7.3%, while disability supports actually increased by 9.7%.136, 137 Senior bureaucrats report that some of the groundwork for the reforms was in place by the mid-1980s in virtually all departments to varying degrees (Kneebone and McKenzie 1997:180). The broad outlines of the reforms were also remarkably similar to a statement drafted in late 1991 by the Department of Economic Development and Trade for a manufacturing strategy (Lisac 1995:49). It appears that although the kernel for reforms was in place before Klein became premier, a sufficient galvanization of forces had yet to be achieved to shake extant arrangements out of their inertia (Pierson 2000). The first phase of the Klein era consisted of rapidly laying the foundations for a massive transformation in the government’s structures and the culture of its relationship with Albertans, who saw themselves transformed from citizens to consumers. In 1996, three years after the start of the reforms, the government announced its first budget surplus in a decade, a trend that remained until 2008. Growing public pressure in face of the much improved financial position forced the government to reverse funding cutbacks in targeted areas. The second phase of the Klein era was a period of reluctant reinvestment amid further reinforcement of structural reforms and cultural shifts.

5.2 1997 to 2006: Reinvestment and the Reinforcement of Reforms From 1996 to 2008, with strong economic growth and rising energy prices, the province experienced consecutive years of surpluses. By 1997, Alberta’s fiscal position

135 The author does not specify whether these were nominal or real dollars; it is assumed they are nominal. 136 Disability supports reported here include funding for SPD, AISH and Personal Supports. A more detailed calculation just for SPD is provided in the next chapter. 137 Chapter Six discusses in more detail how this view played into the funding for SPD program.

155 had turned around dramatically from having the worst deficit-to-GDP ratio among the provinces in 1993 to having the best surplus-to-GDP ratio in Canada. The main factors contributing to the economic turnaround and accelerating population growth included: low inflation and low interest rates; rapid export growth under the North American Free Trade Agreement; and robust investments in energy exploration and development, forestry, and other industries (Alberta Finance 1997b; Sonpal-Valias, Sigurdson and Elson 2016:78-79). As the financial situation improved, public anger against declining public services increased, and the government was forced to reinvest (Harrison 2005:10; Gazso and Krahn 2008:167). It did so primarily in targeted areas such as health and education, where public pressure was greatest, and in areas such as employment and career development, which were essential to the neoliberal agenda to move people from welfare to workfare. Social services, however, remained underfunded until well past Klein’s tenure. The reinvestment rate in health was faster than in education, and both were significantly faster than in social services. Real per capita spending for health and education reached or came close to 1992/93 levels in 2000/01; social services did not reach 1992/93 levels until 2010/11 (see Chart 5.1).138 In 2005/06, the provincial debt was eliminated. Between 1992/93 and 2005/06, real per capita spending increased by 33% for health and by 4% for education. In contrast, spending for social services dropped by 15%, in part due to the replacement of CAP in 1995 by the Canada Health and Social Transfer (CHST), which did not obligate provinces to recognize citizens’ rights to social assistance to the same extent as had CAP. The Klein government, which had targeted social assistance for reforms even before the demise of CAP, tightened eligibility criteria, and diverted clients to employment training programs, resulting in a significant decline in caseloads (Gazso and Krahn 2008:159-160).139

138 Flanagan (2005) reports similar analysis, ending in 2004. The values that he reports are slightly different from mine even though we both use constant 1992 dollars. Flanagan does not cite his sources (e.g., annual reports or historical fiscal summary) or what estimates were used to compute the adjusted values (e.g., Alberta CPI rates or Canada CPI; average annual population or estimate for July 1, etc.). Thus, it is not possible to discern where the discrepancy stems from. Notwithstanding the slight discrepancies in actual values, the shape of the graphs, the overall trends, and the findings are essentially the same. 139 Between 1993 and 2003, for example, the social assistance caseload declined by 71%, due to these reasons and strong economic growth (Gazso and Krahn 2008:160).

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Figure 5.1 Annual Expenditures in Health, Education and Social Services in Alberta from 1992/93 to 2012/13

Klein Stelmach Redford $3,000

$2,500

$2,000

$1,500

$1,000

$500

$0 Real per Real Capita $) 1992 (in 1992/3 1997/8 2002/3 2007/8 2012/3 Health Education Social Services

Enlarged markers indicate 1992/93 (pre-cutback year), and year when funding amounts first reached values comparable to 1992/93 (2000/01 for health and education, 2010/11 for social services). Sources: Compiled from nominal values reported in Government of Alberta historical fiscal summaries (Alberta Finance 2003, 2014b), adjusted for provincial inflation (Statistics Canada CANSIM Table 326-0021) and population growth (Statistics Canada CANSIM Table 051-0001).

The reinvestments occurred under an overarching series of activities to reinforce the reforms initiated during the first phase. Structural changes included the centralization of authority in the premier’s office, Treasury’s stronger role over budget allocations, and the concentration of policy and budgetary review powers in the Standing Policy Committees (Brownsey 2005). In addition, a significantly strengthened and expanded Public Affairs Bureau was given the role of strictly controlling and coordinating any public communications about government policies and directions (Sampert 2005). Reflecting new public management (NPM) practices, greater accountability processes such as three-year business plans and performance measures were gradually implemented in all program areas (Mansell 1997:50). Under the guise and rhetoric of improving quality, these techniques legitimized new forms of control and coercion, decrease service autonomy and flexibility at the frontlines, and create private markets in public program areas (Taylor, Shultz, and Leard 2005). In health care, there was a push to increase user fees, private payment options, for-profit delivery of selected procedures, and more individual responsibility (Horne 2005; Steward 2005). In education, the

157 government pursued public-private partnerships, established structures to involve the private sector in policy development, and increased parents’ purchase of private tutorial services (Taylor, Shultz, and Leard 2005). In social services, organizations were forced to be more competitive, and pressured to collaborate to access resources for programs that fit governmental priorities. Responsibility was shifted increasingly towards individuals and families for their own welfare (Shedd 1997). The overall outcome was a “new normal” consisting of the decentralization of operational decision-making within the constraints of more centralized mechanisms for control and oversight. The transformation did not occur without vocal opposition. The Alberta Federation of Labour brought together various citizen groups in 1994 to form The Common Front, a united opposition for political action. Although the Front fizzled due to inadequate resources, other advocacy groups, such as the Alberta Disability Forum, Albertans for Social Justice, and Poverty in Action were formed in the 1990s, as was the Parkland Institute which was formed as a provincial version of the Canadian Centre for Policy Alternatives (Foster 2012:215-216). Groups such as Friends of Medicare fought extensively against health reforms (pp. 211-212), while school board trustees and parents protested against reforms in education (Taylor Shultz, and Leard 2005:244-245). Also involved were professional associations such as the Alberta Association for Social Workers, United Nurses of Alberta, and Alberta Teacher’s Association (Foster 2012:215- 216). For the most part, these groups were discredited by the Klein government as self- serving “special interests” whose aims were in opposition to those of “regular folk;” the rhetorical strategy worked during the first phase of the reforms, but lost its power as the province’s financial status improved (Harrison, Johnston and Krahn 2005).140 Many protests were largely unsuccessful due to government’s determination, relatively underdeveloped political mobilization of public sector workers, and people’s own acceptance of the framing that everyone needed to “do their part” to solve the deficit problem (Foster 2012:211-212). However, some groups did score modest successes. In the developmental disability field, for example, the self-advocacy group Disability Action

140 The terms “special interest groups” was popularized in Canada by Preston Manning, who framed such groups as having illegitimate influence in the political process (Harrison, Johnston and Krahn 2005:89).

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Hall was formed in Calgary in 1998 supported by staff and researchers. Garnering much media attention and support from other social justice groups, the Hall had considerable influence softening government decisions in services and AISH.141 Collectively, these groups added alternative ideas to the array of cognitive repertoires to confront neoliberalism’s dominant discourse within their respective spheres of influence. If the first phase of the Klein era was marked by a doggedly ideological focus, the second phase was characterised as being relatively haphazard and ill-planned. As the fiscal crisis vanished and “the revolution lost its momentum,” the government revealed itself as having no apparent vision or firm grasp on how to respond to extant or emerging social problems (Harrison 2005:10). The haphazardness may have reflected the “experimental” nature of the trial-and-error processes that some scholars say characterise neoliberal reforms (Peck 2004:393; Ong 2006:19; Clarke 2008:144; Brodie 2010:1561). Regardless of this apparent loss of focus and seeming haphazardness, the Klein reforms collectively entrenched neoliberal ideas, beliefs, normative prescriptions, and techniques of governance across the public sector, and transformed government’s relationship with civil society. The overarching outcome was: the emergence of a larger, more integrated, pervasive, impenetrable, and centralized State. That is to say that while the government (the immediate political body upon which citizens may have an influence through their vote) has grown smaller, the State (the more amorphous collection of institutions, regulations, and practices—the machine) has grown larger and more distant from popular control. (Harrison 2005:13) 5.3 Contextual and Institutional Forces Behind the Reforms Kneebone and McKenzie (1997) identify a number of conjunctural forces that made possible the institutional transformation arising from the Klein reforms; they are similar to many forces commonly found in other significant policy reforms (Wilsford 1994). These include: a right-leaning shift in voter preference based on a perceived fiscal crisis, most likely resulting from the speed with which the province had slipped from a net asset to a net debt position (Kneebone and McKenzie 1997:159); Klein’s consistent and unwavering focus on a goal that was simple to understand (eliminate the deficit by

141 Disability Action Hall. http://actionhall.ca/pdf/Hall%20booklet_standard.pdf. Accessed July 12, 2015. As discussed in subsequent chapters, the Hall continues to play an active self-advocacy role in the field.

159 cutting spending without raising taxes) (p. 177); a caucus that was united on the need for fiscal and institutional reform (p. 180); basic elements for a groundwork for change already in place (p. 180); the use of mechanisms such as round tables and standing policy committees to engage, obtain input, educate and create buy-in (p. 181); and the determined leadership of Premier Klein and Treasurer Jim Dinning, combined with the strong and central role of Treasury in directing all aspects of the reforms (p. 183).142 A critical element in the success of the reforms was the combination of the breadth, depth and rapidity of the cuts. It forced senior bureaucrats to rethink their programs and processes (Kneebone and McKenzie 1997:178), reinforced the message that the political leadership was committed to the reforms, created a “restructuring mindset” (p. 179), and minimized the likelihood of organized opposition from within the bureaucracy or external interest groups (p. 193). With every department and every group impacted by the cuts (albeit to varying degrees), self-serving opposition to the cuts was effectively muted (p. 182). Regardless of whether bureaucrats saw the cuts as threats or opportunities, their breadth, depth and rapidity, provided the high-octane “jolt” to shake the system (Meyer 1982)—already primed by the groundwork put in place during the 1980s—out of inertia, and launch it decisively on a neoliberal trajectory.

5.3.1 The role of ideas A stupid despot may constrain his slaves with iron chains; but a true politician binds them even more strongly by the chain of their own ideas. (Servan 1767, cited in Foucault 1995:102-103).143 The distinguishing feature of sociological approaches to institutional analysis is their attention to the role of cultural-cognitive elements in maintaining or disrupting institutions. This requires understanding how ideas are used to perpetuate old, or create new, beliefs and shared meanings of social reality. To push the analysis in this direction, I draw upon Campbell’s typology ([1998] 2001) to illuminate the interplay of ideational forces upholding the Klein reforms. The analysis provides another level of insight into

142 The authors argue that, unlike departments in charge of program areas which may have a tendency to get attached to their specific constituencies, the Treasury is a neutral department which has the interests of all taxpayers, not just some. 143 J. Servan. 1767. Discours sur l’administration de la justice criminelle, cited in Michel Foucault. 1995. Discipline and Punish. The Birth of the Prison. New York: Vintage Books, pp.102-103.

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why, even though neoliberal ideas had infiltrated the provincial bureaucracy by the mid- 1980s, transformative change did not occur until Klein became premier, and why the reforms became further reinforced and entrenched even though the original fiscal crisis evaporated within a few short years. Campbell ([1998] 2001) suggests that historical institutionalism (HI) considers ideas to become powerful when they are supported by elites, especially those who have access to policy-making arenas (p. 161). However, because HI tends to view ideas as constraining action, it has neglected to see how elites and other influential actors make selected ideas dominant by deliberately packaging and framing them in order to transport them into the centre of policy arenas, and how they may use underlying norms and values to enhance the appeal and legitimacy of ideas (p. 163). In contrast, Campbell argues that sociological (organizational) institutionalism (OI) has a more dynamic view; it sees the potential of actors self-consciously and deliberately manipulating already legitimate cultural-cognitive concepts to bring about change by recombining old elements in new and socially acceptable ways (p. 164). By integrating the insights from HI and OI, Campbell proposes a typology of four types of ideas which exert unique effects on policy making (see Table 5.1). The ideas may be in the background (taken-for-granted assumptions) or foreground (explicitly articulated and contested) in policy debates, and cognitive (specifying cause-and-effect relationships) or normative (consisting of values and attitudes). The causal relationship of the ideas to each other depends on the empirical situation under consideration. Table 5.1 Types of Ideas and their Effects on Policy Making

Background Assumptions Foreground Concepts/Theories

Paradigms Programs Cognitive Assumptions of policy-making elites that Policy prescriptions and theories that Level constrain the range of alternatives perceived specify to policy-making elites how as useful and worth considering. to solve specific policy problems. Public Sentiments Frames Normative Assumptions that constrain the range of Concepts and symbols used by Level alternatives perceived by policy-making elites policy-making elites to legitimize to be publicly acceptable and legitimate. program decisions to the public. Source: Adapted from Campbell ([1998] 2001:166).

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The typology serves as a useful analytic and taxonomic tool to untangle the ideational elements of the Klein reforms. Since the typology includes the notion that interests and ideas interact in the policy making process, it is consistent with my conceptualization of individuals as capable of strategic action involving at least some degree of self-interested calculative behavior within the constraints of cognitive and normative contexts (see Chapter Two, Section 2.3.2). The program ideas embedded in neoliberalism arose out of ideological assumptions and policy prescriptions in the 1950s, built on classical liberalism’s core tenets of the invisible hand of self-regulating markets and undebatable concepts such as freedom, individual rights and empowerment (Steger and Roy 2010:Ch.1). This once- marginal ideology became a widely accepted paradigm by the mid-1980s when its deeply-seated old ideas were reformulated in response to globalization’s new challenges, and promoted by powerful right-wing think tanks, reputable corporate journalists and media outlets, prestigious business schools, and international bodies such as the International Monetary Fund and the World Bank. The ideology’s conversion into policies by Thatcher and Reagan revealed its potential for governments, such as Alberta’s, struggling with rising government spending and stagnant economies. The pervasive nature of the ideology was explained by an interview respondent as follows: The idea that you have to be fiscally conservative is just taken for granted, not just here but internationally. It’s part of a long history of IMF policy, where everything is explained in terms of a fiscal issue even when a fiscal problem doesn’t exist. The discussion stays in the fiscal realm instead of allowing it to move to any other realm. I think the Occupy movement was an attempt to move it out of the fiscal realm and put it in a different realm, and I think you’re seeing it in the discussions in the European Union, where people are starting to question and say there’s something wrong with this model. (P1C14, personal interview) If the broad outlines of neoliberal ideas were being considered within almost all departments by the mid-1980s (Kneebone and McKenzie 1997:180) why did the full- blown reforms associated with Klein not occur under Getty’s watch? One reason could be that, by and large, the politicians during Getty’s time were not converted to the full- breadth of the neoliberal ideology. This view was offered by Dr. Christopher Smith, Assistant CEO of Muttart Foundation, who observed:

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I do believe that there were ministers, junior ministers at that time, who had joined the Conservative Party during the Premier Lougheed and Don Getty era, and that [the nature of Klein’s reforms] just wasn't their political stripe. That wasn't their philosophy. I think Don Getty sometimes got a bad rap, but I think he was a caring man. He didn’t necessarily manage things well and he got stuck with really low revenue from the resource bases, but I think he was a caring man. (Smith, personal interview) Instead of being driven by neoliberal goals, the evidence seems to suggest that the Getty government concurred with Lougheed’s policies to stimulate development by investing in private enterprises (Mansell 1997:31), a decision which proved costly for provincial coffers (Taft 1997:43). The prevailing view was that oil prices would rebound soon enough, and if not, the “province would be able to grow out of the problem” by raising taxes and keeping expenditures in check (Mansell 1997:31). It is typically easier to adopt policies that exhibit path dependency (Pierson 2000:257-261), especially if there is no political pressure to do otherwise. Since the province did not have a significant deficit until 1986/87, and no net debt until 1991/92, there was little pressure to respond other than in incremental ways by cutting spending as the fiscal situation worsened, and accelerating projects such as privatization that had already started in the 1970s. By the time Getty announced his retirement in 1992, the provincial context had changed drastically, and so had public sentiments. The public was deeply angry with the billions lost to private investments and subsidies, and concerned about the rising debt (Mansell 1997:45). Those who had experienced layoffs and wage cuts in the corporate sector resented civil servants with their unionized wages and assured pensions. The Reform Party’s calls for lower taxes, leaner government, and deep and rapid cuts at the federal level had a sympathetic audience among Albertans and among influential factions in the PC Party. To gain PC membership support for the leadership election and recoup public confidence in the party, Klein had to promise decisive action and remake the party’s image. The influence of Reform drove the Alberta conservatives to the right (Harrison 1995:55-56).144 As Dr. Smith elaborated:

144 A November 1990 poll reported that if the Reform Party had a provincial wing, 57% of people polled said they would vote for it compared to only 15% who said they would support the PCs. (Alberta Report, 12 November 1990: 7-11, cited in Mansell 1997:45). The Reform Party did not have a provincial wing so they were technically not a threat, but the drop in voter satisfaction was naturally disconcerting to the PCs.

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There was a real sense that part of the [Klein] agenda was driven by the election of 22 out of 26 Reform MPs in 1993. Alberta, federally, was becoming not a Conservative province with Conservatives under a big tent, but was becoming a Reform province. Some of those Reformers, and Preston Manning kept saying this was certainly not the case, but some of those Reformers wanted to run provincially as well. So, the new government under Ralph Klein, with advice from people mainly from Calgary who had been involved in Reform, was that “We’d better be as tough provincially as the Reformers are federally, otherwise we will face threat in our own backyard.” (Smith, personal interview) Being a pragmatic and opportunistic populist (Harrison 1995:57), Klein proposed a party platform and a vision for government that resonated with prevailing public sentiments. The underlying ideas converged with the paradigmatic and programmatic shifts waiting in the wings of the bureaucracy for the right time to arrive. The next step was to frame the ideas by packaging them into a tidy bundle that could be easily conveyed and understood in uncomplicated sound bites by the masses. Frequently, the repertoires from which framers select symbols and concepts are precisely the values and opinions that are reflected in public sentiments in the first place. (Campbell ([1998] 2001:175) In addition to the general neoliberal literature in wide circulation at the time, there were plenty of local repertoires from which Klein (or those crafting his messages) could borrow to make the new ideas palatable to a wider local audience and context. These included the Toward 2000 Together consultations held in 1992 (Lisac 1995:52-56), and roundtable consultations in fall 1992 before the PC leadership election (p. 42). If you looked at the words flying back and forth at the start of the Klein revolution you would see a pattern. . . . The remaking of Alberta appeared to rest on certain principles. It was getting difficult to sort out principles from clichés— living within our means; balancing the budget to avoid hitting the wall; deregulation; realizing that we have a spending problem rather than a revenue problem; reforming public life by streamlining government and trimming administration; competitive taxation; getting government out of the business of business; cutting out layers of fat. These were the catch phrases and ideals. (Lisac 1995:180) By picking up on public concerns about the fiscal situation, framing it as a crisis, and using terms and solutions that people could relate to, Klein enhanced the legitimacy of the agenda and provided a clear policy direction which may have originated from a small elite sympathetic to the Reform Party’s ideas (Harrison 1995:55), but became supported (or perceived as necessary) by voters at large. Klein’s journalistic skills made it

164 easy for him to spin the information (Taft 1997:Ch.9) in ways that made “the neo-liberal agenda appear inevitable” (Foster 2012:214). Dr. Keith Seel aptly summarised the unquestioned and unquestionable status of neoliberalism following this ideational shift: Before [the neoliberal turn], there was a fundamental view about society being in the central role: if society was good, then market would be the beneficiary. Healthy society, healthy market. Neoliberalism flips that and we’re now into our second generation of people who’re indoctrinated into thinking that everything can be monetized; everything can be marketed. The flip is: healthy market, healthy society. I am not saying that there is some massive overarching evil plan here, but the fundamental philosophy, the foundation for acting, is now the market. And that may be unconscious for a lot of people. . . When you’ve got a consistency of foundational beliefs around the market, the value of monetizing everything, it’s invisible to us. That’s the issue: it’s invisible. (Seel, personal interview) 5.4 Post-Klein: Entrenchment of Neoliberalism and Signs of a Shift By 2006 Klein’s charisma started to wane, particularly among members of his caucus and influential supporters of the PC Party. With the deficit and debt elimination agenda achieved, there was public discontent with his lack of policy direction (CBC News 2006; Sonpal-Valias, Sigurdson and Elson 2016:80). After garnering only 55% support at the party leadership review in March 2006, Klein announced his resignation as premier, and remained in office until succeeded by Ed Stelmach in December 2006.

5.4.1 Stelmach 2007 to 2011: Search for efficiencies and a plan to end homelessness In 2008/09, the start of a global recession and weak equity markets resulted in Alberta’s first deficit since 1993/94 (Alberta Finance 2009); annual deficits repeated until 2012/13 (Alberta Finance 2014b). The government tightened spending where it could, while maintaining the lowest overall taxes in Canada and attempting to address population growth and overdue infrastructure needs. In 2010/11, $1.3 billion was saved by identifying program efficiencies, reducing funding and discretionary spending in some areas, halting hiring, freezing management salaries, and streamlining administrative and noncore functions (Alberta Finance 2010a). The strategies were uncannily similar to those that Klein had followed during the first phase of his tenure. Stelmach made few major structural changes. Highlights included reducing the number of ministries from 24 to 18 (Alberta 2006b), creating a Treasury Board to oversee “more disciplined government spending” and “to identify efficiencies” (Alberta Finance 2007a:14),

165 replacing standing policy committees with policy field committees (Pratt 2007), and consolidating the nine regional health authorities into one board (Alberta Finance 2009). Despite the weak economy, the Stelmach government made up some of the lost ground in social policy. The most notable effort was Canada’s first provincial plan to end homelessness in ten years, originating in response to many years of advocacy by frontline community groups (Alberta Secretariat for Action on Homelessness 2008). During Stelmach’s tenure, over $500 million were provided to support this initiative which involved a broad range of community-based and private sector partners (Sonpal-Valias, Sigurdson and Elson 2016:92-93). As of December 31 2014, over 10,600 individuals had been provided with housing and related supports.145 The consecutive years of deficits from 2008/09 took a political toll on the PC Party. In 2010 a number of PC MLAs left to join other parties including the Wildrose Party of Alberta (Thomson 2010).146 In January 2011 Stelmach announced his resignation, a move apparently prompted by conflict with Finance Minister Ted Morton, who was not prepared to sign another deficit budget (Wingrove, D’Aliesio, and Vanderklippe 2011; Sonpal-Valias, Sigurdson, and Elson 2016:83).

5.4.2 Redford 2011 to 2014: Results-based budgeting and a Social Policy Framework On October 7, 2011 Alison Redford, the newly-elected leader of the PC Party, became the province’s first female premier, and led the party to a majority win in April 2012 (Fong 2012). Key elements in the party’s election platform included delivering balanced budgets with no new taxes or service cuts, implementing three-year spending cycles with a results-based budgeting approach, and establishing three-year predictable funding for municipalities, postsecondary institutions, and school boards. Also promised were a Social Policy Framework, an aging population policy framework, a ten-year

145 Alberta Statistics on Homelessness. http://humanservices.alberta.ca/homelessness/16052.html. Accessed October 21 2015. 146 Originally called the Wildrose Alliance Party of Alberta, the party was formed in January 2008 from the merger of the Wildrose Party and the Alberta Alliance Party. The party’s first leader, Paul Hinman, was elected in 2004 as a member of the Wildrose, defeated in 2008, and re-elected in the 2009 by-election under the new party banner. Hinman was succeeded as party leader by the media savvy Danielle Smith in October 2009, a move which gave the party renewed appeal (Harrison 2012).

166 poverty reduction plan, and increased human resources funding for service providers (PC Party of Alberta 2012 Sonpal-Valias, Sigurdson, and Elson 2016:83). The 2012/13 budget increased investment in health, education and social services, and justified the forecast $886 million deficit with the principle that “Alberta’s budget is about more than just money or the bottom line. It’s about ensuring that this government is supporting the outcomes Albertans want” (Alberta Finance 2012b:7)—a clear departure from Klein’s priority to eliminate the deficit at all costs. The actual deficit was $2 billion higher, largely due to deeply discounted prices for Alberta’s heavy oil (the so-called “bitumen bubble”). Public sector management salaries were frozen, doctors and nurses engaged in bitter contract battles, and promises for publicly funded full-day kindergarten and increased education funding were put on hold (Wingrove 2013a). Despite public support for higher taxes,147 provincial taxes remained the lowest in Canada. Fortunately, in 2013/14, oil prices rebounded and the province ended the year with a surplus (Alberta Finance 2014a). Structural and administrative changes by Redford’s government included creating the Ministry of Human Services to consolidate a number of social programs and services, and implementing a results-based budgeting process (Alberta Finance 2012a, 2013e). In 2013/14, government’s strategic planning and reporting frameworks were integrated with this process, and work began in various ministries to develop outcomes and measurement frameworks to guide planning and funding decisions (Alberta Finance 2014a). Redford’s most significant contribution in the social arena was the development of Alberta’s Social Policy Framework (Alberta 2013d). Released in February 2013 following extensive input from Albertans, the framework mirrored many concerns and recommendations originally compiled by the Alberta College of Social Workers in collaboration with the Parkland Institute (Alberta College of Social Workers 2010). Individuals, families, communities, private, nonprofit and government sectors were all seen as having important roles and responsibilities in contributing to the achievement of the framework’s four overarching goals to reduce inequality, protect the vulnerable,

147 Seventy-seven per cent of Albertans polled in early 2013 favoured higher taxes for corporations and high income earners, and 72% favoured the reintroduction of a progressive income tax and an increase in oil royalties (Wingrove 2013a).

167 create high-quality person-centred services, and enable collaboration and partnerships. Shortly after its release, work began on aligning the vision and activities of government’s social programs and initiatives to the new framework. Redford, though, was not in power long enough to make any further advancements under this framework. On March 23, 2014, dogged by controversy over travel spending and questions about her leadership, Redford resigned as premier, less than 3 years after assuming the position and within 3 months of receiving 77% support in a PC Party leadership review (CBC News 2014a). “At the end of her tenure, she had limited support from the left (which was angered by her austerity measures and rocky labour relations), the right (which had no appetite for debt or deficit budgets), and even her own caucus (who apparently had their own grievances about her leadership style)” (Sonpal-Valias, Sigurdson, and Elson 2016:85).

5.4.3 Recent developments: History in the making Redford was succeeded by Dave Hancock who served as acting premier148 from March 23, 2014 until Jim Prentice was elected leader of the PC Party, and sworn in as premier in September 2014. Prentice’s tenure as premier was short. After announcing a budget in March 2015, he dropped the writ for a provincial election to be held on 5 May 2015. The budget forecast an unprecedented $5 billion deficit due to a weak economy and falling energy revenues. It included introducing a progressive income tax and a health care levy, increasing various user fees and “sin” taxes, and cutting 2,000 positions in health care and education, while leaving corporate taxes and oil royalties untouched. The province would borrow money to complete capital projects, and draw on the contingency fund to cover the deficit. The Wildrose opposition called it “a liberal budget passed by a conservative government” and the NDP slammed it as favouring the corporate sector over ordinary Albertans (Bellafontaine and Estabrooks 2015). The budget never saw the light of day in the legislature.

148 Hancock, who was Deputy Minister when Redford resigned, served in an Acting capacity because it was some months between the sudden resignation of Redford as Premier and leader of the PC Party, and the PC Party’s leadership election.

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On May 5, 2015, the left-leaning New Democratic Party (NDP), which had never held power in Alberta, won a clear majority under leader Rachel Notley. After 44 years in government, the PCs were reduced to 10 seats, while Wildrose under Brian Jean became the official opposition with 21 seats (CBC News 2015a). The reasons for this historic shift have yet to be fully analysed, but probably include: (i) public anger against a budget that ignored public calls for increasing corporate taxes;149 (ii) a comment by Prentice suggesting that Albertans (not the PCs) were responsible for the province’s financial state; (iii) the PCs’ acceptance of a number of Wildrose defectors, including their leader Danielle Smith, a few months prior to the elections; (iv) the early election call, in open defiance of the province’s fixed election legislation (CBC 2015b); and (v) a near flawless campaign by the youthful and likeable NDP leader, Rachel Notley, daughter of a former NDP leader, Grant Notley, whose death in a plane crash in 1984 still generated public sympathy for his family and the party more than three decades later. Notley’s election promises included raising corporate taxes, rolling back the fees and cuts announced by the PCs, reviewing energy royalties, investing in social programs and capital infrastructure, and promoting job creation (New Democratic Party 2015). The NDP’s inaugural budget, announced in late October 2015, forecast a historic $6.1 billion deficit to keep some of these promises in an ongoing weak economy due to low energy prices. In a markedly different approach than had been the norm since the Klein era, the government planned to increase spending to maintain health, education and social services, borrow money to stimulate the economy by speeding up long overdue capital projects, and incur debt in 2016/17 to pay for part of the operating costs. By 2017/18 total borrowing was estimated to reach over $36 billion dollars, and would require changes to legislations introduced by the Klein government which set limits on government borrowing (Estabrooks and Bellafontaine 2015). At the time of writing, with energy revenues plummeting and the Wildrose opposition party keeping up the pressure for fiscal conservatism, it was still too early to gauge whether the new government would herald in a new critical juncture in Alberta’s social policy arena.

149 About 70% of Albertans who responded to a government survey said they supported raising corporate taxes (Bellefontaine and Estabrooks 2015).

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5.5 Concluding Remarks The neoliberal orthodoxy based on principles of small government, free markets and individual entrepreneurship was epitomized in the Klein reforms. Devolving public service delivery to the voluntary and private sectors, creating competitive markets, and using techniques from the corporate world to enhance efficiencies and accountability, have increasingly been taken for granted over the past two decades as the way to govern well. Premiers Stelmach and Redford departed from Klein’s “no debt, no deficit” policy in their attempts to address population growth, global economic crises, and vagaries of the energy market. Both also introduced important initiatives (of which only two most notable ones were presented here)150 to move the province forward on a lagging social agenda, suggesting that their governments had a slightly different understanding of neoliberal approaches. Were these the beginnings of a shift in the province’s policy landscape? The relatively short tenures of both these premiers and the rapid demise of the PC Party just over a year after Redford’s resignation make it impossible to say to what extent the developments would have had sticking power under a PC regime. For the most part, as fiscal pressures increased, both premiers retreated to what was for them the relative comfort of a neoliberal script by reducing government spending, and further entrenching modes and techniques of accountability and scrutiny over those now responsible for public service delivery. Nonetheless, within the net trend towards neoliberalization, countering efforts were evident, and some of these legacies are available in the institutional environment for Alberta’s current left-leaning government to take advantage of. It remains to be seen how and to what extent the new government is able to alter the province’s institutional landscape while navigating the constraints posed by significantly weak energy prices and a fiscally hawkish opposition party. The analysis in this chapter showed that, even in seemingly hegemonic regimes, heterogeneous elements exist that can spark developments to counter dominant currents. It is within this political-economic context that reforms in the field of services for adults

150 Redford, for example, also introduced a ten-year plan to end poverty in response to a report published by a coalition of nonprofit groups (Briggs and Lee 2012; Sonpal-Valias, Sigurdson and Elson 2016:93-94), and created legislation to enhance policies affecting children and youth (Alberta Finance 2014a).

170 with developmental disabilities were implemented. The next four chapters trace these developments from 1992 to the present. The discussion is organized into four themes, each reflecting a particular empirical facet of neoliberalism’s policy and governance prescriptions. The chapters reveal the sometimes paradoxical and experimental ways in which the reforms unfolded in the field of services for adults with developmental disabilities, and analyse how they shaped (and were shaped by) the field’s institutional elements and contours of power and relationships.

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CHAPTER SIX: PROGRAM CUTBACKS AND NEOLIBERALISM’S PENETRATING REACH

I’m sure things have improved in many ways. There’s a French expression: “Nostalgia pour la boue;” nostalgia for the mud. (P2120, personal interview)

6.1 Introduction In this and the following three chapters, the manifestations of neoliberal reforms in the field of services for adults with developmental disabilities are presented. The manifestations are categorised under four empirically revealed themes, each reflecting neoliberal goals or principles of governance.  Imposing cutbacks and limitations on the scope of the program.151  Restructuring the program into a community governance model. 152  Giving more control to families and individuals.153  Implementing managerial techniques for scrutiny and accountability. 154

In each chapter, the narrative unpacks how each of these aspects unfolded, and analyses the role of salient actors and factors in shaping the developments. It also pays attention to the extent to which the developments demonstrated consistency, coherence and harmony, or contradictions and tensions. The impact on service provider organizations is examined, and their similarities and differences in responses are analysed. Where appropriate, focused examples are used to deepen the insight. Collectively, the chapters tell a rich story of the actors, forces, and processes underlying neoliberalization in the field of services for adults with developmental disabilities. Overall, the net impact of the reforms was to build on the field’s existing institutional landscape, and transform it by infiltrating it with the beliefs, values, normative prescriptions, and strategies and techniques characteristic of neoliberal

151 Related to the neoliberal ideology of small government. 152 Related to neoliberal principles #1, #2, and #9 (Chapter Five, Box 5.1). 153 Related to neoliberal governance principles #2 and #6 (Chapter Five, Box 5.1). 154 Related to neoliberal governance principles #4, #5, #6, #7 and #8 (Chapter Five, Box 5.1).

172 regimes. However, within this overarching trend, the analysis reveals significant differences in acceptance, resistance, and efforts by actors to co-create or reshape the institutional context to further their own interests. The result is a field that is institutionally complex, rife with contradictions and paradoxes, converging and opposing forces, experimental and reflexive processes requiring ongoing and active work, and nuanced differences in processes and outcomes. A useful analogy is that of a flowing river, with the net movement of water in one direction, but—depending on the nature of the water and the local factors and forces—containing within it, currents of different strengths, turbulence, swirls, eddies and even stagnant pools. Organizational differences in responses in this environment seem to be shaped by their particular professional logics and biases, cultures and sense of self-identities. The information is based on all of the data collected for the research, from both Phases One and Two. The sources include: Government of Alberta’s annual reports and ad hoc publications; scholarly literature and media reports; key informant interviews conducted in 2012 and 2013 with twenty senior government officials, and disability and nonprofit sector leaders; and organizational case studies155 conducted from July 2013 to April 2014 at Calgary SCOPE Society (SCOPE), Optional Rehabilitation Services Inc. (Options), and Vecova Centre for Disability Services and Research (Vecova). The organizational data sources include: interviews with 28 people at various organizational levels including senior executives, board directors, middle managers, and frontline staff; and organizational documents such as current and archived annual reports, strategic plans, financial summaries, and policy and procedures manuals.156 Also added to the data is my own perspective based on my observations and experiences of having been a member of the field as an employee of Vecova from 1997 to 2010. In the next section, the case study organizations are briefly described to highlight their salient and relevant similarities and differences, before the main body of the current chapter begins.

155 I refer to these organizations as “case study” sites for the sake of simplicity; technically, they are embedded units of analysis (Yin 2009:50) as discussed in Chapter Three. 156 See Chapter 3 for details. Not all organizations provided the same type or depth of information.

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6.1.1 Description of organizations Options, SCOPE and Vecova are well-respected, Calgary-based organizations that have been providing a range of community-based supports to adults with developmental disabilities for at least close to three decades.157 As part of the PDD-funded service provider network, they are similar in their structures, policies and processes that meet or exceed the field’s formal accreditation standards. Each organization serves 200 to 300 clients, employs 125 to 250 fulltime staff, and has an annual operating budget of $11 million to $25 million. They are members of ACDS, and their frontline staff generally have the same basic qualifications and training required in the field. Their leaders, each with a long history and respect in the field, have been active participants in various provincial and regional committees or forums for planning policies, services and standards, and engaging in field advocacy. There are, however, some important differences between the organizations in their origins, auspices, and organizational cultures that suggested they might be well-suited for an exploratory comparison to add nuanced insights into organizational responses. Vecova is a registered charity incorporated as The Vocational and Rehabilitation Research Institute (VRRI) in 1966 to conduct “scientific research, diagnostic services, vocational training, and vocational rehabilitation for the people of the Province of Alberta.” 158 Established as one of the nine research and demonstration centres as part of the Centennial Crusade (see Chapter Four, Section 4.1.2), it was so named because of its formal status as a research institute of the University of Calgary and its dual mandate for research and service demonstration. When it opened in 1969, it provided on-site residential service, vocational training, medical assessment, and psychiatric support to adults with developmental disabilities. It also had a community recreation program for individuals with any disabilities. Research was the dominant activity in the organization’s early days and remains part of its mandate, but was rapidly displaced by service provision

157 Basic factual information about each organization is presented in Appendix C2; the rationale for selecting them is presented in Chapter Three. 158 Vecova archived documents: application to form a society; original by-laws 1966; Program and Funding Proposal to the Government of Alberta. Prepared by Dr. David Gibson for the Board of Directors of the Institute and the Canadian Association for Retarded Children National Crusade, Sep 1966.

174 as the primary focus, reflecting the shifts in public funding. Vecova remains formally affiliated with the University of Calgary, although research has comprised no more than 5% of its budget and activities since at least 2010 (and probably much longer).159 Vecova’s dual mandate sets it apart from its peers and has shaped its culture in unique ways. The organization sees itself as a leader and innovator, and states collaboration and knowledge-sharing as part of its values.160 The organization demonstrates leadership and collaboration by participating in forums on policy, service practice, and administrative systems and procedures development. Whether framed as innovation or simply as change, Vecova’s history is one of continuous evolution to reflect (or forge) new ways to fulfil its mandate. More recently, the organization updated its name, and transformed its structure to better integrate service provision, research and social enterprises. The transformation expanded the service mandate to include persons with permanent, degenerative and temporary disabilities.161 Vecova’s image, evident in its annual reports, website, and other public presence, is that of a “polished professional,” whether that stems from the scholarly style of earlier annual reports (reflecting the academic background of its senior staff and primary audience), the clean corporate style in the 1990s and 2000s (presumably reflecting the pressure for nonprofits to appear “business-like”), or more recently, the short, full-colour infographic spreads (reflecting current communication and media trends to share information graphically and quickly). SCOPE is a registered charity incorporated in 1983.162 It began providing outreach services in 1987 to children and adults with behavioural and emotional difficulties, and community-based residential supports for adults, based on the philosophy

159 The oldest T3010 return available online at CRA is 2010. As a member of Vecova’s research department since 1997, I do not ever recall research being more than 5% of the organization’s total operating expenses. Financial summaries in the annual reports do not provide a breakdown by function. 160 Vecova. “Mission/Vision/Values.” http://vecova.ca/about-us/mission-vision-history/. Accessed October 3, 2015. 161 Vecova Annual Report 2013. http://vecova.ca/wp-content/uploads/2014/06/Vecova-2013-CEO- Welcome1.pdf. Accessed October 21, 2015. 162 The original acronym stood for “Support, Coordination, Operation, Planning and Evaluation;” in 1995/96 it was changed to “Support and Coordinated Opportunities for Participation and Equality” (SCOPE AGM Meeting Minutes and Report.1995/96, p.5).

