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Canada
2004 IDRM Country Report
Key Factors: Canada has a history of victimization of people with disabilities including forced sterilization. In reaction to that past, today Canada has constitutional and other legislative guarantees protecting the rights and equality of people with disabilities. The growth of human rights movements in Canada has led to initiatives of deinstitutionalization, more individualized funding, and increased visibility of the issues faced by the disability population in recent history.

 

Terminology

Canada now officially recommends the use of person first language in discussions of disability. A recent publication for media producers regarding appropriate language to be used with respect to people with disabilities stated that "the word "disabled" is an adjective, not a noun. People are not conditions."1 However, earlier documents sometimes used terms that are now considered problematic. For example, one important document from the early 1980's uses the term "handicapped." When directly quoting documents, the original terminology has been retained.

Definition of Disability

Across Canada and within the numerous factions of the disability community, the definition of disability is a continuously debated subject. Consequently, there is no general definition of disabilities.

Instead, much of the country's legislation either does not specifically define disability or merely defines it in reference to a particular act. With little consensus on the definition of disability, governments and organizations have turned to operational definitions and classifications of disability.

Operational definitions of disability originated out of a need to define eligibility criteria for services, programs, membership, rights and resources, and the analysis of health related issues. Thus, they vary according to the services being rendered. This research focuses on definitions written into government documents, legislation, and programs. The Pension Plan Act, for example, defines when someone is considered to be a person with a disability and when they have ceased to be a person with a disability. It states "a person shall be considered to be disabled only if he is determined in a prescribed manner to have a severe and prolonged mental or physical disability."2 It goes on to say that "in no case shall a person be deemed to have become disabled earlier than fifteen months before the time of the making of any application."3 In this example, both the severity and the duration of a prescribed condition are subjective in nature.

In its attempts to enumerate the disability population, Statistics Canada has turned to international definitions of disability put forward by the World Health Organization (WHO). Surveys in the 1980s and 1990s followed the WHO's 1980 report, International Classification of Impairments, Disabilities, and Handicaps (ICIDH), which defines disability as "... any restriction or lack of ability (resulting from impairment) to perform an activity in the manner or within the range considered normal for a human being."4 The most recent disability survey moved to a definition based loosely on the WHO's newer ICF framework. The definition provided in the survey report states that a disability is "an activity limitation or a participation restriction associated with a physical or mental condition or a health problem."5 The Canadian government, however, has not officially adopted the ICF definition, and disability continues to be defined inconsistently. For example, a recent government publication defined disability in language very close to the ICIDH, calling it "a functional limitation or restriction of an individual's ability to perform an activity."6

Disability Population

As of 2003, the Canadian population exceeded 32 million people.7 The most recent Participation and Activity Limitation Survey (PALS) found that 3.6 million Canadians, or 12.4% of the population, reported having a disability.8

This figure is lower than the previous estimate of 14.7% reported by the 1991 Health and Activity Limitation Survey (HALS).9 The difference is the result of numerous methodological changes made by Statistics Canada since 1991. Operational definitions of disability, sampling plans, questionnaires and target populations varied greatly between the PALS and HALS documents making comparisons between population rates difficult. Both surveys used filter questions included on the long form of the Canadian census as the basis for the sampling frame. Because surveys are imperfect instruments, however, some individuals with disabilities are not identified by the filter questions. The HALS included respondents who had not reported an activity limitation on the census in order to detect these "false negatives." For 2001, the filter questions were changed to make them more neutral and better able to detect persons with mild disabilities. The rewording appears to have reduced the number of false negatives, but it has not eliminated them entirely.10 Thus, disability rates are likely higher than estimated by the PALS report.

Additional problems are presented by the use of census data as the sampling frame. The 2001 census data excluded persons living in the Yukon, Northwest Territories, Nunuvut, institutions, and First Nations Reserves where there are a large number of aboriginal people.11 Thirty percent of people of aboriginal heritage in Canada have a disability, suggesting that there are more persons with disabilities in Canada than currently are being reported.12

Although the size of Canada's disability population has not changed significantly in the last ten years, the population of the country is aging. Within the next 20 years a significant portion of Canada's population will be over 65 years of age, meaning people with disabilities will make up a greater portion of the population. Approximately 40.5 percent of the population in this age group has a disability.13

Legislation & Disability Rights

Legal Protections

Canada has not signed the OAS Inter-American Convention on the Elimination of All Forms of Discrimination Against Persons with Disabilities. However, international law has had an important influence on Canadian law and policy. First, in 1948, the UN passed the Universal Declaration on Human Rights. Second, the UN National Assembly passed the Declaration of the Rights of Disabled Persons in 1975. Third, in 1981 the UN announced

The International Year of Disabled Persons and designated 1983 through 1993, the International Decade of Disabled Persons. Canada's response was the creation of a Special Committee on the Disabled and the Handicapped.13 In 1981, this committee released a report entitled Obstacles that set the direction for Canadian disability policy.14

Following a period of growth in institutional care that began in the 1920's, human rights movements began to grow in North America during the 1960's and 1970's. These movements catalyzed much of the anti-discriminatory and disability related protection that Canada implemented in the 1980's. Prior to that time, legal protections for people with disabilities were almost nonexistent.

