History

From hospital and agency care toward CSIL

The chapters below follow a possible order of events from hospital and agency care toward a named CSIL program — and what later sources say happened after that program appeared. They start before CSIL existed as a named program, then look at its early years and later changes.

The evidence does not show that Creekview formally became ECPM, or that ECPM formally became CSIL. The order below is a way to read the story, not a claim that each step officially became the next.

The story in brief

Before CSIL, many people with high physical support needs lived in institutions such as Pearson Hospital, or received limited hours of care through agencies. Disabled people and community-living advocates tried other arrangements in the 1970s and early 1980s. That earlier housing-and-support context is written into the Creekview chapter, mainly from Haw’s 1989 later overview plus 1984–86 Hansard.

Creekview (c. 1984–89) was a Vancouver co-op where six men with high-level, mostly ventilator-dependent quadriplegia moved out of hospital. Records from the time describe a resident-and-CPA project that needed government agreement. Public sources from 1987–89 confirm that an evaluation existed. The report itself has not been read, and Patricia Ryan / Ryan & Wiggins authorship is unconfirmed.

Creekview did not create CSIL. It showed that people with very high support needs could live outside an institution. Haw later described some self-direction in the house; the evidence does not show a CSIL-style individual employer contract. The next part of the story moves from shared support in a housing project toward funding and employer responsibilities that followed the individual.

ECPM (c. 1990) is a name that appears on a 1990 training manual meant to train consumers to act as employers. A later bibliography confirms that the manual existed. We have not found a copy to read. Later organizations also use the name for an individual-funding project they say came before CSIL. Those two uses may or may not be the same effort. Whether a 1994 ECPM training manual is a distinct document is still unresolved. Keys on Freedom is still unconfirmed.

CSIL design and pilot. By late 1995 a Ministry of Health program publicly named Choice in Supports for Independent Living existed. Later official records say CSIL was piloted or introduced in 1994 and made available province-wide in 1995. A later recollection uses 1993, and it conflicts with other later wording. A 1995 union newspaper still called CSIL new or a pilot. The chapter does not choose a single founding year.

Later evolution (2008–2012 and after) describes a scaled program, a 2008 program review, 2011 rate changes, and later definitions of a client support group and a CSIL representative. Those later rules are present-day descriptions, not recovered 1990s documents.

The timeline lists the same dates in order. The sources catalogue holds the individual records.

What the evidence shows — and what it does not

Well established (from public sources that have been read, or from a bibliography that lists them)

  • Creekview existed as a mid-1980s community residence for a small group of men with high-level, mostly ventilator-dependent quadriplegia. It was planned by February 1984 and in place by April 1986 (Creekview).
  • A 1990 ECPM Skill Development Manual (BC Rehab and Greater Vancouver Home Support Society; five modules) is independently listed in the Roeher / Salisbury bibliography. The manual itself has not been read (ECPM).
  • By late 1995 a Ministry of Health program publicly named Choice in Supports for Independent Living existed. A union newspaper described it as new or a pilot, housed in Community Support Branch / Continuing Care Division (HEU Guardian Nov/Dec 1995).
  • A November 2008 CSIL Program Review Synthesis Report exists and has been read as an Internet Archive Microlog fiche. It dates CSIL only to “the 1990’s.”
  • Current ministry policy defines CSIL employer, client support group, and CSIL representative (HCC Policy 4.C). Those are present rules, not recovered 1990s documents.

Later accounts (not records from the 1980s or 1990s)

  • SCI BC and journalistic accounts of Creekview residents, of people “championing” the project, and of the spelling “Creekside.”
  • IFRC and Gauthier materials that name ECPM as a step before CSIL and that call CSIL “established” in 1993 or 1994.
  • The 2012 Ombudsperson report’s pairing of pilot 1994 and province-wide 1995, including later wording that mid-1990s policy already contemplated a client support group.
  • Order of Canada “Initiator” language for Paul Gauthier (an official honour, not a 1990s file).

Unresolved / missing

  • Formal succession from Creekview to ECPM to CSIL.
  • The full text of the 1990 ECPM manual, and whether any 1994 ECPM training manual is a distinct document. The evidence is not clear enough to decide.
  • Keys on Freedom (title, author, and year still come only from early project notes).
  • Original 1993–95 Ministry of Health design and pilot records.
  • A single founding year. Later official records give 1994 and 1995 different meanings (pilot, then province-wide). A later source uses 1993. A 1995 newspaper still said new/pilot and does not confirm that a province-wide rollout was finished.
  • The 1987 Creekview evaluation report (known to have existed; copy still sought).
  • Whether the Ombudsperson’s “provincial review in 2007” is the 2008 synthesis.

Chapters

Background note: earlier housing-and-support context