175 that an individual “is best served in his or her significant environment.”163 The organization stands out in the field as having a strong social justice approach that goes back to its founding days, when its program philosophy was described as “accept[ing] the rights of individuals to direct the course of their own lives and facilitat[ing] their independence,” and the role of the agency was stated as being “a good friend or partner.”164 Even before self-advocacy became prevalent in Alberta in the mid- to late- 1990s, SCOPE’s clients chaired their own planning meetings and were involved in selecting their staff. SCOPE’s social justice values are explicitly stated in its current mission statement (to work “in alliance with people with disabilities, their families and friends, and other community members to understand problems and create solutions to personal and social justice issues”).165 The organization was instrumental, together with Vecova’s researchers, in creating the Disability Action Hall, a Calgary self-advocacy group that meets weekly to talk about current issues. SCOPE supports all of the Hall’s activities, and also organizes the annual “Picture This …” international disability film festival. SCOPE is the only one of the three case study organizations that states “community development” as part of its formal range of service offerings; under this umbrella, which includes its work with the Hall and the film festival, SCOPE fulfils political and associative functions for people with developmental disabilities. In contrast to Vecova’s distinctly professional public image, SCOPE’s self- identity and culture may be described as “casual, folksy;” SCOPE staff and board members see themselves as friends and allies of individuals with disabilities rather than simply as service professionals. They also see their job as that of transforming society, not just creating individual change. Unlike Vecova’s annual reports, which are developed for an external audience, SCOPE’s seem to be targeted internally: they are interspersed with insider jokes and, at times, self-deprecating humour. Their commitment to treating people with disabilities not just as clients but as equals is evident in both what they say and how they say it: a number of annual reports, for example, incorporate hand-drawn

163 SCOPE Annual General Meeting 1987/88 Meeting Notes and Report, p.1. 164 SCOPE Annual General Meeting 1988/89, Meeting Notes and Report, pp. 1, 3. 165 Calgary SCOPE Society. http://www.calgaryscope.org/. Accessed January 5, 2016.

176 graphics in the same style as used in client planning and group meetings, which is consistent with the organization’s culture to be accessible and meaningful to its clients. Options began providing services in 1987. Unlike Vecova and SCOPE, Options is a private, for-profit company. It is owned and led by President and Director Elaine Yost, and is guided by an advisory board consisting of parents, consumers (Options’ term for clients), professionals and lay people.166 Options, like SCOPE, was formed during the height of privatization in the field under the Getty government. Yost, herself a parent of a child with a developmental disability, was motivated to create a service that provided person-centred supports for individuals with complex needs by actively involving them and their families in the design and decision-making as an alternative to the large-scale, nonprofit organizations typical of the time.167 Initially offering only residential services (operating their own homes and providing outreach support and monitoring for supported homes), Options expanded in 1993 to offer community access options (leisure and personal growth activities). The service expectations and the tone of the culture at Options are strongly set by Yost, as was evident from all the staff I interviewed. Caring, integrity and family involvement are seen as paramount, and reflected in the mission statement (“Seek to understand and share in the celebration of life of those often thought out of life”) and in the policy and procedures manual, which states that families must be recognised as expert resources and involved in all decisions including interviewing of potential staff.168 The organization’s culture may be described as that of a “nurturing parent.” Options was included in the research to see if institutional constraints resulted in different experiences or outcomes for it as a for-profit entity than for nonprofit organizations. From the financial statements I was given free rein to examine, it was apparent that the business neither generated notable profits, nor compensated its owner with a remarkable salary, suggesting that the organization’s for-profit auspice did not define its service philosophy or raison d’être. This became more evident as I got to know

166 Options. “About Us.” http://optionsrehab.org/about-us-2/. Accessed October 23, 2015. 167 Source: Personal interview with Yost, and Options Personnel Handbook. March 1988. 168 Source: Options Policies and Procedures Manual (version revised 2011).

177 the organization better via my interviews. As it turned out, Options’ interest in the wellbeing of families and clients extended well beyond any profit motive or mindset. Thus, even though Options did not turn out to be a good choice in terms of exhibiting a bottom-line focused approach that one might expect in a for-profit organization, its family-focused perspective and location outside of the institutional contexts specific to nonprofit organizations (e.g., CRA regulatory requirements, public expectations of charities, etc.) set it apart from the other two organizations. It was expected that this difference might still add a valuable perspective to this research. Besides the overarching differences mentioned above, all three organizations demonstrate the isomorphic properties and tendencies expected from highly embedded organizations (DiMaggio and Powell [1983] 1991), especially in their formal structures, systems, written policies and processes, staff qualifications, and service technologies. However, given their different origins and philosophical emphases or biases (professional knowledge for Vecova, social justice for SCOPE, and family expertise for Options), each organization has a unique culture and takes a somewhat different path to responding to, and shaping, the institutional developments in the field. These differences are discussed where appropriate in the findings. In the remainder of this chapter, the institutional context of the field and the prevalent service model in 1992 are reviewed to provide the backdrop for understanding subsequent changes. This is followed by a discussion of the first of the four areas of reforms: the imposition of program cutbacks and scope limitations. Three focused examples are provided to demonstrate the penetrating reach of this first facet of reforms.

6.2 1992: The Institutional Legacy When Klein became premier of Alberta, services for adults with developmental disabilities were provided by the Ministry of Family and Social Services through the decentralised Services for Persons with Disabilities (SPD) program. Six regional offices were responsible for local-level decision-making, program administration and support- provision to service delivery organizations. The central office provided program oversight and coordination, and developed policies, procedures and standards in cooperation with regional offices (Alberta 2006a).

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A number of respondents mentioned that community stakeholders such as the Alberta Association for Community Living (AACL, now Inclusion Alberta), service provider councils, and AARC (now ACDS) actively collaborated with government to develop policies and standards. One person described it as, “It was honestly a very exciting time” (P1C16, personal interview). Norman McLeod, who was the Executive Director of SPD in the early 1990s and later the Chief Executive Officer of the PDD Provincial Board, elaborated on this collaborative climate: When I was the ED in SPD in the early 90s, we had a management committee, which existed for about 3 or 4 years and which I chaired, with representatives from each region. We had the managers from each region, we had AACL via Bruce [Uditsky]; Gail Stevens or I guess Gail Davis as she is now, from ACDS or what used to be AARC; we had ACCD [Alberta Committee of Citizens with Disabilities]. It was our management committee. So if we had anything that was being developed in terms of policy, funding, standards, all were discussed openly at that table. The community had as much authority as any of the regional managers. We all saw the stuff that came forward, and I think there were really quite a lot of progressive things that came forward in that time, and it all came to that committee. That committee no longer exists. It was disbanded when SPD was disbanded. (McLeod, personal interview)

Total SPD funding for 1992/93 was $168 million, about 9% of total spending on social services for that year (Alberta FSS 1993). Service delivery was mostly privatized to community-based nonprofit and for-profit providers, who received close to $72 million to support about 5,200 individuals with person-centred residential, vocational training, employment, and community access supports, at an average funding of $13,850 per community-based client.169 Service providers ranged from a few large organizations providing multiple supports to many small agencies serving a few clients with one or two specific supports. In addition, the government operated residential facilities in Red Deer, Edmonton and Calgary; these institutions received $87 million for just over 1,000 individuals, for an average cost of $87,000 per resident. The vast difference in funding allocation between community-based services and institutions was due largely to the significantly higher and more complex support needs of the residents in the institutions, a

169 Figure 6.2 later in the chapter displays the average funding per client based on total program caseload (community-based clients and residents of institutional facilities).

179 larger cadre of on-site professional supports (nurses, psychiatrists, etc.), and the relatively higher compensation rates for unionized public sector employees. The key institutional forces within the developmental disability field that shaped the policies and the mixed service model that existed in 1992 included:  the deinstitutionalization and normalization movements, which had spurred the birth of community-based services (Nirje 1969 [1994]; Wolfensberger 1972);  the social and rights models of disability, which viewed disability as a product of social barriers and which promoted individual rights (Jongbloed 2003:206);  parental and self-advocacy organizations, which relentlessly fought for more and wider array of supports to improve quality of life (Neufeldt 2003:50-51);  academic rehabilitation programs, which developed a cadre of professionals that diffused norms and standards for services (Neufeldt and Egers 2003:312); and  the medical model of disability, which continued to persist, and as a result of which medical professionals (mainly psychiatrists) had the power to diagnose disability, control access to benefits, and prescribe interventions in community- based services and, especially, in institutional facilities (Jongbloed 2003:205). The service model was also shaped by neoliberal ideas which began taking root during the economic downturn of the 1980s and which spurred the decentralization and privatization of social services. The nexus between deinstitutionalization, privatization, and the province’s financial challenges created new structural relationships, shifted government’s role from direct provision to development, support and oversight, and brought new expectations, opportunities and challenges for people with developmental disabilities and service providers. Two service providers (R1 and R2) who were jointly interviewed summarised their perspectives on this shift: R1: In terms of overall shifts, there has been a shift in the service model in the field in terms of philosophy. Some of the beliefs around how we think about disabled people really interacted with the policy, and vice versa. There was a movement that came from within the disability community around community inclusion. For example, say in the late 80s, we learned about Social Role Valorization theory, social inclusion, and so on. That was when we were shifting from the medical, institutional model and into a community model where the thought was that people needed to be in the community and actively involved.

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That was in the just post-institutional period, and it was strongly led by academics, like Wolfensberger and Bengt Nirje, and by people in the community, but not by politicians.

What we see in the shift after that, which definitely begins with Klein, is a gradual, and now extreme, shift to services driven by government based on fiscal conservative policies. We got people out of institutions, got them excited about all of the possibilities that they could have out in the community. Originally, the government thought the community was going to take care of it all. And then when it hit them what the costs would be, we got the fiscal conservative side coming into play.

R2: There was a real belief that if we got people out of group homes and into apartments in the community, their neighbours will start hanging out with them and helping. If we got people out of sheltered workshops and working at the bank, we may have to provide a few hours of support per week, but their co-employees will pick up what needs to be done, and all that. And you know, it’s been 25 years of community inclusion, and I think of it as a failed experiment. It has not been successful. The same stories you heard 20 years ago in sheltered workshops are the stories you hear now. There’s been a few individuals scattered across the region, the province, who have made it, and the vast majority are still, you know ... We didn’t really create a change model, we created high expectations and eliminated the kinds of supports that are really needed, and we left people really unhappy and in a high need for service. (P1C14, personal interview)

In sum, by the 1990s, services for adults with developmental disabilities reflected progressive international shifts in disability philosophy diffused to the provincial level by federal developments and advocacy by parents, academics and field professionals. The goals of these movements, to move people from residential institutions to life in the community and to afford them the same rights to self-determination as enjoyed by all citizens, were supported by a progressive government in the 1970s. The neoliberal turn of the 1980s, which took root amid the economic downturn and the province’s fiscal challenges, drove government to seek ways to reduce costs; part of that included continuing the deinstitutionalization of individuals, and increasing the capacity and involvement of families and communities in activities previously undertaken by government. Though founded on different rationales, the government’s pragmatic and ideological aims converged with the goals of disability philosophy, and set the stage upon which Klein’s reforms would unfold.

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6.3 Cutbacks and Constant Constraints: The Paradox of Scarcity Amidst Plenty Like all programs, SPD experienced cutbacks when Klein came into power, albeit to a lesser degree than some other programs (see Figure 6.1).

Figure 6.1 Annual Expenditures in SPD/PDD Program Compared to Rest of the Programs in Social Services 1992/93 to 2013/14

Klein Stelmach Redford

$800 25%

$700 20% $600

$500 15% $400

$300 10%

$200 Real Per Real Capita 1992 (in $) 5%

$100 SPD/PDD SPD/PDD %of total Social Services $0 0% 1992/3 1997/8 2002/3 2007/8 2012/3 SPD/PDD Progam Social Service not inc. SPD/PDD SPD/PDD as % of Social Services

Sources: Compiled from Social Services nominal values from Government of Alberta historical fiscal summaries (Alberta Finance 2003, 2014b), and SPD/PDD nominal values from ministry annual reports; all values adjusted for provincial inflation (Statistics Canada CANSIM Table 326- 0021) and population growth (Statistics Canada CANSIM Table 051-0001).

From 1992/93 to 1995/96, real per capita170 spending in SPD dropped 14% (from $64 to $55), compared to the much higher 31% cut (from $654 to $453) in the rest of social services during the same period. Conversely, during the reinvestment phase of the Klein era between 1996/97 and 2006/07,171 SPD/PDD funding increased dramatically by 32% (from $79 to $104),172 compared to 16.6% (from $429 to $500) for the rest of the

170 Adjusted for inflation and total population growth, in 1992 constant dollar values. 171 In 1996/97, $80 million was transferred into SPD from the personal benefits supports envelope in welfare, as part of almost $500 million redirected from welfare to children’s and disability services (Alberta FSS 1997). Since its implementation in the 1980s as part of the Supports for Independence funding, individuals and families had used the personal benefits program to access supports not funded through SPD’s service provider contracts; it was not new or additional funding per se. The surge in funding visible in the graph is, thus, an artefact of this transfer: it does not represent the infusion of additional funding. By beginning the analysis at 1996/97, the effect of this initial artificial spike is removed (as opposed to beginning the analysis at the previous year). 172 The PDD Community Boards structure was created by legislation in 1997 and implemented in 1998.

182 programs in social services. Part of this increase was due to the costs related to the implementation of the regional community board structure (discussed in further detail in Chapter Seven). The effect of the Klein government’s targeting of welfare programs for a disproportionate share of cuts can be seen in both the total spending on social services (the top of each column), which declined until 1999/2000 before gradually increasing again, and in SPD/PDD’s percentage share of this total (line), which grew rapidly until peaking at 19% for the first half of the 2000s. The pattern of cuts reflected the view that people with disabilities are more deserving of charity and public support than individuals on welfare (Reichwein 2002:27). Norman McLeod summed it up as follows: When Klein came in with his budget cuts, PDD, or SPD in those days, actually didn’t do too badly primarily because of social allowance cutbacks. The welfare program was severely cut in terms of the money they were giving people and who was eligible for services. So the department of social services had significant surpluses, which were shared with other departments. But this whole business of always cutting back on community agencies, always making them accountable for all the moneys being spent, and in lots of ways nickel and diming the agencies—in some ways it might even have happened under Getty. It’s just been a gradual kind of process over time. There are the poor, and then there are the deserving poor. In some ways people with developmental disabilities are seen as the deserving poor, but you still had this whole business of being accountable for how you spend your money. And I think it reached its climax in the Klein years. (McLeod, personal interview)

Figure 6.2 displays the real funding (inflation-adjusted, in 1992 constant dollars) for SPD/PDD and the estimated real average funding per client from 1992/93 to 2013/14.173 Although the computed values for the average annual funding per client are estimates at best, the graph is illustrative with respect to general trends.

173 The average cost per client is based on estimated caseloads reported in ministry annual reports; it is not possible to tell whether the estimates are annual averages or year-end figures, or whether reporting is consistent from year to year. Caseload numbers were not reported for 1992/93, 1996/97, 1999/2000 to 2003/04, 2006/07 and 2013/14. Bounded missing values were replaced by linear interpolations; unbounded values for 1992/93 and 2013/14 were replaced by values reported for 1993/94 and 2012/13 respectively.

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Figure 6.2 Annual Expenditures in SPD/PDD Program and Average Cost Per Client

1992/93 to 2013/14

Redford $500 Klein Stelmach $50 $450 $45 $400 $40 (1) $350 $35 $300 $30 $250 $25 $200 $20 $150 $15 $100 $10 $50 $5

$0 $0

SPD/PDD SPD/PDD Programfunding (1992 millions) $, Mean funding per funding thousands) Mean(1992 client $, 1992/3 1997/8 2002/3 2007/8 2012/3

SPD/PDD program Mean funding per client Trendline (mean funding/client) Sources: Compiled from SPD/PDD nominal values from ministry annual reports; all values adjusted for provincial inflation (Statistics Canada CANSIM Table 326-0021). Caseload data are estimates provided in annual reports; missing values replaced by linear interpolations between closest available lowest and highest values. Note (1): Transfer of Personal Supports Benefits funds from welfare to SPD.

During the cutback phase, real average funding per client remained steady between $26,000 to $27,000. Original data on caseload breakdown shows a decrease in clients funded for vocational supports during this phase, from 2,030 in 1992/93 to 1,434 in 1995/96; the reduced funding may have resulted from a decrease in federal VRDP funding not being topped up by the provincial government, or cuts in provincial funding, or both.174 Regardless of the reasons, real average funding per client during the cutback phase did not decrease. However, between 1996/97 and 1998/99, real average annual funding per client decreased by 8% (from $33,700 to $31,000) while the caseload increased by 19% (from under 6,500 individuals to over 7,700). After that, real average

174 In 1998/99, VRDP was redesigned into a more active, employment focused program, emphasizing shared (vs. government) responsibility and a person-centered approach to identify and develop work skills and experience. Reflecting the neoliberal turn at the federal level, individuals were relabeled from “recipients” to “participants” (Canada Human Resources Development 1998). There may have been some reduction in funding to SPD/PDD that occurred as a result of this, with some funding transferred to provincial employment programs. However, this is purely a speculation on my part.

184 funding per client grew at or above the overall average rate (regression trend line) until 2009/10 when it reached close to $42,000 before dipping in 2010/11 and 2011/12 due to cuts in actual funding in 2010/11 combined with caseload growth. The cuts in SPD between 1992/93 and 1995/96 were not as drastic as in some other programs, and there has been a general trend in increased real program funding and real average funding per client from 1998/99. However, the funding did not keep up with the true costs of service delivery. The most significant contributor to higher service costs was the increase in the proportion of clients with complex support needs as medical advances enabled them to live longer than was previously possible. In addition, costs related to some community-based services such as housing and transportation rose at much higher rates than inflation due to a generally booming economy (Zwozdesky 2000:12-17). Service providers had to somehow absorb these costs. The funding situation significantly constrained the ability of agencies to provide the required supports. Agencies had difficulty planning services with no assurance of contract stability or renewability of Individualised Funding from year to year (Zwozdesky 2000: 18-19; Interviews 2013). They could not compete with government for new hires,175 were forced to hire part-time employees, and faced threats of unionization (MacFarlane 2009:21). It impacted staff morale and led to burnout and high turnover176 (Zwozdesky 2000:18-19). Significant concerns were expressed by individuals, families, and service providers at this state of affairs, culminating in a protest rally in spring 1999 that received significant media coverage (Jeffs 1999). Soon after the rally, in June 1999, Minister Halvar Johnson announced the immediate infusion of $10 million into PDD and requested Associate Minister Gene Zwozdesky to conduct a review to determine the reasons for the challenges (Zwozdesky 2000:4). Following the review, $15 million in additional funding was injected in 2000 to

175 Wages and annual increases for government staff are determined by union contracts. Between the mid- 1990s to mid-2000s wages for community agency staff (who are not unionized, except in a few agencies and that only recently) were as much as 30%-45% lower than their government peers (Zwozdesky 2000:31; Sonpal-Valias 2005:57), and agency benefits were 9-12% in addition to wages, compared to government benefits which were an additional 16% (Alberta FSS 1999). 176 Staff turnover averaged 30-40% in the late 1990s (Zwozdesky 2000:18). The same issues were voiced a few years later in an independently contracted study on workforce issues (Sonpal-Valias 2005:55-57).

185 eliminate a projected deficit; in addition, agencies were awarded a 5% wage increase that year and 4.5% the year after (Alberta FSS 1999; Zwozdesky 2000:32). The Zwozdesky review was well-regarded by families and service providers, who felt their concerns had been heard (Interviews 2013). The review is an example of some of the tensions within government (politicians and bureaucrats alike) during these times about how far the government could or should go along the cost-cutting agenda. Dr. Smith, Assistant CEO of Muttart Foundation substantiates this view: There were some members of the government who also raised internal concerns about the impacts of cuts to the most vulnerable. Certainly, there were some strong supporters in the civil service who argued for a more socially just approach. I recall that a number of these individuals left the province during the first term of the Klein government. (Dr. Christopher Smith, personal communication) Even though there were differences in commitment to the neoliberal ideology within government, funding and cost containment remained ongoing challenges for community-based services even as Alberta’s economy surged from 1996 to 2008 and resulted in an “embarrassment of riches” (Harrison 2005:10). While earlier funding cuts may have been a pragmatic response to fiscal pressures, since these pressures were not an issue in a surging economy, ongoing cost containment seemed to be driven by an ideological commitment to shrink public services and costs. The very slow recovery in funding for social services in general gives further credence to this argument. Service providers and family advocates were certain that the government would have restrained funding to the field were it not for their advocacy to keep the issue in the public spotlight (Interviews 2013). Following their protests, cutbacks were usually either cancelled or reduced, or money was added to the budget on numerous occasions (see, for example, Alberta Health and Wellness 2001, 2002; Alberta Community Development 2003; Alberta SCS 2006). As an “organized voice,” field advocates leveraged off the framing of people with disabilities as the “deserving poor” to generate public sentiment in their favour. Bruce Uditsky, Chief Executive Officer of AACL, explained: Even though there were substantive cuts to the social sector, because of the fact that people with developmental disabilities were seen as the deserving poor, [the developmental disability] sector escaped many of the cuts that others experienced who were not seen in that classic paradigm. This particular sector does have a history of an organized voice and advocacy since the 1950s. There

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are many other marginalized groups that have far less voice. And it’s not just people with developmental disabilities by themselves, it is of course the families. As an organized voice, relative to the social policy changes that were taking place, we were able to minimize the impact of many years of what I think of as the “negative era.” (Uditsky, personal interview) One of the most troublesome outcomes of inadequate funding was chronic poor compensation for community-based staff, and associated with it, the challenges of recruiting and retaining a skilled workforce. In 2004, AARC (later ACDS) launched Workforce 2010, a collaborative initiative to address this issue. The discussion that follows illustrates how the power wielded by the primary funder shaped the scope of activities for the intersectoral forum. It also demonstrates the effects of neoliberalism at the field level, and provides insight into some of neoliberalism’s inherent paradoxes. Following the Workforce 2010 discussion, two further examples are provided to illustrate neoliberalism’s reach from the field to the organizational and individual levels.

6.4 Neoliberalism’s Penetrating Reach

6.4.1 Workforce 2010: A partnership where some were more equal than others The Workforce 2010 initiative is often touted as one of the few examples of a well-run collaborative effort between PDD and the community sector. However, as this discussion will show, the infiltration of power relations from the field into the forum prevented it from actually solving the problem that it was created to address. Recruitment and retention challenges in the field were well documented, and had reached a crisis point by the late 1990s and early 2000s due to the funding cutbacks in the early 1990s, inadequate restoration of funding, and the province’s booming economy which had resulted in well-paying jobs in most other sectors. In 2004, AARC brought together representatives from PDD, services, families and guardians (e.g., AACL), post- secondary institutions (e.g., Grant MacEwan College), and other government ministries (e.g., Human Resources and Employment, and Children’s and Family Services) to collaborate on Workforce 2010, a three-year project co-chaired by AARC and PDD, to

187 develop a comprehensive strategy for a skilled and stable community-based workforce (see Box 6.1 for the initiative’s vision, goal and objectives).177

Box 6.1 Workforce 2010: Vision, Goal and Objectives

Vision By the year 2010, the Province of Alberta will have a well-trained and stable community rehabilitation workforce recognized as professionals providing valued services. Goal To provide a comprehensive solution to current and long-term human resource challenges in services to persons with developmental disabilities through a series of integrated strategies. Objectives Through six inter-related projects spanning over three years, WORKFORCE 2010 aims to : • develop and disseminate labour market intelligence • provide employers with industry-specific human resource management training and planning tools • develop the groundwork for implementing a successful human resources social marketing campaign, and • build community capacity by forging alliances and sharing best practices and principles. Source: Murphy-Black, Hillyard, and Riediger (2005).

By its end in 2007, Workforce 2010 had produced and disseminated labour force data for the field, a profile of current and future service requirements, and various planning tools and resources for employers. The achievements were essential building blocks for ongoing work by ACDS in this crucial area. At the time of writing in 2015, ACDS was continuing this effort through a new partnership arrangement which included PDD, Alberta Human Services, Service Canada, post-secondary institutions, and member agencies. A provincial and six regional workforce councils had been established under ACDS’ coordination to work on various activities including: implementing a job classification tool for consistent positions and job descriptions in the field; piloting a cultural competency toolkit to support a diverse workforce;178 expanding the use of an

177 As Director of Research at VRRI, I was invited to participate in some of the planning meetings for this initiative. VRRI’s research team was subsequently contracted to provide background research and develop employer planning tools. I attended and presented at numerous committee meetings from 2004 to 2007. 178 Due to low wages and stressful work conditions, skilled frontline workers are hard to find; many employers have chosen or been forced to lower job requirements, making these positions attractive stepping-stones for new immigrants or those with limited fluency in English.

188 online tool to collect human resource data from agencies; offering foundational training for frontline workers; developing online job boards; and attracting future workers by making presentations at schools, career fairs, and youth organizations (ACDS 2015). The successful creation of Workforce 2010 was attributed by many to Gail Davies, then ED of AARC, who originated the idea for a co-chaired structure which placed PDD at the centre of the committee alongside AARC (Interviews 2013). Maureen Murphy-Black, a senior bureaucrat who served as the project manager for the initiative, provided this back story: Gail Davies was the driver for that. Gail decided that this wasn't going to work unless she could figure out how she could get one person from community and one person from government who would be accepted as leaders within both of their sectors to chair this. She got Alex [Hillyard, then CEO of Northeast Region PDD Community Board] and Ed [Riediger, CEO of Robin Hood Association] to agree to co-chair this whole initiative. At that point, she went to the Provincial Board and told them that she wanted me to come in as the project manager and that they should pay for my salary, because she felt that I had credibility in both sectors, and she felt that this is the least that the provincial board could do if they were truly committed to the recruitment and retention issues. She literally masterminded that little triad from the onset. And to get Alex and Ed to co-chair, that was quite brilliant. Ed is very passionate about HR issues, he has fought that battle since he was twenty. And Alex has such ability to influence the bureaucracy. And from there, she structured it so that everybody owned it. (Murphy-Black, personal interview) The strategically-designed leadership structure was intended to ensure that the initiative’s activities would be trusted and supported by the government and, with AARC at the helm, also by service providers. Although the Workforce 2010 members engaged in a lot of activities, with genuine commitment and hard work from all involved, Workforce 2010 did not solve the fundamental issue of inadequate funding for community-based agency staff wages. A view shared by a number of service providers was that PDD agreed to be part of the initiative and to fully support all its activities provided that the committee’s work did not broach the issue of funding. One of the members of the initiative elaborated on this perspective: Workforce 2010 is perhaps an example of an intersectoral process that was most collaborative. However, I don’t think everyone felt that their concerns and issues were equally heard, and that was because of the strong influence from the funder [being] at that table. The fundamental issue that needed to be addressed, but was never allowed to be part of the Workforce 2010 process, is the issue of fair and

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equitable wages. We could initiate all these other strategies, like being employers of choice and so on, but we were not allowed to put forward the issue of wages. Wages could not be talked about. So, from the [community] sector’s perspective, they did not feel that their issue got addressed. It was heard but it was not allowed to be addressed. So, there’s a bit of catch 22 about that. We still have a huge wage gap and it is getting bigger not smaller. Even aside from the wage gap between government and the [community] sector’s wage, or the wage gap with the private sector, even apart from that, there is still the fundamental problem that the wages are simply not fair or adequate. (P1C12, personal interview) Workforce 2010’s structure had promise: it had a range of stakeholders at the table and a co-shared leadership model. It theoretically reflected at least two important principles of neoliberal governance: community-owned government (empowering communities), and decentralised government (engaging in collaborative decision-making) (Osborne and Gaebler 1992). But co-leaders do not necessarily translate in practice to equal partners. In this case, the agenda of the more powerful partner (PDD’s goal to control spending) appears to have trumped the goal aspired to by the co-leadership structure. Even though the formal goal of Workforce 2010 was to “provide a comprehensive solution to current and long-term human resource challenges” (italics added), the one activity that should have been the linchpin in this—dialogue on how to address the insufficient funding for staff wages—was deliberately excluded as a result of PDD’s representation at the table. Not surprisingly, Workforce 2010’s vision to “have a well-trained and stable community rehabilitation workforce recognized as professionals providing valued services” by 2010 is still nowhere in sight. Workforce 2010 exemplifies the power that a funder has to shape the activities of those who depend on it for political and material resources (i.e., legitimacy and funding). In this case, the presence of the funder circumscribed what activities the forum could and, more critically, could not do. Resource dependence theory postulates that organizations at the receiving (dependent) end of such relationships of power will attempt to enhance their autonomy by creating new relationships to reduce dependencies (Pfeffer and Salancik 1978). AARC worked around the circumscription of Workforce 2010 by leaving the wage funding advocacy work to another structural entity, its Fair Compensation

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Committee.179 This did not change the dependency relationship with PDD, but allowed the forum to move forward on mutually agreed upon activities, a lot of which were technical projects that few would find fault with. Organizational institutionalists would describe this as a decoupling move, which enabled the forum to maintain face (Meyer and Rowan ([1977] 1991:58).180 The inconsistency between the activities the forum was able to do (gather data, create tools and resources) and the primary work that it needed to do (address the funding issue) was resolved by concentrating on the former activities; it allowed members to avoid conflict, and have the “logic of confidence” (p. 58) that all members were acting in good faith. Organizational institutionalists argue that many technical tools and instruments are “rational myths,” that is, largely untested technologies or processes believed to enhance organizational efficiency and effectiveness. They become taken for granted as legitimate because they are disseminated by professional associations or accreditation bodies, and they are adopted by organizations to demonstrate their own legitimacy as efficient, responsible, and rational entities (Meyer and Rowan ([1977] 1991:44-45). The tools and instruments produced through the Workforce 2010 initiative, while arguably useful in some respects (e.g., aligning job classifications or enhancing staff training), have not solved the primary problem that well qualified frontline workers continue to be difficult to recruit because the wages are neither competitive nor in some cases adequate. Wages—not problems with organizational practices, lack of cultural sensitivity, and so on—remain the primary deterrents (Sonpal-Valias 2005:57). However, in order to continue functioning amicably, the Workforce 2010 initiative had to decouple the political work that needed to be done on the wage issue from the technical work that members could more readily agree on. The decoupling was necessary because some members held more power than others. The relations of power and the normative pressures in Workforce 2010 operated to institutionalise activities such that they became unquestioned. As Mik-Meyer and Villadsen observe, “The actors in a field have difficulty

179 The committee is identified in Murphy-Black, Hillyard and Riediger (2005) as part of the map of “AARC’s inter-related human resource strategies.” 180 Organizational institutionalists borrow the concepts of face and face management from sociologist Erving Goffman.

191 seeing the socially constructed nature of the myths. They are … too engaged by the game itself to recognise their role as players” (2013: 93). The next example shifts the analysis from the field level to the organizational level. It draws on organizational data from Vecova to show how the scope and nature of its research activities were shaped by dependence on government funding, and also how the organization acted to reshape its relations of dependence. The discussion includes the period before the Klein reforms since important shifts had already happened by that time.

6.4.2 Vecova’s transformation from a research institute to a service provider Since its inception, Vecova’s dependence on external funding for research has shaped the amount of time and resources devoted to research activities, the nature of these activities, and the relative distribution of power within the organization. The following discussion examines the evolution of the organization from being a service- based research institute to becoming a service provider with a small research component. The discussion draws on Vecova’s archival documents, interviews, and my own observations as a member of the research department from 1997 to 2010.181 Research activities at VRRI, as it was then called, began in 1966 when the organization started receiving annual grants from the federal departments of Health and Welfare and Manpower and Immigration for research into the health and welfare aspects of developmental disabilities, administration and services, and personnel development needs. From 1968 through the 1970s, the provincial department of welfare also provided annual research grants. At the same time, funding to expand residential and vocational programs increased considerably with the escalation of deinstitutionalization. As a research institute of the University of Calgary, VRRI had a strong connection with senior faculty for program oversight, board leadership, research support and student training. Research and services were closely integrated; research findings were the primary driver for the establishment and evaluation of new services, assessment tools and training. The organization was highly regarded locally and internationally for its research contributions to the field as it actively disseminated knowledge and resources to the scientific and

181 Sources are not cited here to ease readability. A full list of documents reviewed is available upon request; access to the documents may be restricted by the organization to other parties.

192 professional communities, and consulted to provincial agencies, hospitals and school boards. All staff contributed to research activities through data collection and dissemination. Until 1993, with the exception of two years, the organization’s top position was closely associated with the university’s department of psychology. By the early 1980s, within a decade of the organization’s establishment as a research institute, service delivery—not research—had become the organization’s dominant activity in terms of the time and resources allocated. In the 1982/83 annual report, Executive Director Dr. Diana McColl reasserted VRRI’s research and demonstration mandate, “even though visitors are frequently left with the impression that the primary activity that goes on within the agency is direct client service” (p. 3). Key reasons for this shift were the huge increase in funding for community-based services and a significant decline in long-term research grants in lieu of short-term program development and evaluation funds. As well, once the organization implemented new programs and demonstrated how best to provide them, it did not stop offering these programs, although this had been the original vision underlying its research and demonstration mandate. In part, this tendency to hold on to service provision was because agencies were pressured to expand their programs to address the demands created by the rapid deinstitutionalization and surge in privatization (see Chapter Four). It also provided a source of more stable funding for the organization than research grants did. In other words, the organization’s response to these institutional shifts was to acquiesce by consciously complying with the pressure to expand programs—a response which may be understood as having been strategically enacted in anticipation of receiving greater and more predictable resources (Oliver 1991:152-153). Since service programs were almost guaranteed to get increasing funding as deinstitutionalization progressed, while research funding seemed to be drying up, it made sense from a survival perspective for the organization to shift its activities towards service delivery. An alternate explanation emanating from resource dependence theory, which suggests that organizational units that succeed in securing resources acquire power relative to other internal units (Astley and Sachdeva 1984), is as follows: that, as VRRI’s service delivery units grew in size, scope and relative contribution to the revenue base,

193 they wielded considerable power in the organization and could easily ensure that they kept growing. The Board’s dismay with, and apparent lack of control over, the lopsided development of activities in the institute is evident, for example, in the 1983/84 annual report, where the Chair Dr. Lary Mosley felt it necessary to assert that: “As a service- based research institute we have a responsibility that transcends our immediate physical surround. Research and demonstration demand the abandonment of parochial attitudes. We are duty bound to abandon our successes and respond to the challenges to move forward into sometimes unfamiliar and occasionally unfriendly areas” (p. 5). Those familiar with the history attribute this sentiment, in part, to conflict between the Board and residential services unit which, due to its large size and service focus was not seen as being sufficiently research oriented. The Chair’s position was that VRRI should stop providing residential services or inject a strong research component into the unit; the residential director opposed this because it would require reallocation of part of residential funding towards research activities. In the end, the group homes were spun-off as a branch society under VRRI, thus buffering them from the parent institute’s research mandate—a victory for the large and powerful residential department. Decoupling or partially detaching internal work activities from formal organizational structures is a common strategy to avoid external scrutiny (Pfeffer and Salancik 1978:273; Meyer and Rowan [1977] 1991; Oliver 1991:155). This example shows that decoupling may also be enacted as a strategy by an organization to manage internal conflict, in this case, the tension arising out of the dual mandate for research and services. Despite the Board’s numerous attempts to reinforce the research mandate, research activity declined as funding became harder to procure in the late 1980s and as the Klein cutbacks began in the early 1990s. Federal research funds dried out and the provincial SPD program became VRRI’s main source of much declined research funding. Committed to maintain its research mandate and remain relevant to the developmental disability field, led by the vision of Director of Research Dr. Randy J. Tighe, the organization shifted its focus from internally-driven program design and evaluation-based research to a more diverse agenda of participatory research which actively involved field practitioners and clients in conducting research driven by their needs. Even though SPD

194 funding was only enough to pay for 6-8 research positions, the change in focus made VRRI’s research more collaborative and directly relevant to the needs of the community. The shift proved to be critical to the department’s survival at the turn of the century. In 1999, a year after PDD replaced the SPD program, the Calgary Region PDD Board slated VRRI’s research funding to be eliminated as the region faced a $7 million deficit. In theory, elimination of research capacity is contradictory to the neoliberal principle of anticipatory governance, whose focus is supposedly to build foresight and encourage preventative measures—both of which can be facilitated by robust research activities (Osborne and Gaebler 1992:Ch.8). However, this principle took a back seat in face of the pending deficit. Fortunately for VRRI, outcry from community agencies, which had greatly benefited from the locally-specific and collaborative knowledge generated by VRRI, and support from sympathetic senior bureaucrats in the PDD Provincial Board resulted in PDD finding a way to maintain VRRI’s research funding. From 1999 to 2000, the PDD Provincial Board and Calgary Region PDD each paid for half the funding, and continued with the existing arrangement of letting VRRI decide what research activities to undertake based on its community consultations. From 2001 to 2010, the Provincial Board182 assumed full responsibility for the PDD-funded portion of research funding. With this came another shift in VRRI’s research activities. As part of its annual contract discussions, and contrary to PDD’s rhetoric of community governance and empowerment, the Provincial Board identified projects that it—rather than the community—wanted done. Although VRRI’s research leaders sometimes succeeded to include within this annual list one or two projects identified through its community consultations, the department’s flexibility to conduct internal or community- driven research using PDD funds essentially ended. Despite the constraints, in 2003 the research department consulted the community to develop a new research agenda, and as predicted by resource dependence theory (Pfeffer and Salancik 1978:26-27) attempted to enhance its autonomy from PDD by more aggressively applying for external grants and contracts, and by providing plain language

182 After the PDD Provincial Board was disbanded in 2006, the funding contract was assumed by the PDD Provincial Branch, which was responsible for policy and research.

195 translation and research consultation services. Through these pragmatically-forced entrepreneurial efforts, the department doubled its revenues in 2003/04 and maintained it at this new level until at least 2010, enabling it to expand its staffing and undertake both PDD’s projects and many that the community had identified. These efforts, however, resulted in a shifting terrain of new dependencies that left the department no more stable than before, and ironically, with little flexibility to conduct any research for VRRI’s own service programs or units, unless these areas were able to pay for it through their own resources or external grants. In 2010 (a few months after I had decided to leave VRRI to pursue my doctoral research), PDD announced it would no longer “sole-source” VRRI for the projects it had been funding on an ongoing basis;183 each project would have to be competitively bid upon. The neoliberal agenda to marketize everything was now complete as far as the VRRI research department was concerned. In recent years, PDD has ramped up the emphasis on outcomes measurement and reporting for its performance-based contracting system and made available some resources to do so. In response, Vecova’s research staff (reduced to fewer than six) have come full circle to supporting its services units’ research and evaluation needs. The organization has restructured so that research staff are integrated within the service areas to support these accountability-driven activities. While research remains part of the organization’s mandate, its relevance to the field at large is almost extinguished. The above history shows how, even when an organization’s activities are a core part of its identity and mandate, dependence on an external source can severely change the nature and extent of such activities. Notwithstanding its status as an affiliated institute of the University of Calgary, the central power that research had in its early days declined rapidly and almost totally as service programs became the major revenue generators for the organization. The university connection and any influence it had, became little more than symbolic. Interestingly, though, organizational members are quick and proud to identify the research mandate as that which makes Vecova unique; it remains strong in the organization’s psyche—and the organization has a large cadre of long-term staff who

183 These ongoing projects were a significant portion of the contract and gave the department a substantial level of security and predictability with respect to its funding; they included annual or biennial surveys related to performance measures that PDD or the ministry had to report in their business plans.

196 remember the days when research played a prominent and central role. In a frontline service organization, research is also one of those “specialty positions” that cannot be easily substituted. Resource dependence theorists suggest that these positions are likely to acquire power relative to other groups (Lachman 1989:249). In the case of Vecova’s research department, this power is symbolic, not material or political.184 It bestows on the organization a capacity that is scarce in the field (Salancik and Pfeffer 1974:467-468). This, together with research’s deep roots in the psyche of the organization might explain why the organization did not simply give up this part of itself over the years as it morphed from being a research institute to being overwhelmingly a service provider. Government policies and funding not only shape organizational identities and activities, but also have the power to shape citizen identities. This is the subject of the next section, which discusses how regulatory developments over time have restricted who can be considered developmentally disabled and what supports they need.

