Hansard Blues
Select Standing Committee on
Finance and Government Services
Draft Report of Proceedings
The committee met at 8:32 a.m.
[J. Routledge in the chair.]
J. Routledge (Chair): Good morning, everyone. My name is Janet Routledge. I'm the MLA for Burnaby North and the Chair of the Select Standing Committee on Finance and Government Services, a committee of the Legislative Assembly that includes MLAs from the government and opposition parties.
I would like to acknowledge that I am joining today's meeting from the legislative precinct here in Victoria, which is located on the traditional territories of the Lək̓ʷəŋin̓əŋ-speaking people, now known as the Songhees and Esquimalt First Nations.
I would also like to welcome everyone who is listening to and participating in today's meeting on the Budget 2022 consultation. Our committee is currently seeking input on priorities for the next provincial budget and has been hearing presentations from a number of organizations and individuals this week. So far this week we have heard from almost 100 individuals and organizations.
British Columbians can also share their views by making written comments or by filling out the online survey. Details are available on our website at bcleg.ca/fgsbudget. The deadline for all input is 5 p.m. on Thursday, September 30, 2021.
We will carefully consider all input and make recommendations to the Legislative Assembly on what should be included in Budget 2022. The committee intends to release its report in November.
The public hearings this week are being held virtually, with most presenters organized into small panels based on theme and others making individual presentations. Today we'll be hearing about several areas, including public safety, justice, social services, health, mental health and youth.
Each presenter has five minutes for their presentation. To assist presenters, there is a timer available when in gallery view.
Following presentations from the panel or following an individual presentation, there will be time for questions from committee members. At that time, I ask that members indicate they have a question, and we will keep a speaking list. I also ask that everyone please put themselves on mute and wait until you are recognized before speaking.
All audio from our meetings is broadcast live on our website, and a complete transcript will also be posted.
I'll now ask the members of the committee to introduce themselves, starting with the Deputy Chair.
B. Stewart (Deputy Chair): Good morning, Chair. Thanks very much for that introduction.
I'm Ben Stewart, the member for Kelowna West.
L. Doerkson: Good morning, everybody. My name is Lorne Doerkson, and I represent the riding of Cariboo-Chilcotin. I'm looking forward to today's presentations.
G. Kyllo: Good morning. My name is Greg Kyllo. I'm the MLA for Shuswap.
I come from the traditional territory of the Secwepemctsin-speaking peoples.
H. Sandhu: Good morning. My name is Harwinder Sandhu. I'm the MLA for Vernon-Monashee.
We are located on the unceded and traditional territory of the Okanagan Indian Nations.
Thank you for joining us today. I look forward to your presentations.
P. Alexis: Good morning. My name is Pam Alexis. I'm the MLA for Abbotsford-Mission.
We sit on the unceded and ancestral territory of the Stó:lō People.
I, too, look forward to today's presentation.
M. Starchuk: My name is Mike Starchuk. I'm the MLA for Surrey-Cloverdale.
It is located on the traditional, unceded territories of the Coast Salish people, including the Kwantlen, Katzie and Semiahmoo.
J. Routledge (Chair): Assisting the committee today are Jennifer Arril and Mai Nguyen from the Parliamentary Committees Office and Amanda Heffelfinger with Hansard Services. "Assisting" is an understatement. They keep us on track, they keep us focused, and I thank them for that.
With that, I will turn to our first presenter. Our first panel is on gender-based violence, and the first presenter is Amy FitzGerald, B.C. Society of Transition Houses.
Budget Consultation Presentations
Panel 1 – Gender-Based Violence
B.C. SOCIETY OF TRANSITION HOUSES
A. FitzGerald: Thank you very much for this opportunity to testify to the Select Standing Committee on Finance and Government Services' Budget 2022 consultation. My name is Amy FitzGerald, as indicated. I'm the executive director for the B.C. Society of Transition Houses.
I would like to acknowledge that our office is in Vancouver on the unceded territory of the Coast Salish people, shared by the Squamish, Musqueam and Tsleil-Waututh Nations, whose history is tied to this unceded ancestral land, and we are grateful to be here.
Our society was founded in 1978 with six members and is a member-based provincial umbrella organization with 117 members all across British Columbia. Our mandate is to train, support and advocate for our member anti-violence organizations — some of them you will hear from today — all working collaboratively to end gender-based violence.
That portfolio includes the women's transition housing supports program, which consists of 66 transition houses, 20 second-stage houses and 25 safe homes that are all funded by B.C. Housing, along with 86 PEACE programs — which was the Children Who Witness Abuse program — which provide psychoeducational counselling and specialized services for children and youth between the ages of three and 18 who have witnessed or experienced family violence. The PEACE program was started by the transition house movement in the 1990s and is currently funded by the Ministry of Public Safety and Solicitor General.
All of these anti-violence services have been identified by the province as essential services supporting vulnerable populations. Our members are experts on gender-based violence. As I indicated, you will hear from many of our members as part of this engagement process. And sincere thanks for the consideration of their submissions and wisdom, as they have been doing this front-line, life-saving work for decades and continue to do so under challenging times.
The society's budget recommendations, which I will highlight here, will be followed by written submissions. Today we will focus on an overview, which are investments in (1) our members' core funding, (2) housing, (3) transportation and (4) technology.
We are requesting an investment in sustainable core funding for all of our membership. Sustainable, coordinated, adequate operational funding for all anti-violence programs is required, as are yearly increases in accordance with standard-of-living costs. This funding must meet the continuously evolving and complex needs of the women, children and youth that are being supported.
Existing programs have been operating for decades with inconsistent, varying levels of funding and with high rates of casual and part-time staff. Core funding will allow programs to offer full-time employment to help address the challenge of single staffing, wait-lists for services, and recruiting and retaining skilled staff in a competitive market where similar sectors often offer better compensation.
Funding for community-based victim services has been uncoordinated and have been a patchwork for many years. One of our member programs, the Victoria Women's Transition House Society, will be testifying later today as to the need to look systemically at these essential services, in a comprehensive way.
Two, we are requesting an investment in housing and homeless prevention. In Canada, domestic violence is the primary cause of women's homelessness. In B.C., after women leave a transition house or safe home, only 4 percent move to affordable housing, 21 percent find housing mostly beyond their means, and 75 percent remain temporarily sheltered or return to home. In 2018, the province committed, in their 30-point plan, point 16, to build 1,500 units of housing supports for women and children affected by violence, over ten years. This was the first significant investment in decades for housing for women, children and youth fleeing violence.
Seventy-five of our member programs have submitted proposals to build housing to support women, children and youth. These projects are in varying stages of development, but no new housing has yet been opened. Over the next years, this funding must be sustained to meet this commitment, as women, children and youth are still at a deficit and struggling because of the current, limited, affordable housing options in B.C.
Homeless prevention funds provide direct resources for women to secure market rental housing. That has been widely supported by our member programs as a stopgap measure to provide housing until the new-build projects can be completed. Only a quarter of our programs have these funds, and we're asking for full funding for all of our projects. We are also asking for a request in investment and transportation funds for accessible transit systems for rural and remote communities, as 70 percent of our members indicate that existing transportation options do not meet the needs of their clients.
Finally, we are also asking for an investment in provincewide Internet access and technology as a public health and safety necessity. Over 70 percent of our programs have indicated that they will continue to use technology after the pandemic, but there are significant connectivity, infrastructure and technology needs across the province.
The BCSTH and our membership welcome this opportunity to testify and to submit additional materials. Extraordinary things have happened during this pandemic, illustrating loss and social inequities but also compassion and collective strengths. It is possible to bring that same sense of urgency and possibility to this work, to address the existing public health and safety emergency of gender-based violence through the B.C. budget in 2022.
Thank you very much for the consideration of our submissions. Wishing you all well.
J. Routledge (Chair): Thank you, Amy.
Next we'll hear from Angela Marie MacDougall, Battered Women's Support Services.
BATTERED WOMEN'S SUPPORT SERVICES
A. MacDougall: Good morning, everyone. Thank you for this opportunity to speak to you, to the Finance Committee.
I am Angela Marie MacDougall, executive director of Battered Women's Support Services. Battered Women's Support Services was established in 1979 with the goal of ending gender-based violence through the provision of services, through education and training, through prevention and through systemic advocacy.
Currently we have 28 staff delivering a number of programs, several that are funded through the province. We have 100 volunteers that work in a number of different capacities throughout our organization. We have a crisis line that we operate 24-7 as well as support groups, counselling services and specialized support services for those individuals who are Black, Indigenous, Latin American, East Asian or South Asian. Our services span outreach as well as prevention for youth, and we provide counselling, including counselling for children.
My remarks today are specifically in harmonization with the national action plan framework that was developed recently to end gender-based violence and violence against women in Canada. It was tabled with the federal government. Within the national action plan, there are specific recommendations for provinces. As a co-chair of the supports for survivors and their families, we paid particular attention to British Columbia, and many of the recommendations within the national action plan speak specifically to British Columbia. I will submit the national action plan framework, with my remarks, after this presentation today.
My remarks are specific to four areas of concern and investment that we think is vital in ending gender-based violence and in providing services. The first is in relationship to social infrastructure and enabling environments. Amy FitzGerald, thankfully, mentioned several that I echo and support 100 percent.
We also are very concerned and want to see investment in economic security. We want, certainly, to see an investment in the employment services that are available through WorkSafeBC and to have those be specific for survivors of violence, to increase that investment to ensure that any survivor that is seeking employment, or wanting to, has access to employment services. This means we would like to see a shift in a way so that those services are not funded through a fee-for-service model but, rather, that the employment services for survivors of violence are core-funded.
The other piece that's vital for us is around prevention. We would like to see every single community-based organization with a mandate for social services have funding for prevention. We think that prevention services are vital, and we certainly would like to see the community-based victim services organizations receive prevention funding in order to support youth and children around violence prevention, as well as shifting the culture, which means that we would like to see the Finance Committee reducing funding to prevention programs from for-profit entities, such as the B.C. Lions. We think that community-based response in the non-profit sector is an important investment in prevention.
We would also certainly like to see core funding with respect to supports for survivors and their families. Core funding is long overdue. Echoing Amy FitzGerald, this is something that we've spoken about over the years, and we think it's vital and should be a priority, which also means that we are expanding then and seeking funding for the Stopping the Violence counselling program. Counselling services are vital for healing and work to shape and to ensure safety in the long term, but we would like to see that investment increase.
Finally, with respect to legal services — I'm certain that Kim Hawkins, our colleague from Rise Women's Legal Centre will speak to this — we would want to ensure that there is an increase in legal aid so that those survivors that are navigating the legal system, in particular family law, are able to have the resources they need to access a lawyer.
In that sense, we would also like to see some defunding of the alternative dispute resolution model that is currently the policy being advanced. We think that that creates significant safety risks for survivors of violence, and we would like to ensure…. Ultimately, survivors need lawyers through that process, so we think the addition of legal aid is vital, which leads me to the piece around policing.
Currently our services are focused on police, and a lot of investment is in seeing that the police services are acting in a way that is in accordance with safety. We know that most survivors who are asked are contacting the police and that most survivors are reaching out to community-based organizations. From that point of view, we would like to see a policy shift in financing that would look to ensure a strong and vibrant community-based response that would be less reliant on police and centring on police but, rather, on supporting community.
We think that there are many options in the national action plan, which I will send after this gathering today, for future recommendations and, hopefully, implementation. With that, I thank you all.
J. Routledge (Chair): Thank you, Angela.
Our next speaker is Kim Hawkins, Rise Women's Legal Centre.
RISE WOMEN'S LEGAL CENTRE
K. Hawkins: Good morning. Thank you for providing me with the opportunity to speak today.
I'm from the unceded territory of the Musqueam, Squamish and Tsleil-Waututh First Nations.
I'm the executive director of Rise Women's Legal Centre. We're the newest organization on today's panel, having opened in 2016. We run a legal clinic, staffed with law students from the University of British Columbia, as well as a virtual legal clinic that operates around British Columbia providing free legal services in Vancouver and across B.C.
I just want to say that I fully endorse the comments that have been made by my colleagues this morning, particularly everything that Angela MacDougall has just said about legal aid and supports for women who need it.
This is a crisis that we're working in, and I will be focusing on legal services, as this is the space that we work in.
There are two actions that we're urging the government to take immediate action on to combat gender-based violence and ensure gender equality. The first is to increase funding to Legal Aid B.C. to ensure full and comprehensive legal representation if the recipient or their children are at risk of family violence, including applications for economic support.
The second is to review courthouse safety around the province and ensure both that survivors of violence can access court processes by virtual means, where this is necessary to minimize risk, and that all courthouses have access to the resources like duty counsel who can assist survivors with protection orders and other urgent applications and technology, to ensure that all British Columbians have equal access to the court system.
Family law is widely understood to be the greatest area of unmet need for legal services in B.C. and throughout Canada, and years of research by West Coast LEAF and other organizations have demonstrated that this disproportionately impacts women.
Women and marginalized genders are also disproportionately victims of family violence, and the global pandemic has forced many to remain at home with abusive spouses. Access to family legal aid is therefore an equality issue and an important consideration when using a GBA+ lens to look at your budget. Although the government of British Columbia has recently provided some funding to increase the number of hours with a lawyer for those who qualify for family legal aid, it has not raised the income threshold for accessing legal aid, nor has it increased the areas of coverage.
Legal aid in B.C. remains restricted to the poorest of people in the worst of circumstances. For a single woman fleeing abuse — let's call her Eva, for short hand — if she earns minimum wage and works more than 30 hours a week, her income will be too high for legal aid, even though this is approximately half of what is considered a living wage in Vancouver.
If Eva receives financial help from family or friends to scrape by, this will be considered income for the purpose of determining legal aid, and it may disqualify her from getting help from a lawyer. If Eva has to flee her home due to family violence and reside in a transition home, and saves the extra $2,000 she needs to pay for a damage deposit and one month of rent to leave the transition home, she will have too many assets to be entitled to legal aid, even though this would not cover the cost of a retainer for most private lawyers.
If Eva received CERB during the pandemic, she may have been turned away from legal aid for having too high an income. If Eva is receiving income assistance through the provincial disability program and works for five hours a week at a supportive employment program, she will be ineligible for legal aid because her income is too high. At Rise, we talk to women like Eva who face the prospect of quitting part-time jobs, potentially leading to homelessness, to qualify for a lawyer to fight for their children.
The impacts are stark. Many survivors not only cannot get legal aid coverage to secure their own safety, but they also walk away from important economic rights and entitlements to child and spousal support because they cannot get representation. It goes without saying that these impacts are particularly severe for marginalized individuals. We therefore strongly urge you to increase family legal aid for survivors, to provide comprehensive legal aid coverage if the recipient or their children are at risk of family violence, including applications for economic support and entitlements.
We are also strongly recommending that you complete a review of courthouse safety to ensure that accessing courts in remote communities is possible and safe for everyone. The barriers to legal services in small communities are immense. We provide services around the province and understand how dangerous it is for many people to attend court at all. Some small towns have no local lawyers, resulting in people having to hitchhike to legal appointments and to the courthouse due to lack of transportation. Once there, they may have to sit in a courthouse with an abusive ex.
During the pandemic, duty counsel was no longer available in many communities, leaving people with no one. As many of the courthouses are reopening, they will require support around technology to allow everyone to access them and to ensure that the act of attending court does not actively put people at further risk of harm. Both of these asks require a commitment of resources.
I am struck by how often the conversation around legal aid in B.C. seems to revolve around making better or more efficient use of existing services, but the existing services are simply not sufficient to meet the need.
Although Rise and other organizations are doing their best to provide some small measure of help, we do not come close to filling the gap in services and are not a substitute for a functioning provincial legal aid program. At this point, we are simply rearranging deck chairs on the Titanic. We need an increase in capacity in this sector. As Vikki Reynolds said: "Ultimately, you can't keep doing more with less. That's not how math works."
This sector is long overdue for an increase in funding, and we ask that you address this urgently. I thank you for your time this morning.
J. Routledge (Chair): Thank you, Kim.
Finally, we'll hear from Dalya Israel, WAVAW Rape Crisis Centre.
WAVAW RAPE CRISIS CENTRE
D. Israel: Good morning. Thank you for the opportunity for WAVAW to testify to the committee today about areas that we believe the province of British Columbia should be investing in — the survivors of sexual violence. My name is Dalya Israel, and I am fortunate enough to be WAVAW's executive director.
WAVAW's Rape Crisis Centre is B.C.'s largest rape crisis centre that has been supporting survivors of sexual violence since 1983. We offer wraparound service delivery to survivors of sexual violence, from our crisis line to sexual assault response to victim services to counselling and cultural supports. We have services specifically by and for Indigenous, two-spirit and trans survivors.
I'm joining you today from the unceded and ancestral territories of the Musqueam, Squamish and Tsleil-Waututh people. These are the same lands that WAVAW supports survivors on every day.
I want to respect the time we have allotted, so my intention is to focus on two areas that WAVAW would like to make specific recommendations on. We will additionally provide written submissions after our presentation.
I want to echo my colleagues' remarks today to say that, as a baseline, there has been an absolute tidal wave of survivors reaching out as we continue to navigate a cultural tipping point on gender-based violence. Increasing funding to already-established programming, like Stopping the Violence counselling programs and victim services, along with a coordinated response, is absolutely essential.
I'd like to start by addressing recommendations in regards to organizational capacity-building and infrastructure support for organizations that hold service contacts. As Amy started us off, for many, many years, our sector has been advocating for core funding to be able to ensure that we are agile and we are able to meet the needs of the people that reach out for support and, for us at WAVAW, for survivors of sexual violence.
For many years, our sector has pointed out that services such as Stopping the Violence counselling and victim service programs do not happen in isolation. They require an organization to house and support them. Part of the challenge of having service-based or project-based funding is that the funding you receive must meet ratios that result in the majority of funding going to salaries and benefits.
If COVID has taught us anything at WAVAW, it's that as a non-profit, we're not ready and did not have the flexibility early on to use funding to be agile and build infrastructure to support our transition to a fully remote workplace, as an example. We're fortunate that we have an incredible fundraising team and donor community, but not all organizations have that. Particularly with the uncertainty of COVID, we were concerned that fundraising efforts would be seriously impacted.
We started to see funders change their philosophy several months into COVID in many foundations and at the municipal level, where funders gave permission to reallocate funds as needed. We've also seen federal and municipal funders recognize that non-profits like ours don't often receive a full investment from funders to continue building the also-important foundation of an organization. Services cannot be successful if the organization is not set up to grow and evolve effectively.
We recommend that the province consider offering capacity-building funds to contract holders in order to ensure that organizations are able to keep up with the evolution of their organization, such as evolving cybersecurity, data management, policy updates that reflect new and emerging realities, to name a few. This is often what we refer to as the need for core funding.
Secondly, we want to address the need of Indigenous, Black and other racialized survivors. Since the early 2000s, we have seen a trend that sexual assault has become treated solely as a law-and-order issue. This has caused many sexual assault survivors to fall into a situation where the only sustained funding that's available to meet survivors' needs is aligned with the criminal legal system and short-term support. We acknowledge that there may be project-based funding that allows for one-off projects. This is also a challenge due to the need to build trust with communities.
We must, at this time, acknowledge that for BIPOC, as well as two-spirt and trans survivors, services that orient towards having to navigate the criminal legal system or hospital system alone will not meet their needs due to structural and systemic violence that is inherent in those systems.
We recommend that the province consider reinstating the funding for a ministry dedicated to gender equality so that programs like STV and victim services can be agile and evolve with research and support from a ministry that has equality as its mandate, rather than law and order. We need a ministry that can look at the intersectional experiences of people impacted by gender-based violence. This matters to BIPOC survivors. This is one way we can commit to decolonizing our thinking around sexual violence.
We recommend that the province invest in additional options for survivors to access care for sexual violence health care outside of hospitals. This is vital for Indigenous survivors, in particular, as well as Black and other racialized people, two-spirit and trans people, who we know experience ongoing systemic racism, as recently documented in the report In Plain Sight. Survivors deserve access to affirming and safe care in settings that are accessible and supportive.
