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Nowhere to Turn Investigation Into the Ministry of Community and Social Services’ Response to Situations of Crisis Involving Adults with Developmental Disabilities

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Nowhere to Turn Investigation Into the Ministry of Community and Social Services’ Response to Situations of Crisis Involving Adults with Developmental Disabilities Nowhere to Turn Investigation into the Ministry of Community and Social Services’ response to situations of crisis involving adults with developmental disabilities Ombudsman Report n Paul Dubé, Ombudsman of Ontario n August 2016 www.ombudsman.on.ca 1-800-263-1830 Office of the Ombudsman of Ontario We are: An independent office of the Legislature that resolves and investigates public complaints about Ontario government organizations and municipalities, universities and school boards. The Ombudsman recommends solutions to individual and systemic administrative problems. Our Values: Fair treatment Accountable administration Independent, impartial Results: Achieving real change Our Mission: We strive to be an agent of positive change by promoting fairness, accountability and transparency in the public sector. Our Vision: A public sector that serves citizens in a way that is fair, accountable and transparent. Nowhere to Turn SYSTEMIC INVESTIGatION INDIVIDUAL CASES Director: Director: Gareth Jones, Special Ombudsman Response Team Sue Haslam, Director of Investigations Lead Investigator: Investigators: William Cutbush Anne Hart Jackie Esler Investigators: Chris McCague Ciaran Buggle Leanne Salel Grace Chau Rosie Dear Early Resolution Officers: Ronan O’Leary Sharon Anderson Adam Orfanakos Heather Conklin Domonie Pierre Anna Gatova Elizabeth Weston Alanna Maloney Andrea Marlowe General Counsel: Dahlia Phillips Laura Pettigrew Alexandra Saginur General Counsel: Wendy Ray Find us on Facebook: facebook.com/Ontario Ombudsman Follow us on Twitter: twitter.com/Ont_Ombudsman Watch us on YouTube: youtube.com/OntarioOmbudsman Ombudsman Report Investigation into the Ministry of Community and Social Services’ response to situations of crisis involving adults with developmental disabilities Nowhere to Turn Paul Dubé Ombudsman of Ontario August 2016 abc Table of Contents Executive Summary ............................................................................................ 1 Investigative Process ......................................................................................... 6 Investigation scope .................................................................................................... 8 Other reviews and related investigations ................................................................ 9 Select Committee on Developmental Services ......................................................... 9 Auditor General ....................................................................................................... 10 Inquests ................................................................................................................... 10 Guy Mitchell ...................................................................................................................... 10 James (Jamie) Hawley ..................................................................................................... 11 Lessons from the Past ..................................................................................... 12 Institutional legacy ................................................................................................... 14 Overview of Legislation ................................................................................... 15 System Overview .............................................................................................. 17 The Ministry of Community and Social Services ................................................... 17 Service agencies ...................................................................................................... 18 Community planning tables ..................................................................................... 18 Developmental Services Ontario ............................................................................ 19 Funding for developmental services and supports .............................................. 19 Special Services at Home ....................................................................................... 21 Ontario Disability Support Program ......................................................................... 21 Passport program .................................................................................................... 21 Flex funding / temporary supports ........................................................................... 22 Transition from children’s developmental services ............................................. 23 Applying for services ............................................................................................... 25 Confirming eligibility ................................................................................................ 25 Needs assessment ................................................................................................. 25 Prioritization ............................................................................................................ 26 Matching and waiting lists ....................................................................................... 27 Urgent response ....................................................................................................... 28 Defining urgency ..................................................................................................... 28 Residential services ................................................................................................. 29 The Many Faces of Crisis ................................................................................. 30 Victims of abuse ....................................................................................................... 31 Falling off the cliff: Adam’s story (East Region) ...................................................... 31 Failure of early warning system ........................................................................................ 35 Give me shelter: Layla’s story (East Region) .......................................................... 37 Safe room ......................................................................................................................... 39 Shelter shock ............................................................................................................ 42 Please call back during business hours ................................................................ 44 Breaking point: Nancy’s story (East Region) ........................................................... 45 Reporting of serious incidents ................................................................................ 48 Institutionalization by Default .......................................................................... 50 Hospitalization – the Band-Aid solution ................................................................. 50 12 years too long: Peter’s story (East Region) ........................................................ 51 Room, board and restraints: John’s story (West Region) ....................................... 52 No place for him: Tommy’s story (Toronto Region) ................................................ 56 A hospital is not a home: Riley’s story (East Region) ............................................. 58 Hospital waiting room: Annette’s story (North Region) ........................................... 63 When Health and Social Services Collide: Hospitalization of Adults with Developmental Disabilities .............................................................................. 64 Inter-ministerial co-ordination and collaboration .................................................. 69 Long-term care: Short-sighted solution ................................................................. 71 Young man, old problem: Patrick’s story (East Region) .......................................... 71 Duelling program priorities ...................................................................................... 75 It’s a Crime: Incarceration of Adults with Developmental Disabilities ........ 76 Jailhouse option: Joe’s story (Toronto Region) ....................................................... 77 Criminalizing crisis: Christine’s story (North Region) .............................................. 79 Order in the courts: Andrew’s story (East Region) .................................................. 80 Redirecting justice ............................................................................................................ 82 Mental health courts and diversion ................................................................................... 84 Dual diagnosis justice case managers ............................................................................. 84 Improving justice alternatives ........................................................................................... 85 Building Community Capacity ......................................................................... 87 Collaborative solutions ............................................................................................ 88 Justice seen to be done .................................................................................................... 91 Incarceration by the numbers ........................................................................................... 91 Early identification and response ..................................................................................... 93 Registering awareness ....................................................................................................
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