The Remedy 101: Key Directives

The Remedy is structured around a collection of six key directives intended to guide reform. Each of the key directions also contain core recommendations, as outlined below.

For a full breakdown of each of the key directives, and their subsequent recommendations, see the original Technical Report of the Independent Experts to the Disability Rights Coalition and the Province of Nova Scotia, Appendix 7, accessed here.

Individualized Planning & Support Coordination

Closure of Institutions

Multidisciplinary Support & Regional Hubs

Individualized Funding

Community-Based Supports & Services

Disability System Capacity

Key Directive #1:

Individual Planning & Support Coordination

Overarching Objective: Help ensure that persons with disabilities have meaningful authority over the decisions that affect their everyday lives. This includes where they live, how they participate in their communities, and what supports they receive. This approach is called Person-Centered Planning.

  • The establishment of community-based coordinators who work directly with individuals in order to develop personalized support plans that honour an individual’s needs, goals, preferences, and their right to self-determination.

    These coordinators are meant to meet people where they are and help them to develop support plans, navigate the right supports, and strengthen their connection to their community.

  • This is an important element of this key directive, because it helps to reduce conflict of interest, and institutional bias. When a support person acts as both the gatekeeper and the planner, they can begin to unintentionally steer individuals toward supports that are easier to approve, are less expensive, or already available and require less output.

    Intentionally separating these responsibilities and areas of purview helps prevent institutional priorities from overshadowing an individuals preferences, needs, and authority over their care.

  • The establishment of specialized teams to help support individuals who are transitioning out of institutions and back into the community, as well as individuals with more complex support needs.

  • The development of provincial expertise, resources, and peer-supported approaches to Person-Centered Planning across Nova Scotia.

Key Directive #2:

Closure of Institutions

Overarching Objective: Address and rectify the unnecessary institutionalization of persons with disabilities in Nova Scotia.

  • The establishment of dedicated closure teams to lead a province-wide, regionally-led facilities closure program. These teams are responsible for coordinating the closure of institutions and supporting individuals with their transition into community living.

  • The establishment of Emergency Response Teams to help people remain in their own communities and prevent their return to institutional settings.

  • The development of a firm “no new admissions” policy to prevent new admissions to institutions and ensure that the system does not continue placing people into the very systems its working to eradicate.

Key Directive #3:

Community-Based Supports & Services

Overarching Objective: Help to ensure that the supports, programs, systems, and environments needed for individuals to thrive within their communities are put into place.

  • The development of flexible arrangements to make it easier for persons with disabilities to live with individuals or their families in community-based homes.

    This program is intended to replace the existing Alternative Family Support (AFS) model.

  • Addressing the funding gaps between the Disability Support Program’s Independent Living Support (ILS), Flex Independent and Small Option Homes (SOH), so that individuals can access the funding needed to build a life in their community.

  • The Innovations Program is a transformation of the Temporary Shelter Agreements (TSA’s). It is intended to be a more flexible, individualized program that is capable of responding to individual circumstances.

  • An intentional move away from the current system of pre-determined service options for individuals with disabilities toward supports that are designed around an individual’s unique goals, preferences, and needs.

  • The creation and establishment of local pathways to support young individuals with disabilities as they transition from school environments into adult life, and community participation.

Key Directive #4:

Multidisciplinary Support and Regional Hubs

Overarching Objective: Ensure that specialized health and clinical supports meet people where they are, within their own communities, so that individuals requiring these services aren’t having to relocate to receive them.

  • Bringing the multidisciplinary resources and services that have historically been attached to intuitions into communities so that individuals can access these supports within their own communities.

    This involves establishing regional clinical hubs with access to professionals including:

    • Psychologists

    • Occupational therapists

    • Physiotherapists

    • Speech-language pathologists

    • Mental health and peer-support workers

    • And more

  • Strengthen the specialized mental health supports for individuals with intellectual disabilities and co-occurring mental health-related disabilities, and make sure these individuals have access to supports province-wide.

  • Audit existing community-based mental health and transition programs to review the adequacy, efficacy, reach, and accessibility of the programming—particularly for people living in remote and rural communities.

    The report specifically identifies several programs for review, including:

    • Community Transition programs

    • Community mental health teams

    • Case management supports for individuals with severe and persistent mental illness

    • Recovery and Integration programs

Key Directive #5:

Individualized Funding (IF)

Overarching Objective: Fundamentally change how disability support funding is allocated, administered, and controlled across the province.

  • Consolidation of existing funding programs, the introduction of personal budgets, and the ability for persons with disabilities to take their funding with them when changing providers or living arrangements.

    Currently, the funding accessed by persons with disabilities is largely attached to programs or homes themselves, rather than the individual.

    This means when the individual leaves a home or a program, they lose access to their funding.

  • Establishing the internal infrastructure needed to support accessible and centralized administrative systems that support eligibility, funding decisions, payroll, budgeting, and the management of individualized supports.

  • Ensuring that individuals living with disabilities have the legal recognition, assistance, and practical opportunities needed to make decisions about their own lives and supports.

    The Individualized Funding model relies on individuals being recognized and supported as decision-makers in their own care. It posits that needing support to make decisions should not automatically result in losing the authority to make your own decisions.

    Given that the Nova Scotia is already in the process of reviewing its Adult Capacity and Decision-Making Act (ACDMA), the Report has recommended linking the Remedy Implementation process.

Key Directive #6:

Disability System Capacity

Overarching Objective: Transforming and strengthening the systems, structures, policies, workforce, and organizational cultures responsible for delivering disability supports in Nova Scotia.

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