In 1982, the Canadian government passed a Constitutional Act that patriated the Constitution and included The Charter of Rights and Freedoms. Section 15 of this charter guarantees "Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability."15

This amendment came into force in 1985.16 Further, Section 15 states that this policy "does not preclude any law, program, or activity that has as its object the amelioration of conditions of disadvantaged individuals or groups, including those that are disadvantaged because of race, national or ethnic origin, colour, religion, sex, age or mental or physical disability."17 This reference to affirmative action programs emphasizes that proactive measures may be necessary to correct circumstances of disadvantage.18

Canada has a number of other laws that specifically reference and protect the rights of people with disabilities. All of Canada's human rights codes prohibit discrimination on the grounds of disability. In 1977, Canada passed the Canadian Human Rights Act (CHRA), which ensures equal opportunity and freedom from discrimination for all Canadians.19 The CHRA has quasi-constitutional status, being that it prevails over ordinary legislation in the case of ambiguity. Other anti-discrimination laws include: the Employment Equity Act, the Immigration and Refugee Protection Act, the Broadcasting Act, the Canada Transportation Act, the Canada Evidence Act, and the Canada Elections Act.

There are no criminal penalties in cases involving discrimination against people with disabilities in Canada. Only severe violations, in cases of abuse or death, which go beyond non-discriminatory law, have crininal penalties. Abuse of persons with disabilities, especially women and girls with disabilities and persons with intellectual disabilities, remains a human rights concern in Canada.

There is little information gathered on the subject and numbers appear to be lower than estimated due to issues of data collection, disclosure and the nuature of care, education and communication of persons with disabilities.

Civil remedies in cases of discrimination usually are monetary and action-based.20 There is little information gathered on the subject, and the number of reported cases appears to be lower than estimated due to issues of data collection, disclosure and the nature of care, education and communication of persons with disabilities.21 However, court cases have been an effective method of social action against discrimination for people with disabilities. Important public cases of discrimination of people with disabilitie have set precedence in Canada for the law to be upheld, and to recognize and compensate the violations of human rights experienced by many people with disabilities in Canada's past.

Canada has many organizations and entities whose responsibilities include monitoring and keeping records of human rights violations and discrimination against persons with disabilities. They include: Human Rights Commission, Canadian Council on Social Development, Office for Disability Issues, Law Commission of Canada, National Clearinghouse on Family Violence (Health Canada), The G. Allan Roeher Institute, Disabled Women's Network Canada, Canadian Civil Liberties Association, Council for Canadians with Disabilities, Disabled Peoples International, and the Canadian Association of Independent Living Centres. These are but a few of the organizations in Canada dedicated to the awareness and enforcement or the rights of persons with disabilities.

Canada may have anti-discrimination laws, yet systematic barriers continue to hinder the capacity of people with disabilities to exercise their legal rights. There are many reasons people with disabilities do not seek recourse when they experience discrimination in policy areas where anti-discrimination legislation offers protection. Lack of knowledge of their rights, lack of support in exercising their rights, fear of negative consequences, isolation, a slow judicial process, poverty, and barriers to accessing the physical or written environment are some of the obstacles people with disabilities still face.

Legal Barriers

Until 2001, when Canada enacted the Immigration and Refugee Act, disabilities and health impairments were criteria for inadmissibly to the country.22

Instead of fully removing the discriminatory elements of the prior immigration law, the 2001 Act shifted inadmissibility criteria to "health grounds" rather than "disability." Specifically, Section 38 states that a foreign national is inadmissible on health grounds if their health condition "might reasonably be expected to cause excessive demand on health or social services."23 This new category may remove "disability" but the new "health grounds" stipulation retains the potential for discrimination.

People with disabilities have historically had their decision-making rights removed through the establishment of guardianship. In recent years, the need to evaluate the role of guardianship in Canada has come into particular attention due to key cases in Canadian courts. Among these is Robert Latimer's murder of his young daughter who had a disability.24 Homicide and filicide (the murder of a child by a parent) deserve special attentions in Canada. In the last ten years, such crimes against people with disabilities have been increasing, yet there has been a decrease in the rates of homicide among the general population. Other cases regarding rights violations hve gone through civil court. For example, in 1986, the Supreme Court of Canada ruled that no one can be legally sterilized without personally consenting to the procedure. This ruling was handed down with regard to a woman, Eve, whose mother sought permission to have her sterilized without Eve's informed consent. In the case of Stephen Dawson, his parents wanted to deny him medically necessary treatment because of his disability. Stephen was removed from his parents' custody and permitted to receive appropriate treatment. Lastly, Justin Clark won his release from an institution where he had been kept against his will. These cases demonstrate the continued need for reforms of guardianship.25

Canadian law and support systems for persons with disabilities are now beginning to explore alternatives to legal guardianship for people with disabilities. New ideas encourage a "supported autonomy" rather than the removal of the rights of certain individuals with disabilities. Family networks, advocacy groups and health service professionals can create a network to safely deal with medical treatment issues for certain people with disabilities, thereby maintaining a degree of autonomy for the individual requiring care. Partial guardianship is also an option that allows some decision-making authority to remain with the person with the disability.

Civic Participation

In Canada, every person who is a Canadian citizen and over the age of 18 is entitled to vote.26 People with disabilities also have the right to be elected to public office in Canada although this is rare in practice.

Elections Canada is the agency responsible for conducting federal general elections, by-elections and referendums. It provides services, information, and education to persons who have a disability, seniors, persons with limited reading and writing skills, and persons living in transitional situations such as homeless individuals or persons living in a shelter for victims of abuse.