6.4.3 Defining developmental disability In addition to cutting funding, the government can control public spending by restricting access to public programs by tightening eligibility criteria, in effect, defining whether a person is developmentally disabled or not. The PDD Community Governance Act defines developmental disability as “a state of functioning that (i) began in childhood, and (ii) is characterized by a significant limitation, described in the regulations, in both intellectual capacity and adaptive skills” (RSA 2000, c P-8, s 1(1)(c)). The specific criteria for significant limitation in either intellectual capacity (defined via an IQ cut-off level) or adaptive skills (defined as the number of skills that an individual can perform satisfactorily without support) are based on the regulation active at the time of determination of eligibility. Before the creation of PDD, adults with functional limitations (e.g., due to mental illness, acquired brain injury, or FASD) were included in the SPD program alongside adults with developmental disabilities. The new system separated supports for adults with

184 There is also the issue that Vecova is located on the University of Calgary’s Research Park, and must maintain a research component to make it eligible to do so. This could also be a very strong motivator for the organization to retain its research mandate. However, in my 13 years of working in the organization, I never heard the research mandate justified in those terms.

197 developmental disabilities from other supports for adults with disabilities. Maureen Murphy-Black explained how the specialised focus of PDD resulted in whole groups of people falling through the cracks: The [creation of] the community boards [resulted in] the total separation of supports and funding for people with developmental disabilities into one pocket. Before that, it was a lot more blended, like for people who had mental illness or other disabilities but not developmental disabilities, there was a lot more joint kind of funding. It was really evident in the small towns, because you would see that there might be a local association for the disabled, and no matter what your disability was, they would help you. But the [creation of PDD] was a total shift in that anything that was not related to people with developmental disabilities, got shuffled elsewhere. CNIB had a little program under employment. That then got held over in the community living branch. People with brain injury went over to some other program. Anything that was not about developmental disability, then had no home. From a policy and political level, people were falling through the cracks. So, over time, we’ve seen that causing huge problems for families. People with mental illness have never had the capacity to grow as strong as families and individuals with developmental disabilities and to be able to advocate for their own funding. Families with kids with mental illness, it is really tough, it’s really tough to get supports. I can absolutely see the connection of how that occurred. (Murphy-Black, personal interview) Although many individuals fell through the cracks due to this structural change, by and large adults with developmental disabilities who had been receiving SPD supports continued to do so under PDD.185 As well, since regional CEOs had considerable discretion to accept into (or keep in) the program a person whose IQ was above the cut- off limit (which was 75 when PDD was created) or who had significant functional impairment, at least a few individuals were prevented from falling through the cracks.186 One of the interview respondents explained: When PDD first came into existence, there seemed to be a rule of thumb that they would fund people with an IQ of 75 or even a bit higher, if there was also a really significant impairment in adaptive functioning. Every agency had a few

185 In 1993/94, eligibility for all social income programs was reviewed and tightened (Shedd 1997:257). Since AISH would have been part of this review, many individuals who lost their SPD supports when PDD was created may also have lost their AISH funding, making an already difficult situation even harder for them. AISH was again reviewed on a case-by-case basis in 1997/98 (Alberta FSS 1998). 186 The PDD Act had a clause to allow current beneficiaries to be grandfathered into the new program, but, according to some interview participants, the clause was either not well known or there were inconsistencies in how it was understood and applied in practice.

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people in the 80s or high 70s who has significantly impaired functioning because of things like Asperger’s or some form of pervasive developmental disorder or some of the personality disorders, and they represented a certain portion of the clientele of every large agency. But my understanding is that the standard is now below 70 points with significant impairment in adaptive functioning and childhood onset. (P2120, personal interview) The change in the IQ cut-off from 75 to 70 occurred in 2009 under the Stelmach government. Following on the heels of the global economic crisis in 2008 and the resulting instability in Alberta’s economy, all social programs and services were reviewed to “ensure they [we]re citizen-centred, aligned and integrated” (Alberta SCS 2009a:3). In addition, any discretionary leeway that the regions had for program intake was eliminated, and PDD staff rather than independent clinicians were assigned the task to conduct eligibility assessments (Interviews 2013). In effect, some people who were developmentally disabled before the regulation came into effect, now were not. The change in the cut-off limit was described by PDD as arising from the need to “improve clarity, consistency and transparency” (Alberta SCS 2010b). However, a number of service providers felt that cost considerations were the driver behind this move. One of the service providers provided the following story to support this view: There was a deputy minister or some senior bureaucrat who came to us and said, “You know, those people who are kind of on the edge, do they really need help?” He called them the bubble people. These are people with a fairly decent IQ who maybe needed a little bit of support, but not too much –the ones in vocational programs, and so on. He seemed to indicate that these bubble people would gradually be worked out of PDD and funding would be focused on more complex people, people who needed a lot more support. But the bubble people were a bubble because there were lots of them; they were the bulk of the population in services. The notion was that if we can get rid of those bubble people, because they needed few supports, they could be downloaded onto the community – onto their families, onto whoever - to take care of, then we can focus on the people who really need daily support. (P1C14, personal interview) One individual felt that, in addition to economics, the timing of the decision may have been driven by legal action in British Columbia: There was a human rights tribunal case in 2009 in BC. There was a woman who had adopted a young man with a condition called Noonan’s Syndrome, which is a genetic disorder that predominantly features as impairment in social skills while intellectual functioning is generally preserved, but they do very poorly in social interaction. The adoptive parent wanted to get a classroom aide for this young man through BC Family and Child Services. But, he was denied the aide

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because his IQ score was too high. So, the mother sued the provincial government. The Human Rights Tribunal found that the ministry did not have the authority to arbitrarily set the IQ level, if it wasn’t specified in the legislation, to deny anybody service. So, they fined the provincial government $20,000 and the boy got his aide. The next thing you know, all of the provinces in Canada now have a regulation appended to their disability service, or PDD equivalent act that specifies an IQ score. I’m pretty sure this change was related to the tribunal’s decision because the timing was right. The tribunal met in March 2009, and by that summer, the new regulation associated with Alberta’s PDD Act had changed. Sometimes legal cases and decisions can have fundamental impact on service delivery. (P2120, personal interview) Bruce Uditsky added that the restriction created yet another gap in services and took away whatever little discretion the regions had, in complete contradiction to neoliberal notions of empowering communities and enhancing their capacity. The eligibility policy that was changed in 2009 is one we’re still trying to undo. It will be undone eventually, but we couldn’t convince anybody at the time that if you do that, you’ll create all kinds of problems. It created a larger pool of unmet needs, and now they’re struggling to figure out what do we do about all those unmet needs. The driver for that was undoubtedly cost-containment. I mean, people will say, “having a coherent program, making sure that people who needed supports are getting the best supports,” but it was actually a cost- containment strategy. It was, in a sense, about trying to have a government by finite boundaries rather than grey areas. I prefer the approach that said, “We’re going to think about whether or not this person is eligible. We have some guidelines, and if they’re not eligible, they can go and appeal.” As opposed to drawing a line in the sand. So basically it eliminated appeal panels, it removed any discretion the CEOs had, and told them you no longer have to think about this. Here’s the rule. We need rules, but when we go too far along those lines, it creates a whole set of other problems for people. (Uditsky, personal interview) Part of the “larger pool of unmet needs” occurred because of PDD’s narrower program scope compared to other policy arenas encountered by individuals with developmental disabilities during their life course. Dr. Keith Seel, a parent of a child with a developmental disability, expressed the frustration felt by parents at this discrepancy: They’re working through regulations to limit what you’re getting. And they have to since they’re only given so much money. So then you’ve got families going, “Everything is changing here. Even the definition of disability. My child had a disability all their life until they turn 18 and now they don’t have a disability anymore because the IQ is changed? They’re still the same person. How does that work? How do three areas of government [health, education and family supports for children under 18], all agree that they have a disability and then the fourth one doesn’t? Explain that. (Seel, personal interview)

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Another way in which program costs are controlled is by determining what types of supports are provided to individuals, and allocating funding tied to each bundle of supports. Prior to 2009, service providers assessed the types of supports required through conversations with the individual and their support network based on prior experience; since then, PDD has implemented the use of the Supports Intensity Scale (SIS)187 as a measurement tool to quantitatively assess an individual’s support needs (Alberta SCS 2010b). Anyone applying for PDD funding now has to be assessed for a SIS score, which is determined by PDD staff trained in the tool. Since the score also provides the basis for allocating funding, it puts PDD in control of both processes, contradicting the neoliberal principle of government “steering rather than rowing.” The implementation of SIS was met with much resistance from families and service providers alike. The main criticism was that the SIS score was simply a snapshot in time, and could not accurately reflect a person’s (sometimes rapidly) changing circumstances, or the efforts that go into maintaining (often precarious) states of stability (Interviews 2013). As any tool administered by humans, it was perceived to be subjective and prone to bias. One of the service providers described how the SIS score worked, and also how it shaped clients into pseudo-consumers in a competitive market; “pseudo” because their funding and their choices were defined not by themselves, but limited by what PDD allocated to their SIS assessment. The tightening up of eligibility, and now the SIS, where people get tested on their support needs. Not only can you not say how much service you need, but now you’ll get a score and be put on a funding band from 1-7, and that’s what you’ll be worth. So, if you get a score of 3, you’re worth $2,000-$2,200 in terms of support dollars, and that’s what you get. The SIS was never supposed to be attached to funding, but it’s specifically attached to a funding band. We were told by our contract manager that this is how it would work. The government would get the SIS score on the individual and then talk to the individual to ask them what sorts of outcomes they want. These are people who don’t know the individual, but they will help the person decide what outcomes they want. And so, the government can say, “We’ve decided that since you’re a level 4 on SIS, you get about $3,000 per month to get these 5 outcomes related to your life. You can now go out and shop for services.” But an agency can say,

187 A tool developed and supported by the American Association on Intellectual and Developmental Disabilities.

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“You know, we can help you meet 4 of those outcomes for your $3,000, so, would you like to not have a job, or would you like to not have assistance for residential living?” Or maybe you can go shop somewhere else, because agency B might say, “Well, maybe we can do it for $3,000.” So, what you’re doing is creating a competitive environment for social service agencies about who can do it cheapest, for one thing, and you’re also creating a consumer in a person who really isn’t a consumer trying to buy a set of services for a certain amount of money. The services might not be what they need or want, but what they’re eligible for under SIS. I don’t know what the outcome of all this will be, except that it’ll be completely individual, tied to a test score, and agencies competing for those dollars. (P1C14, personal interview) PDD was not dissuaded by the criticisms against SIS. By March 2012, almost 5,500 (about 60% of total) PDD-funded individuals had completed SIS assessments (Alberta SCS 2012a; last estimate available at the time of writing). PDD had a webpage explaining that SIS was just one of a series of processes by which supports and funding were determined.188 However, the service providers and family advocates interviewed for this research remained sceptical. Regardless of its merits or checks and balances, the process put PDD in charge of what service providers and clients previously had control over, contradicting the neoliberal principle to increase citizen choice and autonomy.

6.5 Concluding Remarks This chapter is the first in a series of four to examine the manifestations of the Klein reforms in Alberta’s developmental disability field. The first element of reforms, which emanated from the neoliberal agenda to reduce the size and scope of government, involved widespread cuts to social programs and limitations in the benefits provided. Unlike other social programs, services to people with developmental disabilities experienced fewer cuts, in part because of organized and ongoing advocacy by families and services providers, and also because of government’s fear of public retribution for cutting programs and services to society’s most vulnerable citizens. As well, not all in Klein’s government were supportive of harsh measures. However, although the funding increased considerably over time, it did not keep pace with the growing demands of supporting an increasing number of previously institutionalised clients with multiple and

188 Alberta Human Services. “Supports Intensity Scale.” http://humanservices.alberta.ca/disability- services/pdd-sis.html. Accessed November 10, 2015.

202 complex needs in a community setting. The funding constraints severely challenged service provider agencies, and required ongoing advocacy from them and families. This paradox of scarcity amidst plenty during the second period of the Klein reforms from 1996 to 2006 when the province was in a much stronger financial position, is evidence of financial decisions motivated by ideological rather than pragmatic considerations. In the second part of the chapter, three examples were provided to illustrate the pervasiveness and penetration of neoliberalism’s institutional context and relationships of power. The first focused on neoliberalism’s outcomes at the field (intersectoral/inter- organizational) level. The second analysed the Klein reforms’ accelerated transformation of an organization’s core activities. Organizational institutionalism and resource dependence theory were drawn upon to provide insight into the role of power in shaping the outcomes and responses in each example. The third example examined how neoliberal policies and goals shaped individual identities by defining who is developmentally disabled based on program eligibility criteria, and by articulating their needs based on the application of supposedly objective measures. Collectively, the examples demonstrate some of the contradictions inherent in neoliberal projects. This characteristic of neoliberalism is further demonstrated in the next chapter, which analyses the structural reform in the program of services for adults with developmental disabilities.

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CHAPTER SEVEN: COMMUNITY GOVERNANCE ON GOVERNMENT’S TERMS

Community governance was a way to give community what it said it wanted, but on government’s own terms, meeting government’s own objectives. (P1CG11, personal interview)

This is the second in the series of four chapters examining the manifestations of the Klein reforms in the field of services for adults with developmental disabilities. It focuses on the restructuring of the SPD program to the Persons with Developmental Disabilities (PDD) regional community boards model, and subsequent changes over time in the PDD structure. The creation of a regionalized community governance structure for such a relatively small sector was unprecedented and was viewed as a very progressive and positive development, a characteristic not typically associated with the Klein era. However, the devolution of responsibilities and accountability that occurred with the implementation of the PDD system, without an accompanying shift in power from the centre, very quickly and significantly transformed intersectoral relations from those of mutual respect and collaboration to those of distrust and acrimony. The chronically tense climate together with ever-increasing program costs made PDD the subject of numerous reviews, each resulting in regulations or practices to increase efficiency and scrutiny, moving the system closer to neoliberal ideals of accountability over time. The chapter begins by describing how the original transformation came about, and the central role of family advocates and senior bureaucrats in shaping the developments. The analysis reveals how creative actors can generate innovative outcomes by experimenting within neoliberalism’s complex contours and internal spaces in ways that mesh with their own values and interests. The chapter then describes the main sources of tension that arose in the system, including: differences between the original intent and rhetoric vs. the way the system was actually structured and implemented to further government’s objectives; the tensions inherent in the system’s configuration; differences in the normative orientations of service delivery agencies vs. the politicians and bureaucrats responsible for program oversight; and the attempts to control a system with seemingly runaway costs. The analysis links the tensions and acrimony to misalignments

204 in the field’s institutional elements, and reveals how the misalignments created opportunities for actors to shape changes to further their own goals. The analysis also invokes the concept of legitimacy as a frame for understanding the tensions. By so doing, the chapter adds to the emerging literature on institutional entrepreneurship, and to the organizational institutional literature on the analysis of state programs and policies. The chapter ends by comparing organizational responses to the changes in the field and the accompanying climate of tensions; the analysis reveals the important role that organizational culture and identity play in shaping these responses. Overall, the findings lend support to the growing literature that seeks to re-inject agency into institutional arguments, while recognizing that such agency is bounded by structural constraints.

7.1 Birth of a Program with Great Potential On April 1, 1998 the Persons with Developmental Disabilities Community Governance Act 189 replaced SPD with a regional community governance structure for services for adults with developmental disabilities (PDD). It was the most significant structural change in the field since the 1970s, and a unique development for a program affecting a very small population of Albertans. The Act established: (i) six regional community boards to administer service delivery in geographically distinct regions across the province; (ii) one facility board (Michener Board) to administer services in the government-operated Michener Centre; (iii) a central Provincial Board (PDD Provincial) to develop, oversee and evaluate service delivery, coordinate regional activities, establish policies, allocate funding and review appeals; and (iv) a foundation board with the authority to raise funds from the private sector to support capital, pilot and research projects (Alberta FSS 1997; Alberta 2006a).190 The creation of PDD came about in the mid-1990s as a result of the confluence of (i) broader reform activities to dissolve FSS, move programs to newer, larger ministries, and regionalize as many programs as feasible; (ii) developmental work on a governance

189 Persons with Developmental Disabilities Community Governance Act, RSA 2000, c P-8. Available at: http://canlii.ca/t/522rn. Accessed August 19, 2015. Originally enacted in 1997, revised in 2000 and 2006, expired on December 31, 2010, and continued by Order in Council to December 31, 2015. 190 Michener Centre Facility Board and the PDD Foundation were dissolved in 2001/02. Michener Board’s responsibilities were transferred to the Central Alberta PDD Community Board; the Foundation’s assets and functions were transferred to the Provincial Board (Alberta Health and Wellness 2002).

205 model for children’s services; (iii) a model promoted by the Premier’s Council to gather disability programs under a single community supports unit; and (iv) a group set up to discuss the future direction of Michener Centre (Interviews 2013). There was general anxiety in the field that if SPD became part of a larger entity, its funding would either become lost or be determined by a different philosophical approach (e.g., by a medical approach under a health super-board), or be at risk of drawing attention if lumped together with less-well funded groups (e.g., if disability groups were assembled in their own entity). Bruce Uditsky explained: One of the conceptualizations of government was that there would be super- boards [which] would absorb sectors such as ours. The fear of that from us is that health or the medical model was something we’d worked very hard for decades to minimize or escape from to more of a social model. And here we were at a risk of coming back under health and the risk of a more medical model, more lives being determined by rehab professionals or more facility based residences. That threat, plus the fact that regionalization was a train the government was moving down that we were not going to be able to stop, led us as a sector to advocate for our own regional entities. This was a deliberate decision to protect the sector from health regionalization. (Uditsky, personal interview) The Michener group—which included MLA Jim McPhearson, SPD’s Executive Director Norman McLeod, Public Guardian Gordon Cuff, AACL’s Bruce Uditsky, and representatives from Michener staff and parents, AUPE, City of Red Deer, other senior bureaucrats, and community members—could not agree whether Michener should be closed or turned into a world-class facility. But they did agree it was not in SPD’s or its clients’ interest to become part of a large entity. The group’s solution was to craft a community governance model specifically for services for adults with developmental disabilities, with a separate Michener board. The precedent for regional authorities had been established in health and children’s services, albeit with differences in structure and application. McLeod shared his perspective on the rationale and his role in the process: In comparison to other disabilities, funding to people with developmental disabilities is pretty significant. So there was this fear that if all the disability programs joined under one entity, it would become obvious that people with developmental disabilities were getting significantly more dollars than other disability groups, and people with intellectual disabilities, would lose out. So we felt obligated to try and come up with something else. A small group of us from the [Michener Centre] committee put our heads together and came up with this idea of PDD. That would be in 1996. I was the ED of SPD at that time, so it

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became part of my responsibility to craft the new structure and legislation. I had to develop proposals to go to caucus and get their approval, and from there, was responsible for the development of the legislation and to implement the PDD community governance structure. (McLeod, personal interview) The intent of the new model is captured in the preamble to the Act (see Box 7.1). The Act institutionalizes the dignity and equal worth of individuals with developmental disabilities and their right to self-determination and inclusion. It legislates the creation of a program that is responsible to local communities for the provision of services, and values and supports their ability to respond to service needs.

Box 7.1 PDD Community Governance Act - Preamble

WHEREAS the people of Alberta honour and respect the dignity and equal worth of adults with developmental disabilities; WHEREAS it is important that adults with developmental disabilities have opportunities to exercise self-determination and to be fully included in community life; WHEREAS the individual needs of adults with developmental disabilities are most effectively met through the provision of services that are based on equitable opportunity, funding and access to resources; WHEREAS the Government of Alberta recognizes, values and supports the ability of communities to respond to the needs of adults with developmental disabilities; WHEREAS the Government has ongoing responsibility to ensure and oversee the provision of statutory programs, resources and services to adults with developmental disabilities; and * WHEREAS statutory programs, resources and services are best provided to adults with developmental disabilities in a manner that acknowledges responsibility to the community and accountability to the Government through the Minister; THEREFORE HER MAJESTY, by and with the advice and consent of the Legislative Assembly of Alberta, enacts as follows: (followed by the Act)

Source: PDD Community Governance Act, RSA 2000, c P-8 * This statement was removed when the law was replaced by the PDD Services Act, RSA 2000, c P-9.5 in 2013; rest of the preamble was essentially the same.

PDD’s original structure included a provincial board, which consisted of regional (and Michener) board chairs and community members, to balance regional and provincial responsibilities.191 McLeod explained the rationale for this innovative configuration:

191 The next section discusses how the anomalous structure was one of the sources of tension in the system. The provincial board was dissolved in 2006; the regional community boards were dissolved in 2014.

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The provincial board was made up of the community board chairs and an equal number of members from the community. It was seen as a way to achieve balance. The regional CEO would report to their chair, and their chair would report to the provincial chair. In some ways it requires dualistic thinking, because you have responsibility to your local community, but you also have the greater responsibility of the province. The regional health boards and school boards didn’t have that. But we felt we needed to have a provincial entity. The hope was that we would come together collectively and use the wisdom of the group to move us in the direction of the preamble of the legislation, as one kind of organization that had direct access to the minister, with the idea that the department would be supportive, not controlling. (McLeod, personal interview) Families and service providers were hopeful that the community governance structure would strengthen relationships, and their ability to shape programs and services (Interviews 2013). A service provider explained: I think the desire for participation from the community level came from the belief that, yes, we could manage things because we knew what our community needed. What we needed in Calgary was not what was needed somewhere else, like Ft. McMurray, and we could help design that. The community inclusion model fit beautifully with that. We were going to work at our community level, make all the changes here, and make us happy in our own way. So, we willingly went into that. (P1C14, personal interview) The creation of PDD, with its unique structure, was a significantly progressive development in a time not generally known for such advances. Other progressive developments in the field around the same time were the creation of Family Supports for Children with Disabilities (FSCD), which preceded the creation of PDD and also used legislation to enshrine regional authorities for a special program of supports for families,192 and the establishment of the Individualised Funding (IF) model which, like FSCD, gave funding directly to families to spend on supports as needed—an approach that fit the neoliberal ideology of shared responsibilities.193 Uditsky explained how family advocates like AACL, in collaboration with senior bureaucrats, were able to achieve this. We didn’t feel like we could stop regionalization, It was going ahead. Part of the safeguard strategy was to say, well if we can create our own regional authorities [for supports for children and adults], wherever they kept moving us in terms of

192 Prior to FSCD, supports for families with children with disabilities were based only on a single clause in the child welfare act (Uditsky, personal interview). 193 Unlike PDD and FSCD, Individualized Funding did not arise from legislation, but originated in actual practices which later became formalized as a funding model. This is discussed further in Chapter Eight.

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departments, we would still have some capacity for protection. I actually think that it worked in the end because we had, I believe, enough of a political ability in terms of relationships with senior government and ministries, and with the media and the public. What appealed to government was that they were going to put money in the hands of individuals and families who were then going to be in control. It’s a bit of rhetoric, it’s not entirely true, right? But those were the things that could convince a Conservative government. Rather than build a larger service sector, you could put money in the hands of people to have control over their own lives. This is a Canadian story that people don’t understand. The public perception of the Klein era, the legacy, was about everything from a balanced budget to cuts, and not about social progress. Nobody equates the Klein era with social progress. It seems a bit of a contradiction. We ended up with some of the most progressive pieces of legislation in the country and some of the most progressive programs in the midst of the Klein era. What fascinated people outside the province was how was it that we were able to achieve all of this in the midst of all of that. What could people learn from what we were able to achieve when the public perception—and in lots of other sectors the case was that you weren’t moving forward—was that you didn’t have that capacity. (Uditsky, personal interview) Analytically, the creation of the PDD community governance system may be understood as having been crafted by rational and strategic agents, acting within the bounds of the existing institutional context, in response to a perceived problem of program vulnerability for which no existing solution was available (Suchman 1995; Scott 2008:104). A number of studies in the literature link a high degree of uncertainty with institutional entrepreneurship (Hardy and Maguire 2008:203). In addition, the innovative creation of the Provincial Board as part of PDD’s structural arrangement may be viewed as a novel experiment possible because the institutional context was in flux, containing spaces where new “assemblages” could be more readily crafted (Clarke 2008:138). The main entrepreneurs, in this case, appear to be family advocacy groups and their allies in highly senior positions in government, bureaucrats and politicians alike, who shared similar beliefs and values—cultural or normative underpinnings—and who had access to and were part of the very centres of decision-making processes. The literature suggests that actors situated in powerful positions within the field and those in more peripheral locations can initiate change. In this case, the centrally-positioned senior bureaucrats and sympathetic politicians had access to the decision-making process and the ability to mobilise the necessary resources for change; meanwhile, family advocacy

209 groups who were positioned further from the centre were more able to freely articulate alternate views (p. 201-202). These individuals found sufficient common ground in certain elements within government’s neoliberal ideology (belief in community responsibility) and policy agenda (to regionalise social programs) upon which they could create acceptance for the proposed solution by the ultimate decision-makers. Since the precedence for (at least, somewhat) similar models, and therefore their legitimacy, already existed in health and FSCD, the solution could be more readily adapted—or, as Clarke (2008:138) might say, dis-articulated and re-articulated—to the SPD context. The empirical story and its analysis, however, does not end here. The community governance structure was made possible because institutional entrepreneurs framed it in ways that were acceptable to the Klein government’s ideological and policy aims. The regulative framework and the ensuing structure, however, were inherently weak because, while devolution of responsibility to the regional boards was enshrined in the legislation, sufficient authority to respond to the demands that the communities would make on the boards was not; the latter would not have been in the interest of a government whose primary goal was to shrink public spending with minimal negative political fallout. A respondent who worked in the civil service at the time provided the following insight: Governments do not do these types of things without lots of thought. It was a calculated move on behalf of government to structure it in a way that felt comfortable for them. Because it sets the rules and writes the regulations. It was a way to say, “Okay, we can now have some predictability in our funding, and a community governance model.” (P1CG11, personal interview) As discussed next, the system was doomed to be problematic due to misalignments in the various multiple institutional elements abounding in the field.

7.2 Paradoxes, Inherent Tensions, and Misalignments In 1998, when the Community Boards came in, to me, that was the beginning of the end. In my view, some of the things that have been lost are values, what individuals and families want to do. (Yost, personal interview) Since its creation, relationships between the community and government in the PDD system varied across the regions and with time, but were generally fraught with caution, disillusion, or outright distrust (Interviews 2013). The main sources of conflict can be analysed with respect to paradoxes, inherent tensions, and misalignments in the

210 regulative, normative and cultural-cognitive pillars. I argue that these misalignments ensued in perceptions by all parties that the regional board structure had no legitimacy, in the sense that it was unable to achieve the goals that they respectively believed it was created for, and that its actions were contrary to their respective sets of norms and values. Lacking legitimacy, a chronic condition of dis-ease in the PDD system was inevitable.

7.2.1 The paradox of governance without authority The first sign of trouble came within a year of implementation when the regional boards, which had to operate with the same funding allocated in the previous year, were faced with deficit budgets and forced to announce cutbacks, causing much consternation and anger in their respective communities. A key difference between SPD and PDD was that the entire SPD program had one budget, whereas each PDD regional board, as an agent of the Crown, had its own budget. Funding for each regional board was allocated based on business plans approved by the Provincial Board and the ministry months ahead of the fiscal year as part of the government’s budget-development cycle. Regional boards were responsible for managing service delivery within their allocated budgets regardless of cost overruns during the year, leaving them with little room to manoeuvre in the face of unanticipated costs. People felt that the regional boards’ powers essentially served to shield the government from the community. A service provider shared this perspective: Klein’s approach was to put a layer between government and him. You create a community board, you give them a budget, which is last-year’s budget, and you tell them, “It’s your community. Now you figure out how to work your priorities into this budget. Good luck, and don’t come talk to me about it.” Previously, the regional director would get a budget, and it was just a budget. If at the end of the year you needed more than the budget, the money was there. When we went to the government and said, “There’s something wrong with this model,” Klein just said, “Go talk to your community board. They are the ones making the decisions.” So, it was completely downloaded onto these volunteer boards. (P1C14, personal interview) There was also a sense that the regional boards were instruments of government’s will rather than being a voice and an advocate for the community. Two respondents who worked in PDD independently provided the following insider perspectives: The people on the boards are appointed by government, so even though there is a process, often it was people connected to the political folks. So, you now have people on those boards that are likeminded, and you have predictable amount of

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funding in terms of budgets we can move forward on. Well, you could predict it from the supply side in terms of what the government was going to provide. What you couldn’t predict was from the demand side in terms of what was going to be needed. When I was at PDD, there were a lot of communiques around the budget. Prior to the budget coming out, we would get a communication plan, in terms of what to say when the agencies called in: Here are the types of words you can use; here are the things you can’t say. (P1CG11, personal interview) They [politicians] wanted the community boards to be the eyes and the ears of the minister and to be his representation, if you will. The other side of that became quite interesting because some of the local MLAs weren’t quite sure what their role then was. So there were beginning to be some rubs that were going on back and forth. (P1G11, personal interview) It appears that the conflicting expectations of the regional boards’ role arose from what the government promised as opposed to what people thought it actually delivered. As both these models [FSCD and PDD] rolled out, there was a lot of work by government to say to people on the boards they were recruiting, “You will have authority to prioritize choices for your community.” So there were great expectations, and yet, when you look at the mechanics of the regulations, they didn’t actually have the authority. They had no control over a significant portion of their budget. (P1CG12, personal interview) Calgary’s first PDD regional board, which consisted of a number of dedicated community members with a long history in the field, actually resigned as a result of these conflicting expectations. A service provider recalled: The first board actually stepped down, because it was community members that cared at that time, which is no longer the case. They came in with these really idealistic ideas They were all people from the community, senior leaders from agencies, the college, a parent. They all quit. And they were quickly replaced with people who agreed with the government.194 (P1C14, personal interview) These findings reveal misalignment in the basic institutional pillars girding the PDD system. At the regulatory level, there was a discrepancy between the preamble to the PDD Community Governance Act, whereby the government “recognizes, values and supports the ability of communities to respond to the needs of adults with developmental disabilities,” (RSA 2000, c.P-8, p.1) and the lack of authority bestowed on the regional boards to meaningfully respond. Normatively, the discrepancy existed in the rhetoric,

194 I do not believe that individuals who serve on such boards are drawn by material rewards—honoraria, after all, do not amount to that much. Since the motivations or characteristics of these individuals has not been systematically examined, one can only speculate what entices them.

212 which suggested that the government valued community expertise and input, and while this may have been true, in practice, government appeared to value financial control and predictability more. At the cognitive level, this translated into a discrepancy between the community’s beliefs and expectations about the role of the boards (to be its voice and advocates), and government’s beliefs and intention for the boards (to be buffers and instruments of its will). With both parties having different subjective interpretations of the same social reality, confusion was inevitable—even in situations when both parties refer to the same external framework such as the preamble to the Community Governance Act, which for many symbolises a central touchstone for the PDD system: The language in the preamble to the Community Governance Act is something we can all agree with. The idea in the language is just fine. And we take that language back to them regularly, and they look at us like we have two heads. (P1C14, personal interview) 7.2.2 Inherent tensions in structural configuration The PDD system’s innovative parallel reporting structure—which, in theory, gave the provincial board direct access to the Minister while essentially bypassing the ministry bureaucracy—also created tensions in the system. Figure 7.1 shows the organizational structure of PDD when it was first introduced in 1998 (on the left), and after the provincial board was dissolved in 2006 (on the right).

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Figure 7.1 PDD Program Structure 1998-2006 and 2006-2014

1998 - 2006 2006 - 2014

MINISTER

DEPUTY MINISTER

PROV. BOARD CHAIR ASSISTANT DM

PDD PROVINCIAL BOARD COUNCIL OF BOARD CHAIRS (reg. chairs/comm. members) (Chair: DM) PROV BD (CEO/STAFF)

REGIONAL/FACILITY BOARD REGIONAL BOARD MINISTRY CEO FORUM (Chair: ADM) REGIONAL/FACILITY CEO REGIONAL CEO

REGIONAL/FACILITY STAFF REGIONAL STAFF

 Reporting line - - -> Support role

One important source of tension, both before 2006 and after, was the perception that the regional boards had limited authority over their staff and operations, even though, in theory the regional CEO reported to the regional board (Interviews 2013). If you read the authority of the board, they hire the CEO, but there’s someone from HR in the ministry who influences that decision. The PDD board signs off on the decision. And the boards do the CEO’s evaluation, with input from the ministry. But the day to day operations they have no say over. So, functionally and structurally, there are built in tensions in the governance model, which I think is some of what we’re experiencing today. By default, not because of the people, but because of these structural and functional disconnects. (P1CG12, personal interview) While some respondents felt that the regional boards had little more than symbolic control over regional operations and decisions, others felt that the working relationship between the regional boards, their staff, and the community was much closer in the original structure than after 2006 when the PDD system lost direct access to the Minister and became more closely linked with the bureaucracy of the ministry.

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In 2006, the PDD Provincial Board was dissolved. The Branch195 was brought into the ministry, whereas before, it was an arm’s length entity. While the community boards themselves remained intact, the reporting relationship drew the organization into a more corporate approach. New people became involved. New legislation was drafted that repealed some clauses from the original 1997 PDD Community Governance Act and added in a new statement. The new legislation made the regional chairs directly accountable to the Deputy Minister, and the regional CEOs and the Branch became accountable to the ADM. This led to a different era of relationships. Since the dissolution of the Board, it’s been more and more the case that government sets the direction, and informs people rather than engaging them. (P1G17, personal interview) It appears that the Provincial Board never quite fulfilled the role that was originally envisioned for it—to be a forum where regional priorities would get weighed against an overarching vision for the province as a whole, and where mutually agreed upon and consistent policy directions would be set to benefit all regions. Instead, both the regions and the ministry were unhappy with the Provincial Board, albeit for different reasons. Regional interests viewed the Provincial Board as stifling and ineffective. As explained by Dr. Keith Seel, a group of leaders of service provider boards in Calgary were among those who advocated for the dissolution of the Provincial Board. In 2003, I had the experience of creating the Leader’s Council, which was the boards of the 40 or so [Calgary] agencies coming together to meet and talk collaboratively around what were the issues. We made the case that the PDD Provincial Board was ineffective and had far too much power. Nothing done regionally could go through – they just said no and we had no recourse. We had this whole group that could just shut off anything that was done at the regional level. So that advocacy led to that shutdown. The next step was to get a direct connection from the region to the minister. But, lo and behold, [another] piece of legislation comes down that says, ”Actually, we don’t want to hear from the community boards.” The boards, who used to be able to send advice and queries up [to the minister] no longer could send anything up. It was only at the request of the minister. (Seel, personal interview) The ministry, in contrast, felt that the regions were far too autonomous, and that this led to inconsistency in program implementation across the province, a finding echoed by an external program review in 2010 (KPMG 2010:20-22). In 2006, the Stelmach

195 When the Provincial Board was dissolved, board members were dismissed, and the Board’s staff component, which carried out daily functions such as policy and standards development, research and evaluation, and financial support, was renamed the PDD Branch (not shown in Figure 7.1; absorbed into box labelled “Ministry”).

215 government dissolved the Provincial Board, and the Assistant Deputy Minister (ADM) became responsible for setting the program’s strategic direction and policy. A bureaucrat expressed the perception from the ministry’s standpoint. The regions had a high degree of autonomy about what they could do because they were not accountable to anybody other than their constituents. As a result, you had no consistency across the program as to what might be offered, how we would pay for it, what price we would pay for it. The regions said, “There is no provincial policy. You’ve given us a framework but we’ll interpret it and develop our own policies and processes.” Increasingly over time, government became annoyed with this: “What are these people doing? How come we can’t control them? How come we can’t get consistency? This isn’t working for us. It is doing nothing but creating issues.” And so, it came to a head in 2006 where the minister said “This is enough; these people are all over the map. We don’t have a program, we have six programs and everybody gets to do whatever they want.” As a result, we got a new legislation that gives the minister and his designates, the DM and ADMs, more authority over the program. (P1G17, personal interview) Structural changes, whether those of the above magnitude or associated with the program simply being relocated to a different ministry, all result in some degree of shift in the nature and tone of processes and relationships between the parties concerned. These changes in social relations, which are theorised as arising from differences in normative orientations, are discussed next.

7.2.3 Conflicting normative orientations When SPD was restructured into PDD, people felt that intersectoral decision- making processes and relationships shifted from being collaborative to being increasingly driven by government. These views were expressed as early as 1999, within a year or so of the PDD system being in place (Zwozdesky 2000:8-11). When we first came into the field, and you were talking about policy, you’d have your local government bureaucrat call a community meeting. I remember these massive meetings, with day long discussions about what’s relevant, what’s important. And collectively, we’d write the region’s priorities. At a practical level, service providers would have sat in that committee as a group, and people would talk about who’s coming into service, what their issues are and who’s best able to take them into their service. That all just dropped off the map. There was a trend to reduce local community involvement in creating these visions. Now, it’s done entirely through PDD. (P1C14, personal interview)

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Intersectoral relationships were further negatively impacted in the early-2000s when senior government bureaucrats with long-standing knowledge about disability issues, and the history of the sector, its struggles and achievements were replaced by people from financial and managerial backgrounds. Many respondents were of the opinion that the government trusted people with strong financial acumen more than those with policy knowledge or expertise to achieve the reform goals. There was a different sense of allies in government in the past, when a number of people in PDD came from the service provider community. Almost 50% of them seemed to have worked in community agencies. Now, it seems there is nobody that is making decisions in government who has the experience of working in services. (P1C14, personal interview) The opinion was validated by a respondent who had worked in government for many years and had experienced the transition. Government pre-Klein was very much a place where there was a sense of public service. We were career civil servants. In those days, you chose to go into a career and a profession, you got your degree and you specialized, and moved into child welfare or human services, or disability supports. It was philosophically- and value-driven. You moved from region to region to get rural and urban exposures in multiple programs within the scope of human services, and then you moved up into the policy area, or deputy minister, senior administrator, and you stayed there. It was a lifelong commitment. You brought to the policy role that experience from the field; there was a plan for you to experience this and bring it up into policy development. You had people like Don Fleming, for example, who was Deputy Minister for years and years. He started off as a district office manager. So, the model of government was very different. There are only a few people in PDD left with that background. When Klein came in, one of the things they did was that, instead of having long- term senior staff—who were seen as dead wood or resistant to change—the bureaucracy changed to a more business model. The way you were measured and evaluated in your performance changed. Instead of values of public service, values of integrity and consistency, or walking the talk, and improvements in clients’ lives, it shifted significantly to targets and measurements in business plans. And you were rewarded with bonuses – unheard of in government. To be rewarded monetarily just didn’t happen in government. That business model, that private sector model of being driven by money was foreign to many people in public service. The message was, “We want you to be more business-like, more efficient.” But it brought in different criteria for the kinds of people you could have. We want MBAs, not clinical people; we want business people and project managers. So, you start recruiting externally for senior policy positions for people that didn’t necessarily have a background in human services, but were

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experts in business planning, project management and finance. For me it was no longer public service, it was a business. (P1CG12, personal interview) The shift from a client-centred and values-based public service to one driven by financial considerations was echoed by another respondent who worked in government. This individual felt that this shift became even stronger in the 2000s because of the Auditor General repeatedly expressing concerns of lack of accountability in the system, and the Stelmach government’s perception that government was unable to control PDD’s escalating program costs and regional inconsistencies. To me, 2006 [the year the Provincial Board was dissolved] is the lightning rod for the current relationship between government and services. As far as the sector goes, the government felt it had to take on a more corporate and business approach. No longer was it to be based on a handshake, or previous relationships, but based on a business relationship. At the same time, government saw that there were families, and that they felt that they could treat the families differently than the service sector. But you’ve got to understand it in terms of how the program was structured earlier, the fierce regional autonomy, and a government who goes “You guys are totally out of control.” (P1G17, personal interview) In addition to describing intersectoral relationships as having conflicting goals and power inequities, especially after the dissolution of the Provincial Board in 2006, many community respondents felt that new relationships had to be forged every time the program was moved to another ministry (Interviews 2013). For example, when FSS was disbanded in April 1999, families and service providers expressed concerns that PDD’s transfer to Health and Wellness (Alberta Health and Wellness 2000), would revive the medical model of disability, and shift program access and service models to those based on diagnosis and treatment approaches (Zwozdesky 2000:27-28). Subsequent moves included a transfer to Community Development in 2001 (Alberta Community Development 2002), to Seniors and Community Supports in late 2004 (Alberta SCS 2005), and in May 2012 to Human Services, a “super-ministry” created by the Redford government (Alberta Human Services 2013a). With every change, community members were concerned that time and effort would need to be invested to forge mutual understanding, and to ensure that PDD did not get lost amidst other program areas in its new location. This is how one respondent expressed their feelings about PDD being in Human Services, a transfer that had occurred shortly before the interview was conducted:

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Previously, the advantage of PDD was that it could create and hang on to its own philosophy and model, the community, the value systems, the CET [certification standards system]. That was intact. Now, we’re just a small piece in this new ministry. There are only seven people. PDD no longer exists as a division. But, there can be pros or cons. Being part of a bigger ministry means that when there’s a budget problem, there are more resources to pull on. But, we lost all the work [we had done] on identifying all the issues in our sector. There’s also fourteen new ADMs here, and we have our one little ADM going up against all the others. In this big super organization, power, ambition and success are defined differently. Our brand new ADM among fourteen ADMs promoting their agendas. Can she make her voice heard among some very senior, big time people? Perhaps. But we’re very small fish. That is the danger. The loss of history, loss of voice in this new model. We are outnumbered by some very senior people. So, again, these kinds of things happen not because people are evil or intentional, but by default of the structural changes and no mechanism to bring the history over. Now we’re again starting from scratch. New ADMs that have no clue who we are. (P1CG12, personal interview) The concerns voiced by respondents—whether these are due to decreased involvement in influencing policy and service decisions, or shift in the professional training of senior bureaucrats recruited for program direction, or the program being transferred to a different ministry—can all be seen as originating from anxiety about a clash, or at least a misalignment, in the cognitive and normative orientations (shared expectations, philosophies and standards for services, etc.) of: (i) those in the PDD field vs. those less familiar with it, or (ii) the community vs. government. The frequency of program reviews and change initiatives that PDD was subject to, particularly since the time of the Stelmach government, is evidence of this clash in understanding and expectations. It is also evidence of a government seeking to establish control over a program that seemed to be getting out of hand.