Lastly, we recommend investing in programming to support survivors to achieve alternative forms of justice and accountability that live outside the criminal legal system for sexual violence. This would mean investing in people — people that have been harmed, people that cause harm — with the intent of supporting their process. This requires commitment and investment to be done, with integrity and ethics at the centre, in order to centre survivors' journeys. These are the areas that WAVAW deeply believes will create a positive impact for survivors of sexual violence in ways that the province can take immediate action.
Thank you, again, for your time today. We really appreciate the opportunity and welcome any follow-up questions now or in the future.
J. Routledge (Chair): Thank you, Dalya.
We'll now open it up to questions from the committee.
P. Alexis: Thank you all for your presentations.
I just have a general question. Feel free to chime in. As far as COVID went and your experiences through COVID and what we saw with respect to family situations, were there some takeaways that you can share with us as to how we need to be more prepared? So just your experiences and what you noticed — trends, this kind of thing — that would help us with respect to policies and all kinds of things. If you could just tell us a little bit about the experiences through the last 18 months, in particular.
A. MacDougall: Thank you for the question. I think one of the main takeaways that we have is the affirmation of the necessity of core funding. Our sector, the anti-violence sector, has been so important in responding to those survivors who are living with abuse in their homes, adults as well as children.
As an essential service — we received that designation — what was very difficult was that, on one hand, we had the provincial health officer doing, of course, the best that she and her office could do, encouraging the measures to prevent the transmission of COVID-19 specifically, while at the same time, even though we were seeking it, not providing enough information about what survivors could do that were stuck at home. That message was one that eventually came forward, but at that time, I think we had already done everything we could to get the message out there for survivors.
I think there are some challenges, certainly, in understanding all of the issues that we are experiencing right now, because COVID-19 continues. It hasn't stopped. We're in, I guess, the fourth wave. Those conditions remain. They've shifted somewhat.
What we need is to be able to be funded in order to do the services that we do. All of my colleagues here have spoken about the wisdom, the experience, the ability to respond to the needs. What we don’t have is the sufficient funding in order to meet those needs. These are policy decisions that I think this committee can make that would go a long way to alleviating many of the social problems that we have.
We cannot ignore how much gender-based violence is at the heart of so many issues. But it's interconnected with all these other things. Without vibrant, community-based, anti-violence network, sector…. We go a long way to creating a safer society, a stronger community and health and wellness for all people.
P. Alexis: Thank you for that. I have written down "needs core funding" four times. I get the message, so thank you for that. Also, the perspective of community-based is also a great suggestion, so thank you for that.
Did anybody else want to chime in?
K. Hawkins: I just wanted to chime in quickly. I agree with absolutely everything that my colleagues are saying. But I did want to add that I do think we are at a point with COVID where, although it has obviously been an incredibly difficult time for everybody, there are opportunities.
Now that we've had to introduce technology, and we've had to do things in different ways, it is a time when we really need to start looking at what the things are that we can build on and the things that were introduced during COVID to now redesign our processes to increase safety, not to go back to unsafe processes.
Again, I highlight, and Amy FitzGerald has talked about, the issues of transportation, for example, in remote communities. There are ways now that we can work around those, and we really need to take those new opportunities into account when we're designing reopening.
G. Kyllo: Thank you guys very much for the very important and difficult work that you guys undertake. I'm just wondering if you could provide a bit of insight into the funding that's provided.
I can appreciate there's the legal side. There's Housing. There's Health, and probably funding through MCFD. Can you provide any kind of context as far as the magnitude of the funding that's currently provided and then what the incremental ask would be?
Further to that, I think that, obviously, COVID, as you've indicated, created a significant increase in need for the services that you provide. Could you provide some context as far as what percentage of increase you saw as far as need on account of COVID?
J. Routledge (Chair): Maybe ask a specific person. They're all being very polite.
G. Kyllo: Does anybody feel comfortable in providing any context as far as the total amount of money, the gross aggregate funding, that government provides annually and what the incremental ask would be?
D. Israel: Maybe I'll just jump in. When you said "magnitude of funding," it made me kind of giggle a little bit.
I think our provincial funding for WAVAW has afforded us six full-time positions in its entirety for both victim services and counselling. We've had an over two-year wait-list for counselling for many, many years. As the cultural tipping point continues, more and more people are looking for counselling, and our Stopping the Violence counselling funding has not increased substantially since the early 2000s. We used to have 1.5 positions, and now we have about 2.5. Our victim services team has three full-time positions. So for the level of need that is coming to us, we don't have the ability to respond.
At the end of the day, what we're doing is having to look for funding to address the wait-list that we have through foundations and other places. We're looking for funding that is going to reflect the need. Right at this moment, I can't address the percentage of increase, but we can certainly include that in our written submission.
G. Kyllo: Thank you for that. That would be very much appreciated. As you appreciate, the work of this committee is to provide recommendations to government. So having a better understanding of what that ask might be, either in percentage or in gross aggregate dollars, would certainly be helpful.
Thank you again for the very important and difficult work that you guys undertake.
A. MacDougall: I'm wondering if Amy FitzGerald has an answer to that question, if I just may jump in.
I know, Amy, you've got that provincial picture.
A. FitzGerald: Sure. Thank you very much, Angela.
Thank you for the question and the information, Dalya, as well.
You'll hear from many of our member programs as part of this budget engagement process. It is a patchwork of financial support that they receive. They receive funding from the Ministry of Public Safety and Solicitor General for community-based victim services, which includes outreach, Stopping the Violence counselling program and the PEACE programs.
They receive funding from B.C. Housing if they have a housing portfolio, and that's specific to the second-stage transition house and safe homes across the province. That's a separate pot of funding, including the new building funds that I referenced.
Some receive funding from the Ministry of Children and Family Development related to child care and daycare centres. Some receive funding from the Ministry of Mental Health and Addictions for recovery beds. That's what I referred to when I said that it is a patchwork of funding. To be quite honest, it is inadequate. Across the province, it is inadequate in terms of all of these portfolios. You will hear from people.
Our member programs, for instance, with the PEACE program…. As a counsellor, you are only funded at a maximum of 17.5 hours. Currently every single PEACE program in the province has a wait-list. In December of 2020, when we did a snapshot, there were 895 children and youth waiting for services from the PEACE program counsellors across British Columbia. In that same 24-hour period, those programs provided services to over 1,000 children and youth and their non-offending caregivers.
The need is great. The need was great before the pandemic. At that time, our portfolio and our women's transition housing portfolio, when we did a snapshot before the pandemic, there were women waiting for services at transition houses. Specifically, they were able to house, in a 24-hour period, over 1,000 people. But they were unable to house, in that same period of time, 300 people.
This was a public health and safety emergency — gender-based violence — before the pandemic. The pandemic came and created additional demands for services in urban and metropolitan areas. In some of the rural communities, you will hear the comment that there was eery silence because women were sheltering at home and unable to get to transition houses, unable to get to safe supports because of the inadequate transportation services available in rural and remote communities. Those numbers have grown, and now the capacity across the province is consistent, in terms of folks reaching out for supports and services.
What I would just say, with respect to what COVID taught us, is that when you identify an issue, when you talk collaboratively, when you provide financial support — that included federal support that we received from the Department for Women and Gender Equality — you can respond in a meaningful way.
Emergency preparedness really has to be looked at looking at the most vulnerable in our society. The most vulnerable in our society, as identified by the province, are women, children and youth fleeing violence, along with others. That includes not only response to COVID, but it includes response to fires. It is response to the heat emergencies that we saw. We need to build a coordinated system that acknowledges that in those times of crisis, people who are the most vulnerable are going to suffer the most.
Budgets reflect society's priorities. Collaboratively we're going to do our best to ensure that women and children and youth get to safe shelter, but we need the support, financially, of the government to ensure that women, children and youth can actually get to safety, can get to court in a safe way and can build a brighter future going forward.
A. MacDougall: I wonder if I may add, just briefly. Would it be okay just to make a brief comment?
J. Routledge (Chair): We're kind of running out of time, and there are two more questions. I want to give you….
What I am going to do is ask that the questions be really succinct to give you as much opportunity as possible to answer. I'll hear the questions, and Angela, if you want to add in what you want to say to the answer to those questions, that's a good idea.
H. Sandhu: Thank you to the presenters for the work you are doing.
I do a little bit of work with some of the women, and I know how many are still living in very abusive and unsafe situations, along with their children, because they can't afford legal support. I think that as a result, we have seen lost lives and even children, innocent children — how they came to such violence acts.
My question to Angela. You highlighted decreasing funding from for-profit organizations like the B.C. Lions. Has there been any feedback, or what was the reasoning for that? I just wanted to get the bigger picture.
A. MacDougall: I realize this is a bit of a touchy thing, because I know that it was something that came from government a number of years ago. I think that there is lots of evidence to show that community-based responses for prevention are more effective than campaigns such as the B.C. Lions.
There's nothing wrong, of course, with anybody speaking against gender-based violence, violence against women, domestic violence. There's nothing wrong with that.
What we know is that there are so many community-based organizations that are doing that front-line work that can provide a whole host of prevention activities that would be very specific to their communities and that would help build a community response, not necessarily something that's flashy and that's a campaign.
It's that investment in the community response by funding the community-based non-profit organizations that are already in effect all around the province that goes a long way. It's not as flashy, of course, but we do believe really strongly, certainly at Battered Women's Support Services and certainly we've heard from many of our colleagues and from survivors themselves, about the necessity of building that community-based response.
Because the B.C. Lions specifically are a non-profit organization, they are well-positioned to use their profits for the purposes of prevention, if that is what they seek to do. That is something that I think many for-profit entities could do, and we would encourage that.
We think that government is better…. Given the lack of funding for community-based organizations and the need for core funding, we think that the prevention piece, as Amy has said, with respect to the PEACE program, increased investment in that program would be far more effective in actually preventing violence and building stronger and healthier communities.
H. Sandhu: Thank you, Angela. Now that you touched upon that and I'm thinking about the women that I've helped and still help, most of them are getting help from their local small organizations within their communities. Thank you for highlighting that.
J. Routledge (Chair): Thank you.
Lorne.
L. Doerkson: Thank you very much, Chair.
My question is to Amy. Twice in the presentation you touched on transit. I think in your first request you had asked for better transit systems. I live in Williams Lake. We have intercity transit. And 100 Mile, which is also in my riding, does not. Then, of course, there's interprovincial transit as well, that obviously has disappeared over the past number of years.
I can appreciate those challenges, but where do you see sort of the best investment of funds with respect to transit?
A. FitzGerald: Thank you very much for the question. It's a huge issue, particularly for the rural and remote communities in the North, in the Cariboo and along the Okanagan and Kootenays as well.
We did a survey of our member programs asking what they felt the needs were — so these are the front-line folks — and 70 percent indicated that the existing transportation options do not meet the needs of their clients. Limited transit times, limited transit routes and cost were the three most frequently cited reasons for transportation inadequacy. And 85 percent of our member programs indicated that the current transit options in rural and remote communities create barriers for women to access not only gender-based violence services but courts, MCFD and housing. So it's a significant issue.
What we're working on here at the Society is a coordinated process that would involve sort of a hub-and-spoke model where we would build from the local communities and ask them what their needs are in order to connect with the only existing solution right now across the North — the northern bus, with the cancellation of the Greyhound bus.
We have a transportation project here that we're working on. We're working with four pilot sites in the North, asking them what their needs are and how to get women, children and youth safely to these various social services that are so critical to ensure their safety, and to ensure that they can engage actively in society.
I know that the Ministry of Transportation mandate letter, currently Minister Fleming's letter, does reflect the need for a systemic, coordinated system, particularly across the North, and the Highway of Tears and Highway 97. We would actively hope to be part of that conversation and would welcome any way to contribute to that effort.
It's a huge issue, to be honest, for women. It got worse during the pandemic because many of our member programs could no longer transport women in their own cars because of the physical distancing requirements. They had to rely on the public systems that don't exist in many communities.
J. Routledge (Chair): I am sad to say we are out of time. We have another panel waiting to also talk about similar issues.
To thank you for what you do and to thank you for what you've brought to our attention doesn't seem adequate. In the 1970s, I volunteered in a transition house. It was mostly volunteer work then. There was a core staff. I would have thought we would have come further since then. Thank you for bringing this to our attention. I have a million more questions, but we'll have to take that offline. Thank you very much. We'll say goodbye to you now.
We'll go right to our next panel, which is public safety and justice. Our first presenter is Maurine Karagianis.
Budget Consultation Presentations
Panel 2 – Public Safety and Justice
VICTORIA WOMEN'S
TRANSITION HOUSE SOCIETY
M. Karagianis: Thank you very much. Good morning.
Today we are seeking a coherent core funding approach for women's transition house services. By providing immediate shelter for women and children and the supports and services they need to get their lives back on track, transition houses prevent or reduce the damaging personal and social long-term impacts that result from intimate-partner violence and reduce later needs for housing, social services, income assistance, counselling, etc.
However, funding for transition houses has been an uncoordinated patchwork, with occasionally announced increases in response to government policy changes or particularly horrific individual cases of violence. The overall trend, however, has been limited funding, cutbacks, uncertainty and a lack of coherence. While transition houses provide critical specialized service and a range of social and legal services for a distinct population, they are not treated as the essential service they are.
In anticipation of government's review of critical social and emergency services in the aftermath of COVID-19 and reflecting the ministerial mandate letters calling for an action plan to end gender-based violence and a commitment to gender equality in budgets, policies and programs, the Victoria Women's Transition House has prepared a core funding plan, setting out a comprehensive vision for how violence-against-women services can be more effective in supporting women and children, victims of intimate-partner violence.
Victoria Women's Transition House provides two main types of service: shelter and a range of victim supports. B.C. Housing funds short-term shelter, second-stage housing and safe-home programs. The Ministry of Public Service and Solicitor General contracts for a range of services under the general heading of "Services for victims of crime." The broad scope of services connects to the wider social safety net, with the ultimate goal of ensuring a woman and her children become and remain safe, independent and successful members of the community.
However, providing that range of services is achieved only through complex time- and resource-consuming efforts on the part of transition house staff to identify, apply for and manage a range of different funding sources and programs. The numbers served by Victoria Transition House illustrate the value and importance of the services.
In 2020, a year in which many services were deeply affected by COVID-19 and where it was acknowledged that intimate-partner violence increased, over 7,400 services were provided to almost 1,600 women and 295 children. The 24-hour crisis line received over 2,700 calls, an increase of 37 percent from the previous year. The number of women and children receiving emergency shelter increased, 119 women and 54 children, as well as a dramatic increase in the number of women seeking shelter but unable to be served — 62, almost double the numbers from the previous year.
Counselling numbers were up and wait-lists long. With a history of attempts from 2002 to 2015 to implement funding formulas like the proposed reform process in 2014-15, government acknowledges the weaknesses in its previous and ongoing approach. From the point of view of Transition House, there continues to be significant problems with how government establishes and allocates funding for the services critical to the health and safety of women and children.
First, there's a lack of clear accountability, due to the complexity of service contracts, and true costs may not be directly reflected. While we are accountable through our contracts, they do not coherently or effectively address our core mission services. Current approaches mean that transition house services are funded from multiple sources, often with conflicting priorities, and gaps are almost inevitable.
Secondly, there's no process to consistently factor in costs outside of our control — wages, benefits, operational costs. Where there is no means of incorporating these additional costs into our service contract, the level of service is necessarily reduced.
Thirdly, while recognizing government's interest in having consistent funding practices for providers of similar services, the unique nature of violence-against-women services suggests a need for a funding model that is equally consistent. We propose that a core funding model be piloted with Victoria Women's Transition House and potentially others on the south Island from the sector. Core funding would mean that the agency, essential management, administration staff and resources and a set of core services would be provided through a single multi-year renewable contract to include transparent accountability measures and explicit provision for externally driven cost increases like salaries, benefits, insurance and utilities.
Transition House and its critical services would be funded with a single envelope with one set of reporting requirements and a transparent link to external cost factors. This would substantially reduce administration for both government and our agency and enable resources for service delivery to be maximized. A three- to five-year contract with annual performance reviews would ensure stability and flexibility and allow us to respond to current and emerging needs.
J. Routledge (Chair): Thank you, Maurine.
Before we open it up to questions, we'll now hear from Lauren Johnson, Amata Transition House Society.
AMATA TRANSITION HOUSE SOCIETY
L. Johnson: Good morning. I'm living in the Cariboo region, working at Amata Transition House in Quesnel. I'm going to be discussing risk management and operational labour costs.
This is nerve-racking for me. I did some research on how to present to a Finance Committee. Numbers are not my thing. I spoke to friends and family and our staff, and I felt like this is such a big deal. It's a short time, and I'm using some of it right now to share what a big deal it is to be here. The one feedback I got was: "Just give them stats. That's all they want. That's all they care about. They actually don't care about your cause. They don't value the things you value, and it's not their job to provide money."
I'm sitting here in denial of those comments that were made to me, and I'm going to share this because I think you are sitting there as a parliament body and as a steering committee to do exactly that: get this feedback. This committee was struck for a reason, and I want to get to one very important stat that I'll share, but I want to preface that by saying I did research. I looked at documents from 2010, strategic planning initiatives in the sector, in domestic violence. I've been in this sector for the past year now, and what I've been met with is an amazing group of individuals who do an immense amount of work and are truly dedicated.
What can I say to you that hasn't already been said about this sector? I wanted to give you a day in the life of a transition house worker. It starts by driving up to a bullet-proof facility, bullet-proof windows, because we are at risk of the perpetrators that come onto this property or gang violence or a number of things that could show up at our front door.
You walk in on day shift, and you're going to make breakfast, and you've got to tend to the COVID cleaning, or cleaning in general. This is a seven-bedroom home with five bathrooms and seven offices. We do outreach. There's a residence coordinator, child care worker, peace care worker, assisting children in trauma.
They show up here. The phone rings. There's someone doing an outtake, and there's an intake that's coming in at the same time. This is an intense environment that's in chronic crisis. The guests that show up here are in chronic crisis. That crisis often shows up in the police stations and the hospitals to start off with, the mental health facilities, and they're interacting with them on a short-term basis.
Here we are, and those very same crises that are dealt with in 15 minutes or a few hours or even overnight then land on our doorstep. These service providers are doing trauma-based work, and the wage that they're receiving for that is $21.68 an hour in a unionized environment and $18 in a non-unionized environment.
Consider for a moment our operational costs. I'm doing averages. These are crude numbers here, but the cost of labour and benefits to operate this facility per hour for all of the staff we have, which is 21, at a 24-7 operation, is $28.19.
Add that to the operational cost to operate a bed, and I averaged out, over the course of a month, 222 bed stays. That's 222 nights when women and children laid their head on a bed at this house over the course of a month and had a safe place to stay where they didn't fear trauma or violence and they had a meal prepared for them and they were safe. I added those two costs together, and the total per hour to operate this space was $30.67.
The bottom line is that we're underfunded for the resources and the essential front-line work. I compared that to search and rescue operations. I was reading a stat from 2017 that said 139 search and rescues averaged a total cost of $93,000 per rescue. In the course of the year, these women tend to be over 2,500 different women that are in need.
Wage equity and livable wages must be first met with sectoral value, and that's not a mythical beast. It's an active pen-on-paper, and it lives in the moment and in our consciousness and in our conscience.
So we're asking not just for a raise. We're asking for a radical change in insight and acknowledgment and awareness of what it really takes and the risks that we're really facing on a daily basis. Thank you.
J. Routledge (Chair): Thank you, Lauren.
I will now open it up to questions from the committee to both Maurine and Lauren.
M. Starchuk: Lauren, thank you for your presentation. I'm starting to develop carpal tunnel syndrome from all the note-taking I'm taking, and I can't keep up with the numbers. But your numbers were very to-the-point.