The Canada Elections Act guarantees that electoral material is available in alternative formats and polling stations are accessible.27 In practice this means, when a station is found to be inaccessible or does not accommodate a person with a disability's specific accessibility needs, mobile voting stations are made available or the specific disability is accommodated through other means. As a result 80 percent to 100 percent of polling stations are accessible to people with disabilities in Canada based on the availability of services provided by Elections Canada.26

In the area of information access, Elections Canada provides a special ballot registration forms available on the Internet; documents specifically for persons with disabilities; open and closed captioned videotapes for persons who are deaf or hard of hearing, a voting template for persons with a visual disability; a toll-free information line for persons who are deaf or hard of hearing; and a special ballot, which allows early voting by mail, in person at the office of the Returning Officer, or at home in the case of electors who cannot go to the office of the Returning Officer because of a physical disability.27

To ensure accessibility of polling stations, Elections Canada provides mobile polling stations for certain institutions where seniors or persons with disabilities reside; advance polls and election offices with guaranteed level access; polling stations with full level access, with accessibility indicated on the voter information card; transfer certificates permitting electors with physical disabilities to vote at accessible polls if, in exceptional cases, their own polling stations do not have level access; assistance available at the request of the elector to mark the ballot; and transportation of the ballot box from room to room to facilitate voting in hospitals and certain residential institutions.28 Elections Canada also provides election officials and personnel with specialized training on the accessibility issues for people with disabilities.

Access to voting is a democratic right in Canada, which is made highly accessible to people with disabilities. However, although the rights are there it is often questionable as to whether they are always exercised.

Inclusion

Communication

Barriers to equal access to communication exist, although Canada is working to enact its equality laws by supporting and providing a number of accommodations to people with disabilities. Legislation is currently focused on accommodations for persons who are deaf and persons who are blind. However, communications policy is increasingly recognizing physical disabilities and learning disabilities.

In support of this goal, NLC encourages the sharing of materials in alternative formats and supports Canadian libraries in serving their clients with disabilities.

Most federal and provincial government documents are available in alternative formats free of charge, including a Braille version of the Constitution. T-Base Communications does the alternative format document conversion for the government. The Canadian government mandates that the National Library of Canada (NLC) promote equitable access to library and information resources. In 2001, by recommendation of the Task Force on Access to Information for Print-Disabled Canadians, the National Library of Canada established the Council on Access to Information for Print-Disabled Canadians. The Council's role is to provide advice, identify funding requirements, monitor progress, and make recommendations for improving access to information for print-disabled citizens. The Council is currently engaged in a pilot project aimed at developing a clearinghouse for Canadian publishers to make their works available to alternate format producers.29

The Canadian Radio-television Telecommunications Commission (CRTC), which regulates the Canadian Broadcasting System, is responsible for administering the Broadcasting Act of 1991. This act sets out specific policy regulations on broadcasting via accessible formats to people with disabilities. Section 3 of the Broadcasting Act states, "programming accessible by disabled persons should be provided within the Canadian broadcasting system as resources become available for the purpose."30 Services for persons with disability required by the CRTC include closed-captioning for at least 90 percent of programming and 100 percent of local news for all major broadcasters. The CRTC also requires the inclusion of the 24-hour news and information reading service, Voice Print Canada, on all major cable and satellite services.31 Voice Print Canada airs news and information from Canada's primary publications, including more than 100 newspapers and magazines.32

In the case of a natural disaster, civil emergency or criminal assault a number of services are available in Canada for people who are hard of hearing or deaf. Medical interpreting is available in hospital settings or when a doctor is involved. Court-certified interpreters are provided in legal settings. In addition, accessible emergency services are federally mandated, and many telephone emergency services have TTY available. Persons who are deaf or hard of hearing are advised to call 9-11 and leave the phone off the hook, signaling help to arrive. Emergency interpreters are available within 20 minutes at all times. Such services are available throughout Canada, or are in the process of being established. With regard to provincial governments, more interpreting services are being established due to the outcome of court cases that have upheld the right to an interpreter.33In terveners for persons who are deaf-blind are more difficult to locate. As a result, after the age of 19 many high functioning individuals are provided with no or little interpreting services.

The Canada Evidence Act was amended to remove communication barriers to the participation of persons with disabilities in the justice system. Section 6 provides for communication assistance for persons who have special communication needs. It states that "if a witness has difficulty communicating by reason of a physical disability, the court may order that the witness be permitted to give evidence by any means that enables the evidence to be intelligible."34

Section 6.1 permits the admissibility of auditory and tactile methods of identifying the accused.35 In addition, several amendments to the Criminal Code were made to enable greater participation by people with disabilities. They permit people with mental or physical disabilities to provide testimony through videotape, enable persons with disabilities to serve as jurors, and improve protection of persons with disabilities from physical and sexual violence. The Department of Justice provides a variety of services for persons with disabilities, including sign language interpreters for interviews or meetings, and access to offices and resource centers.

Education

There is no precise count of the number of school-aged children with disabilities in Canada. According to the PALS, 1.6 percent of all children 0-4 years and 4.3 of children 5-14 years have a disability.36 In contrast, the National Longitudinal Survey of Children and Youth in Canada and the Canadian Council on Social Development concluded that 13 percent of all children aged 11 or younger had a chronic condition or activity limitation excluding allergies, emotional problems and learning disabilities.37

Education is mandatory for all children between the ages of 6 and 16 years in Canada. Statistics Canada reports that 94 percent of the 5.5 million elementary and secondary students are enrolled in the public school system. Approximately, 5.4 percent of students attend a private educational institution. In addition, .4 percent of school-aged children have received approval by their local school boards to be taught at home. About 1600 students in Canada students attend separate special schools for students who are visually and hearing impaired.38

By virtue of legislative and judicial action, Canada has generally moved toward an inclusive educational system for students defined as having special needs. A Supreme Court ruling on the Charter of Rights and Freedoms, established that education for students with disabilities should be provided in a regular class environment with reasonable but not excessive adaptation provided to promote equal opportunity in the classroom. In addition, provincial education laws require that school boards make education available to all school aged persons in a district.39 This rule is not consistently implemented across the country because school districts can interpret both provincial and federal legislation as they deem fit for their unique jurisdiction. Moreover, all institutions and educational authorities do not share the same views on the definition of disability or inclusion.

