Services and Programs for Adults

There are many therapy services available including physiotherapy, occupational therapy, speech- language pathology and audiology. Therapy services for adults are delivered by Regional Health Authorities and other service providers in hospital and community settings. Hospital-based therapy services are funded by Manitoba Health as an insured health benefit. Many community-based therapy services are also fully funded. A referral from a physician or other health professional may be required for community-based services. Contact your Regional Health Authority for details of services available in your region.

Coverage for Injury

There may be coverage for therapy from specific organizations or programs. For example, Manitoba Public Insurance may provide coverage for specific types of therapy if your injury was caused by a motor vehicle accident. The following chart shows examples of organizations that may provide coverage for therapy:

How Injury or Disability was Acquired	Organization	For More Information
Motor Vehicle Accident	Manitoba Public Insurance	www.mpi.mb.ca/
Workplace Injury	Workers' Compensation Board	www.wcb.mb.ca/
Victim of Crime	Victim Services	www.gov.mb.ca/justice/victims/compensation.html

Private or Employer-Based Insurance

You may have full or partial coverage for therapy services through private or employer- based extended health care insurance (ex: Manitoba Blue Cross). Check with your insurer or employer about coverage and eligibility. A referral from a physician or other health care professional may be required.

Private Practice Therapy

If you are not eligible for coverage through any of the options listed above, or have reached maximum coverage from an organization, you may choose to pay for therapy services. Many therapists also provide services in private practice. The following professional associations provide information on therapy services and how to find a private practice therapist:

• College of Audiologists and Speech – Language Pathologists of Manitoba
• Manitoba Branch, Canadian Physiotherapy Association
• Manitoba Society of Occupational Therapists

Home care is a community- based program that provides home support to any eligible Manitoban, regardless of age, who requires health services or help with daily living activities. Home care services within Manitoba are provided through the Regional Health Authorities (RHA’s).

Services may include:

• personal care (for example: bathing, dressing, toileting)
• home support (for example: cleaning, laundy, meals)
• health care (nursing, therapy)
• in-home relief to caregivers
• respite care services in alternative settings
• some supplies and equipment
• volunteer services
• community housing with supports
• adult day programs
• access to alternate care settings (for example: personal care homes)
• assessment and facilitation of alternate care placement

Home care services may be provided in your home, educational setting or workplace, based on assessed needs. Under special agreement with the RHA, home care may provide services at an alternate site. 

Families or individuals may have the opportunity to manage their own home care services through family-managed or self-managed care options.

For a general overview of home care services in Manitoba, visit:

• www.gov.mb.ca/health/homecare/guide.pdf

Home care services are accessed through your Regional Health Authority. Not all services are available in all regions. Contact your Regional Health Authority for detailed information about home care services, eligibility, or to arrange for a home care assessment with a case co-ordinator. For Regional Health Authority contact information, visit:

• www.gov.mb.ca/health/rha/contact.html

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To be eligible for home care services, you must be a Manitoba resident and registered with Manitoba Health. Eligibility is based on an assessment of your individual needs. To find out if you are eligible, a case co-ordinator will meet with you and complete the assessment. Case co-ordinators are health professionals who are qualified to assess your home care needs. When assessing your needs, the case co-ordinator will consider the supports that you already have in place as well as other community resources available to you.

There is an appeal process if you disagree with the final decision about eligibility for home care, type of service, level of service or personal care home admission decisions. Contact the Manitoba Health Appeal Board at:
Winnipeg: 204-945-5408
Toll free: 1-866-744-3257
Email: appeals@gov.mb.ca

Yes, there are different levels of home care service. The level of service provided is based on the assessment process and the mutually agreed upon, individual care plan developed with you and the case co-ordinator.

Manitoba has a range of mental health services for adults provided in community and hospital settings. The list below provides an overview of services available across Manitoba. The majority of mental health services are delivered by the five Regional Health Authorities with some community-based mental health services provided by self help and advocacy organizations. Not all services are available in all regions. Check with your Regional Health Authority to find out which services are available.

