Story on the deinstitutionalization in Québec
Initiated in the sixties in Québec, the deinstitutionalization is mainly documented towards the mental health and intellectual deficiency, but it is far from being exclusive since they also won other « populations » on the way (elderly people in loss of autonomy, adults with multiple handicaps, children in difficulty, etc).
Until then, for decades, it was customary in Québec and elsewhere in the West to isolate and lock up the mentally ill in asylums or psychiatric hospitals. « The story of mental patient treatment is the story of spatial isolation of the insane and his forgetfulness» (1), we needed to physically separate the ill from the community and just plain forget about them.
From the asylum to the community
It is only after the Second World War that we started to seriously question ourselves on the effects of the internment of the « ill » and that we began to understand that a prolonged confinement caused a loss of necessary skills to survive in the society. It is also in the postwar period that the number of psychiatrists began to grow strongly (2) and, formed by the modern conceptions in psychiatry and in psychoanalysis in the United States or France, they wanted to reform the institutions in which they were joined from their return of their studies. The postwar also marked the beginning of three decades of prosperity and an unprecedented development of social policies worldwide. In addition, it also initiated the psychopharmacological revolution and, thanks to new medications, the mental illness finally became curable. Also, in such a context, did the modernist psychiatrists finish by winning and, starting from the sixties, we prohibited the enlarging of psychiatric hospitals and it was then up to the general hospitals to treat mental illness, which had become a general illness like any other (3) and therefore curable. Since then, all general hospitals must have their own psychiatric ward (4). In parallel, the development of community services, rehabilitation homes and sheltered workshops should have allowed easiness in social reinstatement of the patients because we then started thinking that « the worst shelter is preferable to the best hospital » (5). And mainly after the publication of the shocking book, in 1961, from Jean-Charles Pagé (6) on his experience as an ex-patient at Saint-Jean-de-Dieu (which has now become Louis-H.-Lafontaine), whose afterword is signed by Camille Laurin, figurehead of modernist psychiatrists in Québec at the time.
So, if this first wave of deinstitutionalization has indeed led into a significant outflow of people from psychiatric hospitals, the resources having to ensure their maintenance and social reinstatement remained undeveloped. (7). The same situation happened to the elderly people with loss of autonomy, the adults with multiple handicaps and children in difficulty.
Deinstitutionalization, initially, thus done for humanitarian reasons and therapeutic reasons, but with the crisis of the early 1980s, the rise of neoliberalism and «monetary fundamentalists » (8), its justification became almost entirely financial because it allowed much money to the state.
A network without financial support
The network of non-institutional resources has never really had any financial support from the State, despite the savings which it allows it to make. For example, we estimate that, in the 1980s the cost per day was $280 in a psychiatric hospital, compared to $16.10 in a foster home. (9).
From the late 1980s, we have the testimony from Mr. Vital Simard, who worked at the Ministry of Health and Social Services, from 1988 to 2005. First hired as a liaison agent with the various institutions in the region of Québec, we quickly put him in charge of the file of the foster homes because the discontent settled among the resources who thought unfair the fact « that for the same person [the same user] that had the same difficulties, there were unexplainable and inequitable differences » (10) from one region to another. At that time, the basic contribution was fixed by the Minister, but if the user showed more important problems, it was each of the Social Service Centers (SSC) that « had given itself a kind of classification grid to differentiate a regular foster home and a special foster home» because «the Ministry had not done its homework at that time» (page 47).
Each time that Mr. Simard talked about a committee that he put in place to solve a problem tied to the IR/FTR or foster homes (11), he claimed to have reunited in this committee all the partners and it’s on a consensual basis that, each time, the committee adopted a new definition or solution (12) which was subsequently presented as a proposal to the Minister (13).
