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LACs and ISPCs will have skilled training to ensure that the interests of the individual are central to the planning process. Families and service providers can get help to understand supported decision making and how it works.
 

LACs and IPSCs will have to work to rebuild trust and confidence with families. This will best be done through building relationships, connecting families with other families who have been through similar experiences, and consistent communication and transparency.
 

You are in charge of your plan. Your LAC or IPSC can help you figure out what inclusion looks like in your situation. Your family may also need some support to be creative in their vision of inclusion. Most often, families are scared or protective because they have been told inclusion isn’t possible. Working together can help. But, at the end of the day, your plan is yours and you get to decide. 
 

Part of your plan might include building connections for you or helping you access peer support. You don’t have to have a family for planning.
 

Yes, through LACs, Regional Hubs and other key implementation partners like Inclusion NS. 
 

The Remedy is focused on supporting individuals. Supports to families should never be in place of support to individuals. However, the Remedy recognizes that families are often the main source of support for people with disabilities and need support to continue this role.
The Remedy will support families by:

• Connecting with partners like Inclusion NS to help families build a vision for inclusion, and access information on supported decision making, etc.
• Providing Local Area Coordination supports like system navigation or identifying community connections for their family and/or family member with disability.
• Ensuring space for families on Regional Hub advisory councils.
• Providing Individualized Funding (IF) coordination and administrative support so the responsibility of managing and administering funds and implementing their family member’s plan does not fall to families alone.

If people want support to reconnect with family members, their LAC or ISPC can support this. Families are not expected to resume a primary care role in their family member’s life. 
 

Change can be scary. A thoughtful, intentional, and well-resourced planning process will help lessen the anxiety about change and moving. An IPSC will work with each person to develop a unique plan that works for them and their timeline for moving to community. Each IPSC will provide support to approximately 20 people, allowing for meaningful and impactful relationship-building work.

This may feel overwhelming. Some people have lived in an institution for decades. It may be all they know. It may be what their family was told was safe. By law, institution settings in Nova Scotia must be closed by 2028.

People have the right to choose where and with whom they live. And how they want to spend their days and evenings.

Institutional models of care are outdated and not supporting people to live a full life in community. 

If a connection with their current staff is important, a person’s individualized planning process can include ways to maintain these relationships. For example, the Remedy includes a workforce strategy to support staff to transition from institutions to other opportunities. Not all staff will choose to shift to providing community-based support. A person might meet new support workers that support them in new ways too.

The richness of the Remedy is that it does not prescribe where someone will live. The intention of the Remedy is to empower personal and individual solutions that work for the individual. This marks a shift away from older models that restricted or even penalized individuals for coming up with innovative solutions. This flexibility helps individuals and families reimagine what could be possible. The highly individualized nature of the Remedy means that when we work together creatively and with the individual in the driver’s seat, solutions can be found for everyone. People with high support needs will have access to IPSCs (currently referred to as complex case management) to ensure that the individual’s needs are being met and that due consideration is being given to safety planning.

The Remedy has a five-year timeframe. The closure of institutions must be done carefully and methodically to ensure that individuals are successful and supported in the community. Much of year one (1) of the Remedy was dedicated to building the foundation and infrastructure needed to start reducing institutional populations. A closure strategy was issued in May 2024.  

Slowly and continuously. Change will not happen all at once nor overnight. The planning process will be driven by the individual and support will be in place before, during and after the transition. An IPSC will be dedicated to helping each person through this process. 

There are 27 larger institutions across Nova Scotia: 20 Residential Care Facilities (RCF) and 7 facilities classified as an Adult Residential Centre (ARC) and/or Regional Rehabilitation Centre (RRC).

Regardless of where a person chooses to live and with whom, safety planning is part of the individualized planning process. Clear accountability processes, prevention planning, and more flexible responses increase safety. Also, enhanced staffing ratios will better enable LACs and ISPCs to proactively monitor and ensure safety standards and protocols are being followed. For group homes and Small Option Homes, licensing remains in place.

A whole range of services and supports exist to help people leave an abusive situation, and none of those things are going away with the Remedy. In addition to community organizations and law enforcement, LACs and ISPCs will be empowered with flexible response options that enable them to act quickly when abuse is happening. If you or someone you know needs help to leave an abusive situation, call 211. If you are in immediate danger, always call 911.