7.2.4 Reigning in a system perceived to be out of control Ongoing tensions, chronic distrust, ever-increasing program costs and human resource challenges resulted in PDD being the subject of numerous reviews, stakeholder consultations, and change initiatives. Two particularly prominent reviews were: (i) stakeholder consultations in 2008, culminating in the What We Heard report (Alberta PDD Program 2009); and (ii) an administrative review by consultants KPMG in 2010. Both reviews were started under the direction of Minister Jablonski during premier

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Stelmach’s tenure. Collectively, they set the stage for the transformation of PDD’s structure, processes and intersectoral activities and relations. The 2008 review resulted in six priority actions to make PDD “more consistent across the province, more responsive to individual needs, and more effective and efficient in the way it is administered” (Alberta SCS 2010a:4). The priorities were to: (i) introduce a new regulation, effective August 1 2009, to clarify program eligibility;196 (ii) define a new mission and core businesses to clarify the program’s role, scope, and desired outcomes; (iii) implement the Supports Intensity Scale (SIS) to standardize assessment and funding levels; (iv) increase the uptake of the Family Managed Supports funding option; (v) improve supports for people with complex needs; and (vi) increase program effectiveness and efficiency, internally and in the community delivery system (p. 21). The subsequent review by KPMG in 2010 recommended: (i) dissolving the regional boards to reduce duplication and inconsistencies; (ii) establishing a single organizational model across the province; (iii) implementing contracts with clearly defined performance measures and administrative costs, with services bundled so that an individual could be served by a single provider; (iv) enhancing the use of FMS; and (vi) implementing an integrated case management system to facilitate coordination between PDD and service providers (Alberta Human Services 2012a). The reviewers attributed the community’s frustrations and confusion with the regional boards and the latter’s relative ineffectiveness to the inherent tension in PDD’s governance model (KPMG 2010:35-36). The model, they said, blended elements of both corporate governance (which should “set the tone at the top,” develop strategy and expectations, provide oversight, and ensure compliance) with elements of community governance (which should engage the community, involve it in identifying problems, generating solutions and participating in decision-making, and build trust). Each governance type serves different purposes and achieves different results, thereby creating inherent tension in the role of the community boards. Furthermore, the authors noted that although the community boards were supposed to (and communities expected them to) have a corporate governance role, many

196 The regulation improved consistency and transparency, but narrowed eligibility (Chapter 6, Section 6.3).

220 of the activities related to this role were being carried out at the centre by the Provincial Board/Program Branch.197 Although Minister Jablonski rejected KPMG’s recommendations to dissolve the boards on the grounds that the “boards serve an important role in identifying community priorities and keeping decision-making as close to the individuals and their community as possible” (Alberta 2011), the decision was later overturned by the Redford government. The ultimate outcome of the two reviews was the PDD Change Initiative (Alberta SCS 2012b), which was renamed the PDD Transformation Plan as activities got underway to align the project with Redford’s Social Policy Framework and results-based budgeting process. The goal was to shift PDD to a “one organization, one program approach” (Alberta Human Services 2013f), and from “a program that measures and funds outputs rather than outcomes, operates differently across the province leading to different client experiences, works with a network of community based service providers using historical contracting practices, and is not as efficient or sustainable as it could be,” to one that “operates the same way across the province, works closely with a network of community based service providers, and uses its funding in an efficient and sustainable manner to help individuals be fully included in community life and be as independent as possible” (Alberta Human Services 2014:13). The intent was to standardise everything based on the assumption that doing so would enhance efficiency. The plan’s activities were clustered into four streams: eligibility, assessment, planning, and service delivery. By the end of Redford’s tenure in spring 2014, eligibility, application and intake processes were standardised, a new contracting approach was created based on the SIS assessment, and performance management outcomes were articulated to support the contracting process (Alberta Human Services 2013c, 2013d, 2013e). To further rationalise the system, a strategic procurement approach was developed, which was defined as follows: [A] strategic procurement approach … means the PDD program will be able to identify service areas for adults with developmental disabilities that could be enhanced and areas that are not yet in existence and could be developed. This strategic procurement approach will also enable the PDD

197 When KPMG conducted their review, the Provincial Board had been replaced by the Program Branch.

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program to understand the capacity of the service sector to provide these important supports and where the sector can be better supported to deliver new and innovative options for adults with developmental disabilities. (Alberta Human Services 2013g:11)

Strategic procurement is less about supporting the sector, which can arguably be “supported to deliver new and innovative options” regardless of the contracting approach, but more about giving government significantly greater control over service costs. It also satisfies the Auditor General’s repeated concerns about insufficient accountability and transparency in PDD’s contracting processes. One individual said the move towards this had been under consideration for much longer than people thought: I think that people’s assumption is that this is coming out of nowhere. The fact is that it’s been talked about before, probably more than a decade ago. It’s not new. It’s about when does the political onus come to make it a reality. Who actually puts pen to paper in terms of either supporting it or driving it. I think the driving force to make it happen now came out of What We Heard, but the seeds were probably sown as early as the late ‘90s or early 2000s in terms of a procurement model. The Auditor General has been pushing for a different type of procurement on an annual basis ever since PDD came into being. The procurement process defines specifically what you are purchasing. It gives more predictability on the supply side. With over $600 million worth of services, they have to look at it with a business approach and how you sustain the business. To a degree there’s a push to a more economies of scale approach. I wouldn’t say that there’s a systematic attempt to reduce smaller providers, but when opportunities arise, they do it because they believe that when there are fewer agencies, you require fewer government supports. And those agencies are more sustainable because they have value-added supports within their own organizations. I think they believe that with a procurement model, you can define that supply of supports, you can look at an outcome based system where there’s an expectation of what you must provide. Other ministries have used it successfully. For example, if you look at Employment and Immigration, you can measure the number of people every year that you place in jobs. If you meet those goals, you get the contract, if you don’t, you don’t get the contract. The impacts on people’s lives in this case is small if the agency doesn’t get the contract; they can get employment service somewhere else. But the impact to a person’s life if a disability agency doesn’t get a contract, if they depend on that service for a range of supports, then the impact is huge because of how deeply integrated it is in their lives. So, it’s a very tricky thing in terms of procurements and outcome based models. You have to move forward very carefully. You want to drive better supports and services, but you also can’t create gaps. It will be interesting how this moves forward, but it is not a brand new idea. It is probably ten or

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fifteen years in the making. And we’re probably another two or three years before we really see how it evolves. (P1CG11, personal interview) Standardization and rationalization move government closer to “optimizing outcomes and preventing inappropriate utilization of high cost services” (Alberta Human Services 2014:5). An important implication of this, alluded to by the above respondent, is that standardization and rationalization are likely to result in a trend towards fewer, and larger, service providers. This observation is also noted by Seel (2016:119) who argues that a standard cost schedule coupled with purchasing only what the SIS shows, will likely reduce the number of agencies with which the government will need to contract, favouring larger, most cost-efficient ones who are more likely to have the bundle of supports needed and the systems to accommodate the government’s requirements. The goal to control costs was also brought closer by increasing the use of Family Managed Supports (FMS): by the end of July 2013, with 9,957 individuals receiving supports, over 1,100 (about 11%) FMS contracts were in place.198 Another attempt to control costs, the closure of Michener Centre by spring 2014, was announced in March 2013 (Alberta 2013a). The move, which would have ended Alberta’s tragic history of institutionalization and sterilization, was recommended as a cost-savings measure by KPMG (2010),199 and welcomed by pro-inclusion advocacy groups such as AACL (Wingrove 2013b). The plan was cancelled in September 2014, as Redford’s successor premier Prentice apparently caved in to pressure from the small but vocal and highly influential group of families of individuals housed at Michener Centre, who argued that the residential facility was better able to care for the very complex needs of their family members than community-based services (Alberta 2014; CBC News 2014c).200 The normative misalignment between government’s move towards rationalization and its focus on costs vs. the person-centred focus of families and service providers was again evident in the views expressed by many respondents (Interviews 2013). As one service provider said,

198Source: Alberta Human Services. “PDD by the Numbers.” http://humanservices.alberta.ca/disability- services/pdd-by-numbers.html; accessed October 23, 2015. 199 KPMG (2010:45) identified the government-operated facility as PDD’s single most administratively costly service delivery option. 200 At the time of writing in fall 2015, Michener Centre was still operational.

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They’re coming at it from the perspective of a funding formula, and we’re coming at it from the perspective of providing a good match between the individual and their needs and how they can have a decent life. (P1C14, personal interview). Elaine Yost expressed it as follows: When you talk about business model, procurement model, all these terms, it doesn’t fit for me in terms of what I think services should look like. When we’re talking about outcomes and setting goals for people and measuring all that, the litmus test for me is, “Is whatever we decide going to make a positive difference in the lives of the people we support?” If it isn’t, then we’re barking up the wrong tree. In my view, what any family, what any individual with a disability wants, truly in their hearts, whether you want a job or a home or whatever, is relationships. You want friends, you want purpose and meaning in your life. We’re talking a different kind of language now. We give lip service to some of the language we use. What does inclusion really mean? What does citizenship really mean? I see the values piece as pretty absent from some of the things going on. I think we’ve abandoned the real sustainable values that society needs. And that worries me a lot. I think that just about every decision in our sector comes back to the budget and what we can afford. (Yost, personal interview) Although there was increased momentum towards rationalization and standardization, there was a general sense among community service providers and families that the Redford government was more willing to adopt a genuinely collaborative approach than they had experienced during the Stelmach years. Evidence for this willingness included the creation of advisory councils to help guide the PDD Transformation Plan, although some individuals remained critical that the advisory councils were simply another “Kleinish” (P22111, personal interview) move to buffer government from the front-lines of service delivery. While not everyone agreed with PDD’s direction, people were generally keen to collaborate to make the transition as smooth as possible for the individuals receiving supports. One respondent said hopefully: I am optimistic that the seeds will be sown in this next round of changes [PDD Transformation Plan], that we can safeguard some of the values and principles that I think are key, not just for people with disabilities, but for society as a whole. (P1C16, personal interview) 7.2.5 From community governance to community engagement On January 1 2014, the Building Families and Communities Act came into force. Enacted by the Redford government, the Act dissolved the PDD regional community boards and Child and Family Service Authorities (CFSAs), and made Human Services

224 directly responsible for services to children and adults with developmental disabilities. Regional boards and authorities were to be replaced with Family and Community Engagement Councils (FCECs), with members drawn from local government, private sector, social service agencies, and other groups (Alberta Human Services 2013j). As well, the Premier’s Council on the Status of Persons with Disabilities was strengthened by broadening its scope and increasing its role and influence in influencing policy issues and working with the community (Alberta Human Services 2014a:18-19). By early 2016, regional board CEO positions had been replaced with regional directors, recruitment for the FCECs had taken place but membership had not yet been constituted, and new regional boundaries had not yet been designated.201 According to informal conversations with community contacts, the standardisation and rationalization activities and processes started by the Redford government were progressing along under the newly-elected NDP government.202 Service providers expected that the NDPs would exhibit a collaborative orientation similar to that which had started under Redford.

7.3 The Loss of Legitimacy In theory, PDD’s regional community governance structure was a progressive arrangement with the potential to increase community involvement in shaping locally- specific policy directions and service priorities. In reality, the structure retained power at the centre to institutionally control services through legislations and regulations that forbid deficit budgets, set eligibility and assessment criteria, and established standards and performance measures. Regional boards were responsible for managing, administering and being accountable for services within these constraints. Many of the concerns voiced by community members throughout the existence of the PDD system emanated from their desire and expectations for greater involvement in policy and program development. The inherent conflict in a “top-down” approach to community governance resulted in role confusion, frustration, tensions and strained relationships, as

201 Alberta Human Services. “Family and Community Engagement Councils.” http://humanservices.alberta. ca/department/family-and-community-engagement-councils.html. Accessed October 24, 2015. 202 In early 2016, the Ministry of Human Services indicated that the shift to a “coordinated, transparent and competitive procurement” process would be phased in over the coming years, but would be mindful to not disrupt continuity of care for vulnerable populations. CCVO. “Human Services Procurement Q & A.” http://www.calgarycvo.org/human-services-procurement/. Accessed January 14, 2016.

225 well as discrepancies in policy implementation and service practices across regions (Zwozdesky 2000:14; KPMG 2010:35-36). This research shows that the tensions can be traced to the conflicting normative and cognitive orientations of government (which valued financial efficiency and program sustainability) vs. those of families and service providers (who valued good services and positive life outcomes for clients). It is not surprising, then, that for almost its existence the PDD system was subject to multiple reviews, as both the government and the community expressed ongoing frustrations. I propose that the frustration may be understood as arising from the loss of legitimacy of the PDD program in the eyes of both government and the community it served. Legitimacy is a central concept in institutional theory and resource dependence theory. It is typically applied in organizational literature to organizations; here, I apply it to the PDD community governance system as a whole. In general, legitimacy may be understood as the perceived state of acceptability and credibility that organizations need to survive and succeed in their social environment (Scott 2008:59). Suchman (1995) provides this broad definition: Legitimacy is a generalized perception or assumption that the actions of an entity are desirable, proper or appropriate within some socially constructed system of norms, values, beliefs, and definitions (Suchman 1995: 574). Legitimacy, thus, is a condition or a state that is subjectively constructed, and as such, can be contested and negotiated (Scott 2008:59). Organizational theory suggest that when an organization (in our case, the PDD program) has a number of constituencies each with differing views of how they expect it to function, its legitimacy is typically negatively affected, and organizational actors “find it difficult to take action because conformity to one [constituency] undermines the normative support of other bodies” (p. 60). In addition to normative (value-based) challenges, an organization may also face performance challenges; this is when an organization’s ability to achieve the goals it is perceived to have been created for is called into question (Hirsch and Andrews 1984). The institutional entrepreneurs —family advocates such as AACL and senior bureaucrats such as Norman McLeod—who were instrumental in the creation of the PDD community governance system intended the program to be one that respected the dignity of individuals with developmental disabilities and their right to self-determination and

226 inclusion. They saw it as being responsible to local communities, valuing their ability to identify and respond to local needs. The Klein government seemed to view the program’s structure as one which would potentially buffer it from any negative response from the community to decisions related to budgetary cutbacks. It, and subsequent governments who inherited the structure, expected that it would give them greater predictability and control over program costs. Community members interpreted the program structure (and the preamble to the Act which created it) as an invitation to collaborate with government in the design and development of a program that would provide excellent supports and the best possible life outcomes for individuals with developmental disabilities. These conflicting demands and their respective normative bases clashed, resulting in all three constituencies calling into question the legitimacy of the PDD system. Furthermore, since it was impossible for the PDD system to meet all these misaligned demands, it was viewed as also having failed the performance challenge. Collectively, these failures amounted to the loss of the legitimacy of the PDD system, and the chronic tensions and dis-ease that plagued it almost right from inception.

7.4 Organizational Responses: The Role of Organizational Culture and Identity This section discusses and analyses how the three case study organizations responded to the tensions and pressures in the field due to PDD. The analysis uses Oliver’s (1991) typology of increasingly resistant behaviours that organizations may exhibit in the face of institutional pressures and processes (see Table 7.1).

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Table 7.1 Organizational Response Strategies to Institutional Pressures

Strategies Explanation Acquiesce Accede to institutional pressures Habit Blindly or unconsciously adhere to taken-for-granted values, norms or rules Imitate Consciously or unconsciously mimic institutional models Comply Consciously obey or incorporate values, norms or rules Compromise Conform to institutional pressures in a qualified manner Balance Balance the varied expectations of multiple constituents Pacify Placate and accommodate institutional elements, for example by conforming to only the minimal standard required Bargain Negotiate to achieve some concessions in the degree of compliance required Avoid Circumvent the conditions that make compliance necessary Conceal Disguise nonconformity; display ceremonial conformity Buffer Reduce scrutiny by partially decoupling formal structure from work activities Escape Change goals, activities or exit the field in which the pressure is being exerted Defy Reject institutional norms and expectations Dismiss Consciously ignore explicitly stated requirements Challenge Contest by expressing the superiority of one’s own convictions or rationality Attack Assault or vehemently denounce the sources of institutional pressures Manipulate Actively change the expectations or exert power over institutional sources Co-opt Import influential constituents, obtain their support, or advertise links to them Influence Shape beliefs, values or criteria by directly engaging with the creators of these Control Establish power and dominance over institutional constituents and processes Source: Adapted from Oliver (1991).

When faced with institutional pressures which they felt had to be resisted for some reason or another, all three organizations appeared to demonstrate a common pattern of responses: first, attempting to influence, then showing defiance if the pressures or demands were unchanged, and then complying once the pressures or demands became more palatable, typically after more iterations of trying to influence the changes. Each organization also demonstrated nuanced ways of enacting these responses in ways that were compatible with and reflective of their organizational cultures and identities. I describe the similarities in responses first, and the unique differences next.

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All three organizations attempted to influence institutional developments in the field. Oliver (1991) describes influencing as one of the most active levels of resistance to institutional pressures because “it is intended to actively change or exert power over the content of the expectations themselves or the sources that seek to express or enforce them” (p. 157); it is specifically directed towards normative elements such as values, beliefs, and criteria of acceptable practices or performance. In their own ways, all three organizations expressed the sentiment voiced by SCOPE’s Executive Director Ryan Geake that, “In order to influence things, you need to be at the table. And you have to operate in a credible way” (Geake, personal interview). “Credible ways” typically involve engaging in what might be called “official channels.” All three organizations participate in various intersectoral forums and PDD- initiated consultations in their individual capacities to voice their unique opinions. They also contribute to form collective responses through their membership in ACDS, the Calgary region service provider council and other similar service provider coalitions. In addition, they use tactics such as meeting with political and bureaucratic leaders (e.g., the minister responsible for the program, constituency MLA, regional CEO and/or regional board chair) to assert influence in private without causing public embarrassment to the government. Linkages such as these provide: (i) mechanisms to gain information about developments that may impinge on the organization’s activities; (ii) channels for communicating the organization’s needs or constraints; (iii) ways to obtain commitments of support from the environment; and (iv) legitimization to the organization (Pfeffer and Salancik 1978:145). They are an important means through which organizations manage environmental uncertainty. One Vecova member described the benefits as follows: We’re always at the table. We’re always a player, and we’ve tried to make it a priority to be a player at as many of those tables as we can. Again, at every level, not just at senior management, but at the front-line level as well. We always have our ear to the ground. We keep ourselves current because we are out there. (V01, personal interview) Theoretically, influencing is more likely to be enacted by organizations that have multiple constituencies (with potentially inconsistent or conflicting norms or goals) or who perceive that the pressures will result in loss of decision-making discretion (Oliver 1991:165). It makes sense, thus, that the three organizations would adopt this strategy

229 since the trend towards neoliberalization in the field, which privileges economic and market-based rationalities, may be perceived as inconsistent with their own and their clients’ and families’ goals of inclusion and high quality service. SCOPE’s Director of Community Development, Denise Young, summed it up as follows: Last decade has been very troubled, because I think we’ve seen a significant shift in government in the extent to which they’re being intrusive. Instead of being funders, it’s this whole notion of micro-management. . . . And there’s been a number of times where we’ve sat with government people and challenged them that this is about money. “No, it isn’t.” “Yes it is. This is about cutting costs.” We’re having no conversations about how do we make our services better. Efficient, yes, but not how to make them better. (Young, personal interview) However, when these attempts are seen to make little difference, or when issues escalate and are perceived to threaten fundamental beliefs, values, or commitments to clients and staff, or the survival of a core part of the organization (e.g., when Vecova’s research funding was threatened), each organization is willing to ramp up its resistance to more confrontational levels. These strategies of defiance, which are conceptualised as challenges and attacks (Oliver 1991:156) include encouraging and supporting staff to write letters to politicians during work time, supporting clients in advocacy activities of their choice (e.g., in collaboration with the Disability Action Hall), and organizing protest rallies when deemed necessary (e.g., when funding cutbacks threaten client services or staff wages). 203 Such confrontations typically result in further rounds of intersectoral consultations where the organizations participate in further attempts to influence institutional demands and pressures, until eventually these reach a stage where the organizations decide to comply. In addition to (or within) this general pattern of response, each organization demonstrates unique elements that resonate with their respective cultures and sense of

203 Oliver (1991, see Table 7.1) conceptualises strategies of defiance as less aggressive than influencing because, in her view, the former are not attempts to actually change underlying values or beliefs but to simply reject them. I am not entirely convinced by this argument, since I see challenging and attacking as very public ways of expressing resistance that can diminish or at least lead to the questioning of the credibility of the entity being attacked, and may even lead to change in values or beliefs. Regardless, this is not the place for this debate. Empirically, all three organizations felt that attempting to influence the sources of institutional pressures (in this case PDD or the provincial government) was in their minds less aggressive than publicly confronting them. I will respect, and go along with, the way in which my respondents perceive and make sense of these strategies, hence I describe them as “ramping up.”

230 identities. For example, Options’ image of a caring and protective parent is evident in the following comment by President and Chief Executive Officer Elaine Yost: It’s about working with the family to do what needs to be done. That empowers them, and it empowers us. If you come in with a certificate and a degree and letters after your name, there’s a different appreciation of each other. We don’t have any of that. I’m just going in there as another mum who has had a certain experience, but I know how to do certain things that might be helpful to others. We’ve never felt afraid to try just about everything, whatever we’ve needed to do. I’ve always felt that my role in the agency is to shield our clients and families as much as possible from the vagaries of government – they go up and down, sideways and backwards, all of those things—our job is to support them. That’s our purpose as an organization, so, we inform them, we try to make decisions that have the least impact on them. (Yost, personal interview) With its strong sense of identity as a parent and with its commitment to families, Options—seemingly more than the other two organizations—exhibits a tendency to balance the demands of institutional requirements with its perceptions of what is in the interest of its clients and families (Oliver 1991:153). Options’ behaviour supports Oliver’s prediction that the likelihood of balancing is high when the environmental context is uncertain (“vagaries of government”) and the organization has multiple constituents (funder, clients and families) to which it feels obligated (p. 160). Vecova exerts its influence, more so than the other two organizations, by relying on its long and solid history, its reputation and self-image as a “professional” organization, and its symbolic cache as a “research institute.” In intersectoral forums and consultative processes, its opinions, concerns and recommendations are generally heeded by peers and government alike. Fitting its self-identity, it tends to be more comfortable engaging in “official channels” activities than in public confrontations. Because of its reputation, the position that it takes tends to be mimicked, generally by smaller or younger organizations in the field who have less capacity to hone their own set of responses to institutional pressures. These seemingly “soft” strategies are not to be underestimated in their power to shape change, especially when they originate from an organization with a strong historical presence in the field. When institutional pressures become inevitable, Vecova’s tendency is to position itself to be best prepared for the likely perceived outcome of the developments. Organizational members frame this as being “one step ahead of the game.” This is

231 especially true when it comes to changes in administrative practices. For example, when the Workforce 2010 group (Chapter Six, Section 6.4.1) was developing a job classification tool for consistent positions and job descriptions in the field, Vecova—who believed this was a positive move—was among those who helped shape it and also among the first to adopt it. As one member of Vecova put it: In 2008, we reclassified all of the staff based on the job classification coming down from Workforce 2010. That was driven by the province, and we wanted to be at the forefront. We wanted to do this before were told to do it. Unfortunately, not everyone else followed; even PDD did not adopt it. It’s always been our thinking that we want to be one step ahead of the game, always out there, in front, leading. But in that case, maybe we should have waited a while to see what other people were doing. (V01, personal interview) Similarly, when PDD was indicating shifting to performance measures and outcomes-based contracting model, after engaging in discussions to emphasise the difficulty of measuring such outcomes, Vecova was amongst the first in the field to develop an outcome framework for its various units, and agree to be a pilot site for PDD’s measurement tool. By doing so, Vecova felt that it would be better able to influence the development of more appropriate measures or processes and thereby help shape these inevitable changes in more positive ways. Vecova also demonstrated its penchant for being “one step ahead of the game” when PDD was aligning its activities and processes to the Redford government’s Social Policy Framework by strategizing how to include PDD’s new priorities in its own smorgasbord of services. With the Social Policy Framework having been developed at the provincial level – the concepts around that – is where our focus has been. We know that there’s an emphasis on housing, and on employment. So that’s where our focus is as well. (V02, personal interview) Vecova’s version of compliance, thus, is to go the extra mile and be the first to get there. It is a conscious and highly strategic response, undertaken with the self-interests of the organization in mind, and focused on maximizing the ability to control its own future activities and success. The response fits the prediction that compliance is high when an organization perceives it will result in greater legitimacy (social fitness) or efficiency (economic fitness) (Oliver 1991:161); both perceptions are congruent with Vecova’s desired portrayal of its image as a leading (exemplary), rational and modern, and “business-like” (efficient) organization.

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However, Vecova’s compliance is contrary to predictions that compliance will be low in organizations that are not highly dependent on external funding (Oliver 1991:160). As a large organization with diverse revenue sources, Vecova is less dependent on PDD funding than many other organizations in the field. In 2015, for example, government funding constituted 75% of the organization’s total revenues.204 One would expect, thus, that it might exhibit more aggressive resistance to institutional pressures. A number of senior leaders, in fact, admitted that Vecova’s diversity allows it to have greater control over its activities than other organizations might. Our social enterprises and our attempts to generate revenue streams allowed us to maintain some kind of independence from government even though it might not have been a very big percentage. It did allow us to do some things that they were not interested in funding. I think more than the money it brought in, it allowed us to have a bit of an attitude. As in, “You don’t own me.” We weren’t completely contained by them. (V08, personal interview) Vecova appears to enact this greater sense of control, for the most part, not through public demonstration of resistance to inevitable institutional pressures, but by allocating resources to other activities of importance to the organization. The impact on its research department due to its reliance on unpredictable government funding, for example, was mitigated by generating other revenues through research consultancy contracts externally and with other units within Vecova (see Chapter Six, Section 6.4.2). Similarly, the organization has been able to fund certain special administrative projects and positions by accessing these other revenue streams (Interviews 2013). Unlike Options and Vecova, SCOPE has a much greater willingness to adopt a confrontational stance when it feels that social justice is at risk. This stems from both its natural tendency to turn to self-advocates for its moral compass for action, and also to its self-identity. Executive Director Ryan Geake and Director of Community Development Denise Young explained how the organization’s mission and its connection to the Disability Action Hall self-advocacy group shape the direction of their organization. Young: The Action Hall has significantly influenced SCOPE. Ryan [Geake] and I go to every meeting of the Hall. When you go to the meetings and you hear of

204 Vecova Centre for Disability Services and Research. T3010 Return 2015. Available online at Canada Revenue Agency: http://www.cra-arc.gc.ca/chrts-gvng/lstngs/menu-eng.html. Accessed October 26, 2015.

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people’s day to day experience and the things they are struggling with, you have to bring that in to thinking about how you’re running your organization. Geake: The Action Hall has definitely influenced the amount of lobbying and advocacy we do, and put us on the map. We have a mission statement that says clearly that we would try to solve issues at a personal and social justice level. We actively see our organization as involved in broader issues. The majority of our work is external. This spring, about 80% of my work and Denise [Young] and a few others, would’ve been outside of the organization. We did nothing but external lobbying, not just for SCOPE, but for the broader field. Our external focus ends up sometimes hurting the organization in the short term, hoping that in the long-term, the greater good will be served for the field in general. Young: SCOPE is one of those organizations that takes the level of conversation to a higher level. It opens up the conversation for a whole range of issues under that. We’re not just about figuring out what’s the best way to fill out a contract. We’re about challenging what goes into the contract in the first place, and is this going to have good lives for people? That’s the role we perform. Geake: The fact is, if there’s a vacuum of ideas, there’s a space, and we have to take that space to introduce our ideas. (Geake and Young, personal interview) SCOPE’s response fits the description of challenge (Oliver 1991:156), arising most likely from the organization’s firm grounding in social justice values and vision. Just as rights activists will challenge extant laws and societal norms as a means of expressing their own convictions and integrity, organizations in general will be more likely to challenge the institutional rules and values when they attach considerably less significance to widely shared external beliefs than to their own insular and elevated vision of what is, or should be, appropriate, rational, or acceptable. (Oliver 1991:156-157) Since SCOPE relies on government funding for 95% of its revenues (in comparison to Vecova’s 75%),205 one would expect that this would make it less likely to be defiant to this revenue source. However, to stay true to its values and to achieve its vision, it appears the organization is even willing to risk losing some of those revenues, as evidenced by the following conversation with Denise Young: We just fight with them [PDD] all the time. It’s called “our relationship is complicated” [laughs]. I mean, yes, indeed. We find ourselves in opposition because of our philosophy. We don’t go out of our way to pick fights with them. But because we really do believe people should be able to be involved as active citizens in the community and that they need supports to do that safely, both for

205 Calgary SCOPE Society. T3010 Return 2014. Available online at Canada Revenue Agency: http://www.cra-arc.gc.ca/chrts-gvng/lstngs/menu-eng.html. Accessed October 26, 2015.

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themselves and for the community to be safe. We will fight if they’re going to do something that doesn’t fit with that. . . . If they try to cut the service [for clients], we’ll be back there saying, “Okay, here’s the dangers, here’s the risks. They’re all yours now. You take them.” Because we are saying—as the experts in working with that individual—that this is what he needs. “If you aren’t willing to fund that, then we’re not willing to do it. If you think that the neighbour can provide that support, and if the neighbour gets hurt, it’s your risk, not my risk.” (Young, personal interview) In sum, contrary to the preoccupation of early organizational institutional theorists with organizational tendencies for isomorphism and conformity, this research makes visible the varied agentic capacities of organizations in response to institutional demands. Conformity may result because organizations have no choice, but some organizations may go well beyond minimal conformity to emphatically display their self-image as leaders in the field, as Vecova does. Other, meanwhile, may scrutinise and weigh institutional demands against the varied expectations of the multiple stakeholders of importance to them and enact a balanced response, as Options appears to do. Yet others may choose to defy these pressures more than just symbolically if they clash with the organization’s deeply-held values and beliefs, as SCOPE does. These findings suggest that organizational responses are structured by a complex interplay between, at the very least, the following factors: (i) the cognitive and normative elements of the institutional contexts in which organizations are embedded; (ii) organizations’ inherent professional logics or biases; and (iii) organizations’ sense of self-identity (e.g., as “leaders,” “parents,” or “activists”).

7.5 Concluding Remarks The creation of the PDD system successfully enshrined in legislation and in practice a program dedicated to services for adults with developmental disabilities—a luxury that few (if any) other disability groups have been able to achieve. Family advocacy and supportive and creative senior bureaucrats were primarily responsible for bringing about these developments in a time not known for progressive initiatives. These institutional entrepreneurs successfully combined existing beliefs, philosophical norms, and program elements to produce a counter-hegemonic program that fit their own values, interests and agendas (Friedland and Alford 1991). Their access to decision-making centres and their ability to build trust with the elites gave them the power to influence

235 these new and lasting developments (Garrow and Hasenfeld 2010:43). Once implemented, the inherent tensions and conflicting normative expectations and demands on the PDD system led to it losing legitimacy in the eyes of all constituents. In this sense, the PDD system was like many other neoliberal experiments, which, “as innovative strategies ... may also generate new contradictions, antagonisms, and dysfunctions” (Clarke 2008:144). Organizational responses to the institutional pressures ensuing from structural and procedural changes in the system varied, depending on the culture and self- identities of organizations. Two important points arise from these findings. First, the findings add support to relatively contemporary (post-1990s) institutional arguments that, regardless of how hegemonic a regime appears to be, there is room within it for innovative action and counter-hegemonic possibilities, limited only by the resources and creative capacities of the actors embedded within it to experiment with constructing new forms from the institutional rubble strewn around them. The research also demonstrates that centrally- located actors collaborating with those located further away can bring about significant change when the groups share the same values and goals. Second, regardless of the potential of any institutional environment to contain within it suppressed (but potentially mobilizable) interests, the findings re-emphasize the constraining power of institutional contexts. Misalignments within institutional elements create opportunities for actors to exercise agency to shape changes to further their own interests. However, innovative as they were, the actors who shaped the new PDD program had to work within the context of existing beliefs, philosophical norms and neoliberalism’s ideological aims to craft an acceptable solution. As such, the findings from this study reject theoretical positions— such as rational institutionalism or purely economic or political accounts, premised solely upon individuals acting rationally and strategically to pursue their own interests—which underestimate or are blind to the role of the context in which actors are embedded. A novel contribution of this chapter was to apply the organizational institutional concept of legitimacy to the analysis of the success of (or, in this case, the challenges faced by) a governance system and its structure. The PDD system’s multiple constituents, each with differing expectations, resulted in conflicting demands on the system and its

236 chronic condition of tension. The concept of legitimacy made visible the dynamics underlying this outcome, and demonstrated the concept’s applicability to the analysis of entities larger than organizations. Finally, this chapter showed the role that organizational logics and sense of identities play in shaping the strategic responses of institutionally- embedded organizations.

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CHAPTER EIGHT: INCREASING CITIZEN RESPONSIBILITY

[W]ho is society? There is no such thing! There are individual men and women and there are families .... There is [a] living tapestry of men and women and people. And the beauty of that tapestry and the quality of our lives will depend upon how much each of us is prepared to take responsibility for ourselves and each of us is prepared to turn round and help by our own efforts those who are unfortunate. (Margaret Thatcher 1987)206

This is the third in the series of four chapters examining the manifestations of neoliberal reforms in the field of services for adults with developmental disabilities. It focuses on the neoliberal principle of “empowering rather than serving,” that is, on initiatives to increase the involvement and control of individuals, families, and communities over the issues that affect their lives (Osborne and Gaebler 1992:Ch.2; see also Chapter Five, Box 5.1). The chapter begins with a cursory analysis of the change in the wording of some of the formal statements of the ministries or programs mandated to support adults with developmental disabilities, starting with the Services for the Handicapped Program (SFH) created in 1972. Although formal statements may or may not correlate to the way in which work is actually carried out, at the very least they reflect the aims and values that the government wishes to portray to achieve legitimacy (Meyer and Rowan 1977 [1991]); they also reveal changes over time in the institutional logics, or the meaning structures, that are used to interpret and guide activities in the field (Scott 2008:203). Following this, a number of initiatives are identified through which the government attempted to increase the capacity and involvement of individuals and families. This backdrop is subsequently followed by a more detailed discussion and analysis of two focused examples: (i) a funding model to facilitate families’ expressed desire to be more responsible for managing supports; and (ii) an initiative to increase the workforce participation of adults with developmental disabilities.

206 Margaret Thatcher Foundation. Speeches, Interviews and Other Statements. http://www.margaret thatcher. org/document/106689. Accessed January 17, 2016.

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The first example describes how the use of a small Lougheed-era envelope of funding in the welfare program became legitimized as the Individualised Funding (IF) model in the 1980s and early 1990s, and, after a decade of neglect, how IF was reincarnated in the mid-2000s under a neoliberal government into the more formal Family Managed Services (FMS) option. The analysis of IF’s genesis echoes the finding in Chapter Seven of creative entrepreneurs experimenting within the bounds of the existing institutional context to craft new policy structures. The analysis of the birth of FMS shows how the confluence of beliefs shared by families and government, that families should have greater choice and control, led to both parties embracing FMS, even though doing so meant increasing the burden on families. The second example discusses the Employment First Strategy (EFS) which was initiated by the Redford government to increase the workforce participation of adults of developmental disabilities. Unlike the first example, in which the experimentation by creative entrepreneurs resulted in the successful IF model, the experiment with EFS began with a bit of a misstep. Government’s unilateral decision to reallocate a large part of community access funding (funding for individuals to access activities in the community) to employment funding in order to support EFS was met with uproar. Although all agreed that gainful employment of individuals with developmental disabilities was laudable, most families and service providers saw it as an unrealistic goal for many severely disabled individuals, who, it would now seem, would also lose funding to access leisure and recreation opportunities in the community. The decision was seen as a violation of individuals’ right to control and self-determination. Subsequent consultations with the community resulted in a more reasoned and palatable approach for all parties. The example supports the arguments of those who view neoliberalism’s foray into social policy as an experimental and reflexive process requiring active and ongoing work (e.g., Clarke 2004, 2008; Brodie 2010). It is also another story of neoliberalism’s many paradoxes, in this case, that of intervening in the lives of private individuals while in theory increasing their control and independence. Together, the two examples reveal the nuances and variations in outcomes even within the same social policy domain as neoliberal reforms attempt to move control from the public to the private realm.

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8.1 From Paternalism to Partnership Enhancing citizen responsibility and capacity for self-welfare is an important part of neoliberal efforts to change the relationship between state and society from one that is ‘paternalistic’ to one based on a ‘social partnership’ in which individuals play an increasingly important role alongside government (Steger and Roy 2010:12; Mik-Meyer and Villadsen 2013:4). Central to this initiative are the claims that individuals and their families should take more responsibility for their own care, that government provision of services is ineffective and costly, that reliance on state services weakens individual initiative and undermines family and community ties, and that caregiving is best arranged through voluntary familial and community networks (Luxton 2010:163). As seen in Chapter Four, Albertans tend to place a high value on individual initiative, self-reliance, and responsibility. Individualistic sentiments in the province are not necessarily a product solely of neoliberal ideas. As an approach to government policy, they can be traced at least as far back as the Social Credit era and Premier Manning’s fundamentalist evangelical view of the importance of human struggle to achieve salvation (Finkel 1989:137). However, as the exposition below shows, the emphasis on individual and family responsibility gets increasingly heightened in the formal statements of ministries or programs for services for adults with developmental disabilities as neoliberal ideas begin to infiltrate public services in the 1980s.

8.1.1 Changes in formal statements In 1972, before the spread of neoliberal ideas when SFH was established, one of the guiding principles for creating community services was that they “enable the person to remain with his family by providing resources and support” (Box 8.1). This suggests that families had the choice to look after their disabled family member at home or in the community, and government’s role was to help support this choice.