I just want to make sure that I understand this correctly. Can you just repeat for me –– and my slow penmanship –– the number of rooms that we're talking about? I love the fact that you used 222 nights in a month. It really paints a really good picture. And your analogy and comparison to search and rescue really hits the point.
L. Johnson: Definitely. Thank you for saying that.
What I did was average, in the course of a year…. For example, over the course of the last four months, we averaged a total of 222 beds per month. Some months it would fluctuate to 150, and then it was 259, and then it varied. So when I took the average over our last four months, those were night stays for women and children. On average, we have 15 women and four children staying.
M. Starchuk: If I may, can you just clarify that with your facility? Is that seven rooms with multiple beds inside of the rooms?
L. Johnson: That's correct. Actually, we're funded for five of those rooms — two of those rooms are considered not funded — and in those five rooms, we have 13 beds. So we're over capacity.
During COVID…. We have bunk beds, and those bunk beds can't be used because it's single-occupancy or single-family dwelling. So our numbers actually decreased as a result of COVID. Those 13 beds that we're funded for –– this factors that in. In the course of a year, we might see an average of 2,664.
B. Stewart (Deputy Chair): Maurine, good to see you again.
I wanted to just…. You've kind of suggested that the problem in the previous panel that we were hearing is that, clearly, there is a disconnect because we're funding on an ad hoc basis and we're not really getting to the core issue. I don't know what the solution is. I don't know if the groups actually come together. But anyways, I just wanted to comment that I think starting where you're at and maybe doing something like that may be a solution.
One thing I did wonder, from the previous panel, is…. Because of the cost of delivery, is there an option, not that we need more 811s and 211s and other phone lines like that…? For people that are in rural areas of British Columbia that have the service or access to it, could that be utilized, as a portion, for helping some of these people that find themselves in a situation with violence or need help and then getting them out of that situation?
I don't know where I'd go if I was in their situation. That's what I'm asking.
M. Karagianis: Thanks, Ben. Good questions. Our approach, at this point, is to look at reducing this ad hoc funding, as you so eloquently placed it. I didn't see the previous presentation.
Our funding comes from a whole series of different sources and is often disjointed. There are gaps, as I said in my comments, and those leave the organizations and, most importantly, women and children in the communities vulnerable to the kinds of services that we are able to provide. I think Lauren talks very viscerally about her experience on a day-to-day basis.
We do have crisis lines. That's not necessarily the answer, although people reach out when they are in crisis. When women and their children need to flee, they need somewhere to go now, instantly. When they reach that destination, the shelter or the housing option that we may be able to provide for them, they need services immediately. Often they need trauma services. They need some legal advice immediately. They quite often need other kinds of health services.
All of those things need to be coordinated in a core funding model. That's really what we're proposing here today. It's to say we shouldn't have to apply to several different ministries to get enough funding to put together real services for the front line. So many of the programs don't offer us the administrative coverage that we need to provide those services. Just the whole disjointed perspective of what's happening is not providing the very best services.
We saw with COVID that violence had gone up. Many women and children were locked in with their violent partner because of COVID protocols, so the numbers increased dramatically. Those people needed someplace to go, and they needed those services to be reliable there — the legal services, the health services.
What we're saying is that if we provide a core funding model for transition houses that guarantees that our services will be there — that we are not scrambling, that we're not leaving people out — we will provide better service. And it will be a more efficient and more effective way for government to provide funding as well.
I sit on another Crown corporation board. Our budgeting is done three to five years in advance. We need predictable funding in order to plan and run our organizations efficiently and effectively. We're saying that these kinds of services, especially services for women and children fleeing domestic violence, need to be treated in the same way. So we're asking for a pilot project that would look at one source of funding, one envelope.
That also covers some of the other things that you're concerned about, Ben. When a woman is fleeing a violent partner, an 811 line is less effective than someplace to go to where she is immediately protected, sheltered and supported.
B. Stewart (Deputy Chair): Thanks very much.
J. Routledge (Chair): We have about two more minutes before our next presenter.
Pam, in that context.
P. Alexis: I just wanted to say thank you for including the number of FTEs required, Maurine, in the plan. It was well laid out in the document that you sent in advance. So thank you for that.
M. Karagianis: Thanks very much, Pam.
We've told personal stories there as well. As we've heard from Lauren, those stories are very moving.
We want to approach this in an extremely polished and professional way. I hope that our presentation will help to move government in the direction that we would like to see of more sustainable core funding for all of our organizations. Certainly start in one place and then move up from there, if that's what government feels would be a more efficient way to do it.
J. Routledge (Chair): Okay. With that, I will conclude this presentation by thanking both of you so much.
The way you talked about…. The recommendation you've given in terms of an alternative way of funding violence-against-women-and-children organizations has been very clear and very helpful to us.
Finally, what I'd like to say to you, Lauren, is thank you for being so honest about your doubts about appearing before us. I guess what I'd like to say in response is that in my mind, a provincial budget is like a family budget. It's not about the money; it's about quality of life and the choices that we make to make sure that everyone in the family gets to thrive. So thank you for presenting. We will take what you've had to say in serious consideration on many levels.
Okay, we get to have a brief recess. Our next presenter isn't quite here yet.
The committee recessed from 9:41 a.m. to 9:44 a.m.
[J. Routledge in the chair.]
J. Routledge (Chair): Our next presenter is Gail Jewsbury, Vancouver Island Region Restorative Justice Association.
We're ready for you, Gail.
Budget Consultation Presentations
VANCOUVER ISLAND REGION
RESTORATIVE JUSTICE ASSOCIATION
G. Jewsbury: Good morning. Thank you for allowing me to present to your committee. I'm Gail Jewsbury. I'm the treasurer of the Vancouver Island Region Restorative Justice Association, known as VIRRJA.
I'd like to acknowledge that I live and work on Coast Salish territory.
VIRRJA is a registered society created in 2009 to represent the collective interest of restorative justice on Vancouver Island, the Gulf Islands and the Sunshine Coast. Our aim is to provide a collective voice for our programs and to provide mutual support for each other.
We are the only region to have formed an official society. Our members are community-based programs from both Indigenous and non-Indigenous communities. I did note that there are restorative justice programs in almost all areas that members of this committee represent.
Restorative justice is a proven means to respond to both crime and other harms. No matter what form of restorative justice process is used, an opportunity is created for the party harmed and the community to engage with the person that created the harm to account for the impact of their actions. Restorative justice responds to the needs of victims of harms, as well as the needs of community, which is also affected.
British Columbia has had many community programs since the early 1990s. Most are generally community-based, grassroots organizations, rather than a provincially mandated program, such as exists in Nova Scotia. Most frequently, programs deal with pre-charge situations. However, it is well-documented that restorative justice is effective in dealing with more serious matters than the category 3 and 4 offences.
Files now have an added complexity involving deeper issues, such as mental health, poverty, addictions and elder abuse, to name a few. One study showed that a program had a 24 percent increase in files with complex issues in 2019, followed by a 40 percent increase in 2020. Restorative justice programs are dealing with more and more complex cases.
So 2021 has provided more challenges with words such as "hate" and "reconciliation" becoming commonplace. Restorative justice is to help the province meet its obligations with respect to reconciliation and the convention on the rights of the child, to name just two incidences. VIRRJA believes that to improve restorative justice capacity in B.C., we should support existing programs. These programs are known quantities. This ensures that restorative justice has a strong foundation in community.
In 1998, the government created a senior policy analysis position in the office of victim services in order to establish the community accountability program, which is known as CAP. Unfortunately, this is now a very part-time duty on the desk of one of the victim services staff. Restorative justice programs would benefit from having this position restored to full-time and opening the CAP program to new programs.
From 2012 to 2019, with the exception of 2015, this committee recommended an increase in the community accountability program funding. In 2019, we got an increase from $2,500 per program per year to $4,000 per program per year. This coincided with the stakeholder consultation meetings, which VIRRJA lobbied for when we met with various members of the Legislative Assembly and which we were fortunate to participate in.
To build better restorative justice programs in British Columbia, we have the following recommendations to the committee. We urge the committee to continue supporting restorative justice programs, by recommending an increase in funding to $10,000 over the short-term from 2022 to 2027. We would like additional funding in the range of $30,000 to $40,000 per annum for the highly functional and sophisticated programs, to enable these programs to have paid staff and undertake more complex files. Most programs operate solely with volunteers.
Funding of additional grants to encourage the delivery of public education and activities to broaden the awareness of restorative justice and the benefits to the community and the justice system, by enhancing service from community-based programs.
Finally, to initiate stable funding for establishing regional associations to provide education, training and support services to programs in the area. After the withdrawal from training of the RCMP in 2016, programs have struggled to fund training opportunities for their volunteers.
In conclusion, I would like to thank the committee for its ongoing, continuing support for all the prior years, and I hope we can count on your support for building better restorative justice programs in British Columbia. I'm happy to provide you with any examples of restorative justice and their outcomes, as well as to answer any questions.
J. Routledge (Chair): Thank you, Gail.
We'll now open it up to questions from the committee.
P. Alexis: Just a clarification. I didn't see anything in the file. So I was wondering if you are sending a more specific document to us before decision-making, just to make sure that we've got the right information.
G. Jewsbury: Yes, we have provided a document called Building Better Restorative Justice: Enhancing Services to the Region, which I thought that you had already received.
However, I'm very happy to send another copy of this document. We were told initially that we were not on the list to make a presentation, so that's why we submitted the document.
P. Alexis: Okay. Well, we'll check on this end. I don't have it, but it's possible.
J. Routledge (Chair): Any other questions for Gail?
I have a quick question. Can you just quickly tell us the relationship between restorative justice and alternative dispute settlement? Are they similar or part of the same continuum?
G. Jewsbury: Yes, they're very similar in that restorative justice is an opportunity for parties to sit down with each other and come to a conclusion as to how things happen. When we look at the criminal justice system in B.C., this is normally done pre-charge, before the RCMP submits documents to Crown counsel for charges, and it's often considered part of alt measures. It's also talked about as being diversion.
In some cases, it can be used after Crown has laid charges. For example, when there was the murder in Whistler on I believe it was New Year's Eve, the surviving widow met with the person who was found guilty of killing her husband. They had a restorative justice meeting and made an outcome which was for them to go around and talk in various schools about the effects of the actions on both parties.
Restorative justice — although we only use it in British Columbia generally as a pre-charge thing, programs are often getting asked by Crown counsel if they would take on files before they go to court but once they've been received by the Crown counsel. Crown counsel does not see the need to pay restorative justice programs for this service, so it does come at quite a cost because it requires much more highly skilled volunteers than just a pre-charge mischief or break-and-enter or something like that.
Did that answer your question?
J. Routledge (Chair): Yes. Thank you very much.
Lorne has a question, and then we'll probably have to wrap it up.
L. Doerkson: Yes, just a quick one. Thank you, Chair.
You just touched on something that made me curious. Is there a saving to the court system through your programs? I mean, if your programs are successful, is there a savings to the court system?
G. Jewsbury: There is a huge saving to the court system, not only in time but also in physical dollars. Generally, restorative justice processes are dealt with speedily. When we get a case coming across our desk, we've normally created the team that will deal with that case and contacted all parties within 24 to 48 hours. We also include the community in that as well, because with every harm, the community is impacted.
We then arrange the meeting. The meeting looks at what happened, who's been affected and how they have been affected and what can be done to repair this harm. In some cases, this is a monetary amount. In other cases, it is volunteering community service time and whatever the parties can agree on.
There was recently a case with the community justice program in Courtenay where a young adult was about to graduate and created $18,000 worth of damage to school property. He went to work for the summer, has repaid $5,000 of that, and the school board has found it within their purview to say that he doesn't need to pay any more money because he's gone out and dealt with the situation immediately.
That was a huge saving to the community. The school got something out of it. The person who created the problem worked really hard to pay back the community and the school board. That becomes a win-win situation for everyone, rather than something punitive where people are punished, and they don't necessarily understand what the action was that created the problem they now finally themselves in. So it's a huge savings in cost.
J. Routledge (Chair): Thank you, Gail. Thanks for enlightening us about restorative justice and the work that you're doing. We look forward to reading your brief. I know that there will be a lot more details in there.
We are now going to take a two-minute recess, and then we'll reconvene.
The committee recessed from 9:55 a.m. to 10 a.m.
[J. Routledge in the chair.]
J. Routledge (Chair): Our next panel is on legal aid. We have four panellists. After we hear from each panellist for five minutes, we'll open it up for questions from the committee.
Our first panellist is Lisa Hamilton, Law Society of B.C.
Over to you, Lisa.
Budget Consultation Presentations
Panel 3 – Legal Aid
LAW SOCIETY OF B.C.
L. Hamilton: Good morning, everybody. I am Lisa Hamilton. Thank you for inviting me to speak on behalf of the Law Society. I am a family law mediator, lawyer and arbitrator in Vancouver. I'm also on the governing board of the Law Society, and I will be president next year. It is in that capacity that I speak to you today.
The Law Society regulates the legal profession in the public interest. Our core mandate and function is set out in section 3 of the Legal Profession Act. It calls upon us to protect the public, promote the rule of law and uphold the public confidence in the administration of justice. These duties require us to speak on behalf of others who have a stake in the justice system who are unable to speak for themselves or to be heard.
The Law Society has prepared written submissions that will be filed for your benefit. They will address more than I intend to cover here today in the allotted time. I would just like to highlight three of the recommendations for you today.
First, we have recommended extending further funding for upgrades to technology and infrastructure in court and court services. The last budget included a one-time allocation for this work, but we recommend that the work proceed. It's not completed yet. Much appreciate the allocation, but more work to be done.
Secondly, we recommend that the budget include an increase in legal aid that expands who is eligible to qualify for legal aid, an expansion of the scope of legal services that are covered by legal aid and an increase to the coverage limits. Many British Columbians who struggle to earn a living wage are still viewed as too rich to qualify for legal aid, and many of those who do qualify find that their legal aid runs out before their problem is actually resolved, which can actually be quite dangerous.
Thirdly, I'd like to highlight that we are recommending an allocation of funding to enable an exploration of expanding non-adversarial resolution of family law matters in particular.
If I can just expand on two of the items that I have mentioned today. First, prioritizing provincial funding on broadband technology in rural and remote communities. We appreciate that broadband Internet is often not thought of as a justice issue. However, with the transformation of the courts and court services that is underway and changes that lawyers and law firms have implemented during the pandemic, these have made virtual and online platforms a norm in the delivery of legal services in this short time.
As such, the Internet is making legal services more available and more affordable than ever before, which is a good thing. British Columbians who need help with a legal problem can more easily obtain advice and representation, and they're more easily able to participate in processes affecting them. I see this daily in my private practice. This can help the public resolve their issues earlier, feel that justice has been served and move on with their lives.
The changing nature of how legal services are delivered now, how justice is accessed, creates an opportunity for better fairness and equality of opportunity for everyone who has access to virtual and online platforms. However, in consultations that the Law Society did this summer, we heard that some British Columbians living in rural and remote communities are being left out because of unstable and unreliable Internet.
The province allocates funding to improve broadband, and no doubt will continue to do so. The Law Society encourages this to be a priority because investments in broadband connectivity have returns and benefits for access to justice for all.
Now if I can just turn to expand on the non-adversarial alternatives in family law disputes. The adversarial process promotes winners and losers. Family law clients will often have an ongoing relationship with the other party. The classic example is co-parenting children.
There have been lots of great changes to family law funding, but still, the majority of the funding is directed at adversarial services. Now, with the ability of online mediations and so forth making it safer to participate in mediations, for example, we suggest that more exploration be done to fund non-adversarial processes in family law.
I note my time is up, and I thank you very much.
J. Routledge (Chair): Thank you, Lisa.
Now we'll hear from River Shannon, Pacific Legal Education and Outreach.
PACIFIC LEGAL EDUCATION
AND OUTREACH SOCIETY
R. Shannon: Good morning. First, let me begin my remarks by thanking the hon. members of the Finance Committee for providing us the opportunity to speak this morning.
It's also a delight to share this space with my friends. Hi, Lisa. Hi, Aleem. Hi, Jen.
My name is River Shannon. I am speaking today on behalf of the Pacific Legal Education and Outreach Society. We've been providing legal services to the non-profit and arts sector since around 2005. Last year we received funding from the Vancouver Foundation to pilot a legal clinic for non-profits, and we've also been developing an interactive and online tool that will help non-profits understand their legal obligations and improve their governance.
As Ms. Hamilton mentioned in her submissions, we are moving more and more into an online model of service delivery, and I anticipate that Mr. Bharmal, in his submissions on behalf of the Canadian Bar Association, may also mention the importance of updating our legal profession to meet these challenges without leaving folks behind. This is the kind of work that PLEO has been doing for some time. It is well placed to do that work, because it is part of and enmeshed in the communities that it serves, namely the arts and non-profits community in British Columbia.
We're delighted to learn that the province is providing $132 million more funding over three years to support a justice system that serves everyone in this province and that this includes some amount of funding that has been earmarked for legal clinics. We'd like to highlight the importance of directing this funding not only to family law clinics and poverty law in the traditional sense and not only to existing projects but also to the small grassroots legal organizations like PLEO — and there are others — that are coming up with new and exciting ideas around delivering much-needed help to sectors like the arts and non-profit community.
Like the organizations that we serve, we're nimble, and we work in close relationship with our clients. We are imaginative, and we do a great deal with very little. Our interactive online tool is just one example. It was developed without any funding at all from the province or the Law Foundation.
When we talk about access to justice, I think we often imagine individuals — the single mother seeking child support or the tenant seeking to resolve a strata dispute. We rarely consider organizations. The non-profit sector is an essential part of what makes B.C. such a wonderful place to call home. There are an estimated 26,000 non-profit organizations in British Columbia, and they meet countless needs, from health and wellness to housing to art to sports and music and more. The sector as a whole generates $6.4 billion in GDP, which is larger, I understand, than the combined GDP of agriculture, forestry and fishing in British Columbia.
Even so, the vast majority of this work is carried out by small organizations without the funding to access legal help, organizational guidance and strategic planning. As Ms. Hamilton mentioned, there is a sort of grey area, where organizations are too large to receive support but too small to afford ongoing legal assistance. Many organizations don't even realize the importance of retaining counsel for important and impactful decisions that could be very costly.
Over three quarters of the workers in our non-profits are women, and at PLEO, more than half of our clients have been women, LGBTQ people, Black, Indigenous and people of colour and the organizations that are led by them and that serve them. As our founder, Martha Rans, said in her comments to this committee last year, we need to expand our view of what access to justice means and who has access to that justice. Just as we preserve our economic institutions through the pandemic recovery, so too must we preserve our social and cultural institutions and the ecosystem that supports every member of the population.
Despite their important contributions to the quality of life of our province, non-profits, particularly those serving the arts, often face uncertain futures and precarious situations. I would say, additionally, that many have been profoundly impacted by the pandemic.
Theatres have had to shutter their doors for over a year and a half. Many performers have come to us because they're navigating the new challenges of a digital space, trying to protect their creations and foster communities in a new and strange context and environment. Non-profits with limited funding have had to discover how to do their important work from home or how to operate essential services safely while working with vulnerable populations that are even more at risk because of the pandemic. These challenges, I think, are only more pronounced as we dance with the delta variant, vaccine passports and reopening.
In summary, we would like to encourage the province to invest in legal clinics as a vital component of access to justice and a just recovery. We would recommend that this funding be directed not only to established programs but to younger and smaller organizations like PLEO and that the province take up the challenge of sustaining a vibrant and sustainable network of legal clinics in this province.
This is a real opportunity for us to take leadership and create something new and powerful as we imagine a different and more digital, more online and more progressive legal community.
Thank you very much.
J. Routledge (Chair): Thank you, River.
Next we'll hear from Jennifer Metcalfe, Prisoners Legal Services.
PRISONERS LEGAL SERVICES
J. Metcalfe: Thank you for the opportunity to appear today. I'm the executive director of Prisoners Legal Services. We administer all prison-related legal aid to federal and provincial prisoners in B.C., other than appeals. We help prisoners with issues that affect their liberty rights under section 7 of the Charter, human rights and health care issues.