The following link provides a list of mental health contacts in each Regional Health Authority:

• www.gov.mb.ca/health/mh/region.html 
  

Community Based Mental Health Services

• The Family Physician is often the first point of access for a mental health concern. The physician may refer an individual to specialized mental health services for consultation, assessment or treatment, depending on the needs of the individual.
• Regional Health Authority Community Mental Health Services are programs and services provided by Regional Health Authorities that may include case management services, crisis services, and other specialized programs.
  • Community Mental Health Workers provide case management, assessment, consultation, supportive counselling and crisis response services. This service is available in all Regional Health Authorities.
• Intensive Case Management Program provides a higher level of intensity for individuals with the ability to work on goals related to school, work or social life. There is a strong focus on psychosocial rehabilitation.
• Mobile Crisis Services provide a multi-disciplinary team approach to mental health assessment, crisis intervention and short term follow-up for adults dealing with a mental health related crisis. Individuals, family members and service providers can call for assistance. Check with your Regional Health Authority for hours of operation.
• Crisis Stabilization Units are short-term, community-based settings that provide mental health intervention to people in mental health crises who require specialized mental health support but not hospitalization.
• Housing and Supported Employment Services may be provided by Regional Health Authorities. Housing models may range from supervised group home settings to supported independent housing options. A range of employment support models may also be available.

Other Community Based Mental Health Services

• Crisis Lines provide telephone crisis intervention and suicide prevention services by trained volunteers and staff.
• Self-Help and Family Supports are provided through support networks of people, many of whom are either living with a mental illness or have a family member with a mental illness. Self-help activities include mutual support, public education, advocacy and recovery-oriented services that promote the needs and priorities of people with mental health problems and illnesses.
• The Mental Health Education Resource Centre of Manitoba is a lending library that provides information to service providers, individuals with mental health problems, families, educators and the general public.

Hospital Based Mental Health Services

• In-patient Psychiatric Units provide psychiatric care and treatment in hospitals operated by Regional Health Authorities.
• Out-patient Services are provided at many community hospitals. These services include assessment, treatment and case management services for people with mental health difficulties.
• The Selkirk Mental Health Centre is the provincial psychiatric facility that provides acute and long-term in-patient psychiatric treatment and rehabilitation services to Manitobans whose challenging needs cannot be met elsewhere in the provincial health care system.

Specialized Services

Some Regional Health Authorities may provide a variety of specialized programs and services. These may include:

• Programs for Assertive Community Treatment (PACT) – This is a multi-disciplinary team of mental health professionals including a psychiatrist, nurses, social workers, occupational therapists, mental health specialists, addiction specialists and vocational rehabilitation specialists. PACT services are provided with a low staff to client ratio using a team approach and shared caseloads. Each client has an individualized recovery plan, receives outreach and can expect continuous service over the years.
  
  
• Early Psychosis Prevention and Intervention Services (EPPIS). This is an early identification and intervention service designed for individuals experiencing their first episode of psychosis. Services are provided by a community-based multidisciplinary team that emphasizes a multi-modal treatment plan. The team promotes strategies that allow for early case detection and intervention.
  
  
• Co-Occuring Mental Health and Substance Use Disorders (CODI) Outreach Program. This is delivered by the Winnipeg Regional Health Authority and provides rehabilitation-oriented case management service that combine substance abuse services with mental health services. It is for individuals who have complex mental health and substance use needs. Mental health promotion activities. Many Regional Health Authorities undertake activities and participate in initiatives that promote positive mental health as part of overall health.

For an overview of Manitoba’s Mental Health system please visit:

• www.gov.mb.ca/ healthyliving/mh/ system.html

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These mental health services are available for:

• Individuals experiencing difficulties with their mental health or symptoms of mental illness.
• Families or natural supports seeking consultation and support services (note: health privacy legislation ensures that families or friends cannot get private health information unless there is consent).

Mental health services can be accessed through your family doctor or other healthcare professional, or by calling directly to mental health services of your local Regional Health Authority. For a list of the Regional Health Authorities in Manitoba and contact information for their mental health programs, visit: www.gov.mb.ca/health/mh/region.html

If you are in a mental health crisis or cannot wait for an appointment, you can call your local crisis line or Mobile Crisis Service. The phone number can be found in your local phone book or visit: www.gov.mb.ca/health/mh/crisis.html

There may be other mental health supports available in your community. To search for community services throughout Manitoba, visit: www.contactmb.org/     

You may have access to private services through your workplace. If your organization has private insurance (for example, Blue Cross), ask about whether mental health supports are included.