From book club to trade unionism
So, according to Mr. Alcide Genesse, President of the grouping of Adult Residential Resources of Québec (RESSAQ) and accredited resource himself for 35 years, never have the committees put in place, until the elaboration of the draft law 49, served as true consultation of the partners. There were either invited resources chosen by the government, or the committee explained to the « partners » what the government was going to do, and then he proceeded regardless of the opinion expressed by the representatives of the RESSAQ or the ARAPAQ (14), his predecessor. Which Mr. Alcide Genesse goes to say, that never before has the RESSAQ taken part in the decisions, a situation that changed since the government decided not to appeal against the Judgement Grenier and that they had to create a new labor relations framework for the resources.
Judge Grenier did not buy the consensus design of Mr. Simard and wisely reminded, speaking of the regime established by the government with the Law 7, which was the extended practice established by Mr. Simard, that « we cannot treat in the same way a union and a book club. The trade unions have a history. Their recognition is made of incessant struggle and hope, too often disappointing. They had to face repression before conquering the right to exist and to represent the interests of their members. (…) Historically, workers joined together to overcome the negotiating power inherent inequalities in employment relationships and guard against unfair working conditions, dangerous or exploitative » (15).
It is also funny to read the words of Mr. Simard when he tries to explain to Judge Grenier that the money given to the resources isn’t a salary, nor a retribution, and that he only perpetuated a practice (in fact, Mr. Simard talks about a philosophy) that existed since the 1970s (page 293). After having said that « it was not considered like a job », it was « almost like volunteer work » (page 46), he later retracts saying: « I must have explained myself wrong if that is what you understood » (page 190). The compensation was paid to answer the question: « how can I compensate you adequately so that you may welcome [this person] while not having to defray the expenses that he/she may cause and to recognize your community implication » (page 46).
Once again, Judge Grenier clearly saw: « Admittedly, in this case, even if the government is not the true employer of the (…) IR/FTR plaintiffs, it is the public authority that provides funding. It is not a neutral and disinterested third party through negotiation. Hence the need for control » (16).
To conclude, we will say that, « [...] in a partnership society, actors should have reciprocal rights and duties. They must have power and comparable responsibilities. They must derive tangible or intangible benefits of equal importance. In short, they must be equal in the cooperation. This equity – fairness Americans say – is essential [...] without equity, there is no partnership » (17). This will be something acquired for the resources, who will be able to negotiate equal to equal with the government and even have their word do say on the matter of how to pursue the deinstitutionalization of Québec.
The History of the RESSAQ
Originally, two associations represented the interests of the adult foster homes in the 1980s, there was the Association of Foster Homes of Québec, better known as (ARAQ) and the Association of Adult Resources and Seniors of Québec, better known as (ARAPAQ). As to the latter, its date of declaration for the name to the Companies Registrar dates back to October 31st, 1991 and is identified under the serial number 1143359306. In order to acquire a larger margin of action and more power of bargaining, the ARAQ merged with the ARAPAQ in 1998.
In December 2001, during a general assembly, the members of the Board of directors of the ARAPAQ, supported by a strong majority of votes of the members of the organization involved, the council resigns incumbent President Mr. André Gratton.
At the annual meeting that followed in April 2002, Mr. Alcide Genesse, Vice-President at the time, was elected with a large majority to presidency of the ARAPAQ. In June 2002 the members of the Board of directors resolved to change the corporate image of their association. It was then on June 11th, 2002 that the change of name went from the ARAPAQ to become the RESSAQ at the Registrar of companies.
In April 2003, in a general assembly, the members gave a clear mandate to the Executive Committee of the RESSAQ, namely to analyse any proposal for partnership with a collaborator likely to allow it to acquire a true power of representation and negotiation.
In May 2003, an affiliation is ratified between the RESSAQ and the Congress of Democratic Trade Union (CSD). As of May 8th, 2003, it was under the acronym of the RESSAQ-CSD that the first certification applications would follow their course to the CRT.
In December 2003, the government of Québec sanctioned under closure of the National Assembly’s Bill 7 (2003, chapter 12). A law that revoked retroactively any certification of recognition given by the Administrative Work Tribunal (better known as TAQ). Consequently, the IRs and the FTRs will be excluded from the Act respecting labor standards and benefits and protections that provides the status of « salaried employee » within the meaning of the Labour Code.
