THE EMERGENCE OF SELF-MANAGED ATTENDANT SERVICES IN ONTARIO: DIRECT FUNDING PILOT PROJECT – AN INDEPENDENT LIVING MODEL FOR CANADIANS REQUIRING ATTENDANT SERVICES

We identify the key social and political forces that brought about the Self Managed Attendant Service Direct Funding Pilot (SMAS-DFP). Attendant Services are services for people with physical disabilities (PWD) to assist with daily activities. Direct Funding means that individuals obtain funds through direct funding mechanisms and/or through third parties. Self-direction refers to consumers who know their attendant service needs and can instruct workers to meet these needs. Self-management refers to (PWD) who are employers under the law and are legally responsible for hiring, training, scheduling and paying their attendants. Our analysis of the success of the SMAS-DFP is based on pre-conditions and facilitating elements. The pre-conditions were the: (1) existence of social movements; (2) precedents to direct funding programs; (3) prior experience with the governance of attendant services; and (4) government health reform. Five elements facilitated the SMASD-FP: (1) a clear vision by the community; (2) a core group of leaders; (3) supporters of the SMAS-DFP came from inside and outside of the community; and (4) supporters provided key resources to be used and to deal with barriers. PWD successfully led the pilot (1994–1997) and continue to administer the expanded government program (began 1998).