Guideline 800-10: Intellectual disability

• Canadian Human Rights Act
• Commissioner’s Directive (CD) 800
• Corrections and Conditional Release Act (CCRA), sections 3, 3.1, 4, 30, 69, 70 and 85-89
• Corrections and Conditional Release Regulations (CCRR), sections 17, 18 and 83

To provide continuity of care with respect to the provision of health services and correctional interventions for inmates who may be diagnosed with an intellectual disability

Applies to personnel who work with inmates who may be diagnosed with an intellectual disability

• Responsibilities and Procedures
• Annex A-Cross-References and Definitions

1. The Correctional Service of Canada (CSC) recognizes that some inmates may have an intellectual disability. Inmates diagnosed with an intellectual disability are a vulnerable group and their needs must be accommodated pursuant to the Canadian Human Rights Act, R.S.C., 1985, c.H-6.
2. All assessments and interventions required to be conducted under these guidelines must be performed in accordance with all other Commissioner’s Directives, including CD 800 - Health Services.
3. Where, during the intake assessment process, there are reasonable grounds to believe that an inmate has an intellectual disability (e.g., based on a mental health screening or a reference on file to a diagnosis), a referral by the Chief, Mental Health Services, will be made to a Psychologist who is a qualified health professional in the area of intellectual disability for an assessment and possible diagnosis/confirmation of an intellectual disability. If the inmate is Indigenous, the Chief, Mental Health Services, will consult with an Elder so that the assessment by the Psychologist considers the inmate’s Indigenous Social History as applicable.
4. If the assessment results in a diagnosis/confirmation of intellectual disability, the accompanying report will specify the inmate’s limitations as well as recommendations as to the provision of appropriate care and interventions and the level of support and assistance required. This could include, but is not limited to, occupational supports, volunteers or substitute decision-makers under relevant provincial/territorial legislation. The full report will be placed in the inmate’s Mental Health file as well as in the Offender Management System (OMS). Pursuant to CD 800 - Health Services, the Institutional Head will be informed of the type of accommodation required.
5. For inmates diagnosed with an intellectual disability, the OMS Cognitive Impairment Need will be activated by a health care professional. The activated Cognitive Impairment Need will be managed in accordance with OMS guidelines. As well, a health care professional will add a comment under Alerts on the Encounter Screen/E Chart of the inmate’s electronic medical record (EMR).
6. For inmates diagnosed with an intellectual disability, the Case Management Team will include a health care professional. If the inmate who has been diagnosed with an intellectual disability is Indigenous, the Case Management Team will include an Elder/Spiritual Advisor per CD 702 - Indigenous Offenders. The Case Management Team will ensure the information contained in the assessment report is taken into consideration in all placement and program decisions.
7. For inmates diagnosed with an intellectual disability, the Parole Officer, in consultation with others on the Case Management Team, will consider the assessment report and incorporate the information into the Correctional Plan. The Correctional Plan will contain, among other things, the programs and interventions required to manage risk, including adapted correctional interventions if required. The Case Management Team will be responsible for the implementation of the Correctional Plan and will update it and make changes to it as necessary for successful implementation.
8. Pursuant to GL 726-2 - National Correctional Program Referral Guidelines, inmates with specific physical and/or mental health care needs or disabilities, including intellectual disabilities, may be referred to a national correctional program if it is determined by the Case Management Team/Correctional Intervention Board/Indigenous Correctional Intervention Board that they are likely to be able to meaningfully participate in the program. Correctional Program Officers/Indigenous Correctional Program Officers are expected to use existing tools at their disposal to ensure that they accommodate the unique responsivity needs of inmates diagnosed with an intellectual disability. In cases where it is determined that the inmate is unable to meaningfully participate in a national correctional program based on their intellectual disability, they will be referred to correctional programs adapted to meet their needs.
9. Pursuant to GL 720-1 - Guidelines for Education Programs, the Adult Basic Education Adapted Programs are programs that have been adapted for inmates with specific education needs that cannot be accommodated in the traditional Adult Basic Education curriculum.
10. CSC will ensure that adapted correctional interventions, such as adapted correctional and education programs, are available and accessible to inmates diagnosed with an intellectual disability. In some circumstances, it may be necessary for the inmate to transfer to another institution in order to facilitate participation in adapted correctional interventions if indicated.
11. Further to CD 705-7 - Security Classification and Penitentiary Placement and CD 710-6 - Review of Inmate Security Classification, a diagnosis of an intellectual disability will not be a valid basis for increasing the security classification of an inmate.
12. Pursuant to GL 800-3 - Consent to Health Service Assessment, Treatment and Release of Information, an inmate’s intellectual disability will be taken into account in the process of obtaining appropriate consent, including when gathering health information not normally available to CSC from outside sources. If the inmate does not have the capacity to give informed consent, consent will be governed by the relevant provincial/territorial legislation.

Assistant Commissioner,
Health Services

Original signed by:

Jennifer Wheatley

ANNEX A
Cross-References and Definitions

CD 001 - Mission, Values and Ethics Framework of the Correctional Service of Canada
CD 700 - Correctional Interventions
CD 701 - Information Sharing
CD 702 - Indigenous Offenders
CD 705-5 - Supplementary Assessments
CD 705-6 - Correctional Planning and Criminal Profile
CD 705-7 - Security Classification and Penitentiary Placement
CD 710-6 - Review of Inmate Security Classification
CD 711 - Structured Intervention Units
CD 712-1 - Pre-Release Decision-Making
CD 720 - Education Programs and Services for Offenders
GL 720-1 - Guidelines for Education Programs
CD 726 - Correctional Programs
GL 726-2- National Correctional Program Referral Guidelines
CD 730 - Offender Program Assignments and Inmate Payments
CD 800 -Health Services
GL 800-3- Consent to Health Service Assessment, Treatment and Release of Information

Integrated Mental Health Guidelines

Case Management Team: the individuals involved in managing an offender’s case, which include at a minimum the Parole Officer and the offender, and in institutions, the Correctional Officer II/Primary Worker.

Health Services: physical and mental health services, which include health promotion, disease prevention, health maintenance, patient education, diagnosis and treatment of illness.

Intellectual disability (Intellectual Developmental Disorder): a classified mental disorder that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. For a diagnosis of intellectual disability, specific criteria must be met. (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Washington, DC, 2013.)

Health Care Professional: an individual registered or licensed for the practice of health or mental health care in Canada and preferably in the province or territory of practice. (Certain positions, however, require registration in the province or territory of practice.) Individuals operate within their scope of practice and competence.