Because inclusive education is legally required, schools must have a means of identifying those students who are not completely able to adjust to a standard classroom situation as a result of a disability. Students with disabilities go through an assessment and identification process to qualify for teaching assistance, and a modified Individualized Education Plan (IEP) is developed. In some situations, where there is no specifically trained special education assistant or teacher available (for example, in a more isolated rural setting), the school or school board may authorize and provide training for the teaching personnel at a relevant special needs workshop.

Training in special education is available in some of the post-secondary universities and colleges that offer teachers training. There is, however, no nationwide curriculum. At the post secondary level, each college and university offering training for teachers is free to set its own program of study.40

The process of detecting disability rests with each individual province or territory. In cases where children with disabilities have been identified prior to enrolling in school, existing assessment and other relevant information will expedite the assessment and implementation of an IEP. Otherwise teachers request assessments for students who are perceived to have a disability. In many cases, a school-based team of professionals responds to the request and initiates the assessment process. The disabilities included within these assessments are hearing, seeing, speech, mobility, dexterity, developmental, learning, and chronic illnesses or disability.41

Like childhood education, access to post-secondary education is a right, however it is a costly process with many hurdles for people with disabilities wishing to get an education and enter a desired career path. Limitations and barriers within accommodation, access to academic material, attitudes, and financial assistance all provide obstacles for students with disabilities. Access to post-secondary education has become a highly political issue for many Canadians with disabilities — limitations imposed through income assistance programs, intense need to get out of poverty, the right to choice, increasing tuition and the issues of "the duty to accommodate" have all become key issues of students with disabilities. There is some infrastructure in place to support students with disabilities. This includes campus groups, university disability resource centre support staff, financial assistance/grants, loan programs/banks for assistive technology, and federal/ provincial/territorial vocational rehabilitation programs. The Canadian Association of Disability Service Providers in Postsecondary Education is a national group of professionals who assist university and college students who have a disability.42

Their role is to work towards the removal of institutional barriers, both physical and attitudinal, and ensure that students receive academic and other accommodations which permit them to pursue their studies in an environment of equality.

The National Educational Association of Disabled Students (NEADS) is a consumer organization that advocates for increased accessibility at all levels so that students with disabilities may gain equal access to higher education. The association provides information on the resources available to students with disabilities nationwide.

Technology providers like Special Education Technology British Columbia (SET-BC) may provide services including training, loans, and products that enable students to access academic materials in a variety of alternate formats. Some financial assistance for students with disabilities is available through the Canada Student Loans Program (CSLP) and the Canada Study Grant.

Another important initiative is the Multilateral Framework for Labour Market Agreements for Persons with Disabilities, formerly the Employability Assistance for People with Disabilities (EAPD). This initiative supports a broad range of programs and services to respond to the employment and education needs of people with disabilities including: higher education, employment planning, skills training, and assistive devices. The programs are available only to eligible Canadians with disabilities who have clear educational plans. Eligibility criteria vary, and intensive testing may be involved for determining eligibility. Unfortunately, fiscal cutbacks to programs have dictated that fewer students are supported under these programs, and many of the resources have been directed toward short-term programs focused on employability.43

Disability as a field of study in post-secondary institutions is expanding, although some resistance to the field has been encountered due to the cost of the necessary technological aids.44 When available, disability subject matter can be seen across disciplines and departments. The University of Manitoba had the first Disability Studies Program. It is an interdisciplinary master's degree program linking the departments of Education, Social Work, and Architecture with a strong focus on disability theory. York University also maintains a Masters Program with a focus on Critical Theory in Disability. The University of Winnipeg and Ryerson also maintain disability studies programs.45

There are few formal post-secondary educational options for persons with intellectual disabilities. Depending on the region of the country there may be technical training programs, volunteer opportunities, and learning through job placements. Some organizations such as STEPS Forward in British Columbia are actively working to facilitate inclusive education at colleges and universities.

Employment

The unemployment rate for people with disabilities in Canada is 26 percent, over five times higher than the 5% unemployment rate for people without disabilities. Fifty-six percent of working age adults with disabilities are either unemployed or not in the labour force, compared to less than a quarter, 24 percent, of working age adults without disabilities.46 Thus, more than one million adults with disabilities are unemployed or outside the labour force in Canada. Women and Aboriginal people with disabilities generally face more barriers to employment, and as a result, are more likely to be unemployed. Moreover, once employed, people with disabilities continue to be subjected to discrimination. According to the Public Service-wide Employee Survey released in 2002, nearly 36 percent of federal employees with disabilities have been harassed in the past two years, and 37 percent have been subject to discrimination at least once.47

Canada has three principle anti-discrimination laws in the area of employment for people with disabilities. The Canadian Charter of Rights and Freedoms stipulates the provision of interpreters and affirmative action incentives. Second, the Employment Equity Act (EEA) of 1995 ensures that persons with disabilities are granted full and equal access to employment and opportunity. It states that "no person shall be denied employment opportunities or benefits for reasons unrelated to ability and, in the fulfillment of that goal, to correct the conditions of disadvantage in employment experienced by women, aboriginal peoples, persons with disabilities and members of visible minorities."48 This act requires the accommodation of difference. Finally, a 1998 amendment to the Human Rights Act further establishes the duty to accommodate.49 Accommodation refers to a range of modifications to a given workplace and/or job to promote the employment of persons with disabilities. Modifications can focus on physical, procedural, or attitudinal barriers that prevent persons with disabilities from finding and retaining employment.