The Employability Assistance for Persons with Disabilities Program offers a wide range of employment-focused services to assist adults with disabilities to:

• prepare for work
• get a job
• maintain employment

To receive services from the Employability Assistance for Persons with Disabilities Program in Manitoba, applicants must:

• be a resident of Manitoba living with an intellectual, physical, psychiatric, vision, hearing or learning disability
• be 16 years of age or older
• be legally entitled to work in Manitoba
• show a willingness to prepare for, obtain and maintain employment

There are a wide range of services available through the Employability Assistance for Persons with Disabilities Program. The services that each person receives is tailored to their unique needs and based on available financial and human resources.

• Vocational Counselling: Vocational counsellors work with people to explore their employment goals. To develop these goals, counsellors will talk with participants about their interests, abilities and skills.
• Assessment: Specialized vocational assessments may be completed to help find appropriate employment options and supports.

A vocation relates to employment or an occupation.

Employability Assistance for Persons with Disabilities includes services and supports to help people with disabilities gain suitable employment.

• Vocational Planning: Planning is done on an individual basis to address each person’s unique training or employment support needs. It may involve a:
  • Single service: for example, arranging for equipment or conducting an assessment.
  • Multi-year training plan that includes a variety of supports: a variety of supports may be available during the completion of an educational program. Examples include tuition, books, note-takers and tutors. Supports are determined on a case-by- case basis.
• Vocational Training: Vocational training may include specific job development and/or post-secondary or other adult education courses. This training can be in the form of work experiences, college, university or certificate programs.
• Support Services: Support services may be provided to accommodate disability-related barriers to employment and may provide:
  • supported employment
  • disability-related education expenses
  • sign language interpreting
  • technical equipment
  • building or vehicle modifications
• Direct Employment Services: At this stage, the participant is ready for employment.
  Direct employment services may include:
  • job search
  • résumé preparation
  • establishment of contacts with job placement agencies
  • job referral
  • on-the-job training
  • supports required to obtain or maintain employment

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Yes. The self-directed option provides people with disabilities a choice in how they can apply for Employability Assistance for Persons with Disabilities Program funding. Eligible participants who do not want, or need, assistance from a vocational counsellor can submit a request for funding assistance and manage their own plan. A Self-Directed Employability Assistance for Persons with Disabilities Program Handbook for Applicants is available to help applicants.

The following website has links to both the program handbook and application form.

For students whose main goal is to gain competitive employment when they leave school, the Employability Assistance for Persons with Disabilities Program may play a central role. The Employability Assistance for Persons with Disabilities Program is one of several partners in Bridging to Adulthood: A Protocol for Transitioning Students with Exceptional Needs from School to Community. The Employability Assistance for Persons with Disabilities Program provides a wide range of services and supports to assist eligible people prepare for, obtain and maintain employment.

For more information, please visit, the Employability Assistance for Persons with Disabilities Program website.

When a Employability Assistance for Persons with Disabilities Program participant gets a job, there are supports available to help them keep it.

Monitoring and Follow Up

The Vocational Counsellor will maintain, or arrange for regular contact with, both the participant and the employer to:

• provide counselling support and encouragement to the participant
• act as a resource to the employer if a problem comes up

If the participant needs intensive support to maintain their employment, Employment Supports may be provided for up to 36 months after employment has started. Employment Support provides ongoing support and assistance to participants. The focus is mainly on supports that are directly related to employment. Assistance may also be provided to address or assist with non-employment related issues that affect the person’s ability to maintain employment.

Vocational Crisis

Vocational Crisis Services are disability-related supports provided to prevent job loss. If a person is at risk of losing their job, Vocational Crisis Services funding is available on a priority basis to help the person maintain their job. Vocational Crisis is different from Employment Supports. A vocational crisis is short-term, emergency-related and is required to save or retain a job.