We encourage B.C. to invest significantly in community-based mental health and healing services. This would be less costly than incarcerating people unnecessarily and would result in greater public safety. We were quite disappointed to learn that B.C. is spending $167 million this year on building a new prison in Nanaimo. This will increase the number of high-security beds, including beds for women. This doesn't seem like a very NDP way to spend money.
Many people are in provincial custody for non-violent offences, for administration-of-justice reasons — such as breaching bail or probation conditions — and on short sentences. The average sentence for people in provincial custody is 64 days. Putting people in prison for short periods of time is extremely destabilizing. People can lose their jobs and housing and community support. Being arrested and returned to prison is traumatic. It can result in homelessness, and research cited in my written submission demonstrates that it increases the risk of overdose.
Many of our clients have mental health needs that are not met in the community. We encourage B.C. to invest in services to help people with mental health supports in the community and to stay out of prison. We also encourage B.C. to fund the Forensic Psychiatric Hospital to accept people with high mental health needs to live with dignity when they must be held in a secure setting.
Prisons are not equipped to provide the level of mental health support required by many of our clients. Many end up in segregation. The United Nations considers 15 days or more of solitary confinement to constitute torture or cruel treatment, and solitary confinement is prohibited by the United Nations Mandela rules for people with mental health disabilities.
Although B.C. has made progress in reducing its reliance on solitary confinement, many of our clients with mental health disabilities remain in segregation, in conditions of solitary confinement. We've heard multiple reports of segregation cells being contaminated with feces and mice at the North Fraser Pretrial Centre. This is unacceptable.
We understand that B.C. is currently negotiating with the B.C. First Nations Justice Council on funding for alternatives to incarceration for Indigenous People. We support a dramatic shift in funding priorities toward Indigenous-run healing services, including healing lodges, as an alternative to prison.
It is acknowledged that prison represents a continuation of the genocide committed against Indigenous People through residential schools, yet in B.C. today, 35 percent of prisoners are Indigenous. If B.C. wants to be a leader in respecting Indigenous People's rights to self-determination, we need to end the practice of incarcerating Indigenous People in colonial prisons and ensure that First Nations and Indigenous organizations are well resourced to provide healing services in the community.
Finally, we ask B.C. to invest in an increase in funding for legal aid for prisoners. Prisoners are an extremely vulnerable group in our society, with high needs for legal advocacy.
PLS receives a much higher demand on our services than we have the ability to meet. We receive reports from prisoners that they're unable to get through to speak with a legal advocate because we don't have enough staffing to answer our phones. People are pleading guilty to disciplinary charges and going unrepresented to hearings as a result. A conviction for a disciplinary offence can result in a sentence to segregation.
We're grateful to have received a one-time grant of funding last year when we were in significant crisis. However, we need an annual increase to our funding to be able to maintain our services. We haven't had an increase to our contract since 2012, despite experiencing a significant increase in the demand to our service and the level of services provided.
Thank you.
J. Routledge (Chair): Thank you, Jennifer.
Finally, before we open it up for questions, we'll hear from Aleem Bharmal, Canadian Bar Association, B.C. branch.
CANADIAN BAR ASSOCIATION,
B.C. BRANCH
A. Bharmal: Good morning, everyone. I want to thank you for this opportunity to address you. My name is Aleem Bharmal, and I'm the first vice-president of the Canadian Bar Association, B.C. branch.
I acknowledge I am speaking to you from the traditional, unceded territories of the Coast Salish people, specifically the Musqueam, Squamish and Tsleil-Waututh Nations.
The CBABC has over 7,300 members who are lawyers, judges and law students working throughout our province. We are small business owners or employees of those businesses. We are provincial government employees, federal government lawyers in B.C. and in-house counsel, including those in B.C.'s key corporations — including ICBC, Telus and B.C. Hydro.
Earlier this year the CBABC released its Agenda for Justice 2021, a roadmap for action to improve B.C.'s justice system and modernize provincial legislation for the benefit of all British Columbians. Every member of the Legislative Assembly received that document. We will provide the links again in our written submissions to follow this presentation.
The Agenda for Justice includes more than 40 recommendations in 22 key areas to address everyday situations affecting the people of B.C. It offers concrete suggestions where the legal community and the B.C. government could work collaboratively to move families and communities forward.
Today I will highlight three areas for the committee's consideration. Each one serves the public interest to improve access to justice while building a strong and sustainable economy. Each one puts people first.
First, we suggest allocating funding to legal aid to increase the scope of representation in family law matters. Although many people assume that legal aid is available to address family law matters, the truth is that since 2002 there has been no legal aid funding for representation to address the majority of family law matters, such as child support, spousal support, division of assets and debts, and parenting arrangements.
Legal aid representation is provided only in circumstances where there are actual or threatened safety or violence issues, or to resolve a serious denial of access to children. As a result, many people are left on their own to navigate the complex legal system to secure basics such as child or spousal support and parenting.
Our second recommendation is for the province to continue to allocate funding towards modernizing the court and justice system. There are two parts to this. The province's court digital transformation strategy, announced in 2019, was a key development. The additional funding provided by this government earlier this year to advance that strategy provided a much-needed boost to modernize a court system that primarily operated through paper documentation and in-person appearances. Further funding is required to fully digitize the system to meet the standards enjoyed by British Columbia's health and education systems.
The second component addresses the people who are left behind during this technological transformation. Those without access to telephones or the Internet, or who lack basic computer skills, are unable to appear virtually to represent themselves. Others may not have English as their first language and may struggle to appear virtually in court matters. Still others are in custody, where there continue to be gaps in access to video conferencing equipment.
The CBABC asks that no one be left behind and that the province provide rural communities, including Indigenous communities, with high-speed Internet access and the necessary computer equipment and assistance at secure locations so they can access and participate in the court and justice services.
Now addressing our final recommendation to you, the CBABC recognizes that systemic discrimination towards Indigenous Peoples need to be addressed at every level of the province, of government services.
The CBABC calls on the province to implement section 3 of the Declaration on the Rights of Indigenous Peoples Act — namely, to take all measures necessary to ensure the laws of British Columbia are consistent with UNDRIP and to do so in consultation and cooperation with the Indigenous Peoples in B.C. Nearly two years after the act was passed, there isn't a clear road map for the consultation with Indigenous Peoples, and funding is needed to support that consultation.
In conclusion, we acknowledge that the justice system is not something you hear about from your constituents very often. However, 45 percent of the population faces an everyday legal problem in any three-year period.
As we join others to grieve the sad recovery of unmarked graves at former residential schools across the province, we are reminded of the urgent need to work with Indigenous Peoples. The budget must include funding dedicated to ensuring that all laws include meaningful consultation with Indigenous Peoples.
Thank you for your time. I'm pleased to respond to any questions you may have.
J. Routledge (Chair): Thank you, Aleem.
We've now heard from all members of this panel, and we have about 20 minutes for questions from the committee. I'll open it up to questions.
B. Stewart (Deputy Chair): Two of you mentioned — and I'm sure you're all touching on it — about technology.
Lisa, you mentioned it in your presentation, about the fact that the investment in the court system…. It sounds like it was more at the courthouse rather than the access that's needed out in maybe rural parts of British Columbia, where people can present without having to travel to a particular facility.
Is that correct? What do you see…? Or could you maybe more completely describe the issue around the technology gap? I know that we're not going to have high-speed Internet at every rural location in British Columbia. I know that it has been a long-standing priority of government, and the rules keep changing, and speeds keep going up, etc. Anyway, could you just elaborate — maybe yourself and Aleem?
L. Hamilton: It's partly what happens in court, because the courts are — I think this is a really good thing — moving towards virtual and online processes.
The CBA had a report. Aleem will talk about that. We reached out to people. They described great benefits in terms of cost savings and not having to travel to court to appear, for their clients to be able to appear from distances and be more able to participate. But there are still people that don't even have the basics, so they cannot participate in all these great changes that are happening.
That's true with private practice as well. I've noticed since the pandemic that there's a huge need for mediation and arbitration in family law, for example. The public really wants to resolve their matters quickly and not be dragging on and not having matters unresolved. But the unfortunate thing — this, I guess, combines with the recommendations on legal aid and expanding the scope — is that you worry about people being left behind if they don't have access to technology, they're not technologically savvy or they can't afford to pay for lawyers who can help them navigate that.
My practice has expanded. I now offer services around the province without having to fly to communities, and those who can pay for it greatly benefit from getting their matters resolved. It's such a safe way to do it as well, because you can be on this very technology and use breakout rooms and not even have people where there's family violence being in the same place.
It seems to me that it would be the fairest to make that accessible to everyone as opposed to those who can pay for it or those who happen to be able to qualify for limited services. I hope that answers your question.
A. Bharmal: If I could just add to what Lisa is saying. As a personal example, I had an Indigenous mother as a client, and unfortunately, her hearing did not complete in person before the pandemic started. It had to be continued online, and she did not have the technology in order to do that. Eventually, we came up with the solution of us both appearing, when we were able to under the restrictions, at the tribunal sort of as a hub, and they provided the technology to connect to everyone else.
At the very least, in the rural areas, you're going to need these types of hubs and the technological connections that people can go to, if not providing that access to everyone in their homes. You need to provide the assistance to help them with that technology.
This client was someone who…. Basically, legal aid…. It was through funding from the government that she was getting her legal representation. So all of that needs to be in place for true access to justice around the province, especially in Indigenous communities.
B. Stewart (Deputy Chair): What I was trying to get at is the financial component of this. You mentioned about the hubs, Aleem, and I think that that's probably a more realistic approach. I don't know if the courts are completely set up with the amount of the one-time funding or if there's a big gap there. That's what I'm trying to separate.
I realize it's kind of an incremental thing. If we have the courts set up and we can deal with different courts, whether it's family law or other issues — the idea that people can access it. I guess what I'm trying to do is…. What type of ask do you think is needed?
A. Bharmal: Yeah, these things have to be costed, I think, in consultation with the Ministry of Attorney General. But if there's a will to go forward with it and a recognition of the need, then the costing can be done with the Attorney General, with different levels of service, and it can be worked into the budget.
We just want to emphasize that this should be a priority. To have a just society and to include Indigenous communities within that, we need that capability.
L. Hamilton: If I may add…?
J. Routledge (Chair): Go ahead.
L. Hamilton: I like when Aleem suggests the hubs. Perhaps partnering with courthouse libraries or First Nations band offices, somewhere where people who don't have Internet at home and may not be able to use it — don't have the skills — and can have that facilitated.
P. Alexis: First of all, I want to thank River for the really succinct presentation. You made me think about all the non-profits in my own community and how, absolutely, the legal challenges for so many…. To have this service provided is exceptional. So thank you for that. I didn't know that that was a possibility, so you taught me something.
A question for Prisoners Legal Services. Do you get some partial funding from the federal government, as you are actually serving federal prisoners as well as the provincial institutions?
J. Metcalfe: We don't get any funding from the federal government. Our core funding is from Legal Aid B.C., and then we have some program funding from the Law Foundation of B.C.
P. Alexis: But nothing federally.
J. Metcalfe: No.
P. Alexis: Okay. Thank you.
M. Starchuk: Thank you to the presenters.
I think there's a little bit of overlap between what I'm going to ask and what MLA Stewart had asked, and it surrounds maybe the adaptation or the evolution of non-adversarial family law and the broadband services that would be attached to it.
Was this an evolution that was coming, or is it as a result of the pandemic and adapting to what was there?
L. Hamilton: If I may. I see that it was already happening in a very small way, but the pandemic really gave it a push. I saw lawyers, mediators, arbitrators who would not normally offer their services really jump to it.
Within the span of two weeks, everything changed drastically. Private practice looks very different. The courts really came aboard too. I'm on the Supreme Court rules committee, and I've done work for the Provincial Court as well.
One of the programs that, as a result of the pandemic, there has been funding for is pro bono mediation, which is a virtual mediation project, which has been fantastic. I know River has helped train the mediators. That's up and running to support the Provincial Court family rule changes, which have mediation up front. It's a collaborative effort with the family justice centres as well as Access Pro Bono and Qase technology and the government. That's been wonderful.
All of that, I think, has been pushed by the pandemic. I do worry that there's even more. I think the pandemic has been very hard on families and relationships, and I worry. I lose a little bit of sleep myself that there's going to be even more delay and backlog.
We're all going to have to roll up our sleeves and help families resolve matters more quickly. So I think the use of technology and turning more and more to options for non-adversarial processes to resolve matters more quickly, where that can be done in a safe manner, is a real opportunity for us to look at to help British Columbians.
L. Doerkson: The question is directed at Gail, but first I just wanted to appreciate the comments about connectivity throughout rural British Columbia, particularly because — I'm certainly from the Cariboo-Chilcotin — I can definitely confirm that it is a massive issue. So I'm glad that that's a topic this morning.
Gail, you talked about legal aid and the thresholds. We've heard that this morning, and if you gave a threshold, I didn't hear it. What is the threshold where you are disqualified for legal aid, and what does legal aid look like to somebody that is going to use it? Is there a maximum amount that they can receive? Are there thresholds there as well?
J. Routledge (Chair): Lisa?
L. Hamilton: Off the top of my head, I don't know the exact…. They change it from time to time, but it's very, very low income — lower than subsistence level.
In family law, as Aleem had alluded to, there is coverage if you can prove that there is an urgent need. For example, there are women who are exposed to family violence and are in desperate need of protection orders. They may qualify for an emergency protection order and obtain that, only to then find that that is it for the coverage. So the rest of their legal issues, such as securing child support, spousal support, parenting arrangements, parenting schedule — anything to do with beyond the actual emergency — can be out of scope, out of coverage.
That's a real concern, because if someone is brave enough to come forward and to obtain a protection order, the period of danger for that woman for the six months after separation is the highest. She has mentioned that she's in a violent relationship, taken those steps, put herself in a very vulnerable stage, only to not have any help, going forward.
There's a report by the Rise women's clinic that was recently done that highlights this as a real issue, and there have been other reports as well. So it's a real concern.
L. Doerkson: Thank you very much.
Thanks, Chair, for catching that it was directed at Lisa, not Gail. Gail was a previous presenter.
J. Routledge (Chair): No problem.
H. Sandhu: Thank you to the presenters.
Lisa, quick question — follow-up on that income-based assistance. When we review the income to see if a person is qualified for the legal aid, on what basis do we look at the spouse — like, joint household income or just the victim's income? I know many women, especially, may not be earning that much. But if we're looking at the household income…. Or is it a notice of assessment from previous years? That's the question coming into my mind for a while. Can you please let us know?
L. Hamilton: I believe that you can use your current income, because you're not relying on the other spouse's income, since you're separated.
I can give you an example. For the pro bono mediation project, where a lot of us lawyers have volunteered to be mediators on a free basis to families, our qualification for that is household income in one home of $60,000 or less. Or if there are more than, I think, four children, it can be $80,000 or less in one household.
People accessing pro bono qualify for free mediation on a way higher income than anyone could ever qualify for legal aid, so I think legal aid is way, way farther down in the road. It's based on children and, yes, it doesn't include the spouse, but it's far less than what we do for free mediations.
H. Sandhu: Thank you so much. I think the other aspect, especially when people are fleeing domestic violence…. They cannot, perhaps, work the regular hours they used to work, whether it's that they are trying to hide away from the spouse — you know, to keep themselves safe — or whether it's child care. So that'll also have other impacts on their income, which could be drastic in some cases.
Thank you for sharing this info.
J. Routledge (Chair): Okay. I'm not seeing any further questions at this point. I do want to point out to the committee that if there are additional questions that we come up with later, we can actually forward them to the panellists through our Clerk.
With that, I want to thank you very much for your presentations and giving us some really profound insight into some of the limitations in our legal system. As a committee, we will be addressing these in our recommendations.
Our next presenter is here, so why don't we proceed. This is an individual presentation of Brian Sauvé, the National Police Federation.
Brian, when you're ready.
Budget Consultation Presentations
NATIONAL POLICE FEDERATION
B. Sauvé: Thank you to the Chair. Good morning. Thank you for inviting me to appear before you today.
My name is Brian Sauvé, and I'm the president of the National Police Federation. Our presentation is actually on behalf of an organization, but here I am as an individual.
I would like to begin by acknowledging that I'm speaking from the traditional and unceded territory of the Mohawk Nation.
Today I'd like to highlight three pressing issues that are affecting our members. First is the need to increase long-term funding for RCMP services. Funding for the B.C. RCMP has remained flat in previous years, and the lack of adequate resources impacts important programs such as the integrated gang enforcement team, Combined Forces Special Enforcement Unit and B.C. relief teams.
These units play a vital role in British Columbia and have responded to hundreds of emergencies, arrested gang members and disrupted countless illegal and violent activities. On average, 50 percent of Lower Mainland police calls have organized crime and gang involvement. According to Statistics Canada, in 2018, B.C. gang-related homicides represented over 20 percent of the total national and approximately one-third of all homicides in B.C.
It is more important than ever to ensure police services are resourced and properly funded to protect the public from ongoing public safety threats. We recommend providing funding to increase the number of RCMP members, increase the contribution of the provincial component of RCMP funding to meet service levels within communities that have shortfalls, increase funding for police resources for anti-gang investigations, and increase the size of the B.C. RCMP relief teams to provide support to smaller units that have vacancy or policing pressures.
Second is the Surrey police transition. The city of Surrey has begun a transition from the RCMP to a municipal police service. As the transition moves forward, the province and municipalities will continue to bear the costs. We believe the city of Surrey should be held accountable for all increases in costs from the Surrey Police Service establishment. The Surrey police transition is three years behind and has tripled in costs, causing tax increases to residents and businesses.
Beyond local increases, Surrey's proposed police transition is driving up costs for all British Columbians. During a committee appearance, Minister Farnworth said that the province has already incurred costs, with respect to the transition, estimated at $600,000 in 2021 and $840,000 in 2022. The Office of the Police Complaint Commissioner also received an additional $1.4 million in operating capital and $112,000 in capital funding due to the Surrey transition this year.
In addition, the SPS only requested 26 recruit training positions for 2022 at the Justice Institute of B.C. Training at the JIBC will be challenged by SPS recruit demands but also by other municipal police services that have lost officers to Surrey. This musical ride of police officers will be a large public safety issue moving forward.
We recommend delaying or suspending the current police transition and reassessing its financial implications, assessing where the province can make improvements to the Surrey RCMP, ensuring that emergency management B.C. has adequate resources to continue to respond to emergencies, and intensifying provincial levels of emergency management to include an increase in RCMP to meet emergency management demands.
Lastly, regarding mental health supports. Our members are often the first responders in many complex situations, and they must fill the gaps of reduced and inadequately funded social services. Simply put, our members are being asked to do more and work with less resources, resulting in burnout and mental health issues.
The NPF supports increases in all social services funding. This would allow for officers to concentrate on core policing services while still participating in community-based work. Additional investments in social services must not come from already insufficient police budgets. B.C. needs stronger social services, including the police.
We recommend continuing collaboration between the police and health care agencies, expanding police mental health intervention units and increasing funding for social services, including the police, to improve responses to mental health crises.
Our submission outlines key recommendations for this committee's consideration. The NPF believes it is imperative that the government address these issues.
Thank you. I'm happy to answer any questions.
J. Routledge (Chair): Thank you, Brian. I'm looking around the table for questions.
B. Stewart (Deputy Chair): Thanks very much, Brian. I think the term "individualist" is that you're just not part of a panel. This is a topic that I'm sure we could have a panel on.
Our group actually reviewed that request from the Office of the Police Complaint Commissioner. We had lots of questions about how this is being handled. It still remains outstanding. So I just wanted to thank you for highlighting that.
This gap. I don't know where the officer contingent in the RCMP in Surrey is likely to be redeployed, so I'm assuming that unless they resign, we have to find new people, to be trained up through the Justice Institute, being able to do that. Is that why you're predicting a police officer shortage in the short term while the transition is going on?