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Box 8.1 Services for the Handicapped Program: Goals, Principles and Objectives 1972/73 to 1977/78

Goal “To meet the health and social service needs of the handicapped.” Guiding Principles  “Services for the handicapped should be established at the community level whenever possible.  Community services should be developed in co-operation with local associations having an interest in such services.  Whenever possible, these services should be integrated with other community services.  They should be available for the handicapped as soon as it has been determined that services are required.  Community services should reflect the conviction that the most important resource for the handicapped person is the person’s family. Therefore, services should enable the person to remain with his family by providing resources and support, but not attempt to replace the family.” Objectives  “To assist mentally retarded persons in the maximum development of their individual abilities.  To make it possible for the mentally retarded to function in the community rather than in isolation from it.  To assist physically handicapped persons to lead lives as normal as possible within their own communities.” Source: Alberta Social Services and Community Health (1977:9)

In 1983/84, as neoliberal ideas began slowly penetrating Alberta’s public services but well before the Klein reforms, all social programs were reviewed to assess their efficiency. Included among the assessment criteria was an evaluation of how well a program was “supportive of individual and family responsibility” (Box 8.2). This shift in phrasing suggests that individuals and families were seen as responsible for the program recipient’s needs (rather than having this as a choice), and that government saw as its role to support them to fulfil this responsibility.

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Box 8.2 Social Services Program Review 1983/84: Goal and Assessment Criteria

Goal “To assess the degree to which [social services programs] met government priorities and directions, and to propose modifications required to adjust programs to those directions” with the intent that “the programs designed for service delivery would represent the best fit between the needs of identified client groups and prevailing social, political and economic conditions.” Assessment Criteria: “Programs were assessed to see that they were:  Economical and cost effective;  Incorporating flexible delivery;  Clear and simple, with minimal regulation;  Reflecting values of minimum intervention, prevention, and early intervention;  Favouring the voluntary and community sector;  Respectful of constitutional and individual rights; and  Supportive of individual and family responsibility.” Source: Alberta SSCH (1984:17).

From 1988/89 through to 1992/93, the idea of shared responsibility was more explicitly expressed in FSS’ mandate (“support individual and family independence and self-reliance”) and basic principles (“support of personal responsibility and independence”). There was also the idea of the community being an important partner and “the best place to resolve problems” (Box 8.3). In addition, the statements revealed a focus on fiscal prudence “through stewardship of public resources” and “accountability to the public,” suggesting the beginnings of neoliberal preferences for efficiency and close monitoring (Steger and Roy 2010:12).

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Box 8.3 Family and Social Services: Statement of Mandate, Mission and Basic Principles 1988/89 to 1992/93

Mandate (1988/89 to 1992/93) “To protect and promote the social well-being of Albertans … by developing and administering statutory and mandated social service programs which encourage and support individual and family independence and self-reliance.” Mission (introduced in 1992/93) “To lead in the provision of income support and social support services through support of clients and families, through partnerships with communities and other stakeholders, and through stewardship over public resources.” Basic Principles (1988/89 to 1992/93)  “Respect for personal worth and human dignity;  Recognition of equal human worth; that all have the same human rights and freedoms and should be treated on an equal basis;  Support of personal responsibility and independence, and the freedom of individuals to choose and take responsibility for their decisions;  Belief that the family unit and the community are the best places to resolve problems;  Belief in the importance of prevention and early intervention;  Commitment to quality services; and  Accountability to the public for the services provided.” Sources: Alberta FSS (1989, 1993).

Once the Klein government came into power, the ideas of shared responsibility and for greater collaboration with the community to help achieve public goals seem to intensify in the early years before becoming more tempered over time. Table 8.1 (at the end of the section) presents excerpts from selected years for formal statements of the ministries or programs responsible for services for adults with developmental disabilities in Alberta. It provides a general flavour of the changes in the language used over time. The first entry in Tale 8.1 is particularly interesting. In 1993/94, the first year of the Klein government, FSS’ mission statement was revised from supporting clients and families to: “Keep families responsible and accountable, adults independent, children safe” (emphasis added). This suggests a shift in government’s view of its role from supporting the achievement of personal responsibility to holding (“keep”) families responsible and accountable. The following year and until 1997/98, the statement was worded as “Help families to be responsible and accountable” (emphasis added). In 1998/99, the year that FSS was dissolved and the PDD program was assumed in turn by

243 other ministries, the vision was condensed to “Help individuals be independent,” and families and friends were seen as a core part of the support network. From 1999/2000 onwards, there were no further references in the ministry’s or PDD’s formal statements to individual or family accountability. Perhaps the focus on accountability had shifted from individuals and families to service providers, as is evident in the technomanagerial processes discussed in Chapter Nine. Instead, from 2000 onwards, the sentiment expressed in the formal statements was that individuals with developmental disabilities be included in all aspects of community life and that the program be delivered sustainably. Embedded (implicitly or explicitly) in this were the expectations that government would collaborate with community partners to achieve these goals by providing “supports that supplement what others can provide” (Alberta SCS 2011:22), and that individuals would achieve “meaningful outcomes” (Alberta Human Services 2013h:6).

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Table 8.1 Formal Statements of Ministries or Programs Responsible for Services for Adults with Developmental Disabilities 1993/94 to 2015/16 Year Formal Statements (selected excerpts) Table page 1 of 2 1993/94 Ministry of Family and Social Services Mission: Keep families responsible and accountable, adults independent, children safe (Alberta FSS 1994:1). Services to Persons with Disabilities Goal: To assist Albertans with disabilities to live and work in the communities of their choice by providing high quality residential services, employment support, day programs and community supports (p. 21). 1994/95 Ministry of Family and Social Services Mission: Help families to be responsible and accountable; help adults be independent; keep children safe (Alberta FSS 1995:1). 1998/99 Ministry of Family and Social Services Vision: Help individuals be independent. Goal: Enable adults with developmental disabilities, with the support of their families and friends, to live, work and participate as valued citizens in the communities of their choice (Alberta FSS 1999:34). 2001/02 Ministry of Community Development Goal #3: To design and deliver individual-based programs that ensure that Albertans who live with a disability have the opportunity to participate in the social, economic and cultural life of the province (Alberta Community Development 2002:22). 2005/06 Ministry of Seniors and Community Supports Goal #4: Albertans with severe and permanent disabilities have access to funding to meet their basic shelter, food, health and personal needs. Goal #5: Albertans with disabilities have an opportunity to achieve full citizenship by inclusion in the social, economic and cultural life of the province.” The goal is clarified by stating that “ ‘full citizenship by inclusion in the social, economic and cultural life of the province’ means that persons with disabilities are valued, participating and contributing community members. Persons with disabilities who are fully included will have opportunities to participate in the employment, recreational activities, volunteer work, education and other activities” (Alberta SCS 2006:20, 34). 2010/11 Persons with Developmental Disabilities (PDD) Program Goals (Alberta SCS 2011b): 1. Adults with developmental disabilities have the home living supports they need to live in the community and to help them achieve desired personal outcomes (p.18). 2. Adults with developmental disabilities have supports that supplement what others can provide and contribute to achieving personal outcomes (p.22). 3. Adults with developmental disabilities participate in community life (p.26). 4. Increased effectiveness and efficiency contribute to program sustainability (p.29).

(Table continues next page)

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Year Formal Statements (selected excerpts) Table page 2 of 2 2013/14 PDD Transformation Plan Vision (Alberta Human Services 2013i:6): 1. Adults with developmental disabilities achieve positive outcomes which are meaningful to the individual, their family/support network, and enable them to reach their full potential. 2. The PDD program operates the same way across the province, works closely with a network of community based service providers, and uses its funding in an efficient and sustainable manner to help individuals be fully included in community life and be as independent as possible. Specifically what success looks like for each of our stakeholders is as follows: • Individuals will have access to consistent, high quality and well planned supports that allow them to achieve their outcomes and reach their full potential. • Families will receive the information they need easily, have relationships with PDD staff, and have confidence in the quality of the services. • Service Providers will have predictable funding and more efficient administrative processes, allowing them to focus on the individuals they support. • Communities will include adults with developmental disabilities in their community. • PDD Staff will have clear, meaningful roles that allow them to be involved with individuals and families.

8.1.2 Capacity-building initiatives and mechanisms for involvement To complement the heightened expectations for families and individuals to take greater responsibility, the government took a number of steps to include them in shaping services and to enhance clients’ self-determination capacities. For example, families and individuals were involved in PDD’s various feedback processes and program reviews. These included: the biennial clients and family/guardians satisfaction survey (Alberta FSS 1999); the Zwozdesky (2000) review; the development of the Alberta Disability Strategy in 2001/02 (Alberta Premier’s Council on the Status of Persons with Disabilities 2002a, 2002b); PDD Provincial Board’s review of governance and accountability in 2004/05 (Alberta SCS 2005); PDD stakeholder consultation in 2008/09; the KPMG review (KPMG 2010) and its follow-up consultations in 2010/11 (Alberta SCS 2011b); the series of consultations and numerous activities involved in the PDD Transformation Plan (Alberta Human Services 2014); and most recently, the review of PDD safety standards by the NDP Notley government (Alberta 2016). Families were also represented via AACL’s involvement in the core advisory and planning committee on Workforce

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2010 (Chapter Six). To enhance individual and family capacity, PDD supported annual Self-Advocacy Summits, funded self-advocacy leadership development training, and funded AACL to host family leadership workshops and develop family networks (Alberta SCS 2005). Some of these initiatives were supported for several years. This cursory examination of government’s formal statements and its activities to increase family and individual capacity and involvement provides a glimpse into the government’s changing view of the distribution of roles and responsibilities in services for adults with developmental disabilities over the past 40 some years. Although families (and later self-advocates) have played a strong role since the 1950s in shaping services due to their commitment to the inclusion and self-determination of individuals with developmental disabilities—and the government has facilitated and welcomed this collaboration to varying degrees (see Chapter Four)—the key difference is that a neoliberal regime expects a high level of engagement and responsibility from individuals, families and communities. As the next example shows, the expectation of shared responsibility is welcomed by families since it converges with their own belief that they should have greater control and flexibility over managing funding. The story begins well before the Klein reforms, and is simultaneously a tale of family initiative and the story of institutional entrepreneurship and change, both before and during neoliberal times.

8.2 Responsible Families: Individualised Funding and Family Managed Supports During the height of the deinstitutionalization movement in the 1970s, Premier Lougheed legislated a small envelope of funding in the welfare program to allow families of individuals with unique challenges to purchase additional supports (Interviews 2013). The move was in response to demands from people with physical disabilities and other disability groups for funding to address individual needs in a flexible way rather than having to fit within existing service programs (Salter 2002:14-15). By the mid-1980s, the personal supports benefit, which gave rise to the Individualised Funding (IF) model, became a significant source of funding due to a confluence of circumstances. As SPD funding began stagnating due to the economic slowdown, families and service providers increasingly recognized the important potential

247 of this loophole and turned to it in large numbers to top up contract funds. Since both SPD and welfare were administered by the same department, and bureaucrats were afforded a high level of autonomy and discretionary powers from politicians in those pre- Klein days, it was relatively easy for them to access the envelope and allow it to grow in response to the rising demands (Interviews 2013). With the federal CAP funding still in place, the provincial government would have been reimbursed for half of all of the rapidly expanding costs. A bureaucrat provided his perspective: As deinstitutionalization came and there was a move of large numbers of people to the community, we knew we were in trouble. It took a few years, but you started to notice the challenges, especially with the increasing number of people with higher needs. We had a fixed budget, and you had these individuals that required more and more services. Another shift was parents wanting a larger voice in their children’s lives. So, IF ended up being a loophole around the contract system. It was a way to access funds outside of the contracts. It grew from something very small to close to fifty percent of the budgets. Agencies liked it because there wasn’t the same amount of scrutiny in terms of an audit. There was a lot more flexibility. It was more like, this individual needs these supports, the agency is saying this is what it will cost, and that’s what was provided. So, there was this snowball in terms of the massive increase in budgets, unlike the predictable contract funding. (P1CG11, personal interview) Bruce Uditsky explains how IF grew because it appealed to government’s value for self-reliance, senior bureaucrats were willing to experiment with the loophole, and there were precedents for direct funding in related disability programs such as Handicapped Children’s Services (HCS): At its peak, in terms of the number of people, Individualised Funding was probably the highest amount of money being spent in developmental disabilities per person in probably the entire world. What appealed to government was that you were going to put money in the hands of individuals and families who were then going to be in control. It’s a bit of rhetoric; it’s not entirely true, right? But those were the things that could convince a conservative government: rather than building a larger service sector, you could put money in the hands of people who have control over their own lives. This was just like FSCD, or HCS as it was then, which often put funding in the hands of families. It’s interesting how policy and legislation emerge. The number of families who were having very high challenges, their push for individualised supports, and the willingness of the senior bureaucrats to use a section of the Social Assistance Act to dispense funds individually allowed the funding to grow into a very large- scale program before there was any legislation governing it. Because it was all part of Family and Social Services, they could utilize this clause and begin to test

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it out. And then it became a major source of growth and funding in the late ‘80s or early ‘90s. (Uditsky, personal interview) By 1990, Alberta was seen as an international leader in IF (Ontario Federation for Cerebral Palsy 2000:36), and by the mid-1990s, the funding amounted to tens of millions of dollars. Recognising the substantial role of this loophole in the funding to people with developmental disabilities, the Klein government transferred about $80 million from the personal supports benefits into SPD in 1996/97.207 The transfer served to legitimize the funding, but also allowed the costs to be better recognised and controlled as part of SPD. Uditsky elaborates how proponents of IF framed its benefits to make them resonate with the Klein government’s values for family responsibility and market-centric principles, even though the ultimate goal for families was greater control over supports and better outcomes for individuals: When IF became a matter of millions and millions of dollars, then it became an issue of how do we regulate that. It went from small initiatives to a much larger scale, with at one time, about three thousand individuals drawing from it. Most of those individuals were contracted through agencies. Families would get the money, they would contract with the agency, the money would flow to the agency. In many ways, it wasn’t true individualised funding. It was really another way to move money to agencies to provide support. Individualised funding allowed us to eliminate the waiting list for supports for adults with developmental disabilities. There’s hardly any other jurisdiction in Canada that’s been able to do that – you could wait years in BC or Ontario, for example, to get supports; here you waited a month, and still often do. You may not get everything you need, of course. The interesting reason why IF continued to increase during the Klein era is that government liked the idea of money flowing to individuals. It was a rhetoric created by proponents of IF. It was over-sold as a panacea, as if you’d be in control of the market place and services. The market was very limited and in fact, it wasn’t enough money. It’s not as if car sales people were competing for our consumer dollars. And also, whatever you did get, you could utilize to do mediocre things or poor things. There is nothing about the money that makes you creative or imaginative for doing good things for people. But, it did allow growth in the sector even when it wasn’t being allowed elsewhere, because it fit well within the notion of true conservatism. If we had a liberal government or NDP, we would have had a different rhetoric to match the prevailing ideology. (Uditsky, personal interview)

207 1996/97 was also the year that CAP was replaced by the Canada Health and Social Transfer and federal matching grants previously available to offset provincial social program costs under CAP ended.

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Analytically, the emergence of IF as an important and legitimate funding source may be understood in two related and overlapping ways: One, as a gradual process of endogenous institutional change described as layering (Streek and Thelen 2005:22-24);208 and, two, as another example of the experimental nature of developments in the social policy arena (Clarke 2004, 2010). According to (Streek and Thelen 2005), endogenous change requires a gap in the logics underlying co-existing institutional arrangements or in an institution’s idealised set of rules and the actual reality of the behaviour under it in order to create room for creative (re)interpretation or deliberate circumvention (Streek and Thelen 2005:14-16). What is most important about change through layering is that it can set in motion path-altering dynamics through a mechanism of what we might think of as differential growth. The classic example from the welfare state literature is the layering of a voluntary private pension system onto an existing public system. While the established public system may well be unassailable, faster growth of the new private system can effect profound change, among other things, by draining off of political support for the public system. . . . In cases like this, new dynamics are set in motion by political actors working on the margins by introducing amendments that can initially be ‘sold’ as refinements of or correctives to existing institutions. Since the new layers created in this way do not as such and directly undermine existing institutions, they typically do not provoke countermobilization by defenders of the status quo (Streek and Thelen 2005:23; emphasis in original). Fundamental change, then, ensues when a multitude of actors switch from one logic of action to another. This may happen in a variety of ways, and it certainly can happen gradually and consistently. For example, given that logics and institutional structures are not one-to-one related, enterprising actors often have enough ‘play’ to test new behaviours inside old institutions ... (Streek and Thelen 2005:18) In the case of IF, there were two important sources for a gap. One was the lack of clear rules, which was a legacy from the earlier, more progressive and permissive approach of the Lougheed era. This was suggested by a number of key informants who worked in government. This is how Norm McLeod expressed it: In 1973, I think it was, services to people with disabilities in Alberta were first separated out from just general social services. And they were called Services to the Handicapped, and it was for the sensory impaired, the physically disabled,

208 See Chapter Two (Section 2.3.4) for more details.

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and the developmentally disabled. It was very broad, and I don’t think there were any policies in place. (McLeod, personal interview) The other source of a gap was the location of the personal benefits support in the welfare envelope; the logics of action (rules or regulations prescribing behaviour) that applied in welfare were different from those in SPD (e.g., less restriction on and scrutiny over the amount of funds disbursed). Since program administrators had relatively high autonomy and discretion, they were able to test out if they could craft on a new component to the existing program without challenging the extant system. In other words, the process of layering (bringing in funds from the welfare envelope into SPD and creating IF) was made possible because supportive old-style civil servants were willing to experiment with new approaches to benefit program clients in collaboration with the families who pressured them for more funds. This view is supported by Uditsky who attributes the success of IF’s creation to the process of “learning by doing,” which is similar to what Streek and Thelen phrase as “test new behaviours” (2005:18), or what Clarke calls “experimentation” (2008:144). It’s an interesting question as to what would’ve happened if we’d tried the usual approach of let’s develop the legislation, the regulation and the policies and then implement it. Would we have the progress we’ve had? As opposed to learning by doing, and then as things grow and consume more money, the need for policy and regulation becomes much more evident. Then you have to worry about whether or not you’re going to stifle it as you try to regulate it. (Uditsky, personal interview) Unlike the mid to late 1980s and early 1990s, when there were a number of civil servants to help families establish small agencies with the money from IF during the height of privatization, or assist them through the cumbersome process of planning and implementing a truly individualised buddle of supports, no such infrastructure support was available once the Klein cutbacks came into effect. Most families were forced to rely on agencies, and many combined IF with block-funded supports from community-based organizations. By 2004/05, only 234 families relied exclusively on IF for supports (Alberta PDD 2006). As a result, new generations of bureaucrats who did not know the history of IF saw it as an inefficient way to disburse funds and would have eliminated the program were it not for advocacy from groups like AACL who convinced them to maintain it as an option. Uditsky explains:

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We went wrong with individualised funding in a couple of places. One was that we didn’t create an infrastructure of support for families to utilize that funding: how do you plan, how do recruit staff, how do you train good staff, how do you direct them, how do you phase them out when you no longer need them, what does a good life look like, what are the steps to get there? Basically, we handed out money. Some families were incredibly imaginative, creative and resourceful; those were the exceptions. We talk as if those exceptions were the rule. Over time, the vast majority of families simply bought from agencies because that was easy, and we made it too complicated for them to easily use the money. Because families didn’t have the resources to use IF meaningfully, it resulted in the creation of more agencies. When you look at the number of agencies over time, there was this “IF moment” in the 80s, when there was a large growth in the number of agencies, particularly private for-profit agencies, because that was a market model. Now, government has to regulate all these additional providers. In a way, IF created a service market and families lost control. Gradually, the government would say, “Gee, why should we pass the money through the hands of families? It would be so much simpler to just give it to the agencies.” And that was part of the process that began to kill IF even further. When the next generation of bureaucrats came in, they had no understanding of the history. They just saw all this money—millions and millions of dollars— flowing to agencies, and we have this pretence of a hoop with the families. So they think, “Why don’t we just leave families out of the equation and give the money directly to the agencies?” When they did that, many families abandoned IF by the thousands. Because they weren’t really directing services anyway. In the midst of that, we almost lost individualization totally. There had been these intense planning groups—I don’t remember the names —where community, government and the service sector worked together to create new funding mechanisms. And these hardly got implemented at all because of a shift in thinking within government that really diminished the idea of individualized funding and choice. And in policy development, when they were drafting internally to roll these out, there was one point where they left individualised funding out altogether, just inadvertently. And we were able to make the case that we need to leave it in there because it is a viable option for some families, don’t end that mechanism, but work with us to develop better resources in the community for families to utilize in a meaningful way. That was the move to the family managed care supports model, but we almost lost it in its entirety. These all contributed to IF going from its height to almost being lost, and then being rebuilt today [as Family Managed Supports]. But, I don’t think it will ever be a major funding source. There are other people who argue for that, but I’ve always argued for a mixed model of funding, and a variety of mixed models, not just one way of funding. I don’t see the need for dollars to be attached to everybody to buy their way into everything. (Uditsky, personal interview)

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As mentioned by Uditsky, in the mid-2000s, there was growing interest from a new generation of families—especially of younger adult children with developmental disabilities who had grown up in community-based settings—to develop, hire, and manage their own supports. In April 2005, PDD engaged a consultant and created an advisory team which included AACL to help frame policy discussions to develop a more formalised family managed funding option (Alberta PDD 2006). From 2007/08 to 2011/12, there were considerable advances in implementing and promoting the Family Managed Supports (FMS) option. For example, in 2007/08, PDD supported AACL to develop resources to help families with practical matters such as staff recruitment and training (Uditsky 2008), and collaborated to revise policies to improve access to the funding option (Alberta SCS 2008). The following year, AACL was funded to establish the Darrell Cook Family Managed Resource Centre in Calgary in collaboration with Family Voices, another family advocacy organization (Alberta SCS 2010b). By 2013, a number of resources and information on FMS were available on PDD’s website, and each regional board had implemented various initiatives to improve family capacity in providing self-managed supports (Alberta SCS 2012b). Although some family advocacy groups have expressed concerns that the funding process for FMS is bureaucratic and onerous (Alberta Disabilities Forum 2012), the option gives families the flexibility and control they desire. It is also more cost-effective from government’s perspective since it is cheaper than funding agencies, and a significant portion of administrative costs are borne by the families. Families who administrator their own funds are responsible for the following unpaid duties: planning supports; recruiting, hiring, and training staff; following the employment code; monitoring services; administering payroll; maintaining financial records and submitting invoices to PDD; and keeping all business records (Alberta Human Services 2012b). FMS meets neoliberal goals to increase family control and reduce public spending. Despite the costs, a significant minority of families have accepted this option. As of July 2013 (latest breakdown available), of the 9,957 individuals receiving PDD services, 1,104 (11%) were using FMS either exclusively or in combination with agency-

253 contracted supports.209 To have flexibility and control, many families have become willing partners in the neoliberal agenda to increase their personal responsibility. The next example describes government’s efforts to increase individual capacity and responsibility through its Employment First Strategy (EFS). Unlike FMS which was embraced by many families, EFS was initially met with significant resistance.

8.3 Responsible Individuals: Employment First Strategy In the 2013/14 budget, the Redford government announced a drastic funding cut in PDD’s community access supports, from $94 million to $55 million (Alberta Finance 2013:127). The ministry’s technical briefing on the budget stated that the community access program was to be “rebranded to an Employment First approach” (Alberta Human Service 2013j:Slides 32, 33). The name of the strategy strongly resembled the Stelmach government’s Housing First initiative to end homelessness in the province (Alberta Secretariat for Action on Homelessness 2008). The plan of the Employment First Strategy (EFS) was to reduce the proportion of PDD clients using community access from 55% in 2012/13 to 20% in 2015/16, while increasing the proportion of PDD clients employed from 30% to 60% (Alberta Human Services 2013i).210 Self-advocates, families and service providers reacted with an uproar (CBC News 2013; Komarnicki 2013), protesting that the plan’s targets were arbitrary and unrealistic, given that many individuals with developmental disabilities are unable to participate in the workforce due to the nature and severity of their disabilities, and that many who are able to work are unlikely to find stable, supportive work environments responsive to their diverse and often complex needs. They also thought that the policy severely narrowed the broad definition and scope of community inclusion by equating it to paid participation in the labour force, and that it did not address systemic barriers (Interviews 2013). Here is how one service provider expressed his frustration:

209 Source: “PDD by the Numbers.” http://humanservices.alberta.ca/disability-services/pdd-by- numbers.html. Accessed January 27, 2016. 210 I do not know where the 30% figure noted in the cited slide came from; at the time of writing, the PDD’s website stated that 18% of PDD clients were employed in some fashion (http://humanservices. alberta.ca/ disability-services/pdd-guide.html#Employment_supports. Accessed November 2, 2015).

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We sit down monthly with our PDD contract managers and service coordinators, and we’ve had numerous conversations with them about, “Okay, here’s this guy. He has 20 diagnostic labels. He can’t be alone. Where do you think we’re going to get him a job?” And oh yeah, it’s not only a job. It’s independent employment. That was one of the core pieces of the contract. You had to sign it. You could not change it. Independent employment. What kind of independent employment do they expect for a person who can’t even be let out in the community without two people with him all the time? And you just have to kick back, at the individual level, and as an organization, saying, “We might be able to find a couple of people jobs, but most of the people we are working with, it would be a danger to them and to the community for them to be independently employed. Wake up!” (P2211, personal interview) The EFS originated as part of the many activities undertaken by the Redford government to align policy initiatives with the broad goals and outcomes articulated in the new Social Policy Framework released in February 2013 (Alberta 2013b). Ann Nicol, CEO of ACDS, described the results-based budgeting process211 during which some of the discussions around employment targets arose; she also provided her perspective on how, in the discussion, the broad definition and scope of community inclusion was severely narrowed by equating it to paid participation in the labour force: It’s fascinating looking at the rationalization of tying community inclusion to the new Social Policy Framework. The government set up challenge panels consisting of private people, citizens, to challenge bureaucrats on their budget plan. The people on the panel for PDD are business people, but they all seem to have some personal connections with disabilities. PDD is one of the first to test this model, by presenting them with, “Here is our business plan, our choices and outcomes, these are the dollars we are putting in the budget line.” . . . They’ve developed outcomes for disability services out of the Social Policy Framework, and this committee was supposed to challenge the budget line items for each of these outcomes. So, for example, an outcome for PDD has historically been community participation. That’s something we measure as a quality of life indicator. The challenge panel asked about employment: How many people with developmental disabilities are employed, getting paycheques, without support staff. And PDD didn’t have a lot of data. “Well, we want to set targets for you because the Social Policy Framework says that Albertans are participating in society and are self-sufficient. So, what’s the target for PDD’s employment? And, you should only pay agencies for achieving employment.”

211 The results-based budgeting process was introduced by the Redford government; it requires building budgets based on defined and measurable outcomes.

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But, because of the questions, and the interest in employment stats, it was interesting watching senior PDD people interpreting that as, “Oh we’ve got to set the targets at like ‘80% without support staff.’ We don’t want employment like shredding paper with a support staff.” So, they translated those questions and that discussion into something that is more like policy. I sat there watching this unfold, and asked some questions. I said, “So, employment would be a measurement and an outcome of community participation. But would not also another measurement be volunteerism, recreation, and other measures of participation?” The response was, “No. Employment. We’ve got to set the bar high.” And then [name of a service provider] said, “What about the life cycle of individuals with disabilities? It might be different than for other populations. They may not be able to sustain full employment until age 65.” “No,” they said, “We have to set the bar high.” (Nicol, personal interview) Nicol’s description speaks to what is, arguably, policy-making on the fly. The initial target announced in the EFS appears to have originated in the challenge “to set the bar high,” though it was reduced from the 80% reported in the above quote to 60% in the draft document. It was still a misstep by the government, seemingly developed as a kneejerk reaction to the challenge posed in the results-based budgeting process, and set in isolation from and without careful consideration of the many dimensions that constitute the lives, personal goals, and aspirations of people with developmental disabilities. In response to the protest rallies in spring 2013 and subsequent pressure from the Wildrose and the NDP (CBC News 2013; Komarnicki 2013), the ministry extended contract timelines to enable service providers to develop transition plans. The ministry also invited feedback from the field to craft the (eventual) Alberta Employment First Strategy (Alberta Human Services 2013g). Following the consultations, the 60% target was eventually removed by the Prentice government (Alberta Human Services 2015b; Alberta Human Services n.d.) before the PCs lost the election to the NDP in May 2015. Although the PCs’ budget did not change in 2013/14, it appears that the advocacy and political activism somewhat softened what could have been a harsh blow to the many individuals for whom employment was neither a feasible nor desired option. In early 2016, the target in the official EFS document was expressed as “More people with disabilities are employed” (Alberta Human Services, n.d.:15, emphasis added). The PDD website stated that while $54 million remained in place for community access supports, PDD would “work with service providers to shift their programs to an

256 employment focus to meet the needs of people being served in the region.”212 It also stated that “[a]bout 60% of PDD-funded individuals have been assessed as having low needs. That means most of these people are probably employable to a certain degree.” As well, the EFS document listed a number of initiatives to assist individuals to enter and remain in the workforce, assist employers to hire individuals with disabilities, and address systemic barrier (Alberta Human Services, n.d.). In its revised form, the strategy was more palatable to families and self-advocates since it recognised both the need to include activities to address structural barriers to participation, and the fact that employment is not a viable goal for many individuals with developmental disabilities. It was still too early at the time of data collection in 2013 to examine how the case study organizations had responded to this new development. It appears that their reactions were consistent with their organizational identities and cultures, however, there are insufficient data to make any certain claims, only superficial observations. Options does not provide employment services, so it is not directly affected. However, since it provides community access services, it stands to potentially lose some funding if clients get diverted to employment. The data did not provide any evidence that the organization was doing anything to address this. As one respondent said: That [employment supports] is not our expertise. And we’re okay with that. I think they should go to organizations that are really good at that sort of thing. (OP04, personal interview) SCOPE, not surprisingly given its activist stance, was challenging the government to think about structural and systemic changes: Our first question to this whole employment first thing was: What’re you going to do about employers’ attitudes? What’re you going to do about misconceptions about people with disabilities in society? (S01, personal interview) Vecova, meanwhile, appeared to be gearing up to position itself as a leading provider of employment supports, as suggested by one of their senior executives: The focus right now is very much on social enterprises, and the Employment First initiative. (V02, personal interview)

212 “Quick Guide to PDD.” http://humanservices.alberta.ca/disability-services/pdd-guide.html. Accessed February 28 2016. At the time the website was accessed, it indicated that it had been last modified on September 29, 2015. Since this was before the budget tabled by the NDP in October 2015, it is not clear whether this amount is still valid. The ministry’s budget for 2016/17 did not provide a breakdown.

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Analytically, the process through which EFS evolved shows the experimental, trial-by-error approach that seems to characterise the unfolding of neoliberal reforms. Its early formulation, as part of the initiatives linked with the Social Policy Framework and with the measurable targets needed by the results-based budgeting process, was a hastily constructed plan: it met the needs of the budgeting process, but without due consideration of its impact on people’s lives or questions of social justice. The protests from the developmental disability community spurred the necessary correction to this initial misstep, eventually resulting in a more considered and reasoned formulation following consultations with the community. As Clarke (2008) proposes, the social policy field is “a disorderly one, characterised by contradictions, antagonisms, and contested political projects.” Innovative strategies to intervene in such fields to direct them in particular ways may result in failures, needing ongoing political activities and practices to “resolve, reconcile, contain, or displace contradictions and antagonisms” (p. 144). One such contradiction arises in the tension between neoliberalism’s policy aim to reduce the size of welfare state (Steger and Roy 2010:14) and its conceptualization of the “ideal citizen [as] one who acts responsibly, is strong-willed, and acknowledges that he or she plays the essential role in solving his or her own problems” (Mik-Meyer and Villadsen 2013:4). In other words, individuals in neoliberal regimes are expected to become independent, but with fewer supports from government to do so. A service provider expressed it succinctly: You say they’re citizens. You want them to be citizens, but you don’t provide the services to allow them to be that. (P2211, personal interview) The following perspective from one service provider, while it refers to EFS and the tightening of PDD eligibility in 2009, could almost have been describing the approach by the Klein government to reduce welfare caseloads (see Chapter Five, Section 5.1): What has become really fascinating for me is how people are being pulled out of disability services, told they don’t have a disability and told to go out and get a job. . . Eligibility levels change and people no longer can qualify for supports. . . . People really don’t know what to do. They’ve been on benefits and supports all their lives and now they’re being told you don’t need any of this, go get a job. (P1C14, personal interview) The analysis is not meant to imply that the Redford government was operating using the same logic that Klein government used to reduce welfare caseloads, but rather,

258 to suggest that neoliberalism’s internal tensions may mean that extra and ongoing work is needed to manage the “new contradictions, antagonisms, and dysfunctions” that arise when innovative strategies are attempted (Clarke 2008:144). One of the challenges that arose from the early formulation of EFS, which one could say was based on the “logic of individual limitations” (i.e., that funding more supports to individuals would enable them to overcome their personal challenges to becoming employed), was that it ignored, or at least obscured, the structural barriers that create dependency in marginalised populations. One service provider used the term “lack of philosophy” to refer to the lack of a coherent approach which takes into account broader issues of social barriers and social justice, and why they think this results in a trial-and-error response: They won’t have broader conversations that have to do with citizenship and what is fair and equitable to this particular marginalised community. That won’t happen with an individual outcome model, ever, because no one will connect the dots. . . . The lack of philosophy then opens up these crazy notions of, we’ll just jump on this, and oh yeah, we need people in the labour market, so yeah Employment First. But not thinking out how this fits into a bigger structural solution, which is, “Where are we going?” And yes, employment might be one of those things that people want. People are already working on employment, and people have some really great ideas on employment. It’s not just going to change overnight because we’ve latched on to a new idea or new term called Employment First. It’s hard work to begin to change how employers accept employees. There are these really famous studies in Britain around employment: The only times in the history of the disability community when they’ve been equally employed in the twentieth century was twice: World War One and World War Two—where you added whatever labour you could add because it was a concerted effort towards the war. Other than that, there has never been equal employment for people with disabilities. (P2211, personal interview) Pinto (2010), who reports on Portugal’s disability policy reforms, argues that by focusing on creating active and enterprising individuals, neoliberalism obscures the systemic barriers that shape the lives of people with disabilities and intensifies patterns of discrimination and inequality. Programs aimed at improving individual employability are chosen over initiatives that fight structural barriers and work to achieve full citizenship for all people with disabilities regardless of their status in the labour market. … Such a perspective creates a contradiction in that it presumes that the disadvantages associated with disability can in most cases be overcome, if only the individual with impairments tries “hard enough.” Absent from this view is a consideration

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of the varying kinds and degrees of needs of the disabled population, or the acknowledgment that oppressive and restrictive environments, including those generated through law and policy, are contributing to their ongoing marginalization. (Pinto 2010:121-122; emphasis in original) It appears that the activism by advocacy groups and service providers in the field have succeeded in preventing EFS from going down the dangerous road of further marginalizing adults with developmental disabilities. The initiatives identified in the EFS document and those subsequently being implemented appear to demonstrate a genuine effort to engage in a collaborative and systemic effort to address structural barriers. The initiative now rests in the hands of the new NDP government; it remains to be seen if they take a more social justice-focused approach to foster inclusion.

8.4 Concluding Remarks Moving control from the public to the private realm achieves ideological as well as economic goals of neoliberal regimes, which strive to reduce public spending and to create strong, free-willed citizens who take responsibility for their own welfare. A cursory examination of the change in the language of the formal statements of ministries or programs responsible for services for adults with developmental disabilities from 1972 to the mid-2010s provided a general insight into government’s increasing expectation of family and individual responsibility. Following this, two focused examples were provided: (i) to enhance family control and responsibility over managing funds, and (ii) to increase the workforce participation of adults with developmental disabilities. The analysis showed the role of creative entrepreneurs experimenting within the bounds of the existing institutional context to craft new policy solutions, how such experimentation sometimes results in failures in part due to neoliberalism’s internal tensions and contradictions, and how ongoing political work is required to correct these missteps. If this chapter was the story of neoliberal attempts to increase citizen control, the next chapter is that of how organizational and individual behaviour are controlled through technomanagerial tools and processes.

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CHAPTER NINE: TECHNOMANAGERIALISM AND SCRUTINY

I remember a cartoon where a person comes and says to the King, “Sire, the peasants have no food. They are revolting!” And the King says, “Double the guard on the pantry!” I think that is, in many respects, the way in which the government reacted when faced with the increasing demands for services for people with intellectual disabilities: creating more and more regulation, and more overseers. (P2120, personal interview)

This is the last in the series of four chapters examining the manifestations of neoliberal reforms in the field of services for adults with developmental disabilities. The chapter critiques the technomanagerial tools and processes which increase government’s scrutiny and control over service providers. Arising from the need for indirect governance when mandated public services are privatised, the use of these approaches exemplifies another one of neoliberalism’s many paradoxes: the goal for a decreased role of the state juxtaposed with increased intrusion into the realm of private organizations. Neoliberalism’s new public management (NPM) mode of governance uncritically borrows values and techniques, which include technomanagerial tools and processes, from the business world. NPM assumes that quantitative targets, measurable outcomes, and market-oriented behavior increase the efficiency and effectiveness of public programs (Osborne and Gaebler 1992), and that they can be readily and appropriately applied to public-funded services (Steger and Roy 2010:12-13). This chapter describes the rise of mechanisms of increased scrutiny in services for adults with developmental disabilities, and shows that these approaches increased the administrative burdens on publicly-funded service providers, shifted costs to them from the public purse, and severely curtailed their flexibility, capacity or impulse for innovation. As evidenced in broader studies of the nonprofit sector, “in so doing, they may be undermining the ability of organizations to do what they do best” (Hall et al. 2005:26). The chapter argues that, contrary to stated goals, these approaches do not improve organizational or program efficiency, and given the constraints they pose, are unlikely to improve the lives of clients. They are, thus, exposed as rationalized myths (Meyer and Rowan [1977] 1991). This research shows that although organizations adopt them because their contractual relationship with government requires them to do so, many organizations

261 exhibit resistance. Their resistance can be traced to fundamental differences in values underpinning government’s fiscally-focused idea of accountability versus service providers’ focus on social values. As institutional theory predicts, organizations manage this conflict by exhibiting ceremonial conformity to institutional demands, decoupling the actual work of service delivery from formal technomanagerial tools and processes. The analysis also shows how the new practices rearranged the loci and circuits of power in the field in multiple and contradictory ways, shifting power from service providers to government and also to individuals and families. I argue that the systemic power embedded in standardised tools and processes controls the work and discretionary capacity of frontline staff and also reduces the power of clients and families. Paradoxically, the imposition of these practices on already over-burdened mid-managers may have unintentionally shifted power from mid-managers back to frontline workers. Finally, the chapter briefly examines if Options, the for-profit service provider included in this study, experienced these technomanagerial trends differently than its nonprofit peers. Even though I had discovered that profit-making is not Options’ goal, I felt that perhaps the organization would express less resistance to adopting these new impositions since they may resemble performance assessment techniques that might exist in a business organization. I also wanted to assess if Options was treated by the funder differently than its nonprofit peers because of its for-profit auspice. The evidence, however, was inconclusive. Overall, this chapter as a whole has broad implications for publicly-funded nonprofit human service organizations because NPM governance approaches are widely applied in neoliberal regimes.

