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Month: December 2012

Failing the Frail – Homecare reductions in Alberta

 Alberta Health Services cuts homecare services

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“…assessed by START (Short Term Assessment and Rehabilitation Treatment) to develop a treatment plan to improve her quality of life and allow her to continue living out in the community.”

Glenrose program keeps seniors active

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My headline for this blog post is, of course, recycled from when I wrote last year about the closure of the START program at the Glenrose Rehabilitation Hospital. The program, highlighted so well in the above quoted article from 2006, was shuttered last year. My father, thanks in no small part to the advocacy of some diligent and committed home-care staff, was one the last patients to benefit from the impressive rehabilitative care offered by the program, and the efforts of staff, a number of whom had been with the program since its very beginnings.

Alas, with little consultation, and wave of approved soundbites in the face of criticism (namely from former patients contacting any local media who would listen), START was quietly closed. Assurances followed that opportunities would be there to treat patients in the community, and that the level of care would not suffer.

Over the past two years, over 5000 additional patients, being treated in their homes, in their communities, have been added to rosters of the Edmonton area’s various home-care providers.

No one asks to suffer from, to endure, and fight to overcome the effects of age, illness, injury, etc. And it’s hard enough finding obstacles and barriers everywhere, and everyday, where healthy individuals may see little more than some steps to climb, a distance to walk, or a curb to step upon. What’s desired is a level of care that enables them to maintain some quality of life, to avoid complications that can lead to setbacks, and hospitalization, and some help for families that struggle to provide and care for a loved one in need.

None of this can truly be appreciated unless it’s been seen or experienced up-close. Unless you’ve witnessed and/or cared for a loved one with medical difficulties, unless you’ve been a nurse, or a therapist, or one of the many talented individuals in the medical field or provide these supports to individuals in their homes, it can be so incredibly easy to under appreciate the issues at hand.

And it would seem that our decision-makers, elected or otherwise, exist detached from the everyday struggles of many Albertans. Perhaps it can be seen in a government that allows a compassionate care bill to die on the order paper. Or maybe in the statement of an AHS official who seems to believe that there’s little connection between a level of care, and the time health-care providers have available to spend with a patient.

“”We are not reducing the level of care for any of our clients. We will be reducing the amount of time spent with them in some instances,” Williamson said.”

 

“I’m sorry Mrs. Johnson, we’re reducing your daily exercise program by 15 minutes, the program that allows you to stay mobile and active”.

“I’m sorry Mr. Jones, we don’t have time to treat all your diabetic sores today, we’ll do the rest tomorrow, or Monday”.

 

The day-to-day life of a homecare worker isn’t just time spent with the patient. Time seems much shorter when a worker new to a patient and unfamiliar with them and their care must deal with the situation. Time which is well used to do more than run through a prescriptive routine, but which can be used to fully assess a patient’s state and condition. Time which is also consumed by travel and the transportation of supplies and equipment.

AHS is once-again acting upon a decision made behind closed doors, without any consultation whatsoever with those affected the most, failing those whose care they have been tasked with.

I challenge AHS to do better. I challenge everyone from senior management to the Minister of Health to set foot in our communities, in our neighbourhoods – to book our community halls and events centres and discuss this issue and many more, face-to-face with everyday Albertans. Listen to those who receive home care, those who provide it to the highest of standards, those who strive to provide the highest level of care to their patients, and those who support and care-for a relative or a spouse in need. It’s called public consultation, it’s called stakeholder involvement, and it shouldn’t take digging by a political party or the media to break an issue out into the open. Transparency, consultation, and open decision should, as a principle, be the standard of this government, and in particular the department with which we entrust our health, our lives, and that of those we care about.

Development Dialog – Summarizing a meeting of minds at a west-end community hall

Earlier this week a group of community and development industry representatives met at the Glenwood Community Hall to discuss proposed amendments to Edmonton’s zoning bylaw and mature neighbourhood overlay.

Some material from the EFCL is available here – below are the presentation materials from a city of Edmonton open house last month, and the complete Council report with mark-ups of all the proposed changes.

I spent a good portion of the evening in what became a very interesting discussion between community and development folks regarding dialog between communities and development proponents, the benefits of proactive consultation, and acknowledging developments which contribute positively to the community through both the quality of the product and up-front discussion.

Below is a summary of the notes which I took throughout. Coming from multiple sides of the development process, I think they speak to the potential for not only positive and enhanced consultation processes, with the potential to alleviate neighbourhood concerns and ultimately create a better housing product in infill situations, but avenues to create neighbourhood plans and architectural/design themes for neighbourhoods.

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Up-front discussion between the community and proponents of a project could help to also facilitate development (addressing concerns about timing) while improving the quality of the project. A positive relationship with a community can reduce time requirements and allow uses to remain as discretionary. “Balance is the key”.