B. Sauvé: In the short term, what we're seeing is that there actually is very little detail on where the Surrey Police Service is going to recruit from. The data from the RCMP shows that very few serving members of the Surrey RCMP are actually looking at moving over to the SPS. So that leaves your experienced police officer complement from the municipal police agencies across British Columbia to fill the vacancies in Surrey, which creates challenges in those communities for public safety risks.
As far as redeployment of the Surrey RCMP members across British Columbia or elsewhere in Canada, again, the lack of a transition plan and an end date to the Surrey RCMP deployment in Surrey…. It's difficult to do an HR transition. So your Surrey RCMP members don't know how long they're going to be in Surrey. The RCMP can't answer that question. The Surrey Police Service can't answer that question. So we really don't know when they're going to be moving out or where they might end up moving out to, mainly because of a lack of clarity.
B. Stewart (Deputy Chair): Thanks, Brian. Yeah, those are exactly our questions.
M. Starchuk: Thank you, Brian. A couple of questions. Maybe you can just expand on it.
Has there been a study or something along those lines to determine which of your members are planning on staying with the organization and/or which members are planning on staying in Surrey and staying with that police service? Secondly, could you also expand on how you portray this as a bigger issue with regards to staffing and how that will have implications on crime in the province of B.C.?
B. Sauvé: There hasn't been a formal study done by us. You have to respect the fact that we're the union representing those members in Surrey, so us canvassing our own membership as to whether or not they want to move away is not something that we would do.
The RCMP, about a year and a half ago, did canvass its members in Surrey –– I believe it was close to 700 of the 800 that responded to it –– as to whether or not they were considering moving to a municipal agency or another police service or Surrey. The response to the Surrey Police Service question was that less than 14 percent were considering that. Now, also keep in mind that that was while we were still negotiating our collective agreements, and since then, we've come close to being a comparator universe–compensated police service. From what I understand, that 14 percent number has dropped even further, to less than 50, basically, who are considering moving over.
The challenge, to your second point, is if you're trying to create probably one of the 20 largest police services in Canada –– 800-and-some police officers –– it's going to take a while to get those recruits and to get those police officers filled, because there is a finite pool of police officers in Canada that are currently serving.
Today, in 2021, I don't think any other police service would disagree with me when they say that it is not the most attractive career to young Canadians in 2021 as it was in 2001. No police service is seeing the massive number of applicants to come through the door. We are all fighting for the same dwindling pool of Canadians to become police officers.
That creates challenges, whether it's that Vancouver becomes the recruiting ground for Surrey and experiences recruit shortfalls, if it's New West or if it's Port Moody or if it's the greater Vancouver Transit Police service. In the Lower Mainland, especially, it's going to create this uncertainty of public safety, with police officers basically moving around and vacancies to fill, a backlog at the Justice Institute of B.C. and a lack of funding for the Justice Institute of B.C. in order to be able to accommodate the increase in requests for cadets.
It's a big issue, and I don't think it has been addressed or really looked at thoroughly through that transition.
M. Starchuk: Just one follow-up. With some of the organizations that are jointly funded in the province of B.C., whether it's on gangs or CFSEU, what impact is there if there is a municipal police force in Surrey?
B. Sauvé: Well, I would hope, if the municipal police force in Surrey ultimately is fully funded and fully staffed and moving forward, that they would elect to participate in the Combined Forces Special Enforcement Unit or the integrated gang enforcement team and share the intelligence, share the challenges that that community is facing. What has been shown over the last 15 to 18 years is that integration and the sharing of resources and intelligence, as well as manpower, actually has a distinct effect on the criminals that know no municipal boundaries.
J. Routledge (Chair): Thank you, Brian, for taking the time to meet with us from another part of the country. I guess, in conclusion, having heard your presentation and your answers to our questions, you represent a group of workers who are doing a job in evolving public expectations and the challenge of keeping up with those expectations.
Also, I want to acknowledge that you're here representing them as their union. You're not here representing the institution, but you're here representing working people who are trying to do a job in difficult times. Thank you for bringing to our attention the challenges that your members face.
We'll go right to our next presenter: Michelle Martins, Tamitik Status of Women.
TAMITIK STATUS OF WOMEN
M. Martins: My name is Michelle Martins. I'm the executive director of Tamitik Status of Women. I'd also like you to know that I am born and raised in Kitimat, B.C.
This is the traditional territory of the Haisla Nation.
I just want to note that because I think it's really important. I feel like I've had a lifelong view, a perception, of Kitimat. I can tell you that it is definitely changing, rapidly, from the town I grew up in 30 years ago.
With that said, I want to bring to your attention TSW's capital project, which I am very concerned about. This project is going to host a spectrum of affordable housing options for women, including a much larger transition house than what we currently operate. As well, this project will house the province's first 24-hour daycare. My concern is that this project has been delayed for about four years for different reasons. It seems to have come to a halt quite recently.
This is particularly concerning to me, because without more robust services, the social challenges that we're seeing and that impoverished people already struggle with in our community will continue to be exacerbated by large-scale industrial projects like LNG Canada. We've seen what can happen on a smaller scale, ten years ago, with Rio Tinto's Kitimat modernization project. We saw illegal evictions, rising costs of living and increased violence against women. These things haven't gone away. We know what to expect as LNG Canada's project comes further along in their construction.
Being able to meet impoverished people's basic needs, like safe shelter and adequate child care, is imperative to mitigate the aforementioned negative effects, yet our project has not been able to move forward in a timely manner. I worry that we will end up competing with trades with the oncoming industrial projects in our area, and we won't really be able to compete on that type of scale. I am concerned that if our project doesn't move forward quickly there will be future roadblocks that may see the demise of our much-needed project.
I want to just bring to your attention that Kitimat has a much larger gendered wage gap than on average. This is because our existing industry is male-dominated. There will continue to be a disparity between male and female workers in a plethora of workforces, not just industry, but supporting sectors as well, if round-the-clock child care isn't available.
We know that inadequate child care is one of the top reasons why women are left out of the workforce, even if they have the ability to have a good job or a good wage. Without more options for affordable housing and child care, women will be forced to stay in unsafe situations. As we know, the number one reason that women stay in abusive relationships is financial dependence.
If our social sector in Kitimat and surrounding areas aren't able to evolve as our economic landscape is, I believe that it will be detrimental for those who are merely surviving and not thriving. Particularly, the Indigenous people of our area are the most impoverished. I believe that there are a number of socioeconomic issues concurrently happening that aren't properly being addressed before these large-scale industries take place.
Thank you. That's all I have to say.
P. Alexis: Has land been identified for the housing project?
M. Martins: Yes. Our municipal government is actually allowing us to build on one of their pieces of land.
P. Alexis: Is it a question about zoning that's holding it up? Can you expand a little bit about why there has been a delay?
M. Martins: Yes. My understanding is that we are having issues with funding with our provincial funders — both B.C. Housing and MCFD.
We experienced a cost escalation due to COVID over the past year because of how COVID has affected the construction market. Neither funder is willing to commit more dollars than what was originally committed to prior to the pandemic. We haven't been able to move past this place. Right now our agency is seeking other capital grants, trying to secure other capital grants, to help mitigate that cost escalation.
P. Alexis: It's about, then, a discrepancy in funds pre-COVID and then escalating costs through COVID. The budget has increased, and that's where there's the issue?
M. Martins: My understanding is that the budget escalation due to COVID this past year has halted our project.
B. Stewart (Deputy Chair): Having visited Kitimat — I lived there back in the '70s — needless to say, having watching the transition to the new LNG Canada plant…. Costs are rising up there, no doubt, not only because of rising housing costs, but LNG Canada is putting pressure on all the trades.
Has your group talked to LNG Canada in terms of getting their support? They're obviously very significant up there. I just think they need that as much as you need it, in terms of the women that are affected. Rio Tinto Alcan also needs it. I guess my thought is that, in a lot of these towns, I see this takeup in the northeast, where natural gas is. We see Spectra and some of these energy companies put significant resources into community infrastructure. I'm just wondering: have they been approached to maybe fill the gap, or to partner?
M. Martins: Yes, they have. Both LNG Canada and Rio Tinto are interested to contribute funds to our project. However, they don't do capital funding. They don't do bricks and mortar.
I actually just recently had a conversation with Rio Tinto around being able to fund our furniture and equipment, rather than capital costs. There is some appetite there, although I think with their kind of corporate mandates, or their grant guidelines, that makes it a little bit trickier.
B. Stewart (Deputy Chair): Okay.
M. Starchuk: Michelle, just one thing for clarity. You said this was the first 24-hour daycare?
M. Martins: My understanding is that it will be the first in the province, yes.
M. Starchuk: Okay. And secondly, what is the shortfall, funding-wise?
M. Martins: What is the discrepancy?
M. Starchuk: Yeah, you mentioned that there was money set aside, and now there are construction changes. So what is the actual shortfall? In all theory, your ask is for what the shortfall would be.
M. Martins: It's about, I would say, $1.2 million. It's what has risen from the last time we got budget approval from B.C. Housing and MCFD.
M. Starchuk: What was the original amount?
M. Martins: B.C. Housing, pre-pandemic, committed $14.7 million, and MCFD had committed just under $2.5 million.
M. Starchuk: Okay. Great. Thank you.
J. Routledge (Chair): Lorne?
L. Doerkson: Sorry, Madam Chair. MLA Starchuk asked the question that I had wanted to ask.
J. Routledge (Chair): Okay. I'm not seeing other questions. So in wrapping it up, I'll just say I'm very impressed with the project. You're appearing before us on a day in which we have been looking at issues of social justice, gender-based violence, and you've clearly proposed your project in a way that is preventative. You're anticipating what the challenges and problems can be and want to act before that happens. I think we all commend you for that.
We will be having an interesting discussion about how we can make sure that your vision of your housing project actually happens. Thank you.
M. Martins: Great. Thank you so much. I appreciate that.
J. Routledge (Chair): We'll recess quickly. We'll take a couple minutes before our next speaker, who's not here yet.
The committee recessed from 11:03 a.m. to 11:09 a.m.
[J. Routledge in the chair.]
J. Routledge (Chair): Our next presentation is Sioned Dyer, who is representing the North Shore Restorative Justice Society.
Sioned, over to you.
NORTH SHORE
RESTORATIVE JUSTICE SOCIETY
S. Dyer: Good morning, everyone. Thank you for having me today.
I come to you from the ancestral, unceded territories of the Skwxwú7mesh, Musqueam and Tsleil-Waututh People.
As shared, my name is Sioned Dyer, and I'm the executive director of the North Shore Restorative Justice Society.
I would like to start by reading a quote from the BCCLA, the B.C. Civil Liberties Association. Their words, not mine: "B.C. has the shameful honour of the country's highest rate of police-involved deaths. Growing proportions of government budgets go into policing, with no legislated audit or evaluation. There is actually very little independent evidence that policing in B.C. works, and in fact, reams of evidence suggest the opposite."
At the North Shore Restorative Justice Society, we provide a valued, legitimate and robust alternative to the traditional court process, whereby victims and offenders of crime engage in a facilitated dialogue to address harms, needs and bring forward community-based resolution. This work is grounded in the Criminal Code and Youth Criminal Justice Act and is supported by large bodies of theoretical and research-based evidence.
We've been providing this kind of work in our community for over 24 years and have seen tremendous growth in demand over that time. In the last 12 months alone, our police-diverted files have increased by 30 percent. This program is aligned with the calls for justice on the disproportionate numbers of incarcerated individuals who are a part of equity-seeking groups. It's an acknowledgment by a government that community-based responses to crime and conflict are an integral part of public safety and is a legitimate response to a victims bill of rights, as victims play a central role in our process.
We also have a strong, well-established restorative justice in education initiative, which provides multiple social-emotional educational opportunities for children and youth. This is our preventative approach.
My recommendations are as follows. One, and really the focus of this presentation, is to provide more sustainable funding for community-based responses to crime and conflict. There is research out of the U.K. that shows that for every $1 put into restorative justice, over $6 is saved through the courts. Further, sustainable funding will create more opportunities to collaborate across services, as non-profits like mental health, multicultural services, etc., will no longer be in competition for the same dollars. We can instead focus our energies on working reciprocally and in tandem to support greater community involvement and engagement.
I also recommend looking at what is already working in communities and sustainably fund that. An example is the legitimate responses to hate and racism in communities. While this is an acute issue now, it has always been a part of our community fabric. It remains a difficult legal issue to prosecute, and our organization has been facilitating many hate-based crime and conflicts for many years with great success. We do not receive special funding for this, but no government funding has been provided to do the same work in the community for other agencies.
Lastly is recognizing that community-based responses to crime have the opportunity to combat many of the challenges facing the province right now — everything from systemic racism, as I've mentioned, to the significant backlog of the criminal justice process in criminal courts — and the increasing costs associated with getting legal support.
Thank you for your time. Happy to answer any questions.
J. Routledge (Chair): Thank you, Sioned.
Any questions from the committee?
I have one. This has actually been kind of in the back of my mind all morning. The first panel that we heard from was representing various organizations that deal with gender-based violence. We also did hear from another restorative justice organization.
In the first panel, they were very concrete, very clear, that they did not think that alternative dispute resolution should apply to gender-based violence. It was a very rich discussion we've had all morning, and I haven't had a chance to ask this question. I'm wondering: what is your response to that? What is your relationship with those organizations, and can you give us some guidance on this?
S. Dyer: I can certainly share my perspective. We're North Shore–based, so we work with North Shore agencies. I imagine that many of them that presented today were Vancouver-based, so in terms of our collaboration with those stakeholders, it would be minimal. But in terms of the collaboration that we have with North Shore agencies focusing on gender-based violence, they're strong.
We do take sexual assault files, and we have for some time. Our perspective is this. We know that of the small number of sexual assault cases that actually go to police, which we know is, I think, maybe 1 percent or 2 percent of the ones that actually occur, it is less than a percentage of those that actually go to court and end up with a conviction. So we're looking at a miniscule number of sexual assault, gender-based violence cases that actually lead to a conviction.
So for us, we see restorative justice as an opportunity for victims to play a central role in their own healing. Our process is very flexible and ensures that the victim gets to identify what their needs are. So what I mean by that is that at no point do we have victim and offender in the same room. We do what's called a shuttle mediation. It's a completely voluntary process. So at any time, they can step back.
What we have found is that in many of the cases that are referred, the victims do not want to go to court. So either nothing happens, which is hugely detrimental to our community and sense of safety as well as the victim…. This is a process whereby we can engage with the offender and give them an opportunity to understand and make them accountable for what they've done.
So an example I can share, and I'll be very simple just for confidentiality, was a prolific youth offender who engaged in many sexual assault acts. Victims did not want to go to court, press charges, etcetera. We were able to work with the offender to a point that they were able to acknowledge the harm. They wrote letters to the two victims who were a part of our process, to share that this was done without the victims' consent.
The victims were so ashamed and so fearful of their reputation and what their families would think of them. This provided them an opportunity to have proof that this was against their own will. As well, the offender went and, along with one of our staff, self-referred themselves to MCFD and now is engaged — and this is over a year ago — with monthly counselling sessions.
That is just one example of where we can provide support to gender-based violence. So we are very clear in terms of our boundaries. We know that restorative justice isn't always appropriate. But there is a lot of opportunity here, and I would hate to be so black-and-white, to be honest, about this particular incident, because there are so many cases that go nowhere. And victims — the trauma that they experience is unimaginable.
Thank you.
B. Stewart (Deputy Chair): You raise so many questions. I don't necessarily understand how the system, whatever it is…. Who initiates the restorative justice process? Then the accountability…. Let's say things fall apart. This kind of mediation, if you want to call it that, between the victim and the accused or perpetrator or whatever it is — whatever the circumstances are — what happens if it fails? Does it go back, in the sense that they refuse to acknowledge the restorative justice process?
S. Dyer: Thank you, MLA Stewart. So I've just written a couple notes, but please let me know if I don't respond to all your questions. So in terms of the system, we are….
[Interruption.]
S. Dyer: Apologies. I've got a family dog who's….
We are a pre-charge diversion program, so that means that police are our main referring agent. They'll attend a call — a service — and they'll decide. We've got a form that they fill out, where they identify if it's an appropriate file to refer to restorative justice.
The main criteria for us is that it's a voluntary process. Both victim and offender need to agree to participate, and the offender needs to take accountability. So they need to say: "I did what I did." They don't need to be sobbing for forgiveness, but they do need to say: "I did what I'm being charged with." In terms of the system, that is where we fit in. Other restorative agencies do post-charge, post-bail, post-conviction, but for us, we do pre-charge.
In terms of your query around what happens if things fall apart, as a part of our process, we meet with each party individually first. It's our initial meeting to ensure that they have a full understanding of what our restorative justice process looks like and that they are engaged and willing to participate. That is our opportunity to really gauge, in particular with the offender, if this is going to be a good process for them.
By hosting those two initial meetings, it allows us to say: "All right. This is going to move forward." Because of that, I would say that of our about 100 files we'll get a year, maybe one or two does not complete. We reject a file if we feel it's not going to go to completion. That allows a police officer to then do a referral to Crown.
We are hugely successful when the process actually goes through restorative justice. I'll just underscore that this speaks to not only the legitimacy of our process but the benefit of our process — not only for the victim, who gets a tremendous amount of healing from the process, but for the offender to ultimately take accountability and to be able to make reparations.
We facilitate the same kinds of reparations you'd see for the same crime in the provincial court, be it letters of apology, community service or financial restitution. And because we really get underneath the crime, which we see as a symptom of a greater issue, the benefits to the offender are huge. They actually acknowledge how helpful it has been, and they're committed to moving through the process.
I'm not sure if there were any other pieces that you'd like me to speak to.
J. Routledge (Chair): Yes, we could talk about it all day, but we can't. Sorry about that. I mean, what you've had to say is great. We'd love to have a further discussion, but we're a bit behind time, and we have two other people waiting in the waiting room to speak to us.
You've piqued our interest. We want to learn more about it. What you say makes so much sense. So thank you so much for your time.
S. Dyer: Thanks for this opportunity. Take care.
J. Routledge (Chair): Okay, we'll move on to our next panel. It's a community social services panel of two. First, we'll hear from Karla Verschoor with Inclusion B.C.
Karla, over to you.
Budget Consultation Presentations
Panel 4 – Community Social Services
INCLUSION B.C.
K. Verschoor: My name is Karla Verschoor. I'm the executive director of Inclusion B.C. I respectfully acknowledge joining you today from the traditional and unceded territories of the Musqueam, Squamish, Tsleil-Waututh and Coast Salish people.
Inclusion B.C. is a non-profit federation working with our partners to build community and enhance the lives of children, youth and adults with intellectual and developmental disabilities.
The UN convention on the rights of persons with disabilities established concrete thresholds and expectations so that people with disabilities can exercise their full citizenship. Well over a decade in, we are not faring well as a country or a province, despite our collective law.
I think some of the answers can be found in Article 31, statistics and data collection. As a province, for the most part, we have decentralized this responsibility to regional bodies, and people across all levels of our system, from the early years to their senior years, spent years of their lives waiting for essential supports and services without much notice, attention or accountability.
We recommend the province of B.C. invest in a coordinated approach to collecting provincial-level data, particularly within the funding ministries of Children and Family, Child Care, Education, Social Development and Poverty Reduction, Health and the Minister Responsible for Housing, and disseminate statistics to help assess if people's support needs are actually being met in our province.
Here are three more reasons why this should be a priority in the 2022 budget. Article 7: In all actions concerning children with disabilities, the child's best interests shall be a primary consideration. Thousands of children in the province are currently waiting for supported child development and early intervention supports, which we know help set the trajectory for our children.
There is no formal mechanism for tracking wait times. However, there is a unique opportunity to address this situation as the province creates more and more child care spaces. By incorporating inclusive practices as a central standard and offering training opportunities for child care teams, we can raise our foundation for support, and the system could be genuinely universal if wait-lists are eliminated for those children who require extra support.