Despite these laws, ongoing audits required by the Employment Equity Act have found persons with disabilities severely under-represented in the federally regulated private sector. The most recent 2003 report states that "since the first Employment Equity Act was put in place, of the four designated groups, persons with disabilities have benefited least. Their representation in 2002 remained at
2.3%, virtually unchanged since 1997."50 Additionally, they show that the majority of employers are required to sign up indertakings and undergo a follow-up audit before they are in compliance with the law.51

There are some programs in Canada geared toward training and job placement for people with disabilities. Until the late 1990's, there was one main program that dealt with the employment issues of people with disabilities. The Vocational Rehabilitation for Persons with Disabilities Program (VRPD) was a jointly funded rehabilitation effort on the part of the federal, provincial, and territorial governments. In 1997, the government launched an initiative to develop greater employability and made attempts to improve the VRPD program. Funding is also available through the Opportunities Fund of the Employment Insurance (EI) Program. Nevertheless, there are still barriers in the labour market, and a greater awareness of accommodation needs to exist for both employers and persons with disabilities who are entering the workforce. Thus, despite the programs and anti-discrimination laws that exist in Canada with relation to the employment of people with disabilities, high rates of unemployment continue to persist for people with disabilities.

Health Services

Health services in Canada are highly subsidized; insurance premiums are low in cost and affordable, and certain jobs, including all government positions, offer basic and extended health care benefits free of charge for employees and their immediate families. Canadians considered to be low-income individuals do not pay any premiums and receive the same level of care.

The Canada Health Act, Canada's federal health insurance legislation, has measures in place that prevent discrimination in health insurance coverage for people with disabilities in Canada.50 In Section 10 of the Act, the Universality clause states "...all insured residents of a province or territory must be entitled to the insured health services provided by the provincial or territorial health care insurance plan on uniform terms and conditions."51 Under the Canada Health and Social Transfer, provinces and territories receive a federal cash contribution to administer the conditions stipulated by the Act. There has never been a national strategy of Community-Based Rehabilitation in Canada.

Very little funding is provided specifically for promoting health and rehabilitation of people with disabilities in Canada. For persons with disabilities on income assistance or on medical referral from a physician, medical insurance coverage includes the subsidized cost of medical supplies, medications, and technical aids, like wheelchairs. Occupational therapy is also available to determine the technical aids and environmental modifications needed. In addition, the Worker's Compensation Board will pay for rehabilitation if someone is injured while working.52

Specialized services, like rehabilitation, and prevention are mostly available in larger cities. There are substantial differences between the services available in large cities as compared to smaller cities and towns. Depending on how rehabilitation is defined, services may also vary. Access to rehabilitation and health services mainly applies to people who are acutely ill rather than the chronically disabled. Services may be available for a person with disabilities if his or her disability and rehabilitation fits into the mandate of a specialized centre, like the Arthritis Centre.53 For rehabilitation services from private service providers, one pays for oneself.

There is training for physical therapy, occupational therapy, physiatry for nurses, prosthetic and orthotic training, speech therapy, and the specialized training of physicians, specialists, physiotherapists, and occupational therapists through post-secondary institutions in Canada. Apart from medical specialists dealing mainly with patients with disabilities, few courses for physicians on the specific needs of people with disabilities are available. When it is available, training is run by other health care professionals using a medical model of disability. Attempts are being made to update ideologies of disability within the health care system, however, and rehabilitation is starting to consider individuals with disabilities in a more holistic sense.

Housing

Access to affordable, safe, and accessible housing for people with disabilities has received special attention especially in the last twenty to thirty years as a response to deinstitutionalization. Support includes: subsidized housing, subsidized housing with supportive services, the Residential Rehabilitation Assistance Program for Persons with Disabilities (RRAP-Disabilities), the Canada Mortgage and Housing Corporation, and national non-profit organizations. In all cases, programs vary across Canada.

Subsidized housing initiatives are provincially run in conjunction with local health authorities, the private sector, and non-profit organizations. Housing is available to people with disabilities who can live independently and qualify for disability pensions or cannot work because of a disability. Subsidized housing does not cost more than 30 percent of a household's gross monthly income.53 There are three types of affordable housing: directly managed or public housing, nonprofit housing, and co-operative housing, which are jointly owned and managed by the members who live in them.

Subsidized housing with a supportive service component is an intermediate option between home care and residential care. Community living options such as group homes for people with intellectual disabilities, supported housing programs for people with mental illness, and Independent Living Units are all examples of Supportive Housing Services for people with disabilities in Canada.

Residential Rehabilitation Assistance Program for Persons with Disabilities (RRAP-Disabilities), a program of the Canada Mortgage and Housing Corporation, provides financial assistance to homeowners and landlords who wish to undertake accessibility modifications for dwellings intended for or inhabited by low-income persons with disabilities.54

Homeowners are eligible for the forgivable loans if their home is valued below a certain amount and their household income is at or below designated limits based on household size and area. Landlords are eligible for the forgivable loans if the rent price of the units is at or below established levels and tenants with incomes at or below the income limits occupy the units.

There are numerous peer-counselling and referral services available in Canada related to all types of disability needs and services. Most are connected to a national network, where information is shared locally, provincially and nationally. The Canadian Housing and Renewal Association, Canadian Association of Independent Living Centres, Canadian Association of Community Living, Canadian Abilities Foundation, Active Living Alliance for Canadians with Disabilities, and the Council of Canadians with Disabilities, are just a few of the cross-disability nonprofit organizations with referral information, advocacy, and research for people with disabilities.