Part of building capacity of community is also building an understanding of behaviour as a form of communication. Research supports that when individuals are meaningfully included and feel a sense of control and empowerment in their lives, crises and incidents of violence decrease significantly. The planning process will include safety planning for individuals where behaviour is a concern.

Policy development on the home sharing model is underway. Key safeguards will include a shared understanding of roles and responsibilities for all parties and clear accountability measures. Additionally, through enhanced planning, there will be more capacity for oversight and ongoing engagement. This could include site visits, check-ins, accessibility modifications, etc.

The Remedy shifts from a placement-based approach to a focused planning process committed to building a life in community based on each individual’s choice. This decreases the risk of “breakdown” and increases the likelihood of meaningful life in community. People change and grow over time and their preferences and interests may change too. The Remedy foresees that things can and will change. The Local Area Coordinator, or an Intensive Planning and Support Coordinator, can support individuals to revisit their plan and revise accordingly. 

Policy development on the home sharing model is underway. Key safeguards will include a shared understanding of roles and responsibilities for all parties and clear accountability measures. Additionally, through enhanced planning, there will be more capacity for oversight and ongoing engagement. This could include site visits, check-ins, accessibility modifications, etc.

As the new home sharing model is developed, recruitment and retention of hosts and host families will be a key factor. DSP is working on addressing feedback and challenges with the AFS program, such as funding, respite, and training needs. A new strategy for recruiting individuals and families for the program will be developed, including a robust screening, assessment, and support process.

The Remedy has prioritized the closure of facilities and congregate settings currently housing more than 4 people. Closure of group homes and developmental residences will begin in year 4 of the Remedy. Small Options Homes will continue to be an option for DSP participants.

All DSP participants will eventually transition to individualized funding, which provides individuals with more choice and control – including the option to move. Through the Remedy’s workforce strategy, we will shift to a system where services will be provided to individuals - wherever they choose to live - and not tied to facilities or beds. 

Home sharing is a shared living model based on respectful, meaningful relationships. It creates connections between those who are open to sharing their homes with those looking for housing. Home sharing works best when not used for emergency or short-term situations. The concept is that the individuals involved are committed to sharing a life in community, not just a house. There is funding available to the individual providing the home to recognize their role in providing some support, shelter and housing. The DSP participant uses their Individualized Funding to cover their core support needs – i.e., what they do during the day. Home sharing arrangements are often supported by an agency that helps recruit people who want to share their home in making the connection to a person seeking a shared living arrangement. 

The Remedy is designed to give people more options and control over where and with whom they live. We know affordable housing is a real challenge for many Nova Scotians right now. Coordinated efforts by government and partners are underway to address housing insecurity. The Remedy has many ways that it will help people find housing and other supports in community. They include:

• Better planning support – Intensive Planning Support Coordinators (IPSC) and Local Area Coordinators (LAC) who have the capacity to help individuals plan and build a meaningful life in community. IPSCs and LACs are anchored in their local communities and can help find and create housing options.
• Removing the traditional “menu” approach that has forced individuals to select from pre-determined housing options (e.g. Small Option Home, Group Home, RCF, etc.) and instead helping people with disabilities access more “typical” housing arrangements.
• Revisiting regulations and building code requirements that have, in the past, restricted or limited access to housing for people with disabilities.
• Introducing approaches like home sharing that have worked well elsewhere.
• Individualized funding (IF), which gives people more choice and control in their lives by assigning funding to the individual rather than to a bed or a service provider. Individual budgets will be developed that better reflect the unique needs of the person and provide them with the means to hire their own staff. Nova Scotia is investing in an “IF Backbone” of administrative support and tools to help people manage their funding. 
• A workforce strategy that guides government’s work to ensure we have the  right people in the right roles to move the work of the Remedy forward, and support Nova Scotians with disabilities into the future  
• A commitment to culture change as we shift away from old mindsets and models to more inclusive and supportive ones 

Yes. There is a workforce strategy underway to look at building and maintaining a professional work force that feels valued, respected, and adequately compensated for the work they do. 

Change can be daunting, especially when there are periods of uncertainty while the Remedy implementation plan takes shape. In the short term, service providers can begin the work on leadership training, culture change, visioning and capability. Supporting staff to feel comfortable understanding how to deliver values-based, inclusion-oriented supports and how that differs from what we are currently doing will help them prepare for the changes to come. 

Work is currently underway to develop individualized funding model that both provides choice to participants and funding stability for service providers. Given current housing shortages, DSP will work to ensure that as many community housing options as possible are available to persons with disabilities.