We recommend eliminating wait-lists for supported child development programs with a funding increase of $50 million per year for the next three years, expanding access to early intervention therapies with a funding increase of $20 million per year for the next three years and ensuring the successful implementation of the CYSN service framework by establishing a targeted fund.
Next, article 24: Children with disabilities should not be excluded from primary education or secondary education on the basis of disability. Funding of education in B.C. is alarmingly low, compared to other provinces and territories. We need to ensure that all students have equal opportunity to develop their potential by providing the supports they need. Research demonstrates that diverse and inclusive classrooms benefit all learners, setting the basis for an inclusive society. However, community surveys, in the absence of provincial data, show that many families of diverse learners are — or are considering — pulling their children from their neighbourhood schools because their educational needs are not being met. This trend is eroding our inclusive education system.
We recommend expanding the funding mandate of the provincial outreach program to allow parents and educators to initiate support requests and increase their capacity to support more students, and in addition, increasing the funding allocation for diverse learners by 25 percent for the next three years.
Next, article 19 — housing. People with intellectual and mental disabilities want and deserve the same housing choices as everyone else. For people with disabilities, there are hidden costs, with a smaller pool of options to choose from when renting. This is an area where we have seen some data. We know that 5,000 people funded through Community Living B.C. will need a place to live in the next four years. Our recommendation is to invest $3 million in portable rental supplements to support 300 people, in collaboration with Community Living B.C., to enter into supported and independent living options on an equal basis with other citizens in our province. Our written brief will include many more recommendations.
In closing, I strongly urge the province to invest in a solid recruitment and retention strategy to address the current crisis that the social service sector is experiencing, including wage inequity for non-union workers. Thank you, and I do hope you have questions.
J. Routledge (Chair): Thank you, Karla.
We'll move on to Brandon Arnett, for B.C. CEO Network Association, and then we'll open it up for questions.
B.C. CEO NETWORK ASSOCIATION
B. Arnett: Good morning, and thank you for having me speak this morning. My name is Brandon Arnett, and I am the vice-president to the board of directors for the B.C. CEO Network and the CEO for NEXUS Community Support Society, supporting communities in southeastern B.C. I acknowledge this morning that I am calling in from my home, which is in the traditional territories of the Coast Salish people and, specifically, the Qayqayt Nation.
I'd also like to acknowledge this government for its ongoing commitment to our sector. Under this government, we have seen the implementation of the community social service round table and the Reimaging Community Inclusion steering committee, both of which show this government's commitment to work with partners and stakeholders on key issues in our sector today.
A notable thank-you to the Hon. Minister Simons for his personal presence and commitment to the aforementioned. These tables have proved invaluable to our sector as it continues to tackle the challenges associated with the COVID-19 pandemic.
So who are the employees in community social services? There are over 36,000 employees in community social services around the province, and women make up nearly 80 percent of the workforce. The work is often demanding, requiring careful attention and support for people who are amongst the most vulnerable citizens in our province. These employees are members of our community and primarily work in less structured environments than hospitals and schools.
Additionally, the community social service sector contracts with thousands of independent contractors who provide community-based respite, foster care, home-share arrangements, home care and other important services for people within our communities.
Today I'd like to leave you with three key considerations that all focus on the sustainability of our social service sector. First is financing capacity-building that provides community social service agencies with the opportunity to be innovative and flexible. At one point or another throughout the course of a lifetime, it's more likely that all British Columbians will come into contact with a social service agency or require services for themselves or a family member. The services provided in this sector are often unique and can't be defined. They're as unique as the people who we serve.
Over the past 20 months, the community social services sector has responded to the COVID-19 pandemic in a number of creative ways. Most services in this sector were considered essential, and as such, we were asked to recreate the way that we do services to meet the provincial health mandate associated with the pandemic while simultaneously supporting people in a way that was both safe and helpful. At many times, this was daunting and demanding work on all social service providers, but we rose to the challenge.
Today agencies no longer have the flexibility within our crumbling infrastructures to build and maintain the complex systems required for nimble responses to the ongoing conditions. While the sector has responded admirably, it hasn't been without a cost to both finances and human resources. Additionally, due to the ever-shrinking funding, agencies do not have access to the technology that is required to implement new strategy systems or acquire the employees essential for doing the work. So we're asking that this government finance long-term and sustainable capacity-building that will provide community social service agencies with the opportunity for innovation and flexibility.
A second consideration is that of compensation for management and excluded employees. Community social service employers face serious challenges due to the significant increase in front-line compensation, while increases for exempt and excluded staff have been frozen or limited. Over the last decade, the issue remains unaddressed and has been further exacerbated by the pandemic. Agencies are unable to attract or retain the skilled and dedicated management staff required to meet the unique requirements at leadership levels within organizations. To ensure a strong and sustainable community social service sector that continues to meet the needs of British Columbians, it's critical that support for management and excluded staff positions be addressed immediately. Competitive wages are required now in order to retain and recruit our brightest and newest leaders.
Thirdly is addressing the issue of equal work for equal pay. It's unacceptable that the lowest-paid workers in the public sector, 80 percent of whom are women working in small community-based agencies, are continuing to fall further behind. On average, a residential support worker in a provincially funded unionized group home is currently receiving 5 percent more per hour than a residential support worker in a provincially funded non-union group home. A clinical counsellor in a community-based support service is receiving upwards of 25 percent more than in an un-unionized setting. In a sector that is already struggling to achieve….
J. Routledge (Chair): Brandon, you're out of time. If you could wrap it up, please.
B. Arnett: Okay. Sorry.
We continue to urge you to provide equal and equivalent access to wages for all community social service employees throughout our sector.
J. Routledge (Chair): Thank you.
We'll now open it up for questions from the committee to both of you, which actually could give you an opportunity, Brandon, to add to your presentation.
I think the committee is just reviewing their notes.
M. Starchuk: Brandon, with regards to the first ask, the financing capacity-building for innovation and flexibility. What would the dollar value be on something like that?
B. Arnett: I'm sorry. I couldn't give an exact dollar value. Apologies.
P. Alexis: Just a comment. Thank you for sending along your well-organized documents so that we've got that information in front of us as well. Thank you for that.
B. Arnett: My pleasure. Thank you.
J. Routledge (Chair): I see people are looking at their notes. I don't want to rush this along, if there are questions.
H. Sandhu: Thank you to the presenters.
My question is for Karla. You mentioned a $3 million ask. What is the funding at the moment? How much?
K. Verschoor: Right now, that would equal a $750 supplement for 300 people. It's where we got the $3 million from. But currently, there is no access to a portable rental supplement for people with intellectual and developmental disabilities. It is something that we have historically…. It has proven to be very meaningful and impactful in creating inclusive housing for people, but it is a place where we've got a bit of backslide, and reintroducing something like that would go a far way in addressing the need for inclusive and affordable housing for the people we're talking about.
H. Sandhu: Okay. Thank you. Really appreciate it, and appreciate the work that you and Brandon are doing.
P. Alexis: With respect to Inclusion B.C., are all the numbers going to be included in a written submission?
K. Verschoor: Absolutely.
J. Routledge (Chair): Okay. I see no more questions. I think possibly that's because your written submissions are very clear and your presentations have been very clear.
In closing, I will say that you are a part of a theme today, in terms of drawing to our attention the challenge of sustainable funding and the implications of the unpredictability that can happen, and the impact that that has on the vulnerable population that you represent. So thank you very much. We will take your input into serious consideration in our deliberations. Thanks again.
K. Verschoor: Thank you for your time.
B. Arnett: Thank you.
J. Routledge (Chair): Bye-bye.
We'll take a two-minute recess.
The committee recessed from 11:38 a.m. to 11:42 a.m.
[J. Routledge in the chair.]
J. Routledge (Chair): Okay. Thanks, everyone, for the brief recess.
We'll proceed with our next presenter, who is Shelita Dattani, the Neighbourhood Pharmacy Association of Canada.
Budget Consultation Presentations
NEIGHBOURHOOD PHARMACY ASSOCIATION
OF CANADA
S. Dattani: Hello. Good morning, and thank you all for the opportunity for me to appear before you today. My name is Shelita Dattani, and I'm the vice-president of pharmacy affairs for the Neighbourhood Pharmacy Association of Canada. I'm also a practising pharmacist, with over 20 years of experience in the pharmacy sector.
I know I only have a few minutes, so I will keep my remarks brief today, but I'll briefly speak about our association and who we represent. I'll talk about the role pharmacy plays in supporting the care of British Columbians, and I'll talk about how we feel that pharmacy can be an even stronger partner in areas like primary care, vaccinations and managing the opioid crisis. Our formal submission will be provided to you later this month, and in that, we'll provide more details on our recommendations.
The Neighbourhood Pharmacy Association of Canada is the respected voice and advocate for the business of pharmacy. We represent the delivery of care through B.C.'s 1,400 pharmacies, including independent, chain, long-term-care specialty pharmacies, grocery chains and mass merchandisers for pharmacies. You might recognize some of our members, which include London Drugs, Save-On-Foods, Rexall, Shoppers Drug Mart, Pharmasave and many other pharmacy retailers, both large and small.
We work with the B. C. Pharmacy Association, and we also work with other pharmacy stakeholders across the province and across the country to advocate for pharmacy's role as a partner in improving the delivery of care around the province.
Pharmacies in B.C. ensure efficient and effective medication stewardship and continuity of care close to home in communities across the province. Pharmacies and pharmacists provide community-based care, and we can really alleviate pressures on other primary care providers. We're typically open for extended hours, and we offer care with the convenience and flexibility and the access that's valued by British Columbians. This accessibility is demonstrated by the fact that Canadians actually see their pharmacist up to ten times more frequently than they see their own family physician.
Pharmacist interventions we know correlate with increased vaccination rates and better health outcomes. Pharmacies can serve as a resource for the B.C. government to provide solutions to the issues that are currently facing B.C.'s health care system, including those that are among the most prominent right now, like vaccinations and the opioid crisis.
Pharmacies in B.C. have played a growing role in B.C.'s immunization strategies in some of the most recent years. In fact, we see that pharmacists delivered 1 million flu shots last year, which is over 70 percent of all the shots that were administered.
Community pharmacists also played a significant role in the province's fight against COVID-19 by delivering AstraZeneca vaccines earlier this year, and we're working with government right now to expand our role to administer mRNA vaccines as well, such as Pfizer and Moderna. We also look forward to playing a role in delivering third doses and booster vaccines when those are made available.
As we continue to manage pressures on the health care system, we all need to work together as health care partners to support the care of people in our communities. We'll have some work to do to catch up on delayed vaccinations to ensure that British Columbians are protected against other vaccine-preventable illnesses.
The role of pharmacy as a key immunization partner is going to help build capacity in these efforts. That will be more important than ever as we come out of this pandemic. We'll continue to work with government to seek out other opportunities to increase our role in the province's vaccination strategy.
As you may know, since 2016, more than 7,000 British Columbians have died as a result of illicit drug use. These deaths have, indeed, been exacerbated through the COVID-19 pandemic. Early on pharmacists were granted expanded authorities to support the continuity of care for Canadians and for British Columbians through being able to manage prescriptions for people who are using opioids. This authority was especially important in those situations where people might not have had access to their regular doctor, or maybe their doctor wasn't open for regular visits as well.
Providing pharmacists who have frequent touchpoints with patients in their communities with the authority to adapt and extend the renewal of prescriptions for those using opioid and other substances will ensure some further supports to provide safe and effective continuity of care for these patients. This means that British Columbians will have access to safe and effective opioid treatments, which mitigates the risk of people using potentially unsafe products or unsafe supply from the street.
As we've seen throughout this pandemic, pharmacy serves as a key partner in B.C.'s health system. Because of our skills, our accessibility and our strong relationships with the patients that we serve in our communities, we feel we have a tremendous role to play in the care of British Columbians. We hope that you will recommend to government that the role of pharmacy in primary care and public health can be expanded because of this. As demonstrated during the COVID-19 pandemic, we're nimble, and we're ready to serve to lessen the burden on B.C.'s health care system.
I want to thank you all for your time today. It's greatly appreciated. I'd be happy to answer any questions.
J. Routledge (Chair): Thank you, Shelita.
We now can open it up for questions for about five minutes.
M. Starchuk: Thank you for your presentation. As a person who utilized a PharmaCare pharmacy to get my vaccination, I can tell you that when Winston jabbed me, I asked him if I could take a picture of it, and he said: "I'm done." I didn't realize it at the time.
I'm more curious with regards to the role of pharmacies in medical clinics. Is that a model that you're working with in the medical system that's out there? Recently my family doctor had moved into a different location, and there's a pharmacy that's attached to it. I can tell you that that is a very smooth and streamlined system for when you are receiving a prescription.
S. Dattani: Absolutely. I mean, many of our….
Thank you for your question, first of all. I loved the story about you not even feeling the injection that your pharmacist gave you. Fantastic.
Yeah. Pharmacies do work aligned with, beside, in nearby locations, whether they're directly affiliated or are in the same building as a medical clinic. That's a wonderful environment to continue to support interdisciplinary care, whether they work directly or indirectly with the providers in the medical clinic. That's always a model, even if they work not directly affiliated with the clinic.
We believe that pharmacies are a big part of the circle of care, even if they're not co-located. All of the work that they do, as I spoke about in my remarks, is in consultation with the other health care providers that are within that circle of care.
J. Routledge (Chair): Any other questions?
L. Doerkson: Thanks for the presentation. I see our pharmacists as a massive resource, honestly, to the province.
I have questions around the vaccination process. It seemed to me that in rural British Columbia, the uptake for pharmacies was a little slower to happen. Are you able to comment on why that was or what we might be able to do better next time?
S. Dattani: I mean, first of all, I'd like to congratulate the province for doing such an amazing job with all of the public health resources and clinics that were out there.
I think we know that in rural communities, there is an opportunity, because of the touchpoints that pharmacies have in every community across the province, to provide additional care. I think we can always build on the opportunity that a pharmacy can provide in a rural environment where there may not be as easy access to other providers.
That's something that we pride ourselves on in the community — that we work in rural environments all over the province. So I definitely think there are some great enhancements that can be made to leverage pharmacy in those types of communities.
L. Doerkson: Thank you.
B. Stewart (Deputy Chair): Shelita, I just wanted to ask about…. This was an unprecedented time, with pharmacies not necessarily knowing that they were going to be either asked or counted on, and I know that there are differences in terms of the vaccines. But I think as part of the ongoing rollout, the communication between government and the health authorities and whoever distributes these vaccines…. I guess the important thing…. It's my understanding –– and I'm just a layperson — about the Pfizer and the Moderna in terms of the temperature range…. I don't know if that can be distributed across the province.
But anyways, is the communication, in terms of helping the pharmacies being able to be a part of the solution…? Secondly, is the recordkeeping seamless in terms of…? Obviously, we know about the vaccine passport that's been announced. I'm assuming…. I just wanted to know that it will be on the record so that anybody getting a pharmacy vaccine will be equally recognized if they need it.
S. Dattani: Absolutely. Great questions. To answer your question about some things being seamless, there's definitely integration. There's the need for a pharmacy to document everything that they do when they vaccinate a patient. There is always better integration that we can have, but it is part of the process for a pharmacy to document into the health record an immunization when they administer a vaccine to a patient.
I think you had an earlier question before that. Maybe I'll just ask for some clarity if I didn't answer it before the question on pharmacy's integration.
B. Stewart (Deputy Chair): Well, it actually goes hand in hand with it, because if we get to where there is a third dose required or multiple annual, let's say, doses or whatever it is, it seems to me that it's logical that the pharmacies in your neighbourhood are a more logical place in setting up pop-up clinics or vaccination-type things.
I just wanted to know: is there good dialogue going on in the sense of…? Is there more that can be done? I guess there's always more that could be done, but I really just wanted to know: with the experience that you had earlier this year and last year –– I guess it was this year –– in terms of doing the vaccines, were the pharmacies able to work with the way that things were? Do we have to put more resources into making that happen at the pharmacy level?
S. Dattani: I think that the allocation and inclusion of pharmacy to be able to provide vaccines, the ability to do things like utilize the pharmaceutical supply chain, as we will be doing for flu vaccines in the fall into even broader vaccinations…. We've done it for COVID vaccines also. It's an important manoeuvre so that we can efficiently access the vaccine to give to the public. So I think definitely, recognizing, as I know there is dialogue now about a larger goal for pharmacy in boosters and third doses next year…. It's something that will be really valuable.
Mass clinics have done a great job in B.C., but I think they cost a lot of money to the health care system. They require a lot of resources. There are pharmacies that have reach across the province that can be leveraged to continue to support immunization of people against COVID and all vaccines, really, because we really don't have a good understanding of whether COVID will be staying with us for a long time and we'll have a long-term booster strategy that's needed. But pharmacists have demonstrated with COVID that they're at the ready to help across the province.
B. Stewart (Deputy Chair): Thanks.
J. Routledge (Chair): Well, thank you, Shelita. We have one more presenter this morning, so we're going to have to wrap this up.
I just want to conclude by thanking you for bringing to us the perspective of neighbourhood pharmacists. As you were speaking and answering questions, I was able to reflect on how I have seen the role of pharmacists change in the last number of years in my community. Pharmacists play a much more proactive role, are much more directly involved in preventative medicine and caring for the health of our community. I see even more of that happening. Thank you so much.
S. Dattani: Thank you so much for those words. Appreciate it.
J. Routledge (Chair): Our next presenter is Geraldine Vance, B.C. Pharmacy Association.
Whenever you're ready, Geraldine.
B.C. PHARMACY ASSOCIATION
G. Vance: Good morning. I'm Geraldine Vance, I'm the CEO of the B.C. Pharmacy Association, and on behalf of the 4,000 community pharmacists in the province, I'd like to thank you for the opportunity to address you.
B.C. Pharmacy Association represents more than 4,000 pharmacists working in 1,400 community pharmacies across the province — pharmacies in communities big and small across the province. Often, pharmacies serve as the first and ongoing point of contact for patients needing care.
When the COVID emergency was declared in March 2020, pharmacists worked hard to keep their patients safe. Pharmacies across the province stayed open. They erected physical barriers, limiting the number of people entering pharmacies and delivering prescriptions to patients homes to keep everyone safe.
In fact, community pharmacists, as some of you may know, have a history of stepping in during public health emergencies. In 2009 B.C.'s pharmacists were first given authority to provide immunizations because of another epidemic: the swine flu, the version of H1N1. Last year, pharmacists injected more than a million doses of flu vaccine in that campaign.
While flu is the most known vaccine given by pharmacists, we have played an increasingly important role in delivering vaccines for measles, HPV, pertussis and now, of course, COVID-19. We were called upon to begin delivering COVID-19 vaccines to eligible British Columbians, and we're very pleased to have helped. We were asked by the Ministry of Health to get vaccines into pharmacies and into patients' arms, and we greatly appreciate the support of Health Minister Dix.
As an organization with relationships with pharmacists, pharmacy owners and distributors, we have and continue to serve as a single point of contact for the COVID response team, as we now look forward to the dose 3 booster campaign. Our expertise and training and knowledge of pharmacy's role in health care has allowed the government team to focus on other areas of the pandemic, while we work to quickly scale up to meet the demand.
I'd now like to spend a couple of minutes talking about the other crisis — of course, the opioid epidemic. The numbers are staggering and heartbreaking. During the pandemic, of course, we have seen that it has created its own set of problems. We want you to know that three years ago, our organization developed and launched a new and comprehensive training program for pharmacists who serve patients with the opioid use disorder. It's called the opioid agonist training program, and the only one of its kind.
We're now happy to be in discussions with Minister of Mental Health and Addictions Sheila Malcolmson about an opportunity to provide more support to patients with opioid use disorder. It's important, because sometimes patients can't see their physicians, leaving them without a supply of their medications, which keeps them safe. Our proposal would allow patients to see their pharmacists when they need a supply of medications, rather than to be exposed to toxic street drugs.