Institutionalization

In 2002, approximately 20,000 Canadian citizens with disabilities were living in long-term care environments, personal care homes, and nursing homes.55

More than 12,000 individuals with intellectual disabilities were living in institutional facilities designed specifically for the housing of persons with intellectual disabilities.56

Deinstitutionalization has been an on-going process for the last twenty years in most provinces across the country. Available within Canada's Health Act, specialized programs allow children with disabilities to be raised at home, eliminating reliance on institutions. Services provided across Canada include: home care, respite, hospice, and individualized funding as well as outpatient health services like physiotherapy and occupational therapy. There are however obstacles to accessing these services for many families, including variation in eligibility criteria within and across provinces. Moreover, not all families know about the services available to them. Despite policy commitments from provinces during the 1990's to move from institutional to community living arrangements, political, social and economic roadblocks continue to afford limited options.57

Institutions have also been the site of extreme victimization and abuse of persons with disabilities, which has included unauthorized sterilization, sexual abuse, neglect, financial victimization, verbal abuse, emotional abuse and physical abuse. Recent studies have found that children with intellectual disabilities were 3.7 times as likely to experience neglect, 3.8 times as likely to experience physical and emotional abuse, and 4 times as likely to be sexually abused. Children with
additional disabilities (e.g., intellectual and behavioral disabilities) were even more likely to experience maltreatment. Numbers are similarly high in adults with intellectual disabilities.58

There are mechanisms for reporting incidences of abuse in such institutions, such as a Critical Incident Report, but these are internal review processes that can be highly problematic in terms of anonymity.59 These reports are compounded with an array of other reporting issues such as unequal power relations, communication, safety and accurate disclosure of abuse in reporting. Thus, by nature, abuse of all forms can be highly underreported, including those cases dealing with persons with disabilities.

There are a number of organizations and entities in Canada that keep records of abuse and violence against people with disabilities; these include: Law Commission of Canada, Canadian Human Rights Commission, Provincial Health Officers (or a congruent provincial position), National Clearinghouse on Family Violence (Health Canada), The G. Allan Roeher Institute, Disabled Women's Network Canada and others.

Accessibility

Currently, provincial building codes uphold Canada's regulations stating that public buildings and facilities must be accessible to people with disabilities.60

A national building code is being revised, and there is some debate over how to deal with issues of accessibility. The Canadian Council of Disabilities recommends the use of less subjective language regarding disability accommodation. They suggest that the language of "reasonable accommodation" be replaced with "duty to accommodate". Some NGO's advocate creating more cohesion and consistency across provincial codes, and others are concerned doing so might weaken the building codes in some provinces.61

Building codes went into effect in 1998. They cover public buildings, including facilities built with public funds or on behalf of the public. Small buildings and houses are exempt from these codes.62 The percentage of public buildings that are accessible to people with mobility disabilities is unknown. Most buildings existing prior to 1998 and many built since that time still pose partial to complete barriers for people with disabilities accessing their environment, including safety issues for many persons with disabilities. Barriers that appear minor to most people without disabilities often go unnoticed and unfixed. One small step into a shop or restaurant is very common yet makes a building completely inaccessible to someone with a mobility impairment.62  Accessible entrances are sometimes dangerous and poorly marked.

Across Canada, concepts of universal design are a component of studio programs in architecture. Post-professional courses are offered across Canada through private universities and colleges and independent publishers and designers.63 Yet universal design is not fully implemented in most plans, and it is not a part of engineering programs.

The Canadian Transportation Agency (CTA) administers the Canada Transportation Act of 1996. The Agency is responsible for enforcing the act, which addresses issues of accessibility and obstacles for people with disabilities within the Canadian transportation system. The act states that "a safe, economic, efficient, and adequate network of viable and effective transportation services accessible to persons with disabilities" must be available in Canada.64  Regulations recommend the design, construction, and modification of accessible signage, the training of personnel, special consideration of the cost of transportation to people with disabilities, and the communication of information in accessible formats. The CTA addresses accessibility violations on a case-by case basis, as well as addressing the systemic barriers in the Canadian transportation system.65

There is an accessible bus system in all major cities in Canada, including the capital city of Ottawa. In Toronto, Canada's largest city, four GO Bus routes are accessible, and a number of busses "kneel" with the use of hydraulics, lowering the bus and a ramp to allow people with mobility disabilities access to the bus. Additionally, thirty-six of GO's 53 train stations are fully accessible to passengers who use mobility devices.66 In Ottawa, the OC Transpo, Ottawa's public transportation system, has three categories of accessible public transit; ParaTranspo, which provides door-to-door transportation service for persons with disabilities; designated bus routes, which are fully accessible low floor buses; and additional bus routes that provide some accessible service.67


62. Further examples include, bathrooms located in the basement of a building, or cubicles too small to enter, double doors/heavy doors, no Braille signage, no elevators to a second storey, elevator buttons that are unreachable or unclear, lighting so poor in a library or book store so that people with visual impairment can't see, only audio emergency instruction or information available, ramp inclines that cause a wheelchair to flip, no "cut-outs' in curbs to access a side walk, counters too high to see over or reach the surface of, bank machines with no Braille and buttons that cannot be reached from a wheelchair.