Intensive training and leadership efforts to foster culture change are underway. These efforts will support a shift from institutional models of support and mindsets to values-based, inclusion-oriented skills and capabilities. These skills will include in-depth understanding of person directed care, supported decision-making, dignity of risk etc. 

Service providers are key partners in all of this, and the Remedy outlines various support measures for them. Stabilization funding will be available to help service providers adapt to new service domains and ways of working. Our aim is to retain service providers by offering opportunities in areas like agency-delivered supports, third-party administrative funding support, home sharing coordination, and more. We anticipate there being an increased need for service providers. Additionally, the Remedy provides a workplace strategy that will help with training and culture change for staff. There will also be a Service Development Transition Fund to support DSP service providers to manage the required changes in culture, capability and infrastructure as needed. 

Yes. The Remedy commits to training for culture change, visioning and capability. 

Yes. Regardless of where an individual lives, LACs and IPSCs will be responsible for oversight and monitoring of the individuals they support. As the system moves away from a placement-based focus and because of the current licensing and building code review, there may be changes in how a particular living arrangement is labelled. 

Yes.  Individualized Funding provides a means for individuals to choose their support workers. They may choose to hire their own, they may choose to work with a service provider that has a rotation of staff. It will be up to the individual to select an option that works best for them.

Yes. In addition to encouraging people with disabilities to apply for roles as LACs and IPSCs, an individual can allocate funds for peer support in their personal budget.

It’s important to remember that all our decisions are influenced by practical constraints, social norms, and laws. Not all decisions are possible and not all wants are funded by DSP. For example, someone may want to go on a trip around the world. That’s not for DSP to pay for, but maybe DSP can help set up a savings account to help that person realize their dream. 

We all make mistakes. They provide an opportunity for learning and growth. Making a poor decision shouldn’t mean you aren’t allowed to make decisions ever again. We are all allowed the dignity of risk. We also don’t have to make decisions that other people like. You are unique and so are your decisions. 

The choice of the individual is paramount. LACs and IPSCs will have an essential role in planning to ensure the decisions an individual is making reflect their interests, not those of people around them. For many people with more intensive support needs, families may be scared or protective and want to choose options that feel safe to them. Often the vision of what is possible has been restricted by what has been provided. Most families have only been offered–or even expected–to make segregated choices for their family member with disability. Families may need support to re-imagine an inclusive life for their family member with disability. 

Individuals who aren’t used to making their own decisions may need time and support to see what is possible. Part of their planning process with an LAC or IPSC might include opportunities to learn and experience new things. Change can sometimes feel scary, but the Remedy includes a network of supports along the way. The planning process can be gradual and is ongoing, not set in stone. It can start with small simple steps as part of building the bigger plan of life in community. 

The starting point in Nova Scotia is that every person is presumed to have capacity to make decisions for themselves. Capacity refers to a person’s ability to understand information about a decision and about how it will impact their life. This might look different for everyone, and support can be given to help a person understand information and to express their thoughts and feelings in a way that works for them.

The Remedy talks about how important it is that people with disabilities have choice and control over their lives and that means planning for a person to have what they need to communicate what they want, and to have the support to reach their idea of a good life in community.

Supported Decision Making takes many forms. It could include:

• Access to plain language resources (documents, websites, etc.).
• Helping an individual work through a decision to understand what should be considered and what likely outcomes will be.
• Support to articulate themselves ,verbally and/or non-verbally, in ways that are understood by others. (Communication support)
• Intensive supported decision-making circles or networks where a group of individuals who are known to and trusted by the individual are relied on to articulate the individual’s likes/dislikes/preferences. 
   

Community organizations, in particular Organizations of Persons with Disabilities (ODPs), are implementation partners. Collaboration and coordination with community organizations is essential to the success of the Remedy. The Remedy secures dedicated innovation funds for Regional Hubs as well as funds for peer and technical support. The parameters of these are in development. 

Community development is a key component of the Remedy. Many aspects of the Remedy – including Local Area Coordination and leadership training for culture change, visioning and capability to shift mindsets to inclusion – focus on strengthening communities and existing community facilities to be welcoming and inclusive. Additionally, safeguards and monitoring will be enhanced with improved staffing ratios.

