A/HRC/43/41/Add.2 59. More efforts need to be made to ensure that all persons with disabilities enjoy an adequate standard of living. Existing social protection schemes and benefits, including the eligibility criteria and assessment of beneficiaries, should be reviewed in line with a human rights-based approach to disability. In addition, the different benefit packages need to take into account principles of universality, coherence and coordination if they are to be accessed on an equal basis by all persons throughout the country. G. Living independently in the community 60. The Special Rapporteur is highly concerned about the lack of comprehensive responses to guarantee the right of persons with disabilities, particularly those with high support needs, to live independently in the community. Legislation, services and programmes on the provision of access to in-home, residential and community support services vary across provinces and territories. While some provincial and territorial governments are taking steps to improve community support, generally, access to support is not considered as a right but rather as a social assistance programme dependent on the availability of funding. Information received by the Special Rapporteur from across Canada echoed a common concern about the lack of adequate services and support to live in the community, resulting in increased use of residential institutions. 61. Statistics Canada estimates that, in stark contrast with the process of deinstitutionalization conducted decades ago, half a million persons with disabilities with long-term support needs and health-related conditions, including older persons with disabilities, reside in nursing homes, group homes and other specialized long-term facilities.20 It is also estimated that persons waiting to be placed in a residential care facility occupy 15 per cent of all “acute-care hospital beds” in Canada. 62. The government of Nova Scotia is investing three times the amount of financial resources in delivering community services for independent living compared to institutional care. Programme funding is provided directly to participants or through non-profit organizations contracted to provide support services for persons with disabilities. The Disability Support Program determines eligibility and maintains waiting lists. While some of these programmes have shown the potential to transform service provision, the overall impact is limited. Consequently, more than 900 persons with disabilities in Nova Scotia live in institutions. 63. A similar concern relates to the lack of community services for persons with disabilities and their placement in medical institutions and other residential settings in Quebec. In 2017, more than half of persons with disabilities in Quebec reported having “unmet support needs”. Many had to wait for long periods before they could access at least some services. Some 3,700 adults under 65 with disabilities were forced to live in hospitals and nursing homes due to a lack of community-based support services. It is estimated that the provincial government spends 42,000 Canadian dollars each year to keep a person in an institutional setting. According to persons with disabilities, the same amount of money provided in the form of direct funding would allow them to pay for 50–60 hours of personal assistance services per week. 64. The government of Ontario supports Direct Funding, a programme for self-managed attendant care services that is administered by the Centre for Independent Living in Toronto and that enables adults with physical disabilities to become employers of their own personal assistants (attendants), determining how and when services are provided. Demand for the programme is strong but, due to the limited resources, many people have been waiting for years to access it. Currently, applicants can expect to wait approximately one year before they are invited for an interview. Meanwhile, although large institutions for persons with 20 12 See www12.statcan.gc.ca/census-recensement/2016/dp-pd/dt-td/Rpeng.cfm?LANG=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GID=0&GK=0& GRP=1&PID=109538&PRID=10&PTYPE=109445&S=0&SHOWALL=0&SUB=0&Temporal=201 6&THEME=116&VID=0&VNAMEE=&VNAMEF=.