HANSARD
Printed and Published by Nova Scotia Hansard Reporting Services
COMMUNITY SERVICES COMMITTEE
Mr. Jim Morton (Chairman)
Mr. Gary Ramey (Vice-Chairman)
Mr. Leonard Preyra
Ms. Michele Raymond
Mr. Maurice Smith
Mr. Leo Glavine
Ms. Kelly Regan
Hon. Chris d'Entremont
Mr. Alfie MacLeod
[Mr. Leonard Preyra was replaced by Ms. Vicki Conrad.]
In Attendance:
Ms. Kim Langille
Legislative Committee Clerk
WITNESSES
Kings Regional Rehabilitation Centre
Ms. Betty Mattson,
CEO
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HALIFAX, TUESDAY, MAY 4, 2010
STANDING COMMITTEE ON COMMUNITY SERVICES
10:30 A.M.
CHAIRMAN
Mr. Jim Morton
MR. CHAIRMAN: Okay, I think I will call us back to order again. I know that this has been a very busy morning and, again, I want to thank everybody for accommodating all of the transitions that we need to make. I will give a moment for the slide presentation to be set up.
I do want to say, as we welcome Betty Mattson to the front of the room to speak a little bit about Kings Regional Rehabilitation Centre and the things she would like us to know, that I am really happy that she is here. I think my very first experience with that facility was when I was 14 years old, going with a youth group to play floor hockey with people who lived at the centre. That was a very formative experience in my life. I think all of us had a great time, on both sides of the floor, and we had many returned matches over the course of two or three years.
AN HON. MEMBER: You actually won one? (Laughter)
MR. CHAIRMAN: We didn't win many. It was rough and tumble and an exciting time, I remember. But, anyway, it was very pleasant.
MS. BETTY MATTSON: As we set the slides up, maybe I can just introduce my presentation while they're working on that. I think there have been handouts that have gone around?
MR. CHAIRMAN: Yes, they have, and if you would do that, it would be fine.
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MS. MATTSON: First of all I want to say thank you for inviting me. It is indeed a pleasure to be here to present in front of the Community Services Committee, the standing committee. I would like to share with you about Kings Regional Rehab Centre - and that is a mouthful, so I'm going to abbreviate it to KRRC and refer to it with those initials. What I would like to cover is who we are, our purpose, what our continuum of support, who uses our services and programs, our progress, and some of the gaps that we that we see in the system. So that is what I hope to cover in this presentation today.
We are nearly 50 years old - we've been around a long time. We're going to have our 50th Anniversary in 2012. We're located in the Annapolis Valley, in Waterville, N.S. We certainly provide quality person-centred care and programs. We serve over 215 adults and youth. We have over 500 professional staff, over 150 volunteers, and we are a community resource not only for the Valley, but we are a provincial resource.
So who are we? We are providing programs and services that support adults with disabilities which fall under the SPD Program, which you've heard the deputy minister and Lorna here speak on. We also have a youth component to our service. It is under the Child Welfare Program, under the Department of Community Services. So the populations that we serve: intellectual disabilities, physical disabilities and long-term mental illness. Sometimes you will know us as ARC/RRC - Adult Residential Centres Regional Rehabilitation Centre.
Our mission, basically, and this is our purpose, what we do - we are in partnership with individuals and families and the community. We provide supportive living, learning and working environments, to help persons with challenges to use their skills and improve their lives. Our values are there and we live our values to our services and programs in everything that we do.
In our continuum of supports, we're not - some people think that we are institutional-based and it is not totally true. We have a continuum of supports under Kings Regional Rehab Centre. The ARC/RRC has 178 clients but it is a supportive living facility. It is 24/7 support, we have seven unique client units, plus a psycho-geriatric program. It's very diverse in the types of individuals that we serve.
We have community support which is the Independent Living Program. We have people in apartments up and down the Valley that we provide 21 hours per week. We also have community homes spread out through the Annapolis Valley. We also have one in Bridgewater, which is 24 hours per day.
Day programs - we have numerous of those. For our youth, for example, we have a day program so that when youth are expelled from school they come back to our day program, continue their academics. We work with the school boards very strongly to get the youth back into those programs.
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We have adult day programs as well, various ones that are to support our adults. We operate the Mountain View Boutique, which is fairly new in the last year, that our clients had to apply for jobs, they run the boutique and so forth. It is really a neat little shop.
We have the Plank 'N Hammer, which was on CBC a couple of years ago, as well as the Apple Tree Industries. The Plank 'N Hammer do fine furniture refinishing, many numerous building projects. The Apple Tree Industries also is for the clients at Kings, but also we have a lot of community clients who attend these service centres. They make dog biscuits, four different varieties, they do CD wrap and small packaging, numerous things they do and are very good at it.
Our outreach - we have a great demand for consultation. We do for education, for client support and it could be any sector. Long-term care facilities are after us to consult with them because our expertise is dealing with persons with challenging behaviours. We're very good at that; that is our expertise among other things as well. We also have a learning and technology centre which is 15 years old and it does a lot of assistive technology for the community, up and down the Valley, provincial resources as well. For those who don't know Jim Roy, you'll get to know him soon because he is everywhere.
We have a loan library, we run a literacy program, we have extensive resources that we provide to people in the community, as well as into KRRC. Education development service - I'm going to skip over that but we have a strong component.
Who uses our services? The geographic breakdown: the western regions, a lot of our individuals come from the western region, 59 per cent; central, 26.5 per cent; northern, 11.6 per cent and the eastern, 2.9 per cent. So that's where they come from. Our referrals are from numerous places. They are from acute psych units. We have East Coast Forensic, long-term care facilities, from other providers such as community-based homes that have reached their capacity in supporting that individual, ARCs and RCFs, emergency departments as well across the province and from homes and from families as well.
Our profile of our clients where more than one diagnosis - we have over 70 individuals in wheelchairs, which we have a wheelchair program, maintenance program, fitting program, the whole thing which we need to do. Most of our individuals are at level five support, which is the highest level in the department. We have a few which may be level four that are in the main centre, but then in our community-based homes, there would be two or three in that range.
Professional service - you can see what we have there. I won't go over them for the saving of time. We see ourselves as a specialized community support. That's how we view ourselves, as our role. We are certainly very compassionate, and we have a very, very committed staff that have been with us for many, many years. Many long-serving people - I have someone that has worked there for 40 years and has still no plans for retirement.
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We live our mission in values, we're guided by our commitment to be a champion in the work that we do, and we want to make sure we offer person-centered care. We have diverse services, we even have requests to support individuals with acquired brain injury. We do quite well with that service. Our specialities are increasingly recognized over the province, and we never know where we're going to get the next call - can you support this individual? It's very, very individualized.
We're very adaptable to the needs of the population. We support persons who require intensive supports, and we work with persons and their families in providing a caring and very inclusive environment. We demonstrate our commitment to our community, and that is so obvious when we look at our satisfaction surveys and so forth.
Our progress - we provide person-centered care and accountability to individuals and families. We're an accredited facility with Accreditation Canada which is in Ottawa. We have a survey done every three years and we meet those standards, which we're very pleased about. We have strong safety and emergency programs, I don't know whether you heard on the news, but we evacuated 178 clients in 15 minutes due to a bomb scare a couple of weeks ago and we were right on the ball. I'm very proud of the staff and I wanted to mention that to you.
We're also mentioned for leading practices with Accreditation Canada, the Learning Technology Centre is a leading practice. There's a database that we worked with St. Mary's and Memorial University for persons with disabilities, and there's hits on that database, thousands, practically every day to look at resources for persons with disabilities. The Plank "N" Hammer was also listed as a leading practice in Canada, not just in Nova Scotia.
Since 2003, we've opened three homes in the community. We've had three independent living sites, and we've also expanded our RRC unit. We've participated in research with Dalhousie University and we have developed a non-verbal pain assessment tool, which is being used in our facility to truly look at how do you tell if people are in pain who are non-verbal. It works extremely well.