9.1 The Rise of Technomanagerialism Neoliberalism’s NPM mode of governance includes techniques and strategies such as setting clear missions, developing quantitative targets, articulating clearly-defined measures of performance and quality, and closely monitoring outcomes through elaborate systems of accountability (Osborne and Gaebler 1992 [see also Chapter Five, Box 5.1]; Steger and Roy 2010:12). Following these prescriptions, SPD and its successor PDD undertook a series of initiatives in the second half of the 1990s to implement or improve accountability. These included: consulting community stakeholders to define program

262 outcome measures; partnering with AARC to implement evaluation standards for community-based agencies; developing performance measures to assess the quality of life of Michener Centre residents; and starting a biennial satisfaction survey of all clients, families and guardians (Alberta FSS 1995, 1997, 1998, 1999). One of the complicating factors with the PDD program in the late 1990s was that it consisted of three concurrent funding models (Zwozdesky 2000:App.4): (i) contract funding: advance quarterly payment to agencies for services to a group of clients; (ii) individualised funding: monthly payment to clients or families for services purchased; and (iii) clustered contracts: advance quarterly payment to agencies for a mixed group of clients funded by models (i) or (ii). In the early 2000s, the Auditor General expressed repeated concerns at the lack of robust mechanisms tying the funding to actual services delivered. This resulted in a series of audits of about 25% of PDD-funded agencies across the province, culminating in three organizations being accused of fraudulent activities and having their funding revoked (P1C12, personal interview).213 Subsequently, the contracting format changed and reporting requirements became increasingly onerous. By 2008, all contracts were individualized; a mechanism to track and report standardised units (hours) of service was developed; agencies had to submit monthly reports of services utilized, account for under- or over-utilization; reconcile accounts quarterly and annually; and payments were based on detailed invoicing of actual units of service provided as opposed to predictable amount of contract funding paid in advance each year (Alberta SCS 2009b). Accountability and technomanagerial approaches increased considerably following the What We Heard review (Alberta PDD Program 2009) and the KPMG review (KPMG 2010). They included the implementation of: a series of standardized tools and processes for assessing eligibility, service needs, and client outcomes; a strategic service procurement framework; a performance management system for assessing service provider outcomes; and new contracting approaches based on these

213 It is not known whether these agencies were deliberately engaging in fraudulent activities, whether their accounting systems were simply sloppy and fraught with errors, or whether contract stipulations were unclear or ambiguous. A number of service providers interviewed stated that there were a number of areas in which the rules of what the funding could or could not be used for were quite unclear.

263 rationalised processes and tools (Alberta SCS 2010b, 2011b; Alberta Human Services 2013c, 2013d, 2013e, 2015b; see also Chapter Seven, Section 7.2.4).

9.1.1 Accountability tools and processes as rational myths The government’s stated goals for greater accountability and technomanagerial approaches were: (i) increased PDD program efficiency and sustainability “to help individuals be fully included in community life and be as independent as possible” (Alberta Human Services 2014:13), and (ii) support for the sector “to deliver new and innovative options” (Alberta Human Services 2015a:11). Although there is undoubtedly a need for mechanisms to ensure checks and balances in any publicly-funded program, the literature overwhelmingly suggests that increased reporting requirements result in high administrative burdens and diversion of material and human resource capacity at the expense of quantity or quality of frontline service delivery (Dart and Zimmerman 2000; Tindale and MacLachlan 2001; Brown and Troutt 2003; Statistics Canada 2005:48). Standardised reporting requirements, tools and practices may hinder frontline workers from using creative, client-centred practices while promoting them to do activities that will be monitored and counted (Smith 2010:258). It may also limit, rather than increase, client or family participation in the formation of goals and service plans (p. 261). As well, frontline workers are less likely to attempt new service models or best practices that do not originate from the mandated tools and technomanagerial processes if they fear that they will be held responsible for potential mistakes of poor outcomes (p. 262). The evidence from the current research concurs with the findings reported in the literature. At the most basic level, service providers expressed little confidence that the needs assessment or outcome measurement tools were sensitive to or meaningfully captured the complexities of the needs and daily lives of clients (Interviews 2013). We have individuals with really complex needs. You can’t have the same outcomes for that individual as you can with someone who’s employable. There has to be different sets of measures and standards. So, how do you measure the outcomes for someone who is extremely complex, has multiple mental health breakdowns, who’s in an extremely restrictive environment because of suicide ideation or self-harm or violence toward staff? What types of outcomes do you have for that type of person? It’s completely different than for someone who works full time and can sustain a job. (P1CG11, personal interview)

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In addition, they felt that the unit of service model shifted service provision from a client-centred focus to one driven by the funding model. As one respondent explained: Funding based on units is like funding based on widgets; it’s how many hours of service is delivered and there can only be 24 hours in a day. But there are overlaps and you can’t ask for additional dollars for that. That’s really limited us. The client’s needs have to fit into the contracted units of service. If the client is funded for 30 hours per week of employment, that’s what the client has to fit into; they can’t do 35 hours of employment; if they do less, they [can’t use the funding] for any other types of support they need. (P1C12, personal interview) Norman McLeod echoed these sentiments. He also expressed concerns that minute reporting requirements resulted in loss of overall vision for the program. In my experience in the last few years in the community sector, working with the Canadian Association for Community Living, there is such emphasis on what it is that you’re going to do that it takes away from the spontaneity of learning in the moment, and of being abreast of best practice and changing it as you go. It seems like you’re confined to your current knowledge in the delivery of services for whatever the term of your contract is. I think that is quite disconcerting. It takes a huge amount of time for the staff to keep track of all the documentation that’s required just to measure the outputs. We get caught up in that to such an extent that it’s not about what’s our vision for where we want to go—which is what I think we should be measuring—and whether we’re getting there. But it gets down to this little individual client-by-client basis that it’s impossible to keep track of all that. We’re in danger of losing our vision of why we provide supports in the first place. You have to be accountable for how you spend your money, but that’s not the reason why we exist. And it’s all with the best of intentions. It’s not like people are doing it because they have some ulterior motives, but it really is for the best of intentions and they really do believe that it will enhance service delivery, but I don’t think it’s actually working. It’s not a level playing field. Government has so much power. (McLeod, personal interview) As suggested by McLeod, extensive reporting requirements created a huge administrative burden, took time and effort away from the work of frontline service delivery, and caused burnout especially in frontline staff and mid-managers responsible for program delivery. This is how one community-based mid-manager expressed how her work had changed due to these requirements: Right now it seems like people are running a 150 miles an hour on a tread mill. There’s so much work, definitely at team leader and coordinator levels, and probably at the senior management level too. There’s so much to do, you can’t

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sometimes even do the important things. It’s been like that for a long, long time now, but it’s getting more so. There’s a lot of stuff. If you took the clients away—if we didn’t even have a single client—it would take a long time to impact my work. There’s so much paperwork to catch up on. Even if there wasn't a single client in service, it would probably take me more than a month. And that goes for anyone in an administrative position, I think. I remember saying that even some time ago. And a lot of people took offense to that. There’s always been a lot of paperwork and administrative kind of stuff. It’s just a whole lot more now. (P2118, personal interview) Another manager described how the new requirements gave organizations little flexibility to manoeuvre funds across service areas, forcing them to bear the additional financial costs and creatively address service delivery consequences. What used to happen is that if you got a million dollars and your staffing cost was a million dollars and you delivered according to your capacity, you got funded. Now, if your costs are a million dollars, but you have not delivered a 100% of your units [of service] because clients leave, change service, go on vacation, whatever, you lose the money tied to the under-utilization, even though you still have all your staff costs. The government saves that money. And there’s no such thing as being able to bill for over-utilization. If a client is only funded for 30 hours a week of employment service, and the support worker is hired for 37.5 hours a week, we have to top up these costs. It is a real challenge for us. We can’t hire people at 30 hours a week because they wouldn’t get full-time employee benefits, so it’s hard to find workers willing to do that. We are in a catch 22. We are restricted to finding employees who’d be willing to take on the work at less than full-time, or we have to find a way to fund the extra hours ourselves somehow. Long-term employees who’ve been hired on a full-time basis are now costing us a lot of money. The only way to sustain that is to lower something at the other end, which is, hiring new people at less hours or less salary. And that’s not the way to go to have skilled people. If a client goes into some sort of crisis and needs more services, we have to get approval to increase their units, and that creates a gap, because we bear the cost of the extra support until it’s approved and paid for. The problem is the gap. And the government makes money because of this. We’re not the only agency facing this problem, so, the government must be making money on every contract. (P1C12, personal interview) Service providers expressed frustration with the frequency with which the requirements kept changing, and how these resulted in a sense of unpredictability and unreasonably high demands on administrators. We’ve certainly had to jump through more hoops than we ever had to before to get funding. By hoops, I mean more involvement by government in all of the processes to get our funding. And some of the hoops were not bad things. We

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developed the accreditation and CET certification processes during those times, and we needed those things. That was good. But there seems to always be changes coming down the pipe; the way that we contract is very different than we used to. That whole contracting process changed three or four years ago, and now this year there’s going to be another change on April 1. It is a huge administrative burden. It takes one person to do just all of that. It takes a lot of time away from doing frontline work. (P1C15, personal interview) Service providers felt that the government did not trust them and exercised unreasonable intrusion into their activities. This is how McLeod described what has been termed in the literature as the shift from the “logic of confidence and good faith” that organizations deliver the services they are paid for (Meyer and Rowan [1977]1991:58), to a logic of doubt and distrust: When I first started working in the community in social services, back in the 80s, our contracts with community agencies were very broad: You will serve X number of people, you will provide audited financial statements at the end of the year, and you will comply with a set of standards that government had at that time. It was very open-ended. We also used to give a fair number of grants, just unconditional grants, to organizations, with the expectation that they would do what they felt was best in providing supports to people with disabilities. That level of trust has disappeared. And I think that’s problematic, that people have to prove versus being trusted that they will do the right thing. I think that we need to be a lot more trusting until we are proven wrong. And I know what some will say, “trust but verify,” and that’s true, but I think that we hold the agencies to such accountability that it’s like they’re part of government operations. We used to be very careful about how our contracts were worded because we didn’t want community agencies to be considered to be government employees. It was very much more arm’s length. I don’t know how they’re getting away with all these demands now. (McLeod, personal interview) Service providers also felt they were subjected to significantly greater intrusion into their operations than other market-based vendors and suppliers to government. From an agency’s perspective, what’s frustrating is that there are multi-million dollar businesses and they’re treated differently from other vendors. The thing that’s very odd is, if I’m procuring for towel supplies at hospitals, I would expect you’re going to deliver X towels for X dollars, and to a certain degree of standards of cleanliness; if you do that, we give you the money and off you go. What is really odd in our sector is the level of detail that our audits require, and the lack of flexibility agencies are given to conduct their day to day business. I think the Auditor General reviews the processes that are in place. If there’s an audit model that dictates you’re looking at these different facets, that’s what they’re going to audit on, what currently exists as the process. The changes that

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community wants is to be more flexible, not to have to ask every time you need to shift money. Let us conduct our business, allow us to say, “We don’t need the money here, we need it here,” and allow us to make those decisions on our own. Quite frankly, to a degree, government breaks its own rules. There’s a statement in the contract that this is not an employer-employee relationship. I think government frequently crosses that line in terms of dictating what are almost employment terms, stating that you cannot spend money here on this employee or that employee. There are frequent times where I believe that that line was crossed. That is the level of frustration. I don’t think that the shifts to a procurement model are going to make things more flexible. There’s no political onus or advantage to do so at this point. (P1CG11, personal interview) The perception of a double standard expressed by the above respondent is echoed in the literature by Armstrong (2010), who observes: “private nonprofit sectors within the formal economy are increasingly being monitored and held accountable to rigid bureaucratic rules of the very sort that neoliberals so vehemently attack when they impinge on the for-profit sector” (p. 198)” When organizations are unable to focus on delivering or improving services because their efforts are inordinately diverted to tracking and reporting on existing funding or searching for new revenue sources, it is difficult to believe that greater scrutiny results in better life outcomes for client. As Bruce Uditsky stated: The things I care about most are immeasurable. How do you know what’s a real home? How do you measure belonging? What does a good life look like? We run the risk of just trying to measure concrete things, and not figure out the stuff in our lives that we live and experience on a day to day basis that’s really critical. (Uditsky, personal interview) While accountability requirements may make it seem like the government is spending its dollars carefully (as in frugally), some of the real costs that should be borne by the public purse are, in effect, being transferred to the private sphere. Such processes may result in perceptions of short-term savings to program funds, however, their long- term social (and, therefore, public) costs are inevitably much higher. Paradoxically, they may even result in greater costs to the current system, as one respondent observed: A bigger and bigger portion of the budget is going to support their infrastructure to do these assessments. It looked to me that in the budget that was proposed last spring, a whole chunk of it was gone before even a minute of service was delivered. I’m not talking about agency administration. This is before the money even came down to any agencies. More and more government workers are being paid to do nothing that has any direct relationship to services. There’s less and

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less service being delivered, but with more and more accountability. They think they’re providing more accountability. But accountability for what? There’s nothing left. If you squeeze out the actual support, all you’re accountable for is inadequate service. (P2211, personal interview) 214 Both the literature (see Chapter Two, Section 2.1.3) and the present research overwhelmingly suggest that technomanagerial approaches are what organizational institutionalists call rationalised myths (Meyer and Rowan [1977] 1991). Instead of increasing program efficiency and effectiveness, they create additional burdens and stress in human service workers, shift costs from the public to the private realm, divert attention from the work of actual client support, and decrease the potential for creativity and innovation. While they may be well suited for sectors where efficiency is readily measured in financial terms, their applicability to the complex professional practices and outcomes that characterise human services appears doubtful. Standardised technomanagerial approaches and tools, which typically rely on quantitative reporting on a narrow set of measures, obscure the reality of the work of human service organizations. Such work uses judgements and logics that are socially constructed, contextually contingent, and situationally specific. Human service work is also highly indeterminate since a multitude of factors can intervene to make service technology outcomes uncertain and unpredictable (Hasenfeld 2010). These unique and central characteristics of human service work make it unamenable to the rubrics and constraints of standardised instruments and practices. The privatization of managerial practice is based more on faith than evidence. It assumes that for-profit practices deliver what they promise and that the methods that work in the for-profit sector will work as well in public sectors such as health, education, and air travel. In other words, it has been accepted as doctrine that the free operation of the market ensures that all businesses are efficient and effective, and that market principles can be applied with equal success to car making and baby catching. (Armstrong 2010:194)

214 My own analysis of actual expenditures from ministry annual reports suggests that, during the first few years after the PDD program was implemented, program support costs (regional offices and boards) were about 14% of total program costs (1997/98 to 2000/01). By the end of 2009/10, they had risen to 22%, and in 2014/15 were about 20%. Although I do not have further breakdowns to assert if these additional costs arose from the administrative costs associated with processes of greater scrutiny, it is reasonable to expect that the latter were responsible for at least a part of the additional costs.

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None of the service providers I interviewed had any reservations about being accountable for public funding. On the contrary, they were keen to collaborate with PDD to develop effective and sustainable accountability practices. However, as the above evidence shows, they did not share government’s belief that the technomanagerial tools and processes measured what they felt was important, that is, service quality. The next section describes how they dealt with these cognitive and normative conflicts.

9.1.2 Ceremonial conformity and decoupling Government funding provides service provider organizations with the economic (financial) resources and political resources (legitimacy) necessary for organizational survival. Resource dependence theory suggests that the more an organization depends on government funding for these resources, the more power it will perceive the government to have on its internal structures, practices and activities (Pfeffer and Salancik 1978). As expected, PDD-funded service providers had little choice but to adopt the practices required by their funder. However, a number of service providers suggested that they responded to the technomanagerialism in the field through what institutionalists call ceremonial conformity (Meyer and Rowan [1977] 1991): although they implemented the required tools and processes, these did not necessarily align with the actual behaviours that constituted daily front line work. Here is how one service provider described it: I listen to the rules and I apply them when I think they are important, otherwise we just do what we think we need to do. … As you get older, you know that nothing will stay the same, it will change. It will be whatever it is. But people’s lives don’t fluctuate and change to that extent, you know. So, I think part of our job is to shield people to some extent from that. (P1C16, personal interview) Two service providers from another agency provided another example of how the organization continued to use their own tools and processes to guide their frontline work in addition to those required by the government: R1: We do PATHS [a service planning process] with clients, and we ask them, “What’s your dream? What’s your wildest dream?” We write it all down, and then we ask, “Okay, what’re the ones you want to work on?” And we work on these with them. We do all of them. But that is of no interest to the government, because even though it’s individual outcomes, the reporting is done at an organizational level. And government’s outcomes are not big outcomes. It’s not like, “I have a good life.” They’re more like, “I went to the doctor.”

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We have an absolute commitment to making sure our clients have good health care. We will continue to do that, and to track that. But we will have some silly little outcome measure that will be: “Asked him if he wanted to go and have an annual physical.” Yup. Done. But now we have to track that silly outcome, and make sure we’ve built a system to track that that sort of information is getting in there. It’s completely irrelevant to his life. We already have a whole planning system to make sure he has great health care. It’s not the outcomes like the United Way kind of outcomes, in terms of “How do you fit into this big plan? How’re you making a real difference in people’s lives?” It’s the absolute opposite. It’s just about what is it that you can count. R2: What’s also fascinating is that, in doing the planning with people, we’ve appreciated the amount of support the person actually needs. But that work is not attached to the contract. It’s all based on what they have figured out from SIS. So if you have a new person coming into the system, they’ve no idea how many hours is needed. And if the outcome is that he has good health care, and it’s measured in terms of “Did he go to a doctor’s appointment,” there’s a huge potential for dishonesty. The outcome is not connected to the level of service that we’ve all worked so hard to make sure people are understood to have. Again, that’s just one small part of the person’s life. There are a million things that are a person’s life. Are they eating well? Are they in recreation activities? Do they have connections to family or spiritual life? We see ourselves as part of making sure that the individual has—as part of his general citizenship—what the rest of Albertans expect as part of their life. (P2211, personal interview) Some people used the terms “schizophrenic” and “fractured” to describe how they felt when faced with these conflicting demands. One service provider, to justify their inconsistent application of tools and processes, explained that the government itself was not sure how each of the various tools and processes connected with each other: Government often doesn’t know what they’re supposed to be doing either! They have no idea – they reel, they spin. It’s outcome measures, it’s quality of life, it’s the four pillars. Who knows?? Like SIS. Once you have your SIS, you’re supposed to fit into a funding band, and the accountability is based on how you meet the outcomes in the ISP [individual service plan]. But I don’t know how that blends with personal outcome measures, and the organizational outcome measures. They don’t even know. The client service coordinators themselves are really just going day-to-day, trying to provide enough funding for service providers to do the work they need to do. It’s not consistent, it’s not fair, it’s not across the board. It’s still as messy as it ever was. (P2111, personal interview) Repeatedly, service providers talked about what they perceived to be a misalignment between government’s financially-driven agenda and their own client- focused goals. They were acutely aware of the clash between two very different logics:

271 the logic of economic efficiency, which led to standardized and rationalized approaches, and the logic of human uniqueness, which required that people with disabilities be seen as unique individuals with particular needs, desires and life goals. Their awareness of this tension enabled then to analyse the technomanagerial demands, be critical of them, and enact ceremonial responses to fulfil supposedly objective accountability requirements, while in their daily work, they continued with activities that meshed with their own values and beliefs of what good quality service should entail. In the next section, I re-invoke the concept of decoupling to analyse some of the ways in which technomanagerialism has reshaped the loci and circuits of power in the field of services for adults with developmental disabilities. I also discuss how technomanagerial tools and processes themselves have power embedded in them.

9.1.3 Shifts in loci and circuits of power The above research showed that accountability and reporting requirements were perceived to have increased, rather than decreased, inefficiency and long-term negative outcomes. The evidence also suggests that these requirements and their associated activities have shifted power and control in the field in multiple, and sometimes contradictory, ways. Initially, as government moved service provision to individuals with developmental disabilities from institutional settings to community settings, it shifted power from bureaucrats and frontline public workers to community-based service providers. These community-based service providers—medical professionals and diagnosticians, social workers, rehabilitation professionals and aides, or their equivalents—had the discretion to determine the nature, frequency and intensity of interventions or supports needed by individuals. The resulting service plans were based on the institutional logics inherent in the assessor’s professional training and judgement, often developed in consultation with other professionals, and guided by the normative values and desires of families or guardians and, in more recent years, of clients themselves. In collaboration with government funders, funding amounts were then negotiated, and formal contracts developed (Interviews 2013).

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Technomanagerial tools and processes, developed largely in response to the Auditor General’s financially-focused concerns, shifted some of this control from service professionals back to government bureaucrats, while leaving the responsibility for achieving program outcomes in the hands of community-based organizations. The shift in control away from service providers was already underway before the developments spurred by the Auditor General’s concerns were implemented in the 2000s. Using the standards evaluation process as an example, Murphy-Black shared her perspective on how the intent was to shift control from service providers to families and individuals: If we look at the history, most services in Alberta were started by families. By the 1990s, though, the power was largely held by government and service providers. The role of families and individuals had been minimized. There were a couple of key things in the 90s that started to reshape the control and power, 215 taking it away from services and bringing it back to families and individuals. Let me talk about standards first. ACDS had some standards, and government had also written some core standards. So, there was a point where you had to ask: why have two bodies creating two different sets of standards, and is there a way how we can do this together? When the quality of life indicators got put into standards, the plan from the very beginning was that the only people who’d get to define what QOL was and what the indicators were for people with developmental disabilities, were to be individuals and families. So, we did all these focus groups throughout the province only with individuals and families on what was a good life, what would that look like for you. This was done in partnership between ACDS and SPD. I personally did about 40 focus groups. Service providers were not happy with that approach, because the standards were for service providers, and at that point in our history, it did not make sense why you’d use individuals and families to create those definitions. In fact, we used to have to ask people to leave the room if they were staff. We got huge push-back because of that. Then there was the whole process of designing how the data was going to be collected. The fact that the survey would be based on randomly selected individuals representative of the population, and that you’d be talking with their personal networks. So, to me, that was a piece of thinking, an approach, that was pretty progressive. We weren’t alone in what was happening in the environment, but it was a shift in terms of how we’d be measuring systems and putting it in the hands of individuals and families. (Murphy-Black, personal interview)

215 Family consultation and feedback mechanisms (such as their involvement in standards evaluation processes) were one example; the other was the development of individualized funding, which was discussed in Chapter Eight.

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As Chapter Eight illustrated, shifting power from service providers to families and individuals was supported by enhancing the capacity of families and individuals to have greater control over evaluating service provision and managing the procurement of individualised services. However, the use of standardised tools in service planning may serve to decrease client or family control in these important processes (Smith 2010:261). Rather than developing plans based on the client’s needs and desires, technomanagerial systems may influence frontline workers to focus on activities that are monitored and counted (p. 258), or to steer service plans and goals towards those emphasised by the government (e.g., “employment first”). This is how one frontline worker described how the new processes changed the focus of her work: [The supports are] going to be based on SIS scores and what PDD is looking for in terms of outcome measures. We’re not going to be asking clients, “What is it that you want to do?” It’s going to be more about, “Let’s look at your SIS score, and let’s look at what it is that we’ve been told you have to do.” Outcome measures are going to be the new focus. … What’s really sad about the outcomes thing, is that the client doesn’t really have to reach that goal. As long as we show on our outcomes report that we’re doing what we said we’d be doing. I don’t know how PDD determines the goals. It’s all based on the SIS score. It seems like the outcome measures are important, but not the goals. The outcome measures are dictating where we’re going to place that person and how we’re going to move them along in this little flow chart. (P2124, personal interview) The worker is describing a form of power vested in the technomanagerial tools and processes, enacted through (what will become) the routine, ongoing practices of frontline workers like herself: “The outcome measurements are dictating where we’re going to place that person and how we’re going to move them along in this little flow chart.” This power is systemic; it is consistent with institutional views “that actors are subject to forms of power that are disconnected from the interests and actions of specific others (Meyer and Rowan 1977)” (Lawrence 2008:178). It obscures the reality that these tools and processes are social and moral constructions, containing within them a particular dominant view of the identity that an individual is to aspire to, and the appropriate path that support workers can take to help them achieve it. Through these technologies, power is exercised indirectly (i) over individuals receiving services, whose lives “are transformed, not through their own actions, but through their placement in a social order abstracted from their lived experiences [their IQ, their SIS score, etc.]”

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(Lawrence 2008:178); and (ii) over frontline workers, whose activities are controlled by constraining the range of intervention options available to them. Such systemic forms of power require two key elements for success: enclosure and surveillance. Theoretically, they work only on organizations or workers who see themselves as part of the community in which these tools and processes apply, and on organizations or workers who believe that their compliance to these tools and processes is being watched (Lawrence 2008:179). However, since much of the work involved in direct service provision occurs in private, one-on-one settings, organizations and their frontline workers retain considerable discretion (Hasenfeld 2010), and can decouple formal requirements from their everyday professional practices. The present research suggests that they do so not to be secretive or dishonest, but to act in ways that are congruent with their strongly-held beliefs and values about what constitutes “good services” in the best interest of the individuals they support. As one service provider said: We really try to focus on providing what we think is good service, and we try to marry that with whatever the external philosophy is, but external philosophy is not necessarily the driver. … Why would you assume that a government official who has never met a person with a disability knows better than you? That kills me. Why would you let them tell you that they know more than you do? … We end up in a bit of a fractured scenario because we build services from the individual up. “What does Fred need? Fred needs all these kinds of things. Well, let’s figure out how to give those to Fred.” The services for Fred are built that way, and then the organization gets structured around it. But, what’s coming down [from government policies and processes] should fit what Fred needs, but it doesn’t. We end up fractured in that we’re fighting the government and we’re fighting to do what Fred needs. (P2211, personal interview) Decoupling the work that occurs at the frontlines from the work that gets reported in formal tools and processes can be a conscious organizational decision (as evidenced by: “I listen to the rules and I apply them when I think they are important, otherwise we just do what we think need to do” [P1C16, personal interview]), or it can occur accidentally, as the following overworked mid-manager explains: We’re farther and farther away from the clients at a mid-management level. Even when we were busy in the past, there was never a time that I’d cancel a supervision meeting with a team leader. Now, I have to do that. I certainly don’t read the log notes. That’s my link to the client: the team leaders, and the team meetings. And more and more, I have to cancel that. I never missed an ISP [service planning] meeting unless I was on vacation or something. Now, we

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don’t go to ISPs at all. I read and edit and sign the ISP, but the team leaders run the meeting and are accountable for the service. (P2118, personal interview) It appears that technomanagerial tools and processes constrain the activities of frontline professionals, and also impose undue burdens on under-resourced organizations, and may serve to decrease the scrutiny over frontline work. One could argue, thus, that two contradictory shifts in power have come about: at the organizational level, from service providers to government, and at the intra-organizational level, from mid- managers to the frontline. In both instances, the systemic power embedded in these tools and processes and the vested interests that they serve remain obscured. Technomanagerialism is rooted in an ethos borrowed from the business world. As such, it is logical to expect that for-profit service providers may already have tools and processes for accountability and efficiency, or be more amenable to adopting them. The next section discusses if Options’ experience with or perceptions of technomanagerialism differed from that of its nonprofit peers.

9.2 Does For-Profit vs. Nonprofit Status Make a Difference? One of the reasons for including Options in the case study sample was to examine if it experienced different institutional constraints or exhibited different outcomes than nonprofit organizations. Compared to the other two case study sites, Options exhibited a unique organizational culture resembling that of a “nurturing parent;” as well, it lacked the structural aspects associated with registered charitable organizations (e.g., a volunteer board of directors or CRA reporting requirements, etc.). In other ways, however, it exhibited similar formal characteristics to the other two case study organizations. Even though my research has established that Options exists to achieve social goals rather than to make a profit (see below), it made sense to use this opportunity to assess if its experience with technomanagerialism differed from that of its nonprofit peers. I was also curious if Options was treated differently by the funder because of its for-profit status. President and founder Elaine Yost explained that Options’ origin was rooted in the desire to provide a particular vision of service which she felt was not available in the existing array of service providers at the time rather than to run a profitable venture; the availability of individualised funding made that vision possible:

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Options was created in 1986. We were formed from a human rights perspective, based on the belief that individuals must have more control about the things that impact their lives, and that they should be able to pick an organization and form relationships with people that they feel are going to best respond to their needs. In 1985 and ‘86, there was individualized funding [IF] that was available. It all started with applying for funding for my son Michael who was about 20 at the time. We wanted him to have his own home. It wasn’t about placing him in a home, or a home-like environment. We wanted him to have his own home. Part of the reason for creating a for-profit organization is that, at the time, the purchasing power was in the hands of the families through the IF mechanism. We really wanted to sink or swim on the quality of the service that we provided. And just like any business, if you don’t do what your customers are expecting, then you go out of business. I had a tremendous regard for that capacity of families to go where they felt they were going to be best supported, and they could purchase it. (Yost, personal interview) Because the business ethos is not part of the culture of the organization, its reaction to the technomanagerial shift was not different from that of its nonprofit peers: I think when you talk about the business model, the procurement model, all these terms, it doesn’t fit for me, at least in terms of what I think services should look like. When we talk about outcomes, and setting goals, and measuring, the thing that keeps going on in my head, the litmus test for me is, “Is whatever we decide going to make a positive difference in the lives of the people we support?” If it isn’t, then we’re barking up the wrong tree. (Yost, personal interview) Interviews with other members at different levels of the organization also showed they had difficulty accepting the shift to a business logic. As one mid-manager said: Now there’s going to be an outcomes based performance reporting system which creates a whole new different level of risk and liability, whole different level of reporting and responsibility. Starting right at the front lines, they have to report on everything the individual does in order to have an outcome performance measure at the end of every day. We never marked people like that before. We just worked with them. Gave them a meaningful day, gave them a great purposeful life. The focus was entirely different. Now it seems to be business oriented, more analytical, with more accountability. (OP04, personal interview) While the evidence suggests that Options did not perceive the shift to technomanagerialism differently than its nonprofit peers, Yost believes her organization’s for-profit status puts them under greater scrutiny by the funder than if they were a nonprofit. For example, in two consecutive years, Options faced what Yost described as “gruelling forensic audits,” which ultimately did not amount to any finding of financial wrong-doing. Although many organizations, both for-profit and nonprofit, around the

277 same time had been subjected to similar audits (Interviews 2013), one respondent suggested that for-profit organizations might have been targeted: When we had the PDD Provincial Board, there were inklings that there was a preference for nonprofit organizations over for-profit. To me it’s an irrelevant argument because the system is set up in such a way that you all have to play by the same rules. It’s really a moot point whether you’re nonprofit or for-profit within PDD. Now, within IF, that was different, because those funds were not audited per se. There were a few instances where some organizations went by the wayside that were taking in a certain amount of money and paying their staff minimum wage, and pocketing the difference. But that’s not what 99.9% of the agencies are up to. They’re not about exploiting their workers. You’re not going to be in business very long by doing that sort of thing. I can go on any website and see what other agencies are paying their workers, and if they’re not in the ballpark, they’re not going to get the workers. (P1CG11, personal interview) This person suggested that, because contracts do not allow organizations to retain unused funds, organizations motivated by profit have little incentive to enter the field. What is your incentive to come into PDD to engage in a contract where every single thing is audited? Certainly for a for-profit business, it doesn’t make sense, and even for a small nonprofit it makes no sense because it is simply money in and money out. You can’t get to the next step. There is virtually no opportunity to have any type of profit for the sake of profit. You cannot retain any funding. It is truly money in and money out. (P1CG11, personal interview) Regardless, another respondent estimated that about half the service provider organizations in Calgary are for-profit entities.216 Most of them, like Options, were created by families to provide services to the founders’ own family member and a small group of clients with similar needs during the height of deinstitutionalization and privatization in the late 1970s and in the 1980s (see Chapter Four). The government was not concerned whether these services were provided by for-profit or nonprofit entities; the rules and expectations for both types of organizations were the same. Unfortunately, there is insufficient evidence in the present research to conclude whether the experiences of for-profit organizations in the field of services for adults with developmental disabilities in Alberta are different from those of their nonprofit peers. The main reason for this is that Options, contrary to expectations, does not exhibit the business ethos and profit motive that had been anticipated when selecting it based on its

216 I do not have the data to verify that number.

278 for-profit status. Nonetheless, it does appear that the institutional rules, standards, and technomanagerial requirements apply across the field to all organizations receiving PDD funding, and from the service providers I interviewed, they all found them to be burdensome, focused on incorrect measures, intrusive, and barriers to rather than facilitators of service improvements. A more rigorous study, however, is needed to assess the perceptions and experiences of organizations driven primarily by a business ethic.

9.3 Concluding Remarks This chapter exposed technomanagerial approaches as rational myths, neither increasing program or organizational efficiencies nor improving the lives of program beneficiaries. Their imposition arises from neoliberalism’s paradoxical mode of governance, which is both facilitative and authoritative at the same time, and which contradicts neoliberalism’s ideological commitment to less state involvement in the private realm. The chapter also showed that these technologies of governance are not adopted uncritically or without resistance. Service providers and families—who approach the work of supporting individuals with developmental disabilities from a different set of human and social, rather than economic, value base—see the limitations and misguided nature of many technomanagerial tools and processes. Forced to implement these rational myths due to their dependence on government funding, organizations manage this conflict by decoupling service delivery work from the formal tools and processes. The chapter also revealed the multiple, contradictory and paradoxical ways in which these tools and processes rearranged the loci and circuits of power in the field, and also how they themselves are conduits of systemic power. The institutional lens applied in this chapter can provide useful insights into understanding and analysing the experiences of publicly-funded nonprofit human service organizations to technomanagerial approaches elsewhere.

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CHAPTER TEN: CONCLUSION

I know you’re interested in systems and structures, but at the end of day, it’s people that make those happen. In our sector, there have been some individuals who’ve been absolute game changers, and that’s why the systems and structures have looked the way they have. Without that leadership, which knows where it’s going, has the right values, and can influence people, all of the other stuff becomes empty and adrift. It’s the values and the people that can lead to systems change, or prevent it. (Murphy-Black, personal interview)

The goal of this research was to contribute to our understanding of how neoliberal regimes shape the institutional contexts and organizational characteristics of nonprofit human services. The aim was to address the gap in scholarly knowledge of the Canadian nonprofit sector in neoliberal times, and to generate practical insights to aid policy makers and sector leaders enhance the vitality of the sector. The research used a case study approach grounded in a constructivist epistemology guided by a theoretical framework integrating insights from resource dependence theory, organizational institutionalism and historical institutionalism. Based on the literature and the theoretical framework, the broad goal of the research was translated into the following questions:  What are the historical socio-political, economic and cultural origins of the institutional elements and arrangements that were present in the field of services for adults with developmental disabilities in Alberta at the start of the Klein reforms in the 1990s?  What were the main general elements of the Klein reforms? Why were the reforms a critical juncture in the province’s institutional landscape and what made the transformation possible?  What were the key manifestations of the neoliberal reforms in Alberta’s developmental disability field? What salient contextual forces and actors shaped institutional developments and how did they do so?  How did publicly-funded developmental disability service organizations respond to the neoliberal reforms, and with what consequences? How can differences in organizational responses be explained?

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This chapter begins by providing a high level summary of the answers to these questions. It then presents a final overarching analysis to assess and explain in broad- brush strokes the extent to which Alberta’s developmental disability field has been “neoliberalized.” The analysis is structured using the ten principles characterizing ideal neoliberal governments (Osborne and Gaebler 1992) as a heuristic tool to synthesise the empirical and theoretical findings from this project. This is followed by a discussion of how neoliberal reforms have shaped organizations. Next, some practical lessons arising from this research are offered for sector leaders and policy makers. The chapter ends with a summary of the dissertation’s main scholarly contributions, and closing comments.

10.1 Summary Just as Canada’s nonprofit sector has been shaped in distinctive ways by the country’s harsh landscape and the political ideologies and values of its colonial settlers, the field of services to people with developmental disabilities in Alberta has been shaped by the intersection of societal shifts in views towards people with disabilities with the province’s unique identity as a frontier province dominated by a socially conservative and religious elite during its formative years, dependent on volatile resource revenues, with a population priding self-reliance. Alberta’s contesting authoritarian and progressive leanings have been reflected in its long and dark history of eugenics, and in innovations such as Canada’s earliest parent-run schools for children with disabilities. This research identified four critical junctures between 1905 and 1992 which transformed policies and services to people with developmental disabilities: (i) the eugenics movement (1920s); (ii) the deinstitutionalization and normalization movements (1950s and 1960s); (iii) the social and rights models of disability (1970s); and (iv) the onset of neoliberalism (1980s+). During any given time, different cultural-cognitive underpinnings often coexisted, resulting in a complex array of emerging and legacy forces competing to shape policy responses and be shaped by the field’s extant structural arrangements. In the early 1980s, when neoliberalism began infiltrating the field’s institutional landscape, it joined forces with currents originating in the deinstitutionalization, normalization, and rights-based models of disability, and manifested as a massive push towards the privatization of services and rapid growth in

281 the number of community-based service providers. Key actors shaping these new developments included policy makers and bureaucrats, service providers, parental and self-advocacy organizations, and rehabilitation academics. Neoliberalism’s wide-ranging effects were felt after 1993 through the deep and rapid reforms implemented by the Klein government. Key elements of the reforms included downsizing government through cutbacks and restructuring, decentralising certain programs by creating regional authorities, improving financial management and program accountability controls, expanding public input processes, and enacting legislation to guide fiscal decision-making. A confluence of contextual socio-political and economic factors with the interplay of ideational forces created the foundations for the reforms, which eventually forged a new institutional context in the province’s social policy arena. After Klein’s resignation in 2006, the ideological, policy, and governance underpinnings of the reforms became entrenched by subsequent PC governments, although there was some evidence of a potential shift towards a more socially progressive stance before the PCs lost the election to the New Democrats in 2015. The reforms manifested in the developmental disability field in four main ways: (i) program cutbacks and limitations; (ii) a new structure for program delivery; (iii) increased citizen responsibility; and (iv) managerial techniques for heightened scrutiny and accountability. These manifestations built on the field’s existing institutional landscape and gradually transformed it by infiltrating it with neoliberal beliefs, values, normative prescriptions, and strategies and techniques. Under this overarching trend, the research revealed poignant differences within and across these four facets in the experimental, messy and sometimes contradictory ways that the reforms unfolded, and the nature and extent of change achieved. There were also differences in the levels and forms of acceptance, resistance, and entrepreneurship exhibited by various actors to shape the institutional changes to further their own beliefs, values and interests. Organizational responses appeared to be shaped by organizational cultures and sense of self-identity, professional biases, and perceptions of dependencies. The research showed that even in seemingly hegemonic regimes, institutional landscapes are multiplex, containing heterogeneous forces acting in complex ways to shape dominant currents.

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10.2 To What Extent Has Alberta’s Developmental Disability Field Been “Neoliberalized”? To get a bird’s-eye view of the overall impact of the reforms, I use Osborne and Gaebler’s (1992; see Chapter Five, Box 5.1) list of ten principles of the ideal neoliberal government as a heuristic device to assess to what extent Alberta’s field of services for adults with developmental disabilities has been “neoliberalized” with respect to achieving these principles. This best-selling publication was widely used by the Klein government to educate bureaucrats for the reform activities (Lisac 1995:147; Interviews 2013). Table 10.1 (next three pages) summarizes key empirical developments and outcomes in the field before, during, and after the Klein era organized under whichever principle they seemed to fit best under. Some cautions should be kept in mind. First, each principle is conceptually large, and not readily operationalised. Second, some principles have significant overlaps. For these two reasons, entries under one principle may just as appropriately have been entered under another. Third, although the columns refer to specific time periods, the developments were not bound by these limits; as such, the entries have been placed in the period associated with the bulk of the change. Despite these challenges, the exercise helps to synthesise the research’s empirical findings in a convenient (if somewhat imperfect) framework. The goal is less about scrutinizing the details and more about revealing overall patterns and trends. Following Table 10.1, developments related to each principle are discussed in more detail. Some principles are discussed together due to conceptual or empirical overlaps.