The city of Victoria, the capital of the province of British Columbia exemplifies the wide range of ground transportation options for people with disabilities. The city of Victoria offers accessible low-floor public-use buses that "kneel"; the Community Travel Training Program, a free service that provides training to seniors and individuals with cognitive or physical disabilities who wish to use the conventional transit service; HandyDART, a door-to-door shared-ride custom transportation service; and a Taxi Saver Program, which provides a 50% subsidy towards the cost of taxi rides.68

Many cities in Canada have a combination of similar types of services available in their city as in Victoria, Ottawa and Toronto. Transportation for people with disabilities, however, is not always a smooth process. Barriers within the accessible transportation system include a wait-list for door-to-door services and required advance booking; the small number of accessible taxis; and flat rate charges by many taxis, which are costly. In addition services are often over-booked and are unreliable with respect to pick-up time. Not all train stations are accessible, and limited space may be available in accessible seating. Overall, however, there is a good variety of accessible and often affordable transportation in Canada.

Air transportation has pre-boarding, assistance on and off the airplane and special seating to accommodate disability needs of passengers. Certain airlines offer "attendant" rates, at as much as half off the price of a regular price ticket. However, one has to give explicit direction for care of a wheelchair, to assure it does not get broken or damaged during the transport. Air travelers with disabilities must often actively demand these rights with air carriers, for they are rarely extended freely.

Disability Action & Awareness

At the national level in Canada, disability policy development is coordinated by the Office for Disability Issues (ODI). Guided by the Canadian government's Disability Agenda, ODI has a mandate to foster policy and program coherence, build the capacity of the voluntary sector, and build awareness. Human Resources and Skills Development Canada maintains its programs. There are four divisions within the ODI.69

The first division, the Programs & Network Development Division, manages three programs to support people with disabilities. The Social Development Partnership Program - Disability Component (SDPP-D) was founded in 1998 and provides grants to non-profit organizations working in social development. The Opportunities Fund (OF) for Persons with Disabilities is a $30 million fund that aids eligible persons with disabilities to prepare for, obtain and keep employment or self-employment. The third program is the aforementioned Multilateral Framework for Labour Market Agreements for Persons with Disabilities (previously EAPD.) The second division, the Policy Coordination and Knowledge Management Division is comprised of two units, the Knowledge Development Unit and the Policy Coordination and Information Management Unit. These units are responsible for developing knowledge and research on disability-related issues. The Strategic Planning and Corporate Services Division provides overall corporate support such as, business planning, staffing, budgeting and so on.70 Finally, the Disability Policy Division is responsible for the analysis and development of policy options and directions.71

Areas of priority in the Office for Disability Issues (ODI) Strategic Plan 2002-2007 include housing, assistive technology, inclusive early childhood development, access to post-secondary education and training, accessible transportation, personal services, inclusive communities, accessible information, employer needs and attitudes, incentives to work and workplace accommodation, and school to work transition. The ODI Strategic Plan is implemented through a variety of partnerships. 72

Apart from governmental initiatives in the area of disability action and awareness, Canada has an active NGO, non-profit and voluntary disability action and awareness movement. These organizations span the entire country and range from community-based grass-roots disability lobbying groups to cross-disability national organizations running on millions of dollars budgets. These organizations represent different types of disabilities and issues in the community and varying political or apolitical positions.

Most of these organizations are run through a combination of fundraising, volunteerism, special project funding, and community support. These organizations create a national network for research, formal publications and e-zines/zines, information, resources, support, events, government consultations, and advocacy for people with disabilities.

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Footnotes:

1. A Way with Words And Images: Guidelines for the portrayal of persons with disabilities, 2002, http://www.hrsdc.gc.ca/asp/gateway.asp?hr=en/hip/odi/documents/wayWithWords/00_toc. shtml&hs=pyp.

2. Defining Disability: A Complex Issue (Her Majesty the Queen in Right of Canada, Gatineau. 2003), 29-30.

3. Defining Disability: A Complex Issue.

4. World Health Organization, International Classification of Impairments, Disabilities, and Handicaps (ICIDH), http://www3.who.int/icf/icftemplate.cfm.

5. Human Resources Development Canada, Disability in Canada: A 2001 Profile, 2003, http:// www.hrsdc.gc.ca/asp/gateway.asp?hr=en/hip/odi/documents/PALS/PALS000.shtml&hs=pyp.

6. A Way with Words And Images.

7. CIA The World Factbook, http://www.cia.gov/cia/publications/factbook/geos/ca.html.

8. Lucie Cosette and Edith Duclos, Participation and Activity Limitation Survey (PALS).

9. This figure is lower than the previous estimate of 14.7% reported by the 1991 Health and Activity Limitation Survey (HALS). The difference is the result of numerous methodological changes.

10. Behnaz Behnia, A New Approach to Disability Data: Changes between the 1991 Health and Activity Limitation Survey (HALS) and the 2001 Participation and Activity Limitation Survey (PALS), Statistics Canada, 2001.

11. Ibid.

12. Edward Ng. "Disability among Canada's Aboriginal Peoples in 1991," Health Reports 8, No. 1 (1996): 25-32.

13. Roeher Institute, Disability Community and Society: Exploring the Links, (The Roeher Institute, North York, 1996), 9.

14. Special Committee on the Disabiled and the Handicapped, Obstacles, 1st sess., 32nd Parliament, 1981; Jerome E. Bickenbach, Physical Disability and Social Policy, (University of Toronto Press, Toronto, 1993).

15. The Constitution Act, 1982, http://laws.justice.gc.ca/en/const.

16. Roeher Institute, Disability Community and Society: Exploring the Links.

17. The Constitution Act.

18. Government of Canada Report, Defining Disability: A Complex Issue, (Gatineau: Her Majesty the Queen in Right of Canada, 2003), 1, 13-20 http://canada.justice.gc.ca/en/index.html.