Strong partnerships - we are out in our community and we have strong partnerships with the local businesses in our area, Acadia University, we work with recreation students, nutrition students, Nova Scotia Community College, we work strongly with the Annapolis Valley School Board. We support a lot of their EAs in how to deal with challenging behaviours in the classroom. We have sessions in our facility for that.
New partnership with SPCA - our clients are working with them and so forth, so it's really wonderful to see that. Our 5th anniversary for the Tools of Life. For those that haven't heard, it's offered in Annapolis Valley, it's usually a two day course, 800, 900 people come. It is across the continuum from youth to seniors to look at tools people can use when they need it.
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Literacy programs, we are very strong in that. We're trying to get clients to know how to read a bus schedule, just the very basics that you and I take for granted every day. Recreation and leisure programs - it's unbelievable the things that we offer for the people we serve. We won the Mobius Environmental Award in 2005 and 2009. We have a strong individual component of our clients that work very hard to make sure we meet some greening initiatives, which we do.
We are launching a book. Acadia recreation students and our clients have written chapters on a book, and we have nine chapters that are to be published in the next week or so that's going to - we'll have a book launch as well. Our clients volunteer, some of them, there are a few that want to give back to the community and they volunteer in the soup kitchen.
What are the gaps? Here are some of the gaps we see in working in the field everyday. We're finding it more difficult to get access to community housing for our clients and people are ready to go to the community to the next level of support and it's just not available and so we really feel there is a strong need to build that. We are very aware that there are some individuals that could be supported under Kings' umbrella because of our specialized access that they can come back and forth and access other services. Our clients have it really well when you can access lab, physio, OT at the drop of a hat there and get into the system for the support that they would need in King's.
The other problem is transition of youth. We have youth homes, they're reaching adulthood and where do they go and how are they being transitioned into the system? That is a real need that we see.
Our population over the last 15 years has changed significantly and we are getting more and more individuals with autism that need behavioural supports. We are getting a very intensive level of client, there is no question and so sometimes our infrastructure doesn't suit the needs for those individuals and so we really need to do some planning to support that population that's coming.
Capital improvements and infrastructure, we need about a $7 million upgrade. We got $3 million two years ago but to complete that we need another $4 million and we are a sector that really, I think in some ways, might have gotten forgotten over the years and now we're seeing that there is more attention to it.
[10:45 a.m.]
Requests for education and training from other service providers is very paramount and we offer our resources to other agencies, the Flower Cart, everyone in the Valley. We provide a lot of training but it's coming out of our budget and there's not support for that and we really need to have that.
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Demand for consultation, which I talked about through our professional staff, and also our assistive technology service. We've had assistive technology for 15 years in this province and even if it's one on one, we get individuals with brain injury that call us and say, can you help us with this, and we do it but it's all out of our budget and we are supporting that.
Understanding the system process - we have a high component of mental illness in our population that we serve. A lot of individuals think sometimes we're the youth centre in Waterville, which we're not. Some people think we're an acute psychiatric facility where you can bring people in and say, okay, you're there, not voluntarily but they are there voluntarily, they're free to leave any time they wish. There's that confusion about the role that we play and we're trying to do that.
We don't operate with security guards, we have none of that. We do it based on programs and services and so when we're getting individuals in from East Coast Forensic or whatever - and I don't mean to paint people that they're violent or anything like that, but sometimes there are those issues, which we have to deal with. We deal with it strictly with programming that really assists people.
The other issue is that recognition, funding and using our expertise in the sector, in all sectors, is really important. The other thing I wanted to mention at the end to close, what are our clients and families saying? We do client and family surveys every two to three years and we had a 97 per cent satisfaction rate and this is extremely high. I just put one quote here from a husband who visits us very frequently - he's from central area and it's amazing. He feels that we're doing an excellent job so I just left you with that. I'll stop there, thank you.
MR. CHAIRMAN: Thank you very much for that very quick overview and I know that you've only been able to touch on some of the things that you're doing. We do have a few minutes for questions so I think I'm going to move to that directly and the first question - and I see your hand up - will go to Michele Raymond. I think, again, if we could keep it to one question each, that would be helpful.
MS. MICHELE RAYMOND: Thank you, the question is actually about accessing the services. Is it Department of Community of Services referrals, Department of Community Services support and is there a wait- list?
MS. MATTSON: It is, we're funded by the Department of Community Services or all our admissions to our areas come through the care coordinators from the department and we review them and see if they're suitable for our mix that we would have.
MS. RAYMOND: So they refer to you and then you act?
MS. MATTSON: Exactly and then we select who . . .
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MS. RAYMOND: There is a wait- list?
MS. MATTSON: There is a wait list for not just us but for the province, I would say, probably 40 to 45 people are waiting for an RCC level .
MR. CHAIRMAN: Thank you, Ms. Raymond. I think that will bring us to Leo.
MR. LEO GLAVINE: Mr. Chairman, I kind of have difficulty using this term, actually, in the context of the rehabilitation centre because I know what an outstanding facility it is. But in the 21st Century, as we across the country have deinstitutionalized, do you feel, Betty, that really the rehab centre has defined and re-defined itself to meet to a myriad of needs and offerings? Because that is where I'm finding, I guess, great comfort in terms of the people that I talk to, both workers and families that are served by the rehab. Do you think we have come kind of full circle here in terms of what this institution does offer in a splendid, individualized way?
MS. MATTSON: I think that question is a very important and insightful question. I think, yes, in time we have re-defined our services only from the point of view that the system has changed. When you look at mental health services in the province, we're increasingly getting more and more persons with serious mental illness. In other provinces, I do surveys across Canada in every province and what I see from province to province is that yes, they have closed some institutions but what they haven't done is found the appropriate facilities for people with severe mental illness - where do they fit? - and, obviously, homelessness big time. That is what happened here in this province to a certain degree is that we have decreased beds for people who require support or maybe there isn't enough community supports to allow people to stay in their homes.
It is our belief that you can support anyone, anywhere as long as you have the resources and the dollars to do it. But how much are you willing to pay? That is the other piece. The other piece, too, is the people we have are very intensive and a lot are from community-based homes that would not, in some way, have the capacity to support the individuals that we see.
MR. GLAVINE: Thank you for that.
MR. CHAIRMAN: Mr. Smith.
MR. MAURICE SMITH: I'm curious about, in your presentation you said that you have over 500 professional staff?
MS. MATTSON: Yes. What we have is when we say professional - I should reiterate. We have RRWs, RNs, LPNs, OT, Physio, as part of that set. Yes, we have 375 regular part-
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time/full time and the other piece would be casual relief in order to support people in our contiuum.
MR. SMITH: What is your budget?
MS. MATTSON: Our budget is around $21 million, approximately.
MR. CHAIRMAN: Ms. Regan.
MS. KELLY REGAN: I'm just wondering, of those 500 specialist staff, can you break down how many are full time/part-time? Ball park.
MS. MATTSON: Oh, gosh, I didn't bring those stats with me. I would say , when we talk about professional staff - I'm thinking about RNs and LPNs and OTs - I would assume that we have about 70 professionals. The rest would be industrial therapists, recreational and leisure, house utility, housekeeping, dietary. We have also medical physicians who come. We have four physicians, psychiatry that come to support us as well to our facility, and psychologists.
MS. REGAN: Would it be possible to just get a breakdown, just send it to our committee of how many full time staff, part time and where they are located in there?
MS. MATTSON: I can try.
MR. CHAIRMAN: I am going to stop you, we're just about out of time and I'm limiting people to about one question each.
MS. REGAN: Okay, but I didn't ask any yet? (Laughter)
MR. CHAIRMAN: But it sounded like a question. I am going to Mr. Ramey next.