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Table 10.1 Reforms in the Developmental Disability Field Assessed Against Neoliberalism’s Governance Principles Neoliberal Governance Principles, Developments, and Outcomes Pre-Klein (1980-1992) Klein Era (1993 to 2006) Post-Klein (2006 to 2015) Table 10.1, page 1 of 3 1. Catalytic: steering not rowing (Ch.4, 6) Creating policy and policy-focused regulatory structures and mechanisms while leaving service delivery to private organizations.  Services privatised, except some  Devolution and deinstitutionalization  Almost all service delivery privatised government-operated facilities continue, most facilities shut down  More government control over assessing supports and determining funds needed

Almost all steering; but more control over Mostly steering; some rowing Mostly steering; less rowing how rowing is done 2. Community-owned: empowering not serving (Ch.4, 6, 7, 8)

284 Moving control from bureaucrats to individuals, families, neighborhoods and communities.

 Considerable collaboration with community  Steps to increase individual and family  Increasing centralization of authority and families; partnership model capacity and involvement  FMS funding option for families  Relationship strong and positive  Community feels unheard in the flurry of  EFS to increase individual capacity  Shared development of IF model decisions from the centre  Structural reforms to increase community involvement Sense of empowerment Confusion, distrust Cautious optimism 3. Competitive: competition not monopolies (Ch. 4, 6, 7) Injecting competition in the acquisition and delivery of public goods and services.  There is little competition  Mix of a few large and many small  Agencies forced to be more competitive  Service demands lead to expansion of providers  Standardization and rationalization will community-based sector likely result in fewer organizations Low, but increasing competition Competitive; many providers Trend to fewer, larger organizations

Neoliberal Governance Principles, Developments, and Outcomes Pre-Klein (1980-1992) Klein Era (1993 to 2006) Post-Klein (2006 to 2015) Table 10.1, page 2 of 3 4. Mission-driven: mission not rules (Ch.4, 9) Replacing systems and activities that stifle creativity with those with clear missions and performance measures to ensure accountability.  Regulatory environment simple  Regulatory environment increases and  Tighter contracts, greater monitoring, more  High level of discretion allowed becomes more complex rigorous reporting Progressive principles Increasing regulations Highly regulated and monitored 5. Results-oriented: outcomes not outputs (Ch.4, 9) Tying funding to the achievement of clearly-defined outcomes and measures of quality.  Output-based reporting based on aggregate  Budget targets, business plans, performance  Measures of financial efficiency; quality of

285 numbers measures life outcomes disputed

Focus on financial efficiency and Aggregate outputs, periodic reporting Individual outputs; financial efficiency questionable/trivial outcomes 6. Customer-driven: meeting the needs of the customer not the bureaucracy (Ch.4, 8) Providing citizen-focused, competitive programs for customers to choose from.  Policies and services developed  Family and client involvement  Families can manage own services collaboratively with agencies  SIS and funding levels restrict flexibility

Person-centred rhetoric, but funding Collaborative constraints limit supports available Consumer choice, within funding limits 7. Enterprising: earning not spending (Ch.4, 6, 9) Generating revenues from public services by training managers to think like entrepreneurs.  Spending based on need expressed by  Deficits not allowed  Rationalization strategies to enhance system individuals, families or services  Senior bureaucrats with policy experience capacity and control costs replaced by those with financial acumen Spending based on need Services become enterprising Rationalization

Neoliberal Governance Principles, Developments, and Outcomes Pre-Klein (1980-1992) Klein Era (1993 to 2006) Post-Klein (2006 to 2015) Table 10.1, page 3 of 3 8. Anticipatory: prevention not cure (Ch.4, 6, 9) Building foresight through long-term planning and budgeting, and cross-departmental/cross-regional approaches.  Regional approaches and discretion  Restricted budgets and annual contracts  Provincial frameworks, cross-ministry  Latitude in identifying and providing restrict long-term planning capacity approaches, and creation of “super” ministry supports  Business plan development  Individual funding and outcomes detract  Funding predictability from addressing systemic barriers

Integrative frameworks co-existing with Predictability and flexibility Decreased flexibility and predictability individual-focused approaches 9. Decentralized: participation not hierarchy (Ch. 4, 7)

286 Giving authority for decisions to be made collaboratively by those close to the problems.

 Decentralised structure of service-delivery  Community governance structure  Rationalization shifts power to centre via regional offices  Power and control centralized while  Post-2010: consultative approaches  Inter-sectoral relationships positive and accountability shifts downwards  Post-2013: proposed community mutually trusting engagement model

Mixed model of local engagement under Decentralization in practice and spirit Decentralised structure in theory only provincial framework 10: Market-oriented: leveraging change through the marketplace (Ch.4, 6, 7, 8) Using the scope of the government to structure market-based incentives for change.  Privatization increases supply of service  Mix of for-profit and nonprofit providers  Strategic procurement of services providers  Funding cutbacks increase competition  Payments based on actual services  Individualised funding puts money in the  Increasing scrutiny  Promotion of family managed service hands of consumers Increase in mixed market of suppliers Mixed market, regulations and policing Strategic procurement

10.2.1 Catalytic government A catalytic government is one which focuses on “steering not rowing,” that is, on creating policy and policy-focused structures and mechanisms while leaving service delivery to private organizations (Osborne and Gaebler 1992:Ch.1). In the field of services for persons with developmental disabilities in Alberta, most service delivery had been transferred to community-based service providers before the Klein reforms. This had come about due to rights-based views originating in the deinstitutionalization and normalization movements converging with government’s urgency to intensify the privatization of services to reduce public costs in the wake of a severe economic slowdown in the 1980s (Chapter Four, Section 4.1.4). The Klein reforms did not change government’s policy to assist individuals to find community-based supports. Over time, all government-run residential institutions have closed, except for Michener Services which houses the most severely disabled individuals with extremely high support needs. In the sense that almost all individuals now receive services delivered by private (for-profit or nonprofit) agencies and not by government, the principle of “steering not rowing” has been achieved. However, there is a caveat to this. In large part, the relatively smooth transition to private delivery has been possible because of the convergence in values that people with disabilities have the right to live in the community. Getting out of the business of service delivery also meets neoliberal goals to reduce costs and increase community responsibility. The argument that cost management (and not just a rights- based conviction) is a factor in government’s decision is evident in the finding that, in the past few years, the government has significantly increased its control over determining what supports are provided, how they are to be assessed, and what sort of funding is to be provided for them (Chapter Six, Section 6.4.3). There is also much higher scrutiny over service-delivery organizations (Chapter Nine, Section 9.1). The government, thus, has successfully shifted to steering in that it engages in very little service delivery, but it is also very much still controlling how the rowing gets done. In that sense, then, it has only partially achieved the status of the ideal “catalytic government.”

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10.2.2 Community-owned government A community-owned government is one which is “empowering not serving;” it moves control from bureaucrats to individuals, families, neighbourhoods, and communities (Osborne and Gaebler 1992:Ch.2). Even before neoliberalism appeared on the scene, the government had strong involvement from families in shaping service delivery, with significant collaboration at the community level during the 1970s and 1980s (Chapter Four, Section 4.1.3). As neoliberalism began to take root in Alberta’s public service in the mid-1980s, the idea of increasing individual and family control and responsibility started appearing in the formal statements of programs or ministries responsible for service for people with developmental disabilities. Efforts to increase the capacity and involvement of individuals and families intensified under the Klein government through consultations, satisfaction surveys, program reviews, family network development workshops, and self-advocacy training (Chapter Eight, Section 8.1.). This expectation of shared responsibility was welcomed by individuals and families since it converged with their belief and goal to have greater control over services. It was this shared belief and goal for families to have greater control that led families and program administrators in the 1980s to collaborate to co-create the Individualized Funding (IF) model, which later morphed into the Family Managed Service (FMS) option (Chapter Eight, Section 8.2). More recently, the Redford government tried to increase individual control and responsibility by implementing the Employment First Strategy (EFS) to increase workforce participation (Chapter Eight, Section 8.3). While the creation of IF turned out to be a successful experiment because it had all parties working towards a common goal based on common beliefs and values, EFS faced some initial hiccups as government’s decision to allocate a part of community access funding to employment funding was seen as a violation of individuals’ right to self-determination. Subsequent consultations resulted in greater acceptance for the strategy. More recently, structural reforms (which have yet to unfold) were announced that are expected to increase family control through their involvement in Family and Community Engagement Councils as well as through a more strengthened Premier’s Council on the Status of Persons with Disabilities (Chapter Seven, Section 7.2.5).

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Although there have been attempts to increase individual and family control and responsibility, they are far from being truly empowered. Family control over funding, for example, has to occur within the limits that government decides to allocate based on its SIS assessments (Chapter Seven, Section 7.2.4). The FMS process is onerous and bureaucratic, and puts significant administrative burdens on families (Chapter Eight, Section 8.2). This research also argued that the use of standardized technomanagerial tools decreases the control of individuals and families (Chapter Nine, Section 9.1.3). Finally, when it comes to matters of financial considerations, families and individuals have often not felt heard, as is evident in the many public protests and advocacy attempts they had to engage in when faced with cutbacks (e.g., Chapter Six, Section 6.3). Thus, it appears that the move to a “community-owned” government has yet to be fully realized.

10.2.3 Decentralized government A decentralized government is about “participation not hierarchy;” it gives authority for decisions to be made collaboratively by those close to the problems (Osborne and Gaebler 1992:Ch.9). It follows from the same logic as that undergirding the principle of moving control from bureaucrats to the community. The empirical example of decentralization was the creation of the PDD program (Chapter Seven). The PDD regionalized community governance structure was an unusually progressive development, unprecedented in such a small policy domain, brought about by the creative agency of family advocates working in close collaboration with senior bureaucrats with shared beliefs and values, and with access to the centres of power. Its unfolding, however, was shaped by the conflict between the neoliberal aim to increase community responsibility and the aim to reduce government spending. The research revealed a number of dimensions along which this conflict translated into discrepancies: (i) in structural configurations (of the program, of the role of the Provincial Board, and in the reporting lines); (ii) in expectations (of the role of the boards and whose interests they represented; of regional flexibility vs. province-wide consistency in service delivery); and (iii) in values (of client-centred services vs. financial efficiency). These misalignments at multiple levels created tension, distrust and loss of legitimacy of the PDD system in the eyes of its diverse constituents. Recent structural reforms are aiming to assuage the

289 tensions and contradictions by creating a mixed model of community engagement within the parameters of a provincially articulated framework. The experiment to create a “decentralized government,” may be considered partially successful in that the PDD community governance legislation did result, at least in theory and potential, in one of the most progressive developments in the field. However it was not realized in practice due to neoliberalism’s conflicting demands. It remains to be seen if the new structural reforms will result in a model that is closer to “participation not hierarchy.”

10.2.4 Competitive and customer-driven government A competitive government aims to inject competition in the acquisition and delivery of public goods and services (Osborne and Gaebler 1992:Ch.3). In the provision of human services, this goal overlaps with that of a customer-driven government, which aims to provide citizen-focused, competitive programs for customers to choose from (Osborne and Gaebler 1992:Ch.6). In the developmental disability field, privatization and the availability of IF arrangements in the 1980s led to significant expansion in the community-based sector. Programs were collaboratively developed, and individuals and families saw a rapid rise in service choices; a number of service organizations were established by families (Chapter Four, Section 4.1.4). It would appear that the field was fairly competitive and customer- driven in the early neoliberal time before the Klein reforms began. Once the Klein cutbacks began, though, there was more competition for funding and some agencies did not survive. Continuing funding constraints made it difficult for agencies to hire and retain qualified staff, and significantly restrained their ability to provide well-designed customer-focused supports (Chapter Six, Section 6.3). The recent moves towards standardization and rationalization are likely to reduce the number of agencies with which the government will need to contract, favouring larger, more cost-efficient ones that are more likely to have the bundle of supports and the systems to accommodate government’s needs (Chapter Seven, Section 7.2.4). Furthermore, even though families have access to the FMS funding option which gives them more control over purchasing services, this choice is partly restricted by the limits imposed by the SIS assessments. It appears, thus, that contradictory outcomes are taking shape. On the one hand, families

290 and government appear to have the upper-hand as far as procuring services goes; on the other hand, if rationalization results in fewer, and larger, organizations, than this limits service options. One can conclude, therefore, that the move to a “competitive” or “customer-driven” government have only partially been achieved.

10.2.5 Mission-driven and results-oriented government A mission-driven government is focused on “mission not rules;” it aims to replace systems and activities that stifle creativity with those with clear missions and performance measures to ensure accountability (Osborne and Gaebler 1992:Ch.4). Since performance measures are usually tied to outcomes achievement, a mission-driven government tends to be results-oriented, tying funding to the achievement of clearly- defined outcomes and measures of quality (Osborne and Gaebler 1992:Ch.5). Chapters Nine and Seven (Section 7.2.4) showed in much detail how, in contrast to the environment of flexibility and discretion that existed before the neoliberal reforms unfolded (Chapter Four, Section 4.1.4), demands from the provincial Auditor General for greater accountability, a perception that the PDD system’s spending was out of control, and the desire to standardise processes across the province all contributed to a much denser regulatory environment and stricter standards, protocols and monitoring mechanisms. Instead of allowing service providers to be “mission-driven,” the empirical evidence suggests that accountability requirements and standardization have increased administrative burdens, and decreased creativity, flexibility and the capacity to innovate (Chapter Nine, Section 9.1.1). In addition, families and service providers expressed little faith that measurement indicators and tools were sensitive to or meaningfully captured the complexities of the needs and daily lives of individuals. There was a sense that the focus was on financial efficiency rather than improved life outcomes for individuals. Some think that the imposition of these measures and tools may even have increased costs to the government in creating and administering these processes. This study suggests that, instead of even partially becoming a “mission-driven” and “results-oriented” government, the increased technomanagerialism in the field may actually have shifted government towards becoming more rules-driven. This appears to

291 have been the paradoxical outcome of following new public management’s prescriptions to increase mechanisms for accountability and attempting to define clear outcomes in the indeterminate area of human services, and of devolving responsibility for mandated services (for which the public holds government responsible regardless of who is delivering them) to private agents (which the state has to scrutinise while, in theory, aiming to reduce its intervention).

10.2.6 Anticipatory government An anticipatory government focuses on “prevention not cure,” that is, on building foresight through long-term planning and cross-departmental approaches (Osborne and Gaebler 1992:Ch.8). Before the neoliberal reforms, services were regionalised, with much local discretion and control over service delivery. Funding was provided annually but was predictable, so service providers could build person-focused support models to address the evolving needs of the individual over time (Chapter Four, Section 4.1.3). The program cutbacks and limitations that unfolded during the Klein reforms restricted that capacity (Chapter Six, Section 6.3). Although the government began developing three- year business plans (Chapter Five, Section 5.1), funding contracts were annual and amounts were unpredictable. As well, accountability measures such as funding tied to specified units of support and short time-frame reporting requirements served to compartmentalise and further remove discretion in the provision of supports (Chapter Nine, Section 9.1.1). Since 2010, the efforts to transform the PDD program by applying a cross-regional, provincial framework, and the program’s integration with other human service programs in a “super-ministry” appear to hold promise for more system-wide solutions, however, some of the means implemented to achieve these, such as standardized tools and processes, serve to continue to remove discretion in service provision at the individual level. These contradictory outcomes suggest that an “anticipatory government” has yet to be achieved.

10.2.7 Enterprising and market-oriented government An enterprising government is one that trains public administrators to think like entrepreneurs, helping it to reduce spending or even generate revenues from public services (Osborne and Gaebler 1992:Ch.7). This business-oriented ethos also underpins a

292 market-oriented government, which uses its powers to structure market-based incentives for change (Osborne and Gaebler 1992:Ch.10). The goal to reduce, or at least manage, public costs is a thread underlying all of the neoliberal reforms. It began in the 1980s with the province’s severe economic downturn (Chapter Four, Section 4.1.4), intensified with the program cutbacks at the start of the Klein reforms, continued even as the province’s financial situation improved (Chapter Six, Section 6.3), and is evident in the move to standardize and rationalize service provision (Chapter Seven, Section 7.2.4). While public administrators in the developmental disability field may not have been looking to generate revenues from public services as Osborne and Gaebler (1992) suggest, they would, at the very least, have had to be financially astute to ensure their programs did not run deficits, since these were not allowed by the Klein government (Chapter Five, Section 5.1). During the Klein era, senior bureaucrats with policy experience were replaced by those with strong financial acumen; government was expected to be “run like a business,” with administrators being rewarded with bonuses for finding cost-savings (Chapter Seven, Section 7.2.3). While some of these strategies (such as bonus incentives) may no longer be in place, strategies to enhance system capacity and ways to reduce costs are evident in the rationalization efforts of recent years (Chapter Seven, Section 7.2.4). Collectively, these are signs of a government that has become increasingly enterprising. However, it would be incorrect to say that the shift is complete. A number of civil servants expressed great discomfort with this expectation to behave in a business- like fashion (e.g., P1CG12 in Section 7.2.3); many others had left the civil service during the early years of the Klein government because they were not comfortable with the shift (Chapter Six, Section 6.3). This, then, is yet another example of a partial shift. Also partial is the market-orientation of the government. Since the start of neoliberal reforms, the developmental disability field has been “marketized” in a number of ways, but with some important limitations. First, the supply of service providers drastically increased with the privatization of service delivery beginning in the 1980s, including for-profit companies entering an arena typically reserved for nonprofit agencies (Chapter Four, Section 4.1.4). This would have increased competition especially when

293 funding cutbacks effectively restricted the “demand” side of the equation in the 1990s (Chapter Six, Section 6.3). The recent move to rationalization, however, may result in changing the supply of service providers as mentioned previously, if it leads to fewer, larger agencies (Chapter Seven, Section 7.2.4). Second, individualized funding options such as IF and FMS put money (purchasing power) directly in the hands of consumers to choose from the product supply (Chapter Eight, Section 8.2). However, the money is limited and controlled by the government through processes such as SIS and funding levels. Third, quality products are incentivized and unscrupulous suppliers are controlled by tying funding to performance measures and outcomes (currently under development), and through various mechanisms of scrutiny (Chapter Nine). However, human service outcomes are difficult to define and it remains to be seen how this rationalized model unfolds in practice. Thus, although the developmental disability field has increasingly come to resemble an open market, there are some important restrictions; it would be fair to suggest that the government is partially “market-oriented.”

10.2.8 Conclusion In this final analysis, then, it appears that the answer to the question of to what extent Alberta’s developmental disability field been “neoliberalized” is not a simple one. The literature suggested that neoliberalism’s expressions and outcomes depend on local contexts and historical legacies (e.g., Jenson and Phillips 2000; Kingfisher and Maskowsky 2008:119; Mudge 2008:704; Atkinson, Béland, Marchildon, McNutt, Phillips and Rasmussen 2013:124), and that its reform efforts are partial (Connell, Fawcett and Meagher 2009:335) and incomplete projects (Clarke 2004, 2008; Kingfisher and Maskovsky 2008:120). This research supports that. As importantly, it shows that, even within the narrow context of a single policy domain within a province much touted for the strength and rapidity of its neoliberal reforms, the reforms did not roll out in a planned or coherent fashion, and only partially achieved the principles considered to be the benchmarks of neoliberal governance. The reasons for this are multiple and complex. Neoliberalism’s success (albeit partial) appears to be highest when there is a convergence in institutional elements among the various actors in the field. Privatization of service delivery came about successfully

294 and rapidly in the 1980s because rights-based views in the field converged with government’s need to reduce public costs and increase community responsibility. The goal to increase individual and family responsibility was also quite successful (e.g., in IF and FMS) because it converged with individuals’ and families’ goal to have greater control over their services. In contrast, EFS was met with initial resistance because although there was goal convergence (all parties supported in principle increasing workforce participation opportunities for individuals), there was seen to be a clash in fundamental belief in the right of people with disabilities to self-determination, and in the belief that workforce participation was a systemic barrier not just a problem of individual capacity. Consultations that addressed these clashes and collaborative development of a revised employment strategy corrected this initial misstep. Other less successful attempts were those in which government enacted contradictory behaviours, such as creating a community governance structure but retaining authority at the centre, or developing long- range business plans but not building in any predictability to annual contracts. The least success occurred in reforms where neoliberalism’s inherent tensions and paradoxes surfaced, such as when it required government to be both facilitative and authoritative (as evidenced by the apparent failure to become mission-driven and results-oriented). These partial successes underscore the point raised by some in the literature that neoliberal reforms are often experimental, reflexive and ongoing projects. They have no (or very few) historical precedents for their creators to draw upon, as was evidenced by the creation of the PDD regional community boards with a Provincial Board as part of its structure, and the crafting of the Individualised Funding model from a loophole in welfare funding. These came about because a group of actors came together with a shared commitment—to an idea, a value, a strategic interest, a goal—and worked within the constraints and opportunities provided by the building blocks in a complex and fluid institutional landscape to “articulate” a new “assemblage” (Ong 2006:13; Clarke 2008:144) that fit their needs. Sometimes these experiments fail and need corrective action, as was evidenced in the hastily developed target for EFS, but always they need ongoing work because institutional contexts are heterogeneous and contested terrains, “rife with conflict, contradiction, and ambiguity” (DiMaggio and Powell 1991:28). In the

295 social policy arena, neoliberalism’s work is even harder because the institutional context is thick, with deeply-seated beliefs and values, creating spaces for clashes and conflicts. At the core of it all, though, it is the agency of actors—individuals and organizations alike—that shapes institutional developments, whether it is by complying, confronting, contesting, or co-creating. This research shows that even in regimes perceived to be highly institutionalised or hegemonic, there is much room for such agency, and the outcomes are contextual, not easily predictable, and sometimes messy. In the next section, I summarize how neoliberal manifestations in Alberta’s developmental disability field have shaped organizational characteristics, and how organizations have responded.

10.3 How Have Neoliberalism’s Manifestations Shaped Organizations? The implications of the neoliberal turn for the Canadian nonprofit sector have been described as Janus-faced (Hall and Banting 2000:18). One side views the sector as being on the verge of a historic potential to rekindle local communities and citizenship (e.g., Korten 1990:120-128; Putnam 1993, 2000; Fisher 1993; Howell and Pearce 2001:33-36); the other side views overwhelming evidence of the sector’s significantly constrained capacities (e.g., Evans and Shields 1998, 2000; Dart and Zimmerman 2000; Phillips and Levasseur 2004; Elson 2008:156). This research shows that neoliberalism’s manifestations in Alberta’s services for adults with developmental disabilities has come with decidedly mixed blessings. Privatization created enormous opportunities to establish new nonprofit organizations or expand existing ones. Organizations proliferated, grew larger, and created employment— albeit at very low wages—for 15,000 men and women (Sonpal-Valias 2005). They have contributed to the province’s economic growth and strengthened the social fabric of our communities. It is in large part through their work that Albertans have come to accept, include and celebrate the lives and contributions of individuals with developmental disabilities. But this research has also shown that they faced insecure funding, stifling controls and scrutiny, staff burnout and turnover, and—as the example from Vecova shows— even shifts in organizational identity and core activities as they chased revenue sources to support their work. Compared to other provinces, nonprofit organizations in

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Alberta engage in more funding diversification and enterprise activities to resource inadequately-funded public services (Meinhard and Foster 2001). In short, neoliberal reforms have permanently changed what nonprofit disability service organizations do and how they do it. Yet, this research shows that organizations are not monolithic in how they have made sense of or responded to these shifts; even among just the three organizations examined in this research, notable differences were discovered. Although all three organizations demonstrated isomorphic properties and tendencies in their formal structures, systems, written policies and processes, staff qualifications, and main service technologies, their different origins and philosophical emphases or biases (professional knowledge for Vecova, social justice for SCOPE, and family expertise for Options) gave each a unique culture from which to draw organizational responses. In its own ways, each organization responded to the institutional shifts by enacting various forms of strategic responses to both survive and to reshape its institutional context. The findings suggest that organizational responses are structured by (i) the cognitive and normative elements of the institutional contexts in which organizations are embedded; (ii) organizations’ inherent professional logics or biases; and (iii) organizations’ sense of self-identity. Once again, the research reveals agentic capacities even in highly institutionalised contexts.

10.4 Implications for Nonprofit Sector Policy and Practice There are many lessons arising out of this research for policy and practices in the nonprofit sector. This section identifies a number of these, and at the end of the chapter I offer some thoughts to ponder about the nonprofit sector as it encounters new realities in a globalized world. One of the lessons arising from this research is that neoliberal contexts have complex, locally-shaped contours in which there are many spaces for creative actors, individuals and organizations alike, to generate innovative responses to further their agendas. This was most clearly exemplified by the creation of the PDD community governance structure. A practical lesson arising out of this is that institutional entrepreneurs seeking to create alternative outcomes can enhance the likelihood of acceptance by leveraging off already legitimate, institutional forms and structures. These

297 can be built on or modelled off existing policy tools or structures to create new ones that better meet the entrepreneurs’ agenda (e.g., a legislated, regional authorities already existed for FSCD prior to the creation of PDD). However, policy makers who aspire to implement institutional changes need to ensure that there is alignment in the cultural- cognitive and normative elements across all stakeholders—which can be achieved through genuine consultation and collaborative development—or, at least, shared goals even if the rationales underpinning them differ (as was evidenced in the successful implementation of the FMS funding option). In addition, success is more likely if groups with similar goals act collectively and with a common vision (as did family advocates and bureaucrats in the creation of PDD), and ally themselves with individuals with access to the centres of decision-making power where they can exercise their influence. Further, institutional changes are much easier to make at the policy guideline level, before these guidelines become formally articulated as a regulation or enshrined in legislation. This was evidenced, for example, by the “line drawn in the sand” when new (and more restrictive) eligibility criteria were defined , which took away any previous discretion program administrators had. It is important, therefore, for field advocates to keep discussions, debates and the avenues for expression of alternative idea formulations open, because it is here that actors have the ability to exert influence over deep-seated elements such as values, beliefs, and criteria of acceptable practices or performance (Oliver 1991:157), before they become solidified at the structural level. At these discussions, there may be various roles that different organizations can play: some, like SCOPE, may be willing to be the rabble-rousers, willing to face the repercussions on their organizations by the depth of their convictions and their commitment to uphold them for the greater good; others, like Options, may add to these conversations in more reasoned and tempered ways of a supportive parent to make them palatable to wider audiences; and still others, like Vecova, may be the ones to bolt off the starting line to be the first to put the ideas into practice and show others how to do it. Understanding the strengths of various organizations in the field and drawing upon them is an important way to engage them and bring about collective change.

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10.5 Summary of the Dissertation’s Main Contributions

10.5.1 Empirical contributions This dissertation makes a significant contribution to the literature on the history of Alberta’s policies and services to persons with developmental disabilities from the creation of the province in 1905 to 2015. There is no research in this policy domain in Alberta that spans this length of time and analyzes developments in the field as a whole, not just selected aspects of it. In addition to describing the evolution of the field, this dissertation identifies the critical junctures in the field, the contextual and institutional forces underpinning and shaping them, and the processes by which the transformations came about. The analysis of the changes from 1905 to 1992 is deliberately limited since the main focus is on the reforms after this period. For the latter period, this dissertation contributes a deeper analysis of the forces and processes that shaped developments. This, in its own right, is a significant contribution to our understanding of why the developmental disability field in Alberta looks the way it does today. This dissertation also contributes to the emerging empirical literature on Canadian nonprofit human service organizations, and adds a distinctively sociological and a theoretically informed perspective to a body that is largely atheoretical. In addition, this dissertation contributes to our understanding of neoliberalism’s many possible manifestations and contours. Since neoliberalism’s expressions are historically and contextually-sensitive, each additional study of neoliberalism adds to our repertoire of knowledge of this paradoxically hegemonic, yet contextually-specific, doctrine. This research also adds to the stock of empirical studies and commentaries specifically on neoliberalism’s effects in Alberta (e.g., to collections such as Laxer and Harrison [1995] and Harrison [2005]). This dissertation also contributes to the growing institutional literature that is increasingly recognizing the importance of attending to the ways in which actors shape (reproduce, reconstruct or transform) institutional contexts, and specifically the bottom- up processes through which creative change occurs, in contrast to the earlier dominant literature that focused on top-down processes of how regulatory structures and elements constrain behavior (Greenwood et al. 2008; Scott 2008:191).

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10.5.2 Theoretical, analytical and methodological contributions To the theoretical literature, this dissertation contributes by developing and demonstrating the successful applicability of a framework integrating resource dependence theory, organizational institutionalism and historical institutionalism, and in so doing responds to those calling for creative combinations of theories to advance understandings of institutional processes (e.g., Thelen 1999:380; Greenwood et al. 2008:28; Scott 2008:192). While resource dependence theory and organizational institutionalism have been combined by others before (e.g., Oliver 1991), the addition of historical institutionalism expands the investigative scope by adding a temporal element. The dissertation also contributes to the theoretical literature in its use of an expanded conceptualization of institutional context, stemming from the integrated framework, as comprised of regulative, normative and cultural-cognitive elements and their associated activities and resources (Scott 2008:48), and relationships of exchange, and their associated resource dependencies, and perceptions of power differentials and uncertainties (Pfeffer and Salancik 1978:68). This conceptualization helps to illuminate how power plays into institutional processes, an aspect which has been relatively neglected in empirical work in the organizational institutional literature (Greenwood et al. 2008:25). The use of Scott’s conceptualization of institutional contexts (2008:48) reveals how differences in alignment between the elements create conflict or open up space for change, resulting in a richer and more nuanced understanding of how neoliberalism unfolded in the developmental disability field. The dissertation makes a number of analytic contributions flowing directly from the use of the integrated theoretical framework. Specifically: (i) the identification of critical junctures in the historical evolution of the developmental disability field in Alberta; (ii) the identification of the ideational forces underlying the success of the Klein reforms; and (iii) the simultaneous examination at macro, meso and micro levels to get a fuller picture of the underlying forces and processes of change. Finally, by using a longitudinal embedded single-case study design (Yin 2009:50) and historical research (Berg 2009:269-309; Singleton and Straits 2005:364) this study

300 adds its experience to the repertoire of knowledge available to others desiring to attempt these approaches.

10.6 Final Words This research was motivated by the profound changes I witnessed in nonprofit human services during and in the aftermath of the Klein reforms. The paradise promised by the reforms may have materialised for some, but it did not for many. Alberta’s GDP has more than tripled since the rise of neoliberalism in the mid-1980s, and both the mean and median income have risen significantly in the province. But so too have social and income disparities on staggeringly numerous fronts (Alberta College of Social Workers 2010). As this and other research has shown, neoliberal developments have been fraught with contradictions and paradoxes. The role of the government has diminished, but the size and reach of the state into private organizations and private lives has increased, while democratic accountability has shrunk (Harrison 2005). More than ever, there is an increased role for the nonprofit sector. Not just for the service delivery functions that governments overwhelmingly sees as the sector’s strength, but for its expressive, advocacy and associative functions—the very capacities through which a robust societal fabric is built and the lives of citizens enriched. At the time of writing, despite staggering oil prices due to a global glut in supply, and daily layoffs in Alberta’s energy sector, there was cause to be optimistic about the province’s and the nation’s social policies and the sector’s role in advancing them. The recently-elected federal Liberals, injecting a wave of warm air on the advocacy chill intensified by the Harper government, just announced the closure of the political audit program for charities (Canada 2016). Federal, provincial and territorial social services just met in Alberta, hosted by the province’s NDP government, to discuss how to work together to provide innovative social services in various domains (Canadian Intergovernmental Conference Secretariat 2016), a conversation that had sorely lacked substance for the past decade. If nothing else, nonprofit organizations have shown tremendous resilience and creative responses to challenges in their political economy. Perhaps these recent developments are heralding in a new and progressive shift in the

301 institutional contexts of these vital organizations; one can only hope that organizations have the capacity to respond with the values and passion they typically bring to the table. On a final note, I would like to end with some questions to ponder over about the nonprofit sector in a global world in which there is an increasing blurring of boundaries between state, market and civil society as public services get privatised, for-profit entities enter into fields previously restricted to social services, nonprofits hive off for-profit units, businesses establish nonprofit elements, and new hybrid forms such as social enterprises proliferate (Kramer 2000). Institutional theorists suggest that a clear sense of a common field is important for the development of a “common rationality” (Scott 2008:217), from which a framework of beliefs, norms and rules can be constructed to guide coherent action. As field boundaries get increasingly blurred, what implications will this have? Will it lead to contradictory and irreconcilable logics (e.g., the logic of compassion vs. the logic of market efficiency) where one eventually trumps over the other, or will it lead to new forms of logics, and perhaps new organizational forms, offering hitherto unimaginable potential to achieve social good? How will the logic of “flexible capitalism” which privileges short-term economic goals, impact fields of human services where long-term relationships, loyalty and trust are paramount? Will it “corrode the character” of these organizations (Sennett 1998)? In a world increasingly saturated with media and migration (Appadurai 1996), where nonprofit organizations are probably just as likely to take on forms that are locally prescribed as they are to import organizational archetypes from Timbuktu, will it lead to less coherence and more chaos, or new opportunities for unbounded creativity? It is an interesting time indeed for the nonprofit sector, if one dare even call it that any more.

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APPENDIX A: RECRUITMENT INVITATIONS AND ANNOUNCEMENTS A.1. Phase One Invitation to Participate (On University of Calgary Faculty of Arts Letterhead) INVITATION TO PARTICIPATE IN RESEARCH Social policies and nonprofit human service organizations: An institutionalist analysis of disability services in Alberta1

Dear [first name last name], I am pursuing my doctoral research at the Dept. of Sociology, University of Calgary, on the evolution of Alberta’s social/disability policies and processes since the 1990s and the impact on nonprofit human service organizations. I am contacting you because I know you have a significant amount of personal knowledge or experience on this topic. I would like to get your perspectives on some of the key social/disability policies, and the structural forums and mechanisms that have shaped government-nonprofit/disability service sector relationships since the 1990s. My aim is to gain deeper insight into the historical context, motives and rationales influencing the decisions around these policies and processes, and the first-hand experiences of the people involved in these activities. I hope that you will agree to take part in a 1½ – 2 hour in-person or telephone interview with me in the next month or so. Your participation in this study would be entirely voluntary, and you may participate anonymously or “on the record”. Your participation will make an important contribution to research that aims to generate new insight into how social policy shapes organizational characteristics and impacts public service- delivery and outcomes. The research will also provide new understanding of how to enhance the long-term vitality and effectiveness of nonprofit human service organizations. If you wish to participate in the study, please contact me ([email; phone number]) within the next few days to schedule the interview. If you have any questions or concerns regarding this research or your participation, you may contact me or my faculty supervisor Dr. Tom Langford ([email; phone number]). I look forward to your response. Sincerely, [signature] Nilima Sonpal-Valias PhD Candidate, Dept. of Sociology 1. This research is supported by the Social Sciences and Humanities Research Council of Canada (SSHRC) Doctoral Fellowship Award #752-2012-1632, and has been approved by The University of Calgary Conjoint Faculties Research Ethics Board.

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A.2. Phase Two Invitation to Participate (On University of Calgary Faculty of Arts Letterhead) INVITATION TO PARTICIPATE AS A CASE STUDY SITE (PHASE TWO) Social policies and nonprofit human service organizations: An institutionalist analysis of disability services in Alberta Dear [first name], Thank you for participating in January 2013 in Phase One of my doctoral research on the evolution of Alberta’s disability policies and processes and the impact on nonprofit human service organizations. Phase Two involves identifying organizations providing services for adults with developmental disabilities in Calgary since the 1980s, and conducting in-depth investigations into the unique ways in which these organizations have responded to the shifting policies and processes and what consequences these have had on the organization’s identity, characteristics and capacities over time. [Name of organization] is an ideal case study site given its long and successful history as a disability service provider in Alberta. It is also unique in [insert one or two unique aspects]. [Name of organization’s] experiences will provide important knowledge about the relationship between social policy and organizational outcomes, and valuable insight on how human service organizations (nonprofit and for-profit) can thrive and succeed in challenging policy environments. Agreeing to include [Name of organization] in Phase Two of the research would involve giving me permission to access your organization as a case study site. The research may take 8 – 12 weeks, and may include review of annual reports and archived documents, formal interviews with selected members of your organization, informal conversations with staff or volunteers, direct observations of the site, and review of current and recent financial, staffing and service data. Your organization’s participation in the study is entirely voluntary and you have full control in consenting to the research activities that may be undertaken at your organization. You also have full choice over whether you want your organization’s participation to be made public or kept anonymous, and of withdrawing from the research at any time. I look forward to seeing you in the next little while to discuss in further detail what the research will involve and what you and members of your organization will be asked to do if you choose to participate. If you have any questions or concerns regarding this research or your participation, you may contact me (email ; phone number) or my supervisor Dr. Tom Langford (email ; phone number) at any time. Sincerely, [signature] Nilima Sonpal-Valias, PhD Candidate.

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A.3. Phase Two Participation Announcement [NAME OF ORGANIZATION] PARTICIPATES IN IMPORTANT NEW RESEARCH ON NON-PROFIT ORGANIZATIONS The context Ever since the structural and fiscal reforms initiated by the Klein government in the 1990s, service providers to people with disabilities in Alberta have become deeply familiar with the challenges of responding to shifting policies and processes; competing for insufficient, short-term and tenuous funding arrangements; devoting already strained resources to new and increasing modes of accountability and audit processes; and doing all this while trying to retain well-trained staff to provide quality and effective services. The research Nilima Sonpal-Valias, PhD candidate (University of Calgary Dept. of Sociology) is conducting important new research examining how the characteristics and capacities of disability (Photo of Nilima) service organizations are shaped by the historical and socio- political contexts in which they find themselves, and by the public policies and processes ensuing from these contextual conditions. The study will provide insight into the relationship between policies, practices and service delivery outcomes, as well as new knowledge on how to enhance the long-term vitality and effectiveness of nonprofit organizations. Nilima has over 20 years of professional experience in the nonprofit sector, including serving as Director of Research at Vecova Centre for Disability Services and Research for over 7 years before embarking on her doctoral studies. [Name of organization’s] involvement [Name of organization] is proud to participate as a case study site for this ground- breaking research. [Organization to customize as they wish]. To conduct her research, Nilima will be on site at [Name of organization from [insert timeframe], reviewing various reports and documents, and interviewing key individuals in the organization. Further information If you have any questions about [name of organization’s] involvement in the project or how you might be impacted, please contact [insert organization’s primary contact for the research]. For questions about the research in general, please contact Nilima (email). The research is approved by The University of Calgary Conjoint Faculties Research Ethics Board, and supported by: (i) Social Sciences and Humanities Research Council of Canada (SSHRC) Doctoral Fellowship Award #752-2012-1632; and (ii) Honorary Izaak Walton Killam Doctoral Award from the Killam Trusts.

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APPENDIX B: INTERVIEW GUIDES B.1. Phase One Interview guide for government representatives Introduction This interview asks you to recall and provide your perspective on key (i) social/disability policies or policy developments, and (ii) intersectoral structures (forums or agreements) and processes since the early 1990s, that have impacted the relationship between government and disability service organizations, and the latter’s characteristics and capacity. The interview begins by asking about policy developments, and then follows with similar questions on inter-sectoral processes. 1. Thinking back to the early 1990s since the Klein government came into power through to the present day, what key policy developments (repeat the question for intersectoral processes) stand out in your mind as having had significant impact on disability organizations and their role in service delivery? (Try to identify one or two policy events or intersectoral processes that really stand out in your mind or on which you think you may be able to provide a particularly unique perspective.) 2. For each of the policy shifts/intersectoral processes identified, answer the following questions. a. What were its distinguishing characteristics? b. What triggered it, i.e., what were the underlying factors that led to or caused it to occur when it did? c. What was the “problem” that needed to be fixed? d. What were the rationales (official and unofficial) and the logic underlying these decisions? e. Who were the key players driving these decisions? What were their motivations and goals as far as you know? What was your role? f. What alternatives were considered? g. Ultimately, what were the factors that shaped this change/event/process to take on the form or the path of evolution that it did? h. What have been some of its positive consequences? What have been some of the unintended or negative consequences? Closure 3. Is there anything else you would like to add? 4. Are there any documents or materials you would like to provide or tell me about? 5. May I contact you for a follow-up conversation in case I need to clarify anything we have talked about? (This could be in person, by phone or email.)