On December 19th, 2003, The Confederation of National Trade Unions (CSN) in alliance with other unions, filed two complaints against the government of Québec for violating the conventions of the International Labour Organization (ILO) ratified by Canada. Also the CSN disputed before the Québec Superior Court the constitutionality of this law under the Canadian and Québec charters of rights and freedoms. A long legal journey will take place. The Honorable Danielle Grenier (J.C.S.) will be taking the case file.
In 2004, the RESSAQ-CSD became the only official representative organization of FTRs with 9 adults or less with the Ministry of Health and Social Services (MSSS). To follow in 2005, the representation of the IRs with 9 adults and less. From that moment on, they began speaking with the MSSS to conclude an agreement for its members. In 2006, the Board of directors of the RESSAQ-CSD unanimously reject a draft agreement proposed by the Minister, which does not take into account any of the main demands of the members of the RESSAQ-CSD.
In 2006, the International Labour Office (ILO) of the OIT favorably receives the request of the CSN and recommends that the Québec government corrects the situation to include workers in the general scheme of collective labor law, thus allowing them to form themselves a union and enjoy the free right of association and collective bargaining. However, the ILO has no declaratory power of a court order.
In 2007, are held the hearings in Québec Superior Court on the Bill 7, for which the CSN and the RESSAQ-CSD are called to testify. To follow in early 2008 come the pleadings of the plaintiff and defence, the Attorney General of Québec.
On October 31st, 2008, Judge Danielle Grenier proclaims the Bill 7 unconstitutional, invalid and ineffective. The Government announces that he will not appeal the decision of the Tribunal. The RESSAQ-CSD files, in late 2008, new requests for accreditation from the CRT. .
In April 2009, the MSSS files its project of Bill 49, Act respecting the representation of family-type resources and certain intermediate resources and the negotiation process for their group agreements, and amending various legislative provisions. Public consultations will be held in parliamentary committee. The RESSAQ-CSD will present his memoire « Near the goal : Towards equal rights equal to those of other workers for resources. ». In June 2009, the Bill 49 (L.R.Q., chapter R-24.0.2) is sanctioned granting RI-RTFs a negotiating process and a special statue of individual workers.
Therefore, the management negotiating committee for the health sector and social services (CPNSSS) is mandated by the MSSS to direct and coordinate the negotiations in consultation with employer’s associations and negotiate the sectoral issues of the collective agreements applied in most of the IR-FTRs with the various unions including the RESSAQ-CSD.
Negotiations with the CPNSSS began in 2010. On February 24th 2012, the RESSAQ-CSD files a request for mediation to the Ministry of Labour, after sixty-three (63) negotiation sessions held between May 18th, 2010 and February 21st, 2012. This mediation necessitated thirty-five (35) meetings. It ended on June 10th, 2012.
The RESSAQ-CSD disagree on many occasions with the employer offer, there will be three great gatherings of members, one in February 2011, the most important and largest one in January 2012 on Parliament Hill in Québec and will follow in November 2012, the demonstration held outside the offices of the CPNSSS in Montreal.
In December 2012, an official request to meet with the Prime Minister of Québec, Ms Pauline Marois materializes. This meeting held in January 2013 will allow the establishment to have an independent committee, the Committee Lampron. This Committee is to find solutions to break the deadlock on the negotiations. The Committee Lampron will remit its report on January 31st, 2013.
Having still not reached an agreement, the RESSAQ-CSD is planning a gathering on May 4th 2013. This will be canceled in extremis at the request of the CPNSSS for a resumption of negotiations. This will culminate in an agreement in principle between the two parties.
On June 13th 2013, is the endorsement by the members in a special general meeting of the first negotiated collective agreement of the RESSAQ-CSD, after a long period of over three years of negotiations with the CPNSSS. The agreement is adopted in a proportion of 79% for and 21% against, the latter were predominantly intermediate resources who were unsatisfied with the employer proposals.
Mr. Alcide Genesse removes himself as President of the RESSAQ-CSD in April, 2014 after twelve (12) years of active associate life.
January 31st, 2014, The RESSAQ dissociates from the CSD and becomes autonomous.