MR. GARY RAMEY: Thanks for coming, first of all, and my question is not meant to sound negative; it may. It certainly sounds like an absolutely phenomenal great facility, but with such a diverse population, I'm wondering if you've had any cases at all of abuse in the system, and if so, how were they handled?
MS. MATTSON: No facility wants to see abuse. We have zero tolerance, zero tolerance whatsoever. All of our staff have been trained under the Protection for Persons in Care Act, they each get a certificate, it has to be on their file. That's done every year on the Act. We also have professional boundaries policies, of how do you do therapeutic relationships with individuals, so that they know what is appropriate. We are highly regulated, let's put it that way. From that point of view, I can say that the staff are very knowledgeable on what is right and what is wrong.
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MR. CHAIRMAN: Ms. Regan, do you still have a question? I think we have another four minutes that we could possibly use.
MS. REGAN: Thank you for being so generous. Currently, the centre serves 200 people, is that right?
MS. MATTSON: The total population of our community is 215 for all the services.
MS. REGAN: Are there any plans to increase this number, or obstacles to increasing this number, or do you even want to increase this number?
MS. MATTSON: My vision - what I would like to see is more community-based homes. But in order to support community-based homes for the individuals that we have, they need to use the supports from the main centre and to augment that program, to build the continuum.
MS. REGAN: But you would like more financing, to help, to be able to support these community homes?
MS. MATTSON: Absolutely.
MR. CHAIRMAN: Okay, thank you. I think maybe that does take us to the end of our available time. Betty, are there any closing remarks that you might like to make?
MS. MATTSON: I just wanted to say thank you for allowing me to increase the awareness, because a lot of people I find really don't know what we do, or how we do it. So, thank you for that opportunity.
MR. CHAIRMAN: Mr. Glavine.
MR. GLAVINE: Just to concur with what Betty said here. I think it would be wonderful for anybody whose a long-serving member of the standing committee - I know Mr. d'Entremont has been there - but to go and tour the facility, and Betty opens the entire place to you. I have been on the tour with Betty and I've been there for a number of occasions, and so forth, but I think if anybody on the standing committee who wants a real insight, take the time to go to Waterville.
MR. CHAIRMAN: Or to attend the Tools for Life Conference, and get a sense of what happens there.
So, thank you very much again for being here.
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We do have a couple of minutes left, and as you are packing up, Betty, maybe we will just move to our closing business. Following our last meeting, our April meeting, we received one piece of correspondence, which I think everybody has in their possession, from the Face of Poverty Consultation. You may have received it, but you'll get it.
I guess, I'm thinking, because of the pressures of time, that perhaps if we could accept this as received and perhaps you could take the time to read it, we would revisit this next time. The consultation makes several comments and asks for a couple of additional, perhaps, opportunities to receive information. So I think we should consider that, but perhaps given a little bit more time for reflection would be helpful.
I am seeing nods, so.
MR. GLAVINE: I move that to be the case, Mr. Chairman.
MR. CHAIRMAN: Thank you very much. There has been a motion.
Would all those in favour of the motion please say Aye. Contrary minded, Nay.
The motion is carried.
Then I think that leaves us with the other piece of business being our next meeting. It is scheduled for Tuesday, June 1st. We have determined some time ago that our witnesses will be from the Department of Health, related to children's mental health services in Nova Scotia. I think the question that's still perhaps somewhat outstanding is whether that time on June 1st would be in the morning or the afternoon. I don't want to predict whether we'll still be sitting (Interruption) Pardon?
AN HON. MEMBER: Afternoon would be lovely.
MR. CHAIRMAN: Afternoon would be lovely - so I think our assumption is should the House have risen, we shall meet in the afternoon between the hours of 1:00 p.m. and 3:00 p.m. Is that acceptable? If the House is still in session, we will meet as we have this morning.
So I think that brings us to the end of our business, unless there is anything else. Thank you.
The meeting is adjourned.
[The committee adjourned at 10:58 p.m.]