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The Employability Assistance for Persons with Disabilities ProgramProgram’s services are available from various service providers, depending on the disability a person has:

• For people with an intellectual, psychiatric or learning disability, contact:
  

  Employability Assistance for Persons with Disabilities Program
  To find the location in your area, visit the following websites:
  Winnipeg service centres
  

  Rural and Northern services centres
  
• People with a vision related disability can contact:
  
  Canadian National Institute for the Blind
  Manitoba Division
  1080 Portage Avenue
  Winnipeg, Manitoba R3G 3M3
  Phone: 204-774-5421 in Winnipeg
  Toll free: 1-800-552-4893
  TTY deaf access line: 204-775-9802
  Fax: 204-775-5090
  
  
• People with a spinal cord injury can contact:
  
  Canadian Paraplegic Association
  Manitoba Division
  825 Sherbrook Street
  Winnipeg, Manitoba R3A 1M5
  Phone: 204-786-4753 in Winnipeg
  Toll free: 1-800-720-4933
  Fax: 204-786-1140
  
  
• People with a physical disability, including the Deaf or hard of hearing, can contact:
  
  Society for Manitobans with Disabilities
  825 Sherbrook Street
  Winnipeg, Manitoba R3A 1M5
  Phone: 204-975-3010 in Winnipeg
  Toll free: 1-866-282-8041
  TTY deaf access: 204-975-3012
  TTY toll free: 1-800-225-9108
  TTY deaf services: 204-975-3083
  Fax: 204-975-3073

Through Supported Employment, people with disabilities have supports to acquire and maintain a job. The goals of the Supported Employment program are:

• to provide employment opportunities for people with disabilities in competitive employment settings
• to allow workers with disabilities to receive supports necessary to maintain employment

The Manitoba Supported Employment Network website provides information for educators, employers and job seekers. For more information, visit: msen.mb.ca/wordpress/

The Manitoba Supported Employment Network website contains a listing of organizations that provide information and/or services for supported employment. For more information, visit: http://msen.mb.ca/wordpress/membership-list/

The answer depends, in part, on how your disability was acquired. If it was a motor vehicle accident, contact Manitoba Public Insurance for information on the supports and services that may be available to you. If it was a workplace injury, contact the Workers Compensation Board of Manitoba. Many employers also have long term disability insurance. Ask your employer what is available to you.

For someone who is currently employed and facing a potential job loss due to a vocational crisis, the provincial Employability Assistance for Persons with Disabilities Program may also be able to assist. If you are eligible, services may include:

• working with you and your employer to modify certain tasks, or your position description, to accommodate your disability
• exploring the use of technical aids and devices to allow you to carry out the tasks of your current position
• receiving financial assistance to purchase/lease appropriate technical aids or devices
• getting training in the use of technical aids and devices

You are not required to disclose a disability. However, there are many things to consider when deciding if, and when, you tell your employer. For more information please refer to the section on Human Rights and Reasonable Accommodations.

On October 4, 1996, a law called The Adults Living with an Intellectual Disability (previously called The Vulnerable Persons Living with a Mental Disability Act) was introduced in Manitoba.

This act was developed to promote and protect the rights of adults living with a mental disability who need assistance to meet their basic needs. The legislation recognizes these Manitobans as adults living with an intellectual disability.

The act defines an adult living with an intellectual disability as “an adult living with an intellectual disability who is in need of assistance to meet his or her basic needs with regard to personal care and/or management of his or her property.” There are three key areas of The Adults Living with an Intellectual Disability Act:

• Support Services
• Substitute Decision Making
• Protection from Abuse and Neglect

In The Adults Living with an Intellectual Disability Act, three key areas are described:

Support Services

Manitoba Family Services may provide support services for adult living with an intellectual disability through the Community Living disABILITY Services Program (more information on this program is provided below). For each person who receives services, an individual plan will be developed. Examples of support services are:

• residential services
• counselling
• vocational training
• life skills programs

Protection from Abuse and Neglect

Through the Act, adults living with an intellectual disability are protected from abuse or neglect. If there are reasonable grounds to believe that an adult living with an intellectual disability is, or is likely to be, abused or neglected, anyone who provides a service to this person must report these suspicions to Manitoba Family Services. More information on the protection provisions of the Act can be found at: www.gov.mb.ca/fs/pwd/ vpact_protection.html

For information on reporting, please visit: Protecting Adults Living with an Intellectual Disability from Abuse and Neglect: Reporting Requirements for Direct Service Providers at: www.gov.mb.ca/fs/pwd/pubs/spl_for_service_providers.pdf

To view a poster that outlines the steps involved in reporting abuse, visit:

• www.gov.mb.ca/fs/pwd/pubs/spl_for_service_providers_handout.pdf

For more information on the act, go to the Office of the Commissioner for Adults Living with an Intellectual Disability's website.