END OF INTERVIEW

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B.2. Phase One Interview guide for nonprofit and disability sector leaders Introduction This interview asks you to recall and provide your perspective on key (i) social/disability policies or policy developments, and (ii) intersectoral structures (forums or agreements) and processes since the early 1990s, that have had significant impact on your organization’s characteristics and capacity. The interview begins by asking about policy developments, and then asks similar questions on inter-sectoral processes. 1. Thinking back to the early 1990s since the Klein government came into power through to the present day, what key policy developments (repeat the question for intersectoral processes) stand out in your mind as having had significant impact on your organization’s characteristics and capacity (e.g., mission, structures, processes, activities and service delivery outcomes? (Try to identify one or two policy events or intersectoral processes that really stand out in your mind or on which you think you may be able to provide a particularly unique perspective.) 2. For each of the policy shifts/intersectoral processes identified, answer the following questions. a. What were its distinguishing characteristics? b. What triggered it, i.e., what were the underlying factors that led to or caused it to occur when it did? c. What was the “problem” that needed to be fixed? d. What were the rationales (official and unofficial) and the logic underlying these decisions? e. Who were the key players driving these decisions? What were their motivations and goals as far as you know? What was your role? f. What alternatives were considered? g. What have been some of its positive consequences of this policy development/intersectoral process for the nonprofit/disability sector as a whole and for service provider organizations? What have been some of the unintended or negative consequences? h. Were nonprofit/disability sector leaders consulted for their opinions on this matter? If so, what did the consultation process involve, what role did nonprofit/disability organizations play and what were the outcomes? i. Ultimately, what were the factors that shaped this change/event to take on the form or the path of evolution that it did? Closure 3. Is there anything else you would like to add? 4. Are there any documents or materials you would like to provide or tell me about? 5. May I contact you for a follow-up conversation in case I need to clarify anything we have talked about? (This could be in person, by phone or email.)

END OF INTERVIEW

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B.3. Phase Two Interview guide for case study participants Introduction 1. What is your current position, and how long have you been in it? Tell me a little bit about your role in [name of organization]. 2. How long have you been with [name of organization]? 3. How long have you been involved in the nonprofit/disability sector? Organizational Changes 4. Thinking back to when you started at [name of organization] right through to the present day, what are some of the big changes you have seen in the organization? (e.g., its identity, structure, activities, capacity, role in disability services, external relationships, etc.)? (Try to identify 2-3 key shifts) [Try to get a list of these and note them in chronological order.] 5. For each of the key shifts identified, answer the following questions. a. What were the distinguishing characteristics of this change? What makes it stand out in your mind? b. What was the rationale/logic underlying this change? c. How did you first come to hear of the change? d. What were your initial thoughts and feelings about it (e.g., did you think it was a good idea, that it made sense, that it seemed irrational, etc.). e. What was your role at [name of organization] at that time? How did you think this change was going to impact the organization as a whole?; How did you think it was going to impact specifically on your work? f. Tell me about how things actually unfolded. What activities did the organization undertake (e.g., changes to formal structures, processes, activities, relationships, etc.)?; How were these activities explained to people (staff, clients, etc.) in the organization? g. What role did you play in the change process? h. What have been the long-term consequences of this change? i. Is there anything else you would like to tell me about these changes? Additional Questions Based on Document Review 6. Ask questions that are based on key shifts identified during the document review research that require further elaboration or clarification. [The questions are different for each case site] Closing Questions 7. Is there anything else you would like to add? 8. May I contact you for a follow-up conversation in case I need to clarify anything we have talked about? (This could be in person, by phone or email.)

END OF INTERVIEW

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APPENDIX C: PARTICIPANT INFORMATION C.1. Phase One Participants Name Position at time of interview, and self-provided biography Mr. Stan Fisher President and Chief Executive Officer, St. Michael’s Health Group. Edmonton, AB. Mr. Fisher has close to 50 years of experience in the nonprofit and public sectors. He served as the Executive Director of the Wild Rose Foundation from 1987 to 1999 and as President and CEO of Chrysalis, an Alberta Society for Citizens with Disabilities from 1999 to 2006. Mr. Fisher is also a parent of a woman with a developmental disability. Mr. Ryan Geake Executive Director Calgary SCOPE Society. Calgary, AB. Mr. Geake has over 20 years’ experience in working with children and adults with developmental disabilities, complex needs, and mental health challenges. Mr. Stephen Golub Director of Corporate Development Persons with Developmental Disabilities Central Region Community Board. Government of Alberta. Red Deer, AB. Mr. Golub began working in the Social Service field in 1984 assisting in the implementation of the 1985 Child Welfare Act. He has since held a variety of roles related to communications, planning and development, and management of the PDD program. He has taken a particular interest in maintaining knowledge of the history of change within the Alberta social services field. Dr. Alex Hillyard Chief Executive Officer Calgary Region Community Board Persons with Developmental Disabilities. Government of Alberta. Calgary, AB. Dr. Hillyard has worked in the human services field for more than 25 years. Prior to coming to Calgary in September 2005, he was CEO for the Northeast region PDD board. During his career, Dr. Hillyard has worked on the front lines and in executive management positions. Ms. Maline Executive Director Jenkinson Resicare Society of Calgary. Calgary, AB. Ms. Jenkinson is a Registered Nurse by training. She has worked in services to persons with disabilities for over 35 years, and has served on several committees during that time. Ms. Gisela Kwok Director of Provincial Disabilities Supports Initiatives Ministry of Human Services Government of Alberta. Edmonton, AB

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Name Position at time of interview, and self-provided biography Ms. Joan Lee Chief Executive Officer Vecova Centre for Disability Services and Research. Calgary, AB. Ms. Lee is a senior leader in the not for profit sector with over 30 years of experience working with people with disabilities. She leads an organization with a rich track record for innovation in service delivery and the demonstration of successful social enterprises. Mr. Doug Luft Senior Director Supported Lifestyles Ltd. Calgary, AB. Mr. Luft has over 20 years’ experience in working with children and adults with developmental disabilities, complex needs, and mental health challenges. His experience in both the public and not for profit sectors includes positions in front line, Supervisory, Contract Management, Project Management, Senior Management and Not for Profit Boards. Ms. Yvonne Director of Human Resources, Finance and Administration Martodam Vecova Centre for Disability Services and Research. Calgary, AB. Ms. Martodam has over 30 years of experience in human services. She is involved in determining the strategic direction of the organization and facilitating organizational systems or processes to achieve results. She has contributed to workforce development initiatives at the regional, provincial and national level. She also completed a 2-year secondment with the Alberta Council of Disability Services to manage the provincial workforce councils for the Community Disability Services sector. Ms. Maureen Founder Murphy-Black Blackstar Consulting Group. Edmonton, AB. Ms. Murphy-Black has a long and recognized career with the provincial government, in positions including Director of the AISH Program and of Policy Development and Innovation for the Persons with Developmental Disabilities Program. She served as lead negotiator for Alberta in a federal/provincial funding agreement negotiation requiring collaboration with community stakeholders, provincial government departments and federal partners. Ms. Murphy-Black has also served in senior secondment positions and as a consultant to the voluntary sector. Mr. Norman Retired Chief Executive Officer McLeod Persons with Developmental Disabilities Provincial Board. Government of Alberta. Edmonton, AB.

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Name Position at time of interview, and self-provided biography Ms. Ann Nicol Chief Executive Officer Alberta Council of Disability Services. Calgary, AB. Ms. Nicol has a Master’s in Social Work and over 30 years’ experience in the human services field in the public, private and nonprofit sectors. While with the Government of Alberta, Ms. Nicol worked with or on behalf of vulnerable youth, children, families and adults. In her current role with ACDS, she provides representation on behalf of 130 nonprofit and private Community Disability Service Providers. Mr. Mark Nicoll Manager of Strategic Analysis for Aboriginal Initiatives and Innovations Ministry of Human Services Government of Alberta. Edmonton, AB. Ms. Yvonne Retired public sector leader. Schmitz Ms. Schmitz is a social worker and an advocate for people in vulnerable situations. She has worked with offenders, people with disabilities, families in poverty and a wide range of human service organizations. Ms. Schmitz has been part of the Women’s Movement, the Labour Movement, the Disability Rights Movement and many anti-poverty groups. She was a member of the Board of Directors of the United Way of Calgary for 6 years and now serves on other Boards and Committees. She is a proud member of the group Social Workers for Social Justice. Dr. Keith Seel Dean of Centre for Excellence in Foundational Learning (member of thesis Bow Valley College. Calgary, AB. supervisory Prior to joining Bow Valley College in September 2012, Dr. Seel committee) was the Director of the Institute for Nonprofit Studies at Mount Royal University. He has been a volunteer board member for 30 years largely in the human services field. Currently he holds appointments to two provincial boards with responsibilities in education and children. Dr. Seel is also a parent of a child with developmental disabilities. Dr. Christopher Assistant Executive Director Smith Muttart Foundation. Edmonton, AB. (member of thesis In addition to his work with the Muttart Foundation, Dr. Smith supervisory serves as the Chair of Success by 6 for the United Way of the committee) Alberta Capital Region. In the late 1980s and early 1990s Dr. Smith worked as an external consultant for the provincial government on issues and initiatives in the areas of health, social services and education. From 1994 to 1998 he served as the program director for the Edmonton Social Planning Council guiding a portfolio of research and policy initiatives all with a social justice orientation.

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Name Position at time of interview, and self-provided biography Mr. Bruce Uditsky Chief Executive Officer Alberta Association for Community Living (now Inclusion Alberta). Edmonton, AB. Mr. Uditsky serves in an advisory capacity to a number of government ministries on policies and legislation affecting individuals with intellectual disabilities. He was instrumental in the development of the Family Support for Children with Disabilities Act, PDD Community Governance Act, Alberta’s education standards on the placement of students with disabilities in the regular classroom, and the individualized funding model. He played a leadership role in the development of a region-wide inclusive early childhood system and Rotary Employment Partnerships. He is the founder of Inclusive Post-secondary Education and cofounder of the Alberta Disabilities Forum. Mr. Uditsky is the parent of two adult children, one of whom is adopted and has intellectual disabilities. Mr. Tim Weinkauf Director of Program Development and Innovation Persons with Developmental Disabilities Program, Ministry of Human Services. Government of Alberta. Edmonton, AB. Mr. Weinkauf has over 25 years’ experience in Alberta’s disability services sector as a provider in the not-for-profit sector as well as a policy maker. Ms. Elaine Yost President and Director Optional Rehabilitation Services (Options) Inc. Calgary, AB. Ms. Yost is founder of Options, a private company operating in Calgary since 1986, born from the desire to develop new, exciting and innovative routes for providing care and support to people with disabilities. Ms. Yost has served on numerous committees advocating for improved funding and services. She is also the parent of an individual with developmental disabilities. Ms. Denise Young Director Calgary SCOPE Society. Calgary, AB. Ms. Young has worked in disability services for 24 years. Her main areas of interest are community development, human rights, disability advocacy and disability arts.

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C.2. Phase Two Organizational Sites Calgary SCOPE Society (SCOPE) 219 18 Street SE, Calgary, AB. T2E 6J5 Website: http://www.calgaryscope.org/home Registered nonprofit society. CRA BN 118824135RR0001; reg. on September 22, 1986 Incorporated on August 4 1983 under the Alberta Societies Act About: “Supporting Individuals with Disabilities Across their Lifespan. The Calgary SCOPE Society is a non-profit agency improving lives for persons with developmental disabilities in Calgary and area for over 30 years! SCOPE works with children, adults, seniors and families as respected, contributing members of Calgary’s communities.” Mission: “The Calgary SCOPE Society works in alliance with people with disabilities, their families and friends, and other community members to understand problems and create solutions to personal and social justice issues.” Activities: Services for children and their families:  Outreach supports for families of children with developmental disabilities to provide parenting and behavioural strategies, or to connect them with resources and services in the community.  Social skills development for teens in Grades 7-12 with a developmental disability. (Max: 30 participants)  In-home curriculum delivery 1 hr/week for 3 programs to help parents improve parenting skills, build positive relationships with their children and encourage their child’s development. Services for adults:  Community support: community based services including housing support for adults with dual diagnosis.  Deaf/Blind: Specialised supports for deaf/blind individuals who require behavioural and mental health services, from 5-24 hrs/day  Counselling support for adults, and support strategy tips for adults and their support teams  Journeys program for seniors, 5-24 hrs/day Community development: grassroots initiatives to build awareness, advocate, and dialogue around the issues facing people with disabilities, including:  Disability Action Hall: “providing a forum for clients, their families, friends and community to join together to address social justice issues that impact people with disabilities;”  Picture This … Film Festival;  Speak Out disability pride parade and rallies. Number of staff: 250 full-time. Number of clients: over 300 (many on short-term referral periods); about 50 in 24/7 housing supports. Annual revenues 2013/14: $15 million

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Optional Rehabilitation Services (Options) Inc. Administrative Office: Suite 120 – 200 Quarry Park Blvd SE, Calgary, AB. T2C 5E3 Day Program Facility: 10601 Southport Road SW, Calgary, AB. T2W 3M5 Website: http://optionsrehab.org/ Private company. President and Director: Ms. Elaine Yost. Incorporated on August 7, 1986. About: “Optional Rehabilitation Services (OPTIONS) Inc., a private company incorporated August 7, 1986, was born from the desire to develop new, exciting and innovative routes for providing care and support to people with disabilities. OPTIONS was formed for the purpose of creating a new service choice for people who wish to initiate innovative routes for the provision of services to people with complex service needs. It is OPTIONS’ belief that people who are disabled have the right to be treated with dignity; have the right to make choices; have the right to dignity of risk and have the right to live in the community.” Mission: “Seek to understand and share in the celebration of life of those often thought out of life.” Activities:  Residential support for individuals living in Option’s properties.  Residential support facilitation (monitoring services) for independent service providers.  Daytime support including: day program, employment services, and community access support. Number of staff: 125 full-time equivalent Number of clients: approx. 230 Annual operating revenues: $11 million

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Vecova Centre for Disability Services and Research (Vecova) 3304-33 Street NW, Calgary, AB. T2L 2N4 Website: http://vecova.ca/ Registered nonprofit society. CRA BN 119286912RR0001; January 1, 1967 Incorporated: July 19 1966, under the Alberta Societies Act. About: “Operating since 1969, Vecova is an accredited, non-profit society and a registered charity. We provide a wide range of supports and services for individuals with developmental disabilities and diverse needs. Vecova is an affiliate Research Institute of the University of Calgary. Our Research Services have garnered a national reputation for producing accessible, practical research that is responsive to the needs of the disabilities sector.” Mission: “Building the capacity of persons with disabilities and enriching communities through leadership, innovation and collaboration.” Activities:  Services and supports to assist individuals with disabilities in Calgary and the Bow Valley area to live in the community, including: living (residential) supports, employment services, community access, professional supports, and transition planning.  Research consulting to nonprofit and disability organizations.  Social enterprises (revenue generating businesses to support the organization’s social mission and activities): Beverage Container Recycling Depot and container pick-up service; Recreation Centre with a fully accessible dryland and aquatic recreation and fitness facility for public of all ages; baggage cart retrieval service at the Calgary International Airport; recycling services at University of Calgary.  Medication Administrations Training for developmental disability sector staff. Number of staff: approx. 260 full-time; 425 part-time Number of clients: approx. 200 Annual revenues 2014/15: $24 million

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APPENDIX D: CONSENT FORMS D.1. Phase One Consent Form (extract) (On University of Calgary Faculty of Arts Letterhead) RESEARCH PARTICIPATION CONSENT FORM Preamble Purpose of the Study What Will I Be Asked To Do? What Type of Personal Information Will Be Collected? Are there Risks or Benefits if I Participate? What Happens to the Information I Provide? Signatures (Written Consent) Your signature on this form indicates that you: (1) acknowledge that your participation in this study is entirely voluntary, (2) understand to your satisfaction the information provided to you about your participation in this research project, and (3) agree to participate as a research subject where your contributions are (please check one):  Public and cited by name OR  Public but cited anonymously In no way does this waive your legal rights nor release the investigators, sponsors, or involved institutions from their legal and professional responsibilities. You are free to withdraw from this research project at any time. You should feel free to ask for clarification or new information throughout your participation. [NAME, SIGNATURE and DATE] Questions/Concerns If you have any further questions, concerns, or want clarification regarding this research and/or your participation, please contact the student researcher Nilima Sonpal-Valias (email; phone). You may also contact the researcher’s faculty supervisor, Dr. Tom Langford (email; phone). If you have any concerns about the way you’ve been treated as a participant, please contact the Senior Ethics Resource Officer, Research Services Office, University of Calgary (email; phone). A copy of this consent form has been given to you to keep for your records and reference. For in-person interviews, the investigator will keep a copy of the signed consent form. For telephone interviews, the investigator will obtain a digital audio-recording of your verbal consent.

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D.2. Phase Two Organizational Participation Consent Form (extract) (On University of Calgary Faculty of Arts Letterhead) CONSENT TO PARTICIPATE IN RESEARCH AS A CASE STUDY SITE Preamble Purpose of the Study What Will I and Members of My Organization Be Asked To Do? What Type of Personal Information Will Be Collected? Are there Risks or Benefits if I Participate? What Happens to the Information I Provide? Signatures (Written Consent) A copy of this consent form has been given to you to keep for your records and reference. The investigator has kept a copy of the signed consent form. Your signature on this form indicates that you: (1) acknowledge that your organization’s participation in this study is entirely voluntary, (2) understand to your satisfaction the information provided to you about your organization’s participation as a case study site in this research project, (3) agree to give me permission to access your organization as a case study site for research that may take up to 8 – 12 weeks, and (4) agree to have the information obtained about your organization during its participation as a case study site as (please check one):  Public and cited by name OR  Public but cited anonymously Please identify which of the activities below I can undertake while conducting research at your organization (check all that you agree to, and cross out any that you do not agree to):  Review of archived documents (e.g., annual reports, press releases, board minutes, organizational charts, strategic plans/reports, funding contracts, program reports, PR materials and media reports) that you voluntarily provide to me.  In-person interviews with board members, senior executives, and select program managers and front-line staff that you identify as potential respondents.  Informal, ad hoc conversations with organizational members as opportunities arise during my daily presence at the organization for the duration of the research.  Direct observations of inanimate aspects of the organizational site (e.g., location, buildings and offices, public spaces).  Review of financial, staffing and service data as reported in any non-public documents that you voluntarily provide to me (Please note that I do not need your permission to access and report information from any publicly-available reports or datasets).

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In no way does this waive your legal rights nor release the investigators, sponsors, or involved institutions from their legal and professional responsibilities. You are free to withdraw from the research at any time. Please feel free to ask for clarification or new information throughout your participation.

[NAME, POSITION, SIGNATURE and DATE]

Questions/Concerns If you have any further questions, concerns, or want clarification regarding this research and/or your participation, please contact the student researcher Nilima Sonpal-Valias (email; phone). You may also contact the researcher’s faculty supervisor, Dr. Tom Langford (email; phone). If you have any concerns about the way you’ve been treated as a participant, please contact the Senior Ethics Resource Officer, Research Services Office, University of Calgary (email; phone). A copy of this consent form has been given to you to keep for your records and reference.

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D.3. Phase Two Individual Consent Form (extract) (On University of Calgary Faculty of Arts Letterhead) CASE STUDY RESEARCH PARTICIPATION CONSENT FORM (INDIVIDUAL RESPONDENT) Preamble Purpose of the Study What Will I Be Asked To Do? What Type of Personal Information Will Be Collected? Are there Risks or Benefits if I Participate? What Happens to the Information I Provide? Signatures (Written Consent) Your signature on this form indicates that you: (1) acknowledge that your participation in this study is entirely voluntary, (2) understand to your satisfaction the information provided to you about your participation in this research project, (3) agree to participate as a research subject where your contributions are public but cited anonymously. In no way does this waive your legal rights nor release the investigators, sponsors, or involved institutions from their legal and professional responsibilities. You are free to withdraw from this research project at any time. You should feel free to ask for clarification or new information throughout your participation.

[NAMES, POSITION, SIGNATURES and DATE]

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APPENDIX E: CHRONOLOGY OF KEY DEVELOPMENTS 1905 Province of Alberta is established on September 1. 1905/06 Premier ALEXANDER RUTHERFORD (Liberal). Official opposition: Conservative. 1905/06 Albertans with developmental disabilities or mental illness are cared for at home or sent to the Insane Asylum in Brandon, Manitoba. 1907/08 Alberta’s Insanity Act permits confinement of persons who are “insane and dangerous.” 1910/11 Premier ARTHUR SIFTON (Liberal). Official opposition: Conservative. 1911/12 Provincial Hospital for the Insane is opened in Ponoka as Alberta’s first institute for Albertans with mental illness or developmental disabilities. 1917/18 Premier CHARLES STEWART (Liberal). Official opposition: Conservative. 1919/20 Alberta’s Mental Defectives Act defines as “mentally defective” “any persons afflicted with a mental deficiency from birth, or from an early age, so pronounced that he is incapable of managing himself or his affairs, and who is not classified as an insane person,” and permits the institutionalization of such persons in specially designated facilities. South Edmonton Home for Mental Defectives is opened as the first residential training institute specifically for children with developmental disabilities. 1920/21 Construction is announced for the Home and Training School for Mental Defectives in Oliver. 1921/22 Premier HERBERT GREENFIELD (United Farmers of Alberta). No official opposition. Largest opposition party: Liberal. 1923/24 Provincial Training School (PTS, later named Alberta School Hospital, and subsequently Michener Centre) opens as a residential care and training facility for children and young adults with developmental disabilities. 1925/26 Premier JOHN BROWNLEE (United Farmers of Alberta). No official opposition. Largest opposition party: Liberal. 1928/29 Alberta’s Sexual Sterilization Act is enacted, and the Alberta Eugenics Board is established. 1934/35 Premier RICHARD REID (United Farmers of Alberta). No official opposition. Largest opposition party: Liberal.

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1935/36 Premier WILLIAM ABERHART (Social Credit). No official opposition. Largest opposition party: 1935-40 Liberal; 1940-43 coalition. 1937/38 Alberta’s Sexual Sterilization Act is amended, removing the requirement for consent from people with developmental disabilities. 1943/44 Premier ERNEST MANNING (Social Credit). Official opposition: 1943-48 coalition; 1949-51 no official opposition; 1952-59 Liberal; 1959-63 no official opposition; 1963-67 Liberal; 1967-68 Progressive Conservative. 1957/58 Deerhome Institution is constructed on PTS grounds for adults with developmental disabilities. 1958/59 Canadian Association for Community Living (CACL, formerly Canadian Association for Retarded Children, and Canadian Association for the Mentally Retarded) is chartered to provide a national voice for local and provincial parental associations. Christine Meikle School, the first for children with developmental disability in Calgary opens. 1960/61 Canadian Bill of Rights is adopted by the federal government. 1961/62 Federal Vocational Rehabilitation of Disabled Persons Act enables the provinces to recover up to 50% of vocational rehabilitation training costs for individuals with disabilities. 1964/65 Federal-Provincial Conference on Mental Retardation brings together governments, academics and parental advocacy organizations. 1965/66 PTS is amalgamated with Deerhome, and renamed Alberta School Hospital 1966/67 Federal Medicare Care Act establishes cost-sharing of universal medicare. Federal Canada Assistance Plan Act extends federal-provincial cost sharing to a wide range of social services, including programs for people with disabilities. Alberta Preventive Social Services (PSS) program expands the size and scope of the voluntary sector in community-based social service delivery. 1967/68 CACL and federal government partner to fund research and demonstration centres in supports for people with developmental disabilities as part of the “Centennial Crusade” initiative. 1968/69 Premier HARRY STROM (Social Credit). Official opposition: Progressive Conservative. 1968/69 One of Alberta’s first group homes is established by PTS in Red Deer.

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1969/70 Blair (1969) report recommends deinstitutionalization and regionally- administered continuum of community-based services for people with mental illness or developmental disabilities. 1970/71 CACL’s “Plan for the 70s” campaign plays a significant role in shifting governmental policy to an emphasis on community-based, individually focused supports. 1971/72 Premier PETER LOUGHEED (Progressive Conservative). Official opposition: 1971-82 Social Credit; 1982-85 New Democrat. 1972/73 Alberta’s Sexual Sterilization Act is repealed, and the Eugenics Board is disbanded. Services for the Handicapped (SFH) program is created to administer government-run institutions and grants for residential supports to new community-based services. Alberta Association of Rehabilitation Centres (AARC, renamed Alberta Council of Disability Services [ACDS]) is established to facilitate cooperation between community-based operators and provincial government. 1973/74 Handicapped Children’s Services (HCS) is implemented to provide financial assistance to parents or guardians of children with disabilities. 1975/76 Coalition of Provincial Organizations of the Handicapped (renamed Council of Canadians with Disabilities [CCD]) has its first national meeting. Community Enrichment Program is opened in Edmonton to teach social skills and the use of community resources to severely disabled adults. It is the first such program in Canada. 1976/77 SFH and Vocational Rehabilitation programs become branches under the new Division of Rehabilitation Services. 1977/78 Alberta School Hospital is renamed Michener Centre. 1978/79 Alberta’s Dependent Adults Act is enacted, enabling Courts to appoint a legal guardian of an individual unable to make personal decisions. It is the first such initiative in Alberta. People First, Canada’s first self-advocacy group of people with developmental disabilities is formed in BC. 1979/80 Alberta’s Assured Income for the Severely Handicapped (AISH) is implemented. It is the first social assistance program in Canada exclusively for people with disabilities unable to work.

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1980/81 1981 is declared International Year of Disabled Persons. Obstacles, the report from the federal government’s all-party Special Committee on the Disabled and the Handicapped articulates 130 recommendations for policy improvements. Alberta government begins a two-year project with AARC to develop long- term goals and policies for the provision of vocational programs. 1981/82 Funding for vocational programs is increased by 40% to enable agencies to remain competitive with government. 1982/83 United Nations declares 1982-93 the International Decade of Disabled Persons. Federal-provincial working group is established to study options for reforming income support programs for individuals with disabilities. Alberta government runs a deficit for the first time in over three decades. Regionalization of services for people with developmental disabilities gets underway. SFH becomes part of Residential Services Program. Residential Services and Rehabilitation (Vocational) Services are separate programs within the Division of Social Services. 1983/84 All programs in the Division of Social Services are reviewed, resulting in program changes and reorganization to create a structure better suited to regional decentralization. 1984/85 The Royal Commission on Equality in Employment (aka Abella Commission) explores the duty to accommodate persons with disabilities in the workplace. Parliamentary Committee on equality Rights issues Equality for All, establishing a framework for meeting the needs of persons with disabilities. Federal Status of Disabled Persons Secretariat is established to raise awareness and support the full participation of persons with disabilities. 1985/86 Premier DON GETTY (Progressive Conservative). Official opposition: 1985-92 New Democrat. 1985/86 AARC is funded to develop standards for vocational services; the standards evolve into an accreditation process to be implemented by AARC. Province-wide consultations are held between regional, community, and policy planners to facilitate the transfer of individuals from institutions to their home communities. An array of residential arrangements are funded; many are parent-operated agencies. In the South region, a tendering process is introduced for SFH grants.

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1986/87 Social Services introduces program and service adjustments to control spending. Use of community-based and generic services is encouraged over specialised services. Residential institution in Wetaskiwin is closed. 1987/88 Premier’s Council on the Status of Persons with Disabilities (PCSPD) is announced to advise on disability policy matters. Youngstown Home is reorganized to serve as a bridge to community living for residents mostly from Michener Centre. 1988/89 Social Services is renamed Family and Social Services (FSS). Minister Neil Crawford drafts a new social policy vision, Caring and Responsibility. The Brassard Committee reviews current and future needs of Albertans with developmental disabilities. The report, Claiming My Future, provides directions that shape the future philosophical and value basis of services and policies. The PCSPD Action Plan recommends that employment support services for adults with developmental disabilities be integrated into mainstream systems and services. Vocational programs move away from sheltered workshops to supporting individuals within mainstream workplaces (supported employment). 1989/90 Programs for children and adults with disabilities are reorganized under a single Services for Persons with Disabilities program (SPD). In Calgary, community agencies join to form a residential council and a vocational council (which later merge to form the Community Rehabilitation Service Provider Council of Calgary) to lobby the government for wage parity and adequate service funding. 1990/91 Programs for adults with developmental disabilities are amalgamated under Adult Services. Interdepartmental committees are established to address the Brassard report. A personal supports benefit is established to provide funding from the Social Allowance program to persons with disabilities in need; this eventually leads to the Individualised Funding (IF) Program. 1991/92 Federal National Strategy for the Integration of Persons with Disabilities is announced, providing funding for five years for time-limited projects to improve the social and economic integration of persons with disabilities. Achieving Full Participation in the Life of Alberta is released, summarizing the steps taken toward the PCSPD Action Plan. A service planning policy is developed to promote consistency across regions.

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1992/93 Premier RALPH KLEIN (Progressive Conservative). Official opposition: 1992-93 New Democrat; 1993-2006 Liberal. 1993/94 Klein reforms begin. Planning gets underway to transfer management of service delivery for adults with developmental disabilities from FSS to community-based regional authorities. Developmental work is undertaken to transfer personal supports benefits for individuals with developmental disabilities to SPD. Three year budget targets, business plans and performance measures are developed by each program to track and report results. 1994/95 FSS begins a consultative process to define outcome measures for SPD. FSS and AARC partner to implement rehabilitation standards and accreditation. 1995/96 Steps are announced for the transfer of management of service delivery for adults with developmental disabilities from FSS to regional boards. Information sessions are held to discuss the reforms with public servants, clients, families and services providers. SPD Foundation (renamed PDD Foundation in 1997) is formed under the PDD Foundation Act to raise funds for capital projects, pilot projects and research. AARC develops Striving for Quality Accreditation Standards. The standards begin to be implemented with all funded agencies. 1996/97 Canada Assistance Plan (CAP) is replaced by Canada Health and Social Transfer (CHST). Personal Supports Benefit (also referred to as the Individualised Funding Program) is transferred from welfare into SPD. Michener Centre Board is established to oversee the management of the institution. 1997/98 The government is sued for the Alberta Eugenics Board’s decisions to approve involuntary sterilizations. PDD Community Governance Act is passed to create the PDD program of community governance of services for adults with developmental disabilities. Six regional boards and the PDD Provincial Board are established. Senior bureaucrats begin receiving achievement awards for keeping program spending under budget; the cost to FSS for this unbudgeted expenditure is almost $4m.

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1998/99 In Unison: A Canadian Approach to Disability Issues is published to provide a coordinated approach for the integration of persons with disabilities in society. The federal Vocational Rehabilitation for Disabled Persons (VRDP) program in redesigned into a more active, employment-focused Employability Assistance program. SPD is fully transferred to PDD. The first biennial PDD Satisfaction Surveys is sent to parents, guardians and clients. AARC’s new Creating Excellence Together (CET) standards are approved. 1999/00 FSS is dissolved. PDD Program is transferred to the new Ministry of Health and Wellness. The government pays out $70 million in legal settlements of sterilization claims. In response to community concerns about funding reductions, a review of the PDD program is undertaken by Associate Minister Zwozdesky. The report, Building Better Bridges, provides recommendations that are addressed over the next few years. 2000/01 Increased funding is provided to service providers for service expansion and staff wages. PDD Regional Boards implement various strategies to involve families, guardians and service providers in providing direction on PDD initiatives. 2001/02 Alberta government undergoes massive reorganization. PDD is transferred to Ministry of Health and Wellness. On March 20, PDD Foundation is dissolved; assets are transferred to PDD Provincial Board. 2002/03 On July 23, Michener Centre Facility Board is dissolved; responsibility for Michener Centre and Youngstown Home is transferred to PDD Central Alberta Community Board. From July, PDD Community Boards begin reporting to PDD Provincial Board. Premier’s Council on the Status of Persons with Disabilities releases Alberta Disability Strategy with recommendations to improve programs and processes. 2003/04 Office of Disability Issues is created. Gaps in Services Initiative undertakes program and policy development for persons with disabilities who fall outside the mandate of current programs. Certification standards are enhanced based on stakeholder input.

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2004/05 PDD is transferred to Ministry of Seniors and Community Supports. PDD Provincial Board holds consultations to develop a governance and accountability framework, and to clarify roles and responsibilities. The first ever Self-Advocacy Summit is held, and leadership development training is funded for adults with developmental disabilities. AACL is funded to host family leadership workshops and to develop family networks. PDD and AARC partner to launch and chair Workforce 2010, a series of initiatives to achieve a well-trained and stable community agency workforce. 2006/07 Premier ED STELMACH (Progressive Conservative). Official opposition: Liberal. 2006/07 On June 30, PDD Provincial Board is disbanded, regional board roles are enhanced. Seniors and Community Supports partners with Employment, Immigration and Industry and Health and Wellness in the federal Labour Market Agreement for Persons with Disabilities program, to pilot new approaches for employment training and supports. 2007/08 On March 30, Canada signs the UN Convention on the Rights of Persons with Disabilities. PDD undertakes a number of initiatives and activities to strengthen accountability and monitoring systems and processes, and more pilot a more rigorous contracting process. Governance roles and capacities of community boards are strengthened and clarified. All program areas are examined and a comprehensive enterprise risk assessment is completed. The resulting framework is intended to guide Community Boards in the development of regional risk mitigation strategies. Family Managed Supports enables families to hire and manage care directly. Pilot projects are implemented to increase employment skills for AISH clients. 2008/09 What We Heard summarises PDD Community Boards stakeholder engagement sessions to improve service provision and address human resource issues. A new contracting process is developed to increase monitoring and accountability. Calgary Region Community board partners with AACL to plan the development of a Resource Centre to assist families in Family Managed Supports arrangements.

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2009/10 Based on What We Heard report, six priority actions are developed to increase PDD consistency, access, responsiveness, and efficiency. The new service provider contracting process is implemented. AACL opens a Family Managed Resource Centre in Calgary, and initiates Family Voices in the Northeast and South Regions to help families connect to each other. On March 11, Canada ratifies the UN Convention on the Rights of Persons with Disabilities. 2010/11 In June, PDD administrative review by KPMG is commissioned as an extension of the six priority actions identified in 2009. A Provincial Advisory Committee is created to communicate with stakeholders and gather feedback on policy, operational and strategic matters. On January 25, Stelmach announces his intention to resign. 2011/12 Premier ALISON REDFORD (Progressive Conservative). Official opposition: 2011-2012 Liberal; 2012-2014 Wildrose. 2011/12 On October 12, Ministry of Seniors and Community Supports is renamed Ministry of Seniors. PDD Change Initiatives Project is established to design and implement nine initiatives consolidating the six priority actions originating from What We Heard and eleven directions arising from the KPMG Administrative Review. A long-term strategy is developed to help agencies attract and retain quality staff. 2012/13 In May 2012 PDD is transferred to Disability Services Division in the new Ministry of Human Services. An Associate Minister is appointed for persons with disabilities. Work continues in PDD on planning, designing and implementing the changes identified in the Change Initiatives Project. In February Alberta’s new Social Policy Framework is released.

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2013/14 Transition plan and framework are announced to move the remaining 125 residents in Michener Centre to community-based facilities and supports. Outcomes focused contract and performance management framework is implemented in service provider contracts. PDD Transformation Plan is announced to develop a sustainable, responsive, outcomes-focused, consistent approach to planning and service delivery. Alberta Employer Advisory Council is created to increase employment opportunities for people with disabilities, and advise on the Alberta Employment First Strategy. Premier’s Council on the Status of Persons with Disabilities mandate is expanded to have greater influence over policy and program development, planning, and supporting relationships with service providers. In January 2014 Building Families and Communities Act comes into force to replace PDD Community Boards with Family and Community Engagement Councils and repeal PDD Community Governance Act. PDD Act remains in force as legislative work gets pushed to the back burner due to political issues surrounding questionable government practices. On March 23, Redford resigns. 2014/15 Premier DAVE HANCOCK (Progressive Conservative). Premier JIM PRENTICE (Progressive Conservative). Official opposition: Wildrose. 2014/15 Regional Boards are dissolved. Management and administration of service delivery continues via PDD regional offices. On September 14 Jim Prentice becomes premier of Alberta. Closure of Michener Centre is cancelled in response to opposition from residents’ families. 2015/16 Premier RACHEL NOTLEY (New Democrat). Official opposition: Wildrose.

Sources a) Legislative Assembly of Alberta. “Premiers of Alberta”. http://www.assembly.ab.ca /lao/library/PREMIERS/. b) ParlInfo Canada. “Alberta Leaders of the Opposition.” http://www.parl.gc.ca/ParlInfo/. b) Government of Alberta and ministry annual reports. c) Alberta (2006a).

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APPENDIX F: ALBERTA PREMIERS AND MINISTERS FOR DEVELOPMENTAL DISABILITY SERVICES 1905 – 1910 Premier ALEXANDER RUTHERFORD (Liberal) Department of Provincial Secretary 1905 – 1909 William Finley 1909 – 1910 Duncan Marshall 1910 – 1917 Premier ARTHUR SIFTON (Liberal) Department of Provincial Secretary 1910 – 1917 Archibald McLean 1917 – 1918 Charles Stewart 1917 – 1921 Premier CHARLES STEWART (Liberal) Department of Provincial Secretary 1917 – 1918 Charles Stewart Department of Public Health 1919 – 1920 Alexander MacKay 1921 – 1925 Premier HERBERT GREENFIELD (United Farmers of Alberta) Department of Public Health 1921 Charles Mitchell (Acting) 1921 – 1923 Richard Reid 1923 – 1925 George Hoadley 1925 – 1934 Premier JOHN BROWNLEE (United Farmers of Alberta) Department of Public Health 1923 – 1934 George Hoadley 1934 – 1935 Premier RICHARD REID (United Farmers of Alberta) Department of Public Health 1934 – 1935 George Hoadley 1935 – 1943 Premier WILLIAM ABERHART (Social Credit) Department of Public Health 1935 – 1943 Wallace Cross 1943 – 1968 Premier ERNEST MANNING (Social Credit) Department of Public Health 1943 – 1957 Wallace Cross 1957 – 1967 Joseph Ross Department of Health 1967 – 1968 Joseph Ross 1968 – 1971 Premier HARRY STROM (Social Credit) Department of Health 1968 – 1969 Joseph Ross 1969 – 1971 James Henderson 1971 – 1985 Premier PETER LOUGHEED (Progressive Conservative) Department of Health and Social Development 1971 Raymond Speaker 1971 – 1975 Neil Crawford Department of Social Services and Community Health 1975 – 1979 Wilma Hunley 1979 – 1982 Robert Bogle 1982 – 1986 Neil Webber

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1985 – 1992 Premier DON GETTY (Progressive Conservative) Department of Social Services and Community Health 1982 – 1986 Neil Webber Department of Social Services 1986 – 1988 Constantine Osterman Department of Family and Social Services 1988 – 1992 John Oldring 1992 – 2006 Premier RALPH KLEIN (Progressive Conservative) Department of Family and Social Services 1992 – 1996 Mike Cardinal 1996 – 1997 Stockwell Day 1997 – 1999 Lyle Oberg Ministry of Health and Wellness 1999 – 2000 Halvar Johnson 2000 – 2001 Gary Mar Ministry of Community Development 2001 Stan Woloshyn 2001 – 2004 Gene Zwozdesky Ministry of Seniors and Community Supports 2004 – 2006 Yvonne Fritz 2006 – 2007 Greg Melchin 2006 – 2011 Premier ED STELMACH (Progressive Conservative) Ministry of Seniors and Community Supports 2006 – 2008 Greg Melchin 2008 – 2011 Mary Anne Jablonski 2011 – 2014 Premier ALISON REDFORD (Progressive Conservative) Ministry of Seniors 2011 – 2012 George VanderBurg Ministry of Human Services 2012 – 2013 Dave Hancock 2013 – 2014 Manmeet Bhullar 2014 Heather Klimchuk 2014 Premier DAVE HANCOCK (Progressive Conservative) Ministry of Human Services 2014 Heather Klimchuk 2014 – 2015 Premier JIM PRENTICE (Progressive Conservative) Ministry of Human Services 2014 – 2015 Heather Klimchuk 2015 - 2016 Premier RACHEL NOTLEY (New Democrat) Ministry of Human Services 2015 – 2016 Irfan Sabir

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