19.Canada Human Rights Act, http://laws.justice.gc.ca/en/h-6/31077.html.

20. Interview with lawyer and member of the Council of Canadians with Disabilities (CCD) International Develoment Committee, January 2004.

21. Interviews with university professors conducted in British Cloumbia and Manitoba, November 2003- January 2004.

22. Immigration and Refugee Act, http://laws.justice.gc.ca/en/1-2.5/64155.html.

23. Ibid.

24. In October 1993, Robert Latimer confessed to killing his 12-year-old daughter with disabilities by running a hose from the exhust pipe into the cab of his truck where he put his daughter to die. A key case in Canadian history, it was complicated by public feelings that it was a "compassionate homicide."

25. Roeher Institute, Disability Community and Society.

26. Canada Elections Act, http://www.elections.ca/content.asp?section=gen&dir=bkg&document =ec92610&lang=e&textonly=false.

27. Ibid.

28. Frank Smith (National Coordinator of the National Educational Association of Disabled Students), interviewed by author, Carleton University, Ottowa, January 2004).

29. Council on Access to Information for Print-Disabled Canadians, National Library of Canada and National Archives of Canada, http://www.nlc-bnc.ca/6/36/s36-120-e.html.

30. The Canada Broadcasting Act of 1991, http://laws.justice.gc.ca/en/index/157848_2813.html.

31. Defining Disability: A Complex Issue.

32. abilities Magazine, spring 2004, http://www.enablelink.org/abilities.html, 44.

33. Scott Wilson (Coordinator of Interpreting at The Island Deaf and Hard of Hearing Centre), telephone interview by author.

34. Canada Evidence Act, http://laws.justice.gc.ca/en/c-5/.

35. Ibid.

36. Lucie Cosette and Edith Duclos.

37. If children with allergies are included, the equation the percentage rises to 23%, and if children with emotional problems are added, the number of disabled children rises to over 30%.

38. Lucie Cosette and Edith Duclos.

39. The School Act, http://www.qp.gov.bc.ca/statreg/stat/S/96412_00.htm.

40. Canadian Ministers of Education, Ministerial Order, http://www.cmec.ca/index.en.html.

41. Ministry of Education of the Government of British Columbia, http://www.bced.gov.bc.ca/ specialed/ppandg/iep_1.htm.

42. Canadian Association of Disability Service Providers in Post-Secondary Education (CADSPPE), http://www.cacuss.ca/en/11-cadsppe/details.lasso?id=319.

43. Multilateral Framework for Labour Market Agreements for Persons with Disabilities, http:// www.sdc.gc.ca/en/hip/odi/08_multilateralFramework.shtml.

44. Ibid.

45. Kerstin Roger (Canadian Centre on Disability Studies), telephone interview by author.

46. Statistics Canada, Participation and Activity Limitation Survey (PALS).

47.Canadian Human Rights Commission, 2002 Annual Report: Human Rights Challenge, (2002), http://www.chrc.ccdp.ca/publications/2002_Annual_Report/page2-en.asp.

48. Employment Equity Act (EEA), 1995, http://laws.justice.gc.ca/en/E-5.401/49886.html.

49. Canada Human Rights Act.

50. Canada Health Act, http://www.hc-sc.gc.ca/medicare/chaover.htm.

51. Ibid.

52. "Vocational rehabilitation services," http://www.worksafebc.com/for_employers/vocational_ rehabilitation_services/default.asp.

53. BC Housing, http://www.bchousing.org.

54. Canada Mortgage and Housing CMHC, http://www.cmhc-schl.gc.ca/en/prfias/rerepr/ readaspr_005.cfm.

55. "Proposed National Plan on Deinstitutionalization," (discussion paper presented at Canadian Association of Community Living, 2003).

56. Ibid.

57. Ibid.

58. Canada Health Act.

59. Health Canada, Family Violence and People with Intellectual Disabilities, (National Clearinghouse on Family Violence Publication), http://www.hc-sc.gc.ca/hppb/familyviolence/html/fvintellectu_e.html.

60. National Research Institute of Canada, http://www.nationalcodes.ca/nbc/questions5_
e.shtml.

61. CCD, "Input Needed to National Building Code," Equality Matters, 13 December 2002, http:// www.ccdonline.ca/publications/equality-matters/1200.htm.

62. British Columbia Building Code, sec. 3.8, 1998, http://www.qp.gov.bc.ca/statreg/reg/L/ LocalGovernment/295_98.htm; Telephone interview with employee at BC Building Corporation, Victoria, BC.

63. Information provided by the University of Victoria Engineering office and the University of British Columbia.

64. Canada Transportation Act, http://laws.justice.gc.ca/en/C-10.4/24543.html.

65. Canadian Transportation Agency, Accessible Transportation, http://www.cta-otc.gc.ca/access/index_e.html.

66. GO Transit website, Accessible GO Transit Services in Greater Toronto Area, http://www. gotransit.com/public/aboutgo/accessibility.htm.

67. Ontario's Public Transportation, Accessibility Services for persons with disabilities, http:// www.octranspo.com/acc_menue.htm.


68. Victoria Regional Transit System, Guide to Accessible Transit Services, http://www.busonline.ca/regions/vic/accessible/family_of_services.cfm.

69. Office for Disability Issues, http://www.hrsdc.gc.ca/asp/gateway.asp?hr=en/hip/odi/01_about. shtml&hs=pyp.

70. Ibid.

71. Ibid.

72. Office for Disability Issues, Office for Disability Issues (ODI) Strategic Plan 2002-2007, (Her Majesty the Queen in Right of Canada, Gatineau, 2002).