From there the discussion went it the relationship between residents and development proponents. There was a consensus that nobody wants to a product that detracts from the look of the community, that’s constructed without regard to community character or strong design standards, by someone whose interest isn’t in building a community and their reputation as a builder.

There was discussion about design standards and a general theme being established for an area through zoning. As well, it was discussed that there are already some standards in place which development officers could and should be using to encourage duplexes with architectural interest, that don’t simply have a copy/paste mirrored look.

Developers noted that one or more poor quality neighbouring projects can adversely affect one’s strategy in a neighbourhood. As well, that certainty is positive when making an investment – leaving to much poorly defined or up to the discretion of the development officer, increases investment risk.

There was also talk about ways that communities can acknowledge positive developments & consultation practices. Highlighting those that make the effort above those who disregard community concerns or are simply looking to “get in/get out”.

Edmonton Zoning Changes – low-density zones and mature neighbourhoods

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Show Your Work – On the Alberta Legislature, open legislation and debate

As you may have gathered..and as I may have mentioned one or two times, I’m a fan of municipal government. I respect greatly, its importance in our day-to-day lives. I value its accessibility to residents, whether it’s an interested citizen or a community group looking to be engaged in policy, and in operation of their city, town, hamlet, summer village, etc. And I appreciate the ability of my councillor, and the small group of decision-makers next to them, to engage in debate and discussion in an intimate setting that allows my representative, and everyone’s representatives to ask numerous questions, to engage one-on-one and have an indepth say. An advantage of a smaller group that also isn’t encumbered by party lines.

Being a good politico I do of course closely follow provincial politics. Their federal cousins however, I tend to consider far out of reach of the average citizen; operating from a place where the concept of “all politics is local” tends to take a back-seat, not so much to national discussion, but party ambition and the ability to fall back upon party name rather than a personal connection with constituents come election time. Yes of course, provincial politics could well be accused of having the same flaws. But 80+ MLAs doesn’t quite match the bustle of 300+ MPs or the sound volume of national campaigns.

Anyways, where am I going with this? Debate, the development of legislation, the consideration of amendments, and consultation with the public throughout.

It’s budget time for municipalities. Aside from a few in camera sessions, the process is open for all to drop into Council chambers and view the proceedings. You can/could attend a public hearing, watch civic departments and agencies make their budget requests, see the Mayor lay into the province and feds over municipal funding and next week, see Councillors debate various motions before arriving at a final product. It’s a far cry from the traditionally behind the scenes provincial budget process with an often rhetorical public discussion.

Not that budgets or even municipal funding were a prime topic for MLA’s yesterday. This past evening I tuned into the proceedings in the Leg, and kept the live stream going mostly out of curiosity as to whether any opposition amendments to the topic at hand, the elections accountability act, would actually pass. I believe the final tally was 2 accepted amendments out of 100+ proposed.

I suppose if you swing heavily to the government side, the process doesn’t particularly bother you. But to this observer, there’s something aggravating about watching, what seemed to be some quality proposals, falling under the wheels of a party bus. Isn’t it supposed to be province first, not party first? Opposition MLA’s are generally strong when it comes to articulating their proposals (I say this regardless of whether or not I agree with their politics). But it’s from the chorus of “NOs” which shot down so many of these amendments, that I’d like to hear some articulation of their viewpoint. The reason for their vote.

Perhaps I’m missing something here and have just spent too much time listening to Councillors speak to their reasons for voting yay or nay, one by one, prior to a vote. Maybe I’m just irked by the differences in accessibility by the general public to the policy development process between provincial and municipal politics. Or maybe I’m just plain annoyed that my elected provincial representative can propose an amendment – good, bad, or in between – and see it shot down by dozens of members on the other side, seemingly along party lines with limited explanation justifying their votes.

With the tools of the 21st century, and with a laptop, a smartphone, and/or an iPad sitting in front of almost every MLA and member of the public, there’s a better way to do this; it’s in the development of legislation and amendments using the open source model. A model that inherently creates public consultation and transparency by starting with a blank page and drafting public policy with many eyes upon it.

 

OpenLegislation – It’s a tool developed for the New York State Senate and Assembly

OpenLegislation is a web service that delivers legislative information from the New York State Senate and Assembly to the public in near-real time.

The platform allows bills and their various versions to be published as they’re drafted and as the legislative process moves on. It shows, in an easily accessible manner, how various members voted and even provides the public with the ability to comment and engage in discussion along the way.

The size and bustle of the Legislature may not allow for that intimate debate that can take place in municipal Council chambers. This is however the era of Twitter, of Facebook, of blogs and online forums. There is absolutely no shortage of tools for provincial politicians to post their thoughts on policy, to elaborate on how they vote and make decisions – or for the government to only reveal a bill when it’s reached what they consider to be a final, or near final product. The only hindrance is laziness, a lack of desire for transparency and the failure of the public to provide any political hit for being aloof and disconnected.