The Remedy is designed to support individuals to find housing and support in their community of choice. Whether urban or rural, the Remedy has the necessary elements to support individuals to build a life where they choose. Through the Local Area Coordination approach and new Regional Hubs, the Remedy will strengthen a locally focused response to planning. Local Area Coordinators will be knowledgeable of their local area and deeply connected to the community. These local teams will work on developing solutions, like availability of “typical” housing stock, along with providing planning support to individuals. Regional Advisory Councils will provide guidance on and help develop solutions at a community level, and they will have access to funding to address the unique challenges in their area.

Yes. The Individualized Support plan should include activities throughout the day. Support to participate in employment, volunteering, and activities could be included in the plan. 

The Nova Scotia government is responsible for funding the implementation of the Remedy.  This includes the departments of Community Services, Health, Seniors and Long-Term Care, Education, Office of Mental Health and Addictions.

The Disability Support Program supports employers paying fair wages to people with disabilities for their work. This recognizes people with disabilities as valuable, contributing members of the labour market, like any other workers.  

Exemptions levels for earned income were increased in the recent budget (2024). Current exemption levels are outlined in this table. They will be updated in Fall 2024 to reflect the changes.

Implementation is rolling out in the Fall of 2024 and all DSP participants will transition to IF over time.

More information on this will be available as we approach the IF roll-out in the Fall of 2024.

IF will mean a new way of working for everyone. It will impact how service providers deliver supports and what types of services they provide. In IF models, the intention is to shift choice and decision making to the individual. In a sense, as the purchaser of support, they will push change by wanting to purchase supports that are community-based, flexible, and individualized. 
The Remedy calls for a workforce strategy that will help with training and culture change for staff which will be rolled out in August 2024. There will also be a Service Provider Development Transition Fund to support DSP service providers to manage the required changes in culture, capability and infrastructure as needed. 

Everyone eligible for DSP will eventually be allocated a personalized budget. This process will happen in stages as people move over from current programs to the IF model. 

Following a needs assessment, an individual will be allocated a personalized budget. How the funding is administered and managed can be determined by the individual. Some people may want to manage the funding on their own (be responsible for hiring staff, paying costs directly, etc.). Others may find this too much work. 
Nova Scotia is developing options for an administrative backbone of support which gives individuals options to access help in managing the funds. Some people may choose to have certain funds allocated directly to a third party (like a service provider). Others may choose an agency to help manage all aspects of funding. Individuals will have reporting requirements and their personal budget will list what funds can be spent on.

Using a needs assessment and based on an individual plan, each DSP participant will have a personalized budget. That budget is designed to cover the supports needed to build and live a meaningful life in community. Help in managing money is available through supports known as the Individualized Funding (IF) “backbone”. 

Individuals with disabilities do not have to be eligible for DSP to access planning and coordination. The strength of Local Area Coordination is that it helps build connections in community for all community members. Anchored in community, this approach can help community members with system navigation, community inclusion facilitation, support links to community groups, and so on. For those who are eligible to receive DSP funding, more focused supports for individualized planning, coordination and self-management are also available.

Programs outside DSP may need to be adjusted and aligned because the whole of government is responsible for implementing the Remedy. For example, SLTC and DSP are working together to procure a common “IF Backbone”, which is the administrative support system to help individuals to manage their own funding.

These programs are already individualized, so participants will transition to Individualized Funding later and might not have big changes to their current arrangements as they switch to IF. The Remedy seeks to bridge the funding gaps between current programs to provide for more local and personalized arrangements. 

Individualized Funding and the development of unique support plans creates flexibility that hasn’t been in place before. The Remedy provides new approaches to support that can address some of the challenges people have previously faced. By working with each individual and building local capacity, the Remedy is designed to think outside urban areas where traditional supports and services tend to be.  Regional hubs supported with innovation funding will test local solutions to local issues. A new role has been created for community living facilitators, and new approaches like home sharing are some of the ways the Remedy will support building more community-based options in rural areas. 

While it focuses mostly on adults, the Remedy acknowledges “the way that families and children with disabilities are supported through the early years and to adulthood fundamentally impact outcomes. Supporting children with disabilities to be included in all aspects of their community from a young age ends the pathway to institutions. The Remedy addresses some of these measures through the School Leavers proposal in section 3.3 and intergovernmental work underway in other departments.”

Further, the Remedy recommends: 

• The continued development and enhancement of the children’s services and progressive redevelopment of that into an individual funding model.
• Exploring how enhancing respite supports for children may contribute to scaling of efforts such as Homeshare. 