Substitute Decision Making:

If an adult living with an intellectual disability is not able to make decisions, even with help, a person known as a substitute decision maker may be appointed to make decisions on their behalf in the areas of personal care or property or both. Substitute decision makers are appointed by the Commissioner for Adults Living with an Intellectual Disability. The Commissioner determines the legal decision making authority of a substitute decision maker. The scope of decision making is limited to those areas where:

• the adults living with an intellectual disability is incapable
• there are decisions to be made

For more information on substitute decision makers, go to the Office of the Commissioner for Adults Living with an Intellectual Disability's website.

The decision making authority of the substitute decision maker is only for the specified period of time required (maximum of five years).

The Community Living disABILITY Services program is a provincial government program that provides a range of support services for families and Manitobans living with a mental disability. The program supports eligible adults to live safely and participate fully in the community. Services are based on the belief that people living with a mental disability should have the opportunity to:

• lead satisfying, productive lives in their communities
• make their own decisions and direct their own lives, with support if necessary
• maintain family bonds
• develop friendships and other relationships that are a natural part of living in the community

To be eligible for the Community Living disABILITY Services program, a person must:

• have significantly impaired intellectual functioning accompanied by impaired adaptive behaviour, existing prior to the age of 18
• be 18 years of age or older
• be a Canadian citizen or adult legally entitled to remain and work in Canada on a permanent basis, and a resident of Manitoba

For more information on eligibility please visit: www.gov.mb.ca/fs/pwd/supported_living

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Service options may include:

• assessment, case co-ordination, planning, resource development and counselling
• residential  supports to assist adults to live in the community
• day services, including supported employment and follow-up services, vocational training and individualized development services
• support services such as transportation to and from day programs, respite, crisis intervention and clinical services

Services are co-ordinated through community service workers and are planned on a person-centered basis to meet the unique needs of each individual. Supports and services are available through regional offices located throughout the province. Services are provided depending on the availability of resources, the assessed needs of the person and the urgency of the need for service.

Residential Services

Residential services include a range of supports to assist people to live in the community. Options may include:

• Independent living with supports: skill development and supports are provided to assist adults to live on their own.
• Family home: supports are provided so a person may live with parents or extended family.
• Residential care facilities: accommodation, care and support consistent with individual needs are provided at a facility operated by an agency or a private provider.
• Adult home share: care and accommodation is provided by an individual or a couple in their own home

Day Services

Day services may include a range of supports and training to help people participate in the community through one or more of the following activities:

• Supported employment and follow-up services: provides supports to individuals to assist in getting and keeping paid jobs in community settings.
• Vocationally-focused services: supports individuals to develop, maintain and enhance vocational and employment readiness skills. These services may be provided in a day service facility or in a community setting.
• Personal development services: develops, maintains and enhances an individual’s personal care, social skills, emotional growth, physical development and community skills.

Support Services

Support services available to assist people and their families may include:

• Respite: offers families short-term alternative care for adults living with a mental disability.
• Day service transportation: may be provided through public or specialized transportation services for people attending approved day services.
• Crisis intervention: ensures the immediate physical safety and well-being of people in crisis while long-term plans are developed.
• Clinical services: provide a range of behavioural and psychological supports, including clinical assessment, therapy and consultation with community programs.

The Community Living disABILITY Services program does have a self-directed program option. The program, In the Company of Friends, supports participants to manage their own services with the assistance of the individual’s support network.

There are many reliable information sources for specific disabilities.

• Consult your doctor: The diagnosing physician can provide information on disability and refer you to other information sources.
• On-line information sources:
  • www.medmatrix.org/_SPages/Patient_Education.asp  
  • www.mayoclinic. org/patient-care-and-health-information Always check for reliability when researching online.
• Local associations: There may be associations in your community that provide information for people with disabilities. To search for community services, please visit the following website: http://www.contactmb.org/

The Family Doctor Connection line through Manitoba Health provides a list of doctors who are accepting new patients. To access the list of available doctors and how to contact them, call:

Winnipeg: 204-786-7111
Toll free: 1-866-690-8260
TTY/TDD: 204-774-8618
Manitoba relay service: 1-800-855-0511

For more information on health services in Manitoba and how to access these services, visit Manitoba Health’s info health guide online: www.gov.mb.ca/health/guide/4.html

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