Yes, the government does have some public surveys and consultation processes. And sure, many members of the Provincial Assembly and many politicians in fact do utilize social media. But a public meeting with no follow-up, a survey whose results are only revealed through an MLA/minister and social media broadcasts – “Proud to be…”, “Great day at…” “Thrilled to be…” – aren’t engagement. They add little or nothing to the public debate, and as a citizen, I’m not particularly interested in giving up an evening to attend a public meeting, the feedback from which I’ll never have any insights into how it’s actually considered. Nor am I interested in a politician’s events schedule and how productive and great their day was. Although, if they wanted to announce what interest groups they’ve met with and who’s set up meetings to lobby them, that wouldn’t be a bad thing ;).

Yes, we live in a representative democracy. We elect people to make decisions on our behalf. But it shouldn’t mean that we aren’t provided a window into the process, from the drafting of policy to its passing, or the ability to open that window and engage in discussion. It shouldn’t mean that we don’t closely follow the progress of our representatives through the term – asking to see why they’ve voted as they have – what their thoughts are on proposals and ideas from all corners of the assembly. When the process is dominated by party politics, much of which takes place outside the view of the general public or with media at a party AGM crammed into a little room – in failing to do so, we probably deserve what poor policy and debate comes down the pipe as a result.

On info, data & access to

I was thinking today about a Freedom of Information request I filed a couple weeks back. Dropped $5 bucks in an envelope along with the form and sent it off to Ottawa. I’ve filed a handful of these requests in my time, but never at the Federal level.

It’s a request that could have been avoided entirely, saving me the price of five small coffees at McDonalds this week, had my MP and/or the crown corporation in question, engaged my community in a public consultation process prior to making an impactful decision- or even if response letters had been returned. Better yet, the info I’m seeking could have been made available through an embrace of the open data movement. Falling within the vein of financial and operating data that could routinely be released to public, both for informative purposes, and as a open & public performance measure.

But with less public data, and more unanswered correspondence than I’d like – I’m out five bucks and left sitting here tapping out a blog entry and wondering if a reply from the government is going to come before Christmas.

In thinking about this blog post, my train of thought went east, then veered north, so we’re going to cover two different paths to the public disclosure of government info.

First, OpenData:

 

– Provide a single-source for information and data catalogs. Don’t bury and scatter this information across government departments and obscure websites. Edmonton’s opendata catalog is great example. A single well-maintained and well-publicized entry point for individuals, businesses, organizations, etc.

– Make the process for requesting data easy and within view of the public. Take an application like IdeaScale, which allows anyone to submit and rank thoughts/ideas, and put it to use for this. Let folks openly submit requests for government datasets, let us see what others have requested, and throw our support behind them. And like the data catalog itself, do it through a central, and easy to find portal.

– If it’s FOIPed as a matter of public interest, make it public. A few years back my Community League successfully got our hands on internal documentation and process info from the selection of a route for the West LRT expansion. The entire request was a few thousand pages, some of it good for mild curiosity if nothing more. But the documentation and internal analysis from the project team was interesting and highly informative. We can and did post some of it to our website, but its reach and availability to an increased audience would have benefited greatly from the city itself, placing the documents online.

 

Government is of course steered by politics, and in politics there’s always going to be those to whom the public disclosure of information, will either be a non-priority, an annoyance, or a curse. Politicians aren’t going to be lining up to put their briefing notes online. There’s always going to be a need to actually drop a cheque in an envelope along with a form asking for the disclosure of X, Y, and Z (oh, how it would be nice to be able to do this online as well).

There are also, always going to be nuisance requests. And there are ways that those who choose to file these, can be left to their own devices in what I’m going to propose. The value of freedom of information is shown constantly in those requests which bring valuable information to light – that which informs, and that which holds those in power, responsible for their actions and decisions. These requests are not always made by a media organization with the funds to pursue information, paying those extra fees that are often charged for xeroxing and a staffer’s time, (my Community League was quoted several thousand for our request), or the platform to widely release what’s revealed.

You’ve probably heard of Kickstarter, the “funding platform for creative projects”. I’d like to suggest something similar targeted towards government prosperity. Maybe it’s put together by media groups, the child of like-minded organizations, or some form of social enterprise.

I’m not going draft any potential non-profit or corporate bylaws for it here, but here is the Coles Notes version of how I’d envision its operation. Anyone – Individual, biz, etc lays out the information they’re seeking. For low-income individuals, this is the chance to have the cost of initial filing fees covered. For others, if they’ve filed a request and have been quoted additional fees to have it fulfilled, this is where our funding platform kicks in. With interested donors covering the fee request with the agreement that the information received will be published online, through the platform.

So if there are folks out there in the media or in the non-profit sector looking for a long-term transparency project, please consider this idea open to all.

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Study ranks Canada’s freedom-of-information laws dead last

Alberta gets a ‘D’ in freedom of information audit