In 2022, DSP received approval to implement changes and enhancements to the existing DSP service for children with disabilities. Income thresholds for Direct Family Support for Children (DFSC) were updated to match the increase in the Consumer Price Index since 2012 and several new benefits were introduced: 

• Providing a new Inclusion Benefit to all participants
• Reducing receipt requirements for respite
• Increasing summer respite funding
• Rolling over unused respite funding 

Approval was also given to create new programs that had been successfully piloted: Intense Family Support Planning, Agency Delivered Respite and Outreach Supports. Given these programs align with the Remedy, implementation will be done at the same time as the Remedy.

The Remedy provides an avenue for anyone who self-identifies as having a disability to work with a Local Area Coordinator to discuss plans and make connections in their community. DSP is actively working to update the criteria that will determine access to funding for disability supports. We know determining the significance of a person’s functional support needs will be considered. The concern around an Autism diagnosis will inform the discussion on updating the criteria.  A recent change to DSP Policy has removed ineligibility criteria such as those in DSP Policy 9.3 and 9.4, shifting DSP from denying supports toward collaboration with partner services to consider what could be possible.
 

DSP will work differently. There will be more support people to work with individuals. Some people may continue working with the same person as before, and many people may meet someone new to help them build a plan. LACs and IPSCs will have more time to spend with each person they work with, to get to know them and what matters to them.

The Remedy puts responsibility on the whole government for implementation. DCS/DSP cannot – and should not – do this work alone. A Government Disability Roundtable is one measure to create intergovernmental leadership and structure. Similarly, alignment with anti-black racism efforts, the universal mental health strategy, Accessibility Act and other cross-government initiatives will be critical. Policy alignment on the Adult Capacity and Decision-Making Act (ACDMA) is needed to advance supported decision making, and a review of licensing and building codes is already underway.

DSP will support this internally within government departments and externally with communities, service providers and others. Intensive training and leadership efforts to foster culture change are underway to shift from an institution-based approach to a values-based approach. 

Regional hubs are a functional concept to develop more local resources and connections in communities. Each hub will be staffed with a team and supported by a Regional Advisory Council, all working toward solutions for that area of Nova Scotia. While specific office locations for the regional hubs are still under consideration, the intention is not necessarily to centralize resources into one office. 

The first step required by the Remedy was to create the position of Director of Allied Health Supports to lead this work for DSP.  The position has been created and filled. The Director will now be focused on fostering collaboration and devising solutions working with health system partners from Nova Scotia Health, Office of Addictions and Mental Health, and Department of Health and Wellness to ensure pathways exist in community for persons with disabilities to access the clinical supports they require.

A universal mental health plan for all Nova Scotians has been developed and is being reviewed to ensure it meets the needs of persons with disabilities. This will help inform the type of health supports delivered in the Regional Hubs.  At the same time, the Director of Allied Health Supports is working with current institutional service providers to find opportunities for re-deploying existing health supports in community as facilities close. 

Yes, the shared services pilot model designed to support people under 65 to move out of long-term care will continue.

By March 2026, which is year three (3) of the Remedy, we expect 200 individuals will have been offered the opportunity to move out of long-term care into community. When this target is met, the pilot will be complete, but the service delivery model will continue to be an option. Moving forward, Individualized Funding will be the model used for all participants of DSP. 

It’s individualized. Good planning means getting to know an individual deeply and is done with people they feel comfortable with. We are often limited by what we see and what we know. Local Area Coordinators and Intensive Planning Support Coordinators will have the skills to help individuals develop a vision for their life and create a plan that supports that. Some people may already have a plan and simply need support to put it in place. Others may need opportunities to learn what is possible. Planning must be intentional and opportunities to see and learn alternative options is necessary. Dedicated Intensive Planning Support Coordinators will have specific skills in helping people with high support needs. Regardless of a person’s support needs, they have a right to live in community. The planning process will help identify what’s needed to make this happen. 

This is up to you. Do you want family, or friends involved? Would you like to use peer support? It’s your choice. Your LAC or IPSC can help you manage this. You are in charge of your plan. If you don’t have family or friends, part of the plan could be to help build connections and relationships. The role of anyone involved in your plan is to help you build the life you want in community. It is your voice and your preferences that matter. Some people may need support to articulate their preferences. Family, friends and people who know you can help with this.

Using a needs assessment and based on an individual plan, each DSP participant will have a personalized budget. That budget is designed to cover the supports needed to build and live a meaningful life in community. Help in managing money is available through supports known as the Individualized Funding (IF) “backbone”.