When it comes to prescribing, we have seen the impact COVID has had on the demand for health care services. This is especially so in rural areas. There's an opportunity to allow pharmacists to prescribe in certain circumstances to help meet these growing needs. Many provinces allow pharmacists to prescribe medications for ailments such as cold sores or acne. Over 3,300 Alberta pharmacists have advanced prescribing authorities to help patients.
With the planned review of the Health Professions Act and the earlier release of the Cayton report, we believe that during the upcoming review of the Health Professions Act, this is the time to enable pharmacists and others to practice to their full scope of practice. This is in keeping with the needs of British Columbia's population.
In conclusion, B.C.'s community pharmacists continue to play an important role in the province's health care system, and we're enthusiastic to play greater roles in public health, the opioid crisis and primary care.
Thank you very much for the opportunity to present to you today. I welcome your questions.
J. Routledge (Chair): Thank you, Geraldine.
Do we have questions from the committee?
I think we all think you were pretty straightforward. Can I just clarify…? Right now pharmacists in B.C. do not have prescribing rights, but they do in other parts of the country. One of your asks today is to have prescribing rights.
G. Vance: Yes, absolutely, for what is commonly referred to as common or minor ailments. Most provinces across the country have that, and we think that would be a great advantage in primary care service delivery.
J. Routledge (Chair): Okay. Thank you for reinforcing that.
With that, we'll thank you again for speaking to us and highlighting the role of pharmacists and making a very clear, concise ask.
G. Vance: May I just clarify…? I know there was a question to the team that presented before around our involvement in the third-dose planning. I want to be clear that we're very involved in planning for the potential for a third dose. A pilot is underway now in the province. There has been full integration, through the B.C. Pharmacy Association, of planning for the third dose. I just wanted that to be clear.
J. Routledge (Chair): Excellent. Thank you so much.
G. Vance: Thanks for your time.
J. Routledge (Chair): We'll now take a recess until 1:15 p.m.
The committee recessed from 12:01 p.m. to 1:16 p.m.
[J. Routledge in the chair.]
J. Routledge (Chair): Good afternoon, everyone. Our first panel of the afternoon is on public health, and we have four presenters who will each be presenting for five minutes. Then, after we've heard from all of them, we'll open it up to questions from the committee.
Our first presenter is Rita Koutsodimos, B.C. Alliance for Healthy Living. Rita?
Budget Consultation Presentations Panel 5 – Public Health
B.C. ALLIANCE FOR HEALTHY LIVING
R. Koutsodimos: Hi. Thank you so much. It's a pleasure to be with you today, and I really appreciate the opportunity to address this committee at a time when there are multiple pressures on the budget. We value the opportunity to inform some of your decision-making and to encourage you to address some of the long-standing health issues.
The health charities and wellness organizations that make up the B.C. Alliance for Healthy Living have been working together since 2003 to prevent avoidable chronic disease and promote the health of all British Columbians. I'm happy to be joined today by some of our members. We've got Charles from the Canadian Cancer Society and Jeff from Heart and Stroke Foundation, as well as our friends from Physicians for a Smoke-Free Canada.
To start off, I'll just remind you that chronic diseases such as cancer, diabetes and lung and cardiovascular disease collectively affect one in three British Columbians, and 50 to 80 percent of that is completely preventable. We have lots of research and evidence that tells us that we know what can be done to prevent that early loss of life: healthy eating, physical activity, limiting alcohol and stopping tobacco will get us most of the way there. But just as COVID-19 has shone a spotlight on some of the gaps that expose some people to more risk for COVID, those same social inequities are at play and put many of those same people at risk for chronic disease.
Poverty makes it extremely difficult to lead a healthy life, and food security is related to that, as is chronic stress. But the research will tell us that the best way to address food security is not through food banks but with income security. So our alliance would encourage government to strengthen the provincial poverty reduction plan by following the advice of the Expert Panel on Basic Income and raise assistance rates to the poverty line according to that market basket threshold, which is a real measurement of real goods — the real cost of rent, the real cost of healthy food. So that would be, on the singles category, $500.
We did some polling in June to get a sense of British Columbians — the impact of COVID and how they're doing. What we found is that British Columbians are very supportive of this. Eighty percent support increasing assistance rates to afford the healthy cost of food and market rental rates.
Our polling also showed that even though British Columbians have been cooking more during the pandemic,
the majority are only eating two servings of fruits and vegetables a day. That is less than half of what we're supposed to be getting, and less than half of parents say that their kids are eating enough fruits and vegetables. That's a complex issue, but we suggest that a universal healthy school food program is just one of the tools that could be used to address this issue, to start increasing fruit and vegetable consumption amongst children and shifting our food culture.
There's strong evidence from other countries. We're the only G7 country without a school food program. From individual programs, we know that providing healthy meals at schools increases children's fruit and vegetable consumption, but it also increases knowledge around nutrition and health and improves focus and academic success. It's also non-stigmatizing, in terms of addressing those gaps, so the kids that come to school without enough to eat are on the same plane as everyone else.
Again, British Columbians are very supportive. Over 80 percent support for that initiative, and 92 percent amongst the lowest-income British Columbians support that.
We would also encourage you to invest in our provincial physical activity and active transportation strategies. BCAHL supported government. We were a partner with government to implement B.C.'s active people, active places strategy, with efforts that focused on improving activity in child care centres, in schools, in Indigenous communities, amongst disadvantaged youth and older adults. The results from the evaluation are truly inspiring — a $7 million investment over three years. We've got tens of thousands of people moving more often.
We would ask for $10 million to continue that work. As well, a minimum of $50 million towards active transportation, which also supports our climate change targets. We've been working with small towns on active transportation issues, to understand those better. What we're hearing from small towns is that they really want to build active transportation infrastructure, and funding is by far the largest barrier they face.
On revenues, we urge government to…
J. Routledge (Chair): Rita, your five minutes is up, so why don't we go to the other members of the panel. Then if there are more things that you want to address that they don't address, you can come back to it in the question part.
R. Koutsodimos: Okay, yeah. I just have one more paragraph, so I'll pause there.
J. Routledge (Chair): Thank you.
Our next panellist is Charles Aruliah, Canadian Cancer Society.
CANADIAN CANCER SOCIETY
C. Aruliah: Good morning, members of the committee. Thank you for this opportunity to speak with you.
Amid the pandemic last year, the Canadian Cancer Society was excited to hear that the B.C. government was taking a step forward in its support for cancer research and care by announcing its ten-year cancer action plan, which aims to make investments throughout the entire cancer care continuum, from prevention to diagnosis and treatment to cancer care support. This plan builds on previous investments in B.C. in cancer prevention and includes $2.5 million in funding, which went to the construction CCS's new Centre for Cancer Prevention and Support.
However, during the pandemic, we continued to hear stories of potential cancer diagnoses being delayed, surgical backlogs and additional stress and anxiety being placed on Canadians living with cancer. This has only further underscored the need to continue to make investments across the cancer care continuum and has highlighted some gaps which B.C. needs to address, particularly when it comes to cancer prevention and early detection.
As you heard from my counterpart Rita from BCAHL on the importance of prevention in health, one such way B.C. can bolster cancer prevention efforts is through the introduction of a cost recovery fee on the tobacco industry. We know that tobacco use is the leading preventable cause of disease and death both in British Columbia and in Canada, killing more than 6,000 British Columbians annually and contributing to about 30 percent of all cancer deaths.
An enormous amount of work remains to be done to achieve the objective of Canada's tobacco strategy, which aims to achieve less than 5 percent tobacco use by 2035. To this end, the full cost of B.C. government's tobacco control strategy should be recovered through an annual cost recovery fee on tobacco manufacturers operating or selling in B.C.
This approach would be similar to the U.S. Food and Drug Administration's tobacco strategy fee, as well as federal cannabis annual regulatory fees and cannabis regulatory fees in provinces, including Manitoba, Quebec and New Brunswick.
Like carbon taxes here and in other jurisdictions, the cost recovery fee is based on the principle of polluter-pay, which stipulates that companies that pollute should bear the costs that they impose on society. As such, the tobacco industry should be required to reimburse the B.C. government for the cost of responding to the tobacco epidemic which they are primarily responsible for creating. If implemented today, a tobacco cost recovery fee would generate approximately $25 million in annual revenue for the B.C. government, based on current investment in the provincial tobacco control strategy.
It is also important to note that the B.C. government had previously committed to introducing the cost recovery fee in 1998. However, no action was taken before the government's next election, and that promise was later repealed.
Like cancer prevention, early detection also plays a significant role in mitigating the health and economic impact of cancer in the province. However, one area in early detection where B.C. lags behind almost every other province is in prostate cancer. Prostate cancer is the most commonly diagnosed cancer among Canadian men, with one in nine Canadian men expected to be diagnosed with prostate cancer in their lifetime, and with prostate cancer accounting for 22 percent of all cancer diagnoses in B.C. Yet it is also one of the least preventable cancers, according to current known risk factors.
Due to the difficulty in prostate cancer prevention, early detection of the disease is critically important. When prostate cancer is detected early, close to 100 percent of men will survive five years or more. While prevention is difficult, prostate cancer can be detected through a blood test known as the prostate-specific antigen test, or PSA test, which looks for high levels of PSA, a protein made by prostate cells.
A PSA test is a critical tool in detecting early signs of prostate cancer, but it is not currently covered by the province for asymptomatic individuals who may be at risk to the disease due to family history or ethnicity and who also have a physician referral. Eight other provinces and three territories cover the cost of the tests by referral, without requiring signs and symptoms.
While we are not asking for a specific provincial screening program, which exists for breast, cervix and colon cancer in the province, it is important to ensure that at-risk individuals who may be concerned about their health are able to access that test at no cost, in consultation with their doctor. Providing coverage for opportunistic screening removes an important financial barrier for detecting prostate cancer in its early stages for at-risk populations, again including those with family history of disease and particularly those of African ancestry.
Investing in expanding coverage of the PSA test, as well as implementing the cost recovery fee on the tobacco industry, are two steps that will mitigate the health, social and economic impact of cancer in the province. These actions, as well as continued support for cancer research through institutions such as the CCS's Centre for Cancer Prevention and Support, will fill in these gaps in cancer prevention and solidify B.C.'s standing as a leader against cancer.
J. Routledge (Chair): Thank you, Charles.
Next we'll hear from Jeff Sommers, Heart and Stroke Foundation.
HEART AND STROKE FOUNDATION
J. Sommers: Thanks, and good afternoon. I just want to say, on behalf of Heart and Stroke, how much we appreciate the opportunity to meet with you today.
Before I start, I'd like to acknowledge that I am here on the unceded traditional territories of the Musqueam, Tsleil-Waututh and Squamish Nations.
Also, it's always a pleasure to be here with my colleagues with whom I work closely on many of the issues that we’re talking about today.
I just want to address two key issues today: tobacco use and sugary drinks. Our recommendations are included in the detailed submission that we made to the committee, and they include support for the cost recovery fee that Charles was just talking about as well as retail reform, tobacco vendors permit fee and smoke-free multi-unit housing options. More generally, though, I'd like to talk about the context that we're making these recommendations in.
First of all, there is some concern that as smoking rates have declined, the urgency of increasing tobacco regulation has also declined. There is a widespread perception that restrictions and controls on tobacco use that emerged over the past 30 years have done their work and only need to be maintained and tweaked to continue this trend.
However, it's important to point out that while the current crop of tobacco control measures are relatively new, they are actually the reimposition of a more rigorous regime that started to erode as the result of pressure from big tobacco in the early 20th century. For example, in 19th-century Montreal, there were rules about when and where men — and I used that term advisedly — were and weren't permitted to smoke. These types of rules all but disappeared under attack from tobacco interests, which framed them as anachronous and as an imposition on people's freedom.
The opportunity to prevent an epidemic through regulation was missed in the early 20th century, and so addiction and disease became intractable problems, difficult to solve even with the best strategies and the best circumstances. This is an issue of social justice, because people who are marginalized, with lower incomes and less education, smoke more than their better-off counterparts. As a result, they suffer a disproportionate burden of tobacco-related illnesses and death.
We see this also in the marketing of food and beverages high in sugar and fat. In fact, sugary drinks are the single-largest contributor of sugar in the diet. About 70 percent of calories in prepackaged beverages come from free, or added, sugars. An especially egregious example of sugar marketing is…. When we look at challenges in access to clean drinking water for many Indigenous communities that we all know about, those challenges mean that their residents often turn to sugary drinks for hydration because they're cheaper than the water that is also bottled by the same companies that make those sugary drinks.
We do thank the provincial government for eliminating the PST exemption on sugary, carbonated drinks. This is a positive step, especially for young people, who consume the most sugary drinks of any group of people. But it's created an uneven playing field, as other sugary, non-carbonated drinks also contribute toward cardiometabolic disease. Continuing to exempt those non-carbonated drinks does not align with public health goals that the province stated were the reasons for removing the exemption from carbonated drinks in the 2020 provincial budget.
Removing the PST exemption from all sugary drinks is justified due to the negative externalities involved. Not only are the decisions to purchase these products often made without full information about their health consequences, but the full cost of consumption and associated medical costs are borne by neither individual consumers nor companies.
This is also the case with nicotine, a business that generates nearly $1 trillion a year in sales globally. In both situations, sugar and nicotine, businesses exploit every niche opportunity to make sales and increase profits while offloading the costs onto society and the public at large. Only government action can counter this.
The measures that Heart and Stroke and other panellists have recommended will go a long way to intensifying pressure on what we call big nicotine and big sugar. The most important thing to do is not let up that pressure and intensify it as much as possible.
In closing, I'd just like to say that, in the same way that COVID has caused a paradigm shift in the delivery of health care, so too we need to have a paradigm shift in tobacco control and the consumption of sugar. Modernizing B.C.'s tobacco control legislation by introducing cost-recovery fees and applying PST on all sugary drinks are just a few ways to begin this shift.
J. Routledge (Chair): Thank you, Jeff.
Next, we'll hear from Cynthia Callard, Physicians for a Smoke-Free Canada.
PHYSICIANS FOR A SMOKE-FREE CANADA
C. Callard: Thank you very much for the opportunity to speak with you today and to present our recommendations that the province put in place a plan to phase out commercial tobacco in British Columbia. We have circulated a written brief with more background that I can include in my remarks today, and our recommendations include support for the measures presented today by my colleagues.
You already know that tobacco causes enormous harm, and through its products, the industry kills more than one in three of its clients, and you know that this industry is the key or a key driver of the major causes of premature death in B.C. — heart disease, lung disease and cancer. You may not know that during the COVID-19 pandemic and during the opioid crisis, tobacco has continued to kill more British Columbians than these two newer health catastrophes or that in B.C., the mortality rate and the infection rate for tobacco use are higher than for either COVID or opioids.
It bears repeating the extent of the economic cost to the B.C. economy caused by the industry. We estimate that the companies extract about $300 million a year in revenue from British Columbia, with the money going to operations and shareholders in other provinces and other countries. Meanwhile, the cost of treating disease, replacing lost income, cleaning up toxic butts and vaping waste and dealing with domestic wildfires caused by tobacco products are externalized onto B.C. families, communities and governments.
Some of the government's costs are offset by the excise taxes paid by smokers, but most are picked up by the general taxpayer or by the household budgets of the province's citizens. None of these costs are paid directly by the industry that causes them.
The need to tackle tobacco use by focusing on manufacturers was once recognized by the British Columbia government, especially in the late 1990s, when B.C. was a global leader in tobacco control. B.C. was the first jurisdiction in the world to force companies to reveal ingredients and toxins in their products, the first province to sue tobacco companies, the first province to impose a cost-recovery fee on the industry.
But sadly, B.C. subsequently abandoned that approach. In 2004, the government shifted away from trying to change the behaviour of the industry and focused uniquely on trying to change the behaviour of smokers. The core B.C. tobacco control strategy has not been updated in almost two decades. It remains rooted in the approaches developed in the last century to deal with the problems as they were in the last century.
Meanwhile, the tobacco industry has reinvented itself and has emerged as a different threat to the health and wealth of British Columbia and other jurisdictions. The industry is re-armed with new products and a new PR strategy. It has moved from a defensive to an offensive position. It has stopped trying to sow doubt about the harms of its cigarettes, and it's now focused on selling hope about its new products.
Governments everywhere have been slow to digest these changes and even slower to respond. As a result, the industry has largely been allowed to set the agenda and to create an expanded market for old and new nicotine products and to increase the number of people who are addicted to nicotine and to prolong its profit-taking. Earlier this year — I believe for the first time — Euromonitor reported that nicotine use in Canada is now going up year over year.
B.C.'s leadership is needed again. I hope you will encourage the government to reset its approach to this problem, not just doing more but doing things differently, not just a health issue but a whole-of-government response, not just helping smokers quit but restructuring the system that has created and has sustained their addiction, not just tobacco control but a commercial tobacco phase-out.
B.C. is now a leader in the decriminalization of currently illicit drugs and is pioneering a safer supply of these substances. The Health Officers Council of B.C. has called on government to address both the criminalization and the commercialization of psychoactive substances that increase harm.
This year B.C. has an historic opportunity to do this. You may have read yesterday that to settle the law suits against it, Purdue Pharmaceuticals is decommercializing its opioid medications. That type of outcome is now available to British Columbia and the other provinces that are in secret negotiations with tobacco companies to settle the tobacco suits that B.C. launched two decades ago.
B.C. always had the right to force change on the industry, but now, with $118 billion in claims against it, it has the leverage to do this quickly. What stands, in our view, between the tobacco business as usual and a new safer supply of nicotine is the support and direction of the Legislature for the government to walk out of these settlement talks with a guarantee of a reformed tobacco market.
I hope that in your private and public communications with those who are directing this file, you'll help to make this happen. Thank you again for allowing me this opportunity to share these thoughts.
J. Routledge (Chair): Thank you, Cynthia. I'll now open up discussion for questions from the committee.
L. Doerkson: Certainly lots to consume there. Thank you for the presentations. I guess I'd go to…. I think it was Charles who referred to the PSA tests.
Charles, do you have an idea of how many of those tests are done in B.C. annually, how much they cost?
C. Aruliah: Yes. CCS recently did some modelling based on FOI data received from the Ministry of Health. In 2020, there were about 25,000 individuals who were not covered for the PSA test, and those are individuals who both paid out-of-pocket or were covered by private insurance. Altogether, about 91 percent of people were covered for the PSA test in the province, so it's a relatively small number.
For those people who did pay out-of-pocket, the cost of a PSA test is $35. The cost to the government to pay for a PSA test is around $11.44. If the province were to cover those 25,000 individuals in 2020, the cost would be around $280,000. That's what we've estimated, which, again, is a relatively small proportion, especially when you look at other provinces. For example, in Ontario, 55 percent of the people who took the PSA test were not covered by the province. That's a much larger proportion of people, and again, the province has a much larger population.
L. Doerkson: Thank you very much.
Chair, one more?
Don't get me in trouble, Rita, but let's hear your last paragraph.
R. Koutsodimos: Okay, thank you so much for the opportunity. I just wanted to quickly say, on the revenue side, I would agree with what my colleagues have said around the fees for tobacco — the annual cost recovery fee. I think that's really important, as we do need to continue to look at fighting tobacco and nicotine, particularly given the trends in youth, who are now going from vaping to tobacco use. I think that's a scary trend.
There's also an opportunity to look at switching the way we tax alcohol to a minimum unit price, in order to target the higher-concentration alcohol, so that we're taxing according to the amount of alcohol as opposed to the amount of volume. That has been shown to be very effective in Scotland in reducing problematic drinking. Of course, excessive drinking is a risk factor across multiple chronic diseases.
Then, of course, there are the sugary drinks. We also wholeheartedly support that, as we have for over a decade.
I just wanted to say that I completely understand the demands and the difficulty that this committee has, but we really hope — given what we've seen in COVID, the importance of protecting our health and how a robust public health system can really save lives — that we can look at doing that around these other diseases that are very prevalent with us, and apply the same level of response to that. Thank you very much. I really appreciate the opportunity.
B. Stewart (Deputy Chair): Thanks very much. Those were great. It brings us back to the reality of trying to make health care work and what we can do to influence the right decision-making.
Jeff, you mentioned about the removal of PST on all sugary drinks — I believe this government brought in a sugary-drink tax — or the removal of PST. I'm not exactly clear. What are the things that are getting past the existing tax and that are still out there? That should be…. A sugary pop is pretty obvious, but what are the other types of drinks that are doing the end run on that tax?
J. Sommers: Well, there's a range of things. I think I've mentioned flavoured coffees, which you can buy now in bottles. There are various types of flavoured water that also have sugar in them. One of my colleagues, actually, was worried that her favourite type of kombucha was going to get taxed, but it's not carbonated, so it's not a problem. Also, all kinds of fruit drinks have added or free sugars in them.
In fact, in the same way that tobacco companies have shifted to these new products, a lot of pop companies shifted to marketing non-carbonated sugary drinks as pop consumption started to decline. They look for these niches, and then they exploit them.
My kids are adults now, but I remember that when they were teenagers, they were drinking it. "Oh, we've got this stuff. It's better. It's good. It's not pop." I looked at the ingredients, and it was basically pop without carbonation. It had actual fruit in it, instead of just syrup, but essentially, it was a sugary drink with tons of added sugar. There are all kinds of stuff out there that are not carbonated that should be subject to PST because they're not really an essential grocery item.
B. Stewart (Deputy Chair): Thanks very much.
M. Starchuk: While you were talking about sugar, I kind of did a little Google search. There's a certain brand — I won't mention the store — but it has 420 calories, 65 grams of sugar and 15 grams of fat in a 473-millilitre container. But it's pumpkin-spiced, so I guess it's okay.
My question is to Rita. You had made mention about tobacco use to be below 5 percent. Where does that put us in relation to other provinces?
R. Koutsodimos: Well, 5 percent is where we want to go. British Columbia is a bit better. I'm sure Cynthia can speak to this in far more detail. But what we're seeing is this disturbing trend where kids who started…. I mean, everybody….
There was such a freedom with vaping products and the idea that this was going to be a harmless thing, and then our kids started taking up vaping like crazy. The kids don't even see it as a problem, but now what's happening is they've gotten used to that nicotine hit. What the research is showing us is that more kids that were just vaping now are transitioning into cigarette use. I think that's extremely problematic if we look at the trend rates going forward.
British Columbia is a little bit better, but I would turn it over to Cynthia to get that more national perspective.
C. Callard: For the last 20 years and even longer, smoking rates in B.C. are about 4 or 5 percent lower than in the rest of Canada, but they're not decreasing at a faster rate. The problem with our statistics is that they were always gathered on the basis of cigarette smoking, and we don't currently have overall nicotine consumption very reliably. Those new surveys won't be available for a few months yet.
M. Starchuk: I guess just a follow-up. The gap that's there, about 5 percent between us and other provinces. From my travels back to Quebec, I remember that not that long ago, there were smoking and non-smoking sections in restaurants. So do we know why we're 5 percent ahead?
C. Callard: Well, British Columbia also has had better tobacco controls for virtually all my lifetime. It was the first province to ban tobacco ads, back in the '70s, and even then, the number of posters and billboards and promotions that existed for tobacco were much smaller in British Columbia than elsewhere.
It didn't have any level of sponsorship promotion. It had higher prices, and it was the first jurisdiction to have smoke-free spaces. The tobacco control measures we count on were implemented in British Columbia before they were in the rest of Canada, but B.C. hasn't really pioneered any new ones in the last decade.
B. Stewart (Deputy Chair): Just to go on to your discussion about the rates. Your chart on page 5 of your presentation, Cynthia, talks about B.C. being at 11.1 and Canada being at 14.8. Does that include all cigarette products, like cigarillos or vaping products? Or are they another…?
I guess what my real question is…. Vaping products — we know that they've gone up. Are they accelerating, or are they flattening out? What's happening? Of course, they're not nicotine-free. We know that…. I mean, there's a whole discussion about flavoured vaping too. Anyway, are we getting the whole picture here, or are we missing part of it?
C. Callard: No, we're getting the picture. It's an old-fashioned picture. The surveys take a long time to put out in the field. For years, they wanted to ask the same question the same way so that they could compare results. The question was always: do you smoke cigarettes? So it doesn't include cigarillos. It doesn't include chewing tobacco. It doesn't include pipes. It doesn't include hookah. It doesn't include vaping products. It doesn't include modern oral nicotine, although that's probably not much of a thing here.
Statistics Canada and Health Canada are working furiously, I think, but it takes time to get data. The Canadian community health survey, some of which will be released next week, will give new information. I don't know if it'll have information on vaping yet.
H. Sandhu: Thank you to the presenters. I could have many questions. Some of my questions are answered. I really like this topic as I always talk about preventative health care. A lot of us do.
Just a quick question. I know sugary drinks…. Jeff mentioned that there are still some that they're able to sell. According to many studies, one tablespoon of sugar doesn't just increase your risk of diabetes; it suppresses your immune system for six hours. A lot of people don't know.
When I'm shopping…. I see, besides these drinks and vaping and tobacco that we talked about…. As Ben touched on, vaping — how it's glamorized, flavours and all. It's the biggest problem in our youth, that they're thinking this is the safest method.
What are your thoughts about other junk food that's widely available, that there are shelves and shelves full of, and if you pick up that packet, the sugary content and other stuff that some people can't even pronounce? What are your thoughts on that, and how can we make some changes?
If you really look deeper, down to nutritional value and health outcomes…. Coming from health care, I get sick to my stomach, the amount of available products there that kids want to buy. Then, when they eat that from pantries or from shelves, they won't go look at fruits and veggies. Many parents want to feed their kids fruits and veggies, and they are hard to afford, but junk food is available at much cheaper prices.
What are your thoughts on that?
J. Sommers: Are you asking me?
H. Sandhu: Jeff or anybody. Whoever wants to chime in.
J. Sommers: I guess I can start. I know that Heart and Stroke and Lung, the organizations my colleagues work for, have long advocated controls and increasing regulation on foods that are full of not just sugar but also fat and salt.
One of the things that we've been pushing through the marketing to kids coalition, nationally, are restrictions on marketing to kids. The federal government was about to bring that in a few years ago, and it crashed and burned in the Senate. So we've had to kind of pull back a little bit and rethink that strategy.
Certainly, we've been advocates for restrictions on salt content for a long. long time. Certainly, any kind of measures that will restrict junk food and promote fruit and vegetable consumption, we're in favour of.
H. Sandhu: Thank you, Jeff. It's reassuring to see the groups like yours working on it. When we see in health care…. We're seeing more renal disease and renal failure. Salt is even a worse culprit than sugar is, so usually we get stuck with one product. But if we look at the broad range, it's a serious concern, when you look on the other side.
Thank you for the work you're doing.
G. Kyllo: Thank you for your presentations. As we start talking about smoking…. I can't imagine that putting any combustible material in your lungs is a good thing, but when it comes to cannabis, are there any studies about the cancer-causing nature of cannabis? I've heard, anecdotally, that cannabis smokers are at a higher, increased risk of getting COPD or emphysema, but cancer is less of a concern.
Have there been any Canadian studies that you guys can point to? And how big of a concern is cannabis consumption with respect to the health of British Columbians?
C. Aruliah: I can take a quick stab at that. I don't have access at the moment to specific statistics, but we do know that cannabis consumption and smoking does contribute to smoking cigarettes as well. So it's just one way of bringing toxins into your body, but then it also acts as a gateway to increased usage of cigarette smoking.
As well, if you already have underlying issues with your lung or respiratory system, that can be problematic as well. So there are underlying causes and concerns, especially when it comes to increased cancer rates.
C. Callard: My understanding is that the epidemiology currently attributes about 800 deaths a year — I'd be using this from my memory — to cannabis, compared with about 45,000 deaths from tobacco use. Cannabis is used in various ways. When it's burned in a joint, it produces very much the same chemicals as a cigarette does with respect to carcinogens. But people tend not to smoke 20 joints a day, as they would with cigarettes, so there's a lesser level of exposure, and people do smoke it in different ways.
Another real challenge is that the epidemiology is based on studies that for many years never asked people about cannabis use. So we don't really have good data in many ways to look at what happens over a lifetime. I think that it's only in recent years that the research councils have started to invest adequately, I would say, in terms of monitoring the relationship between cannabis and other products, and the relationship between cannabis and other diseases.
The beginning of your question was right. Inhaling any kind of smoke into your lungs is harmful and is associated with disease.
P. Alexis: I'm going to change the subject just a tad.
For Rita: you said that a poverty reduction plan is where we need to work on and not necessarily fund food banks. Certainly, it takes time to create and administer and implement a poverty reduction plan. In the interim, of course, the food banks — which we've seen a terrific uptake in use, especially through these last 18 months — have developed some very good relationships with supermarkets, and so there has been this wonderful win-win for my community in particular with respect to food banks.
I think we will always need food banks in times where we have, perhaps, unpredictable salaries. I just wanted you to elaborate a little bit, because I know how important food banks are to communities.
R. Koutsodimos: I wouldn't disagree that they're an important emergency measure, but if you look at…. I mean, there are some really great academics who have looked at food security across a number of different measures and looked at where you can actually impact the diet of people who are below a certain income. When we look at who is the most food-insecure in our society, it is primarily people who are on income assistance and disability assistance — by multitudes.
I don't want to bash food banks. I mean, there are a lot of really dedicated people who do really important work, and there's that community connection as well, which is really nice for a group that's marginalized. But food banks reach less than 10 percent of the people that experience food insecurity. They really aren't an effective way for reducing food insecurity.
If we look at…. When we boost income assistance, there's a lot of shaming that goes on, and there are a lot of beliefs like: "Oh, people just spend that on beer and popcorn." But, actually, when you look at how a dollar is spent when you give people a rise in income, they will spend it on groceries, because that's what they need. They understand that very well.
A number of years ago, we did some focus group testing. We wanted to get at some of these low-income populations, and we asked these low-income populations: "What's the biggest barrier to your health?" They understood that they should be eating fruits and vegetables. They understood that quinoa was a superfood. They have as just a sophisticated understanding of diet and nutrition as you and I, but they said that the number one thing getting in the way was their inability to buy healthy foods.
That's what the research says, and that's what the people say too. I think we need to sort of shift the way we look at this issue.
J. Routledge (Chair): Sadly, we're out of time. I want to thank you for providing us with such a wide range of very important information. Equally important is that you have helped us connect the dots in a very commonsense way.
I really look forward to our deliberations, so that we can figure out a way to share what you've shared with us and find its way into the future of decision-making in this province. So thank you very much.
We'll take a two-minute recess.
The committee recessed from 1:59 p.m. to 2:03 p.m.
[J. Routledge in the chair.]
J. Routledge (Chair): We'll turn to our next panel, which is on mental health and addictions. There will be three panellists. They'll each have five minutes to speak, and then we'll open it up to questions from the committee to the panel.
Our first panellist is Jonny Morris, Canadian Mental Health Association, B.C. division. Over to you.
Budget Consultation Presentations
Panel 6 — Mental Health and Addictions
CANADIAN MENTAL HEALTH
ASSOCIATION, B.C. DIVISION
J. Morris: Thanks so much, committee Chair. A pleasure and a privilege to be here.
I'm joining you from unceded and ancestral Lək̓ʷəŋin̓əŋ-speaking territories.
I think the committee has a set of slides in front of them, so I'll quickly move through them and get to our core recommendations within the time I have.
J. Routledge (Chair): No slides. We have no slides. They'll come later.
J. Morris: Okay, great. I'll be visually descriptive.
For those of you who might not know the Canadian Mental Health Association, we're one of the most established national charitable organizations. We work every day toward a vision of mentally healthy people and a healthy society. We have 14 independent branches across many constituencies here in the province, working towards a mandate of education, training, advocacy and direct service.
I think, for many folks around this table, it's likely become very clear, particularly through the pandemic, and also as we grapple with the impacts of wildfires, climate-related impacts and changes, the compounding traumas of confirmed recoveries and findings of Indigenous children at former residential school sites, that mental health has absolutely risen to be a key priority that merits continued and sustained investment, going forward.
In the materials that we'll submit, underpinning our written submission by your deadline, what we're seeing in our own research that we've done with the University of British Columbia and other partners — I think, as we saw earlier this week — are increases in the number of overdose-attended events, increases in the number of drug toxicity–related deaths, increases in calls to the crisis line service.
The crisis line network in B.C. has been the backbone of so much crisis care here in the province recently. We've seen increases in the rates of suicidal ideation amongst folks, pressures in the emergency room. You might hear from my fellow panellists on some of these issues too. Arguably, this is an opportunity to shore up what we need around crisis care, going forward.
Typically at these finance presentations, we as an organization would continue to call for sustained investment in prevention and early intervention, and we've been very encouraged by the investments that we've seen over recent times, including community counselling, efforts in schools, trying to broaden access to psychotherapy.
This year, given what we're seeing, we're urging committee members and government to consider really looking at the area of crisis care and strengthening that, going forward.
Our core recommendation's for this year's submission process is to invest, and invest significantly, in an effective and comprehensive mental health crisis response system that provides before-, during- and aftercare that aids recovery and sustains well-being.
We are at such a punctuated point in history, where people's mental health…. If they were living with mental health concerns before the pandemic, they've worsened. They are some of the groups that have been most impacted. Folks who weren't living with challenges have gone on to develop symptoms, and there is risk that those symptoms will continue to develop with acuity, going forward.
Our three specific recommendations, which we'll flesh out in our written submission, for the committee's consideration are to look at how the province, through the health system, can step up the investment in crisis lines that are currently integrated with 911 and dispatch support. It's the system that's on so many health practitioners' and others' voicemail addresses after hours. It is the go-to, the 310-6789 service that our partners operate.
So look at shoring up investment in the crisis line network, and look at other supports that can be put in place, including the continued expansion of access to psychotherapy. There's been some good work done there in community counselling. I know it's a hot topic, but look at improving that.
Build upon some recent momentum in enhancing the availability of civilian-led mobile crisis teams. We see a need to expand the array of mental health supports in communities to reduce a reliance upon police. I know that's a topic that's currently in front of the select committee on Police Act reform. There is an opportunity to invest there, and that aligns with a number of mandate letter priorities for the current government that's in power.
Also, look at investing in crisis-receiving and stabilization facilities. Currently the emergency room, and sometimes a police jail cell, are where folks who are in crisis end up. There is an opportunity there to deepen that response by increasing the array of supports that are available for people in community experiencing crisis.
I see my time is up. So I'll hand it to back to the committee Chair.
J. Routledge (Chair): Thank you.
Our next speaker is Dr. Lesley Lutes, B.C. Psychological Association.
B.C. PSYCHOLOGICAL ASSOCIATION
L. Lutes: Hi everybody. Thank you so much, hon. Members, for giving me the time to speak with you today on behalf of the BCPA. I know that I only have five minutes, so I want to keep it short and to the point.
I want to tell you about my Auntie Betty. She was amazing. She was larger than life. When she walked into a room, she immediately commanded everybody's attention. Her laugh was pure joy. Her hugs could cure whatever ailed you, and her zest for life was infectious.
She also suffered from bipolar disorder. When she was depressed, she gained weight. She eventually developed diabetes and became insulin-dependent.
Sadly, after four previous attempts, she would ultimately use all of those medications prescribed to keep her healthy to take her own life. That was 25 years ago, just one year before I would start my doctoral degree in clinical health psychology.
While I wish I was sharing a tragic story that is unique just to me and my family, I know it is not. Every single person in this room has someone special in their life, or even themselves, who is struggling with either a chronic mental health or physical health condition. They may be suffering in silence, just surviving, or worse, ending with a similar outcome as my Auntie Betty.
What many people don't fully understand is how closely mental and physical health are connected. When people are stressed and suffering emotionally, they are more likely to become physically ill, partly due to the direct effects of the stress on their bodies. Also, it's much harder to engage in positive health behaviours like exercising, taking our medications as prescribed, getting enough sleep and eating healthy when we are distressed.
This is where psychologists can help. The best models of integrated primary care around the world have psychologists and/or those that they've trained and supervised working side by side with their family doctors in primary care practice providing mental and behavioural health interventions.
Integrated primary care psychologists are different from traditional mental health providers, usually getting 60 minutes a week in a traditional outpatient office. This can clog up fast-paced primary care systems immensely. Primary care psychologists help patients in managing health conditions like chronic pain and diabetes or being better at adherence to medication, helping change initial and long-term health behaviours, as well as treating mental and behavioural health concerns like anxiety and depression.
For example, in one clinical trial that I conducted in rural North Carolina, we compared 140 patients who were struggling with unmanaged diabetes and who were also suffering with undiagnosed distress or depression. Half of them received traditional primary care. The other half received integrated primary care focusing on their mental or behavioural health needs.
After just ten 30-minute treatment sessions across 12 months — with either a nurse, a master's-level clinician or a psychologist, depending on the severity of their symptoms, all supervised by psychologists — not only did their mental health improve, but for the first time in ten years, their physical health improved. They increased their physical activity, improved their dietary intake and lost weight, and the 90-day average of their hemoglobin A1c, or blood sugar, decreased. This study was published in 2019 in a leading medical journal, Diabetes Care.
These models are innovative, but only in B.C. In the rest of the world — including places such as New Zealand, the U.K., the Veterans Administration in the U.S. and my former institution in North Carolina, where I was before returning home to B.C. in 2015 — it has been the standard of practice for years, even decades, and for good reason. Not just does people's mental and physical health improve. It saves money within the health care system, and it improves GDP. The U.K. alone showed a 4 percent increase in GDP when they invested in mental and behavioural health, according to evidence-based models.
It costs more money to have psychologists as a part of the team, compared to other allied health professionals. Since I've been home in 2015, this resource had been essentially unused to date within the primary care system in British Columbia, leaving patients — though only with good health insurance or enough money — to access these services privately. There is one exception, the Burnaby Primary Care Network — amazing people. Following a meeting where I flew down to meet with them in December of 2019, despite the higher cost, they hired psychologists to help develop their first behavioural medicine service called B Well.
Since its launch in October 2020 — yes, during the pandemic — patients have experienced significant improvements in all physical and mental health outcomes — including depression and anxiety, even though it is not a mental health program — promoting weight loss, physical activity improvements and significant engagement across the board with their health behaviours. Moreover, physicians are thrilled. One physician described B Well as life-changing for her practice. Notably, I want to document that the coaching is delivered by undergraduate master's-level clinicians, only supervised by psychologists.
What am I asking for? Just as the government currently allocates separate funding for physicians, nurses and pharmacists in the primary care system, I'm asking that the B.C. government also dedicate separate funds for psychologists who are choosing — and that PCNs are wanting to include in — the primary care system. By creating access to psychologists alongside our other colleagues, we can ensure that all people across B.C., representing the full spectrum of physical and mental health needs, receive comprehensive, team-based care right in their backyard.
J. Routledge (Chair): Thank you, Dr. Lutes.
Finally, we will hear from Gary Eisele, Community Connections Society of Southeast British Columbia. Then we'll open it up for questions.
COMMUNITY CONNECTIONS SOCIETY
OF SOUTHEAST B.C.
G. Eisele: Thank you very much for entertaining my presentation. I'm with the Community Connections Society of Southeast B.C. We're basically an umbrella organization for multiple social service practices.
We have children's services for autistic children, underprivileged children, all sorts of different groups like that. We have family law and poverty law advocates in our practice, community action for children and a women's resource centre — it used to be known as the women's centre — in Cranbrook. We have homeless outreach and prevention in our organization. We also, until recently, had a walk-in counselling clinic where people could access free, strength-based, single-session, brief therapy, which dovetails quite nicely with Dr. Lutes's model as well.
Mental health in Canada. The statistics are frequently quoted. One in five will experience a mental health issue. The CCMHI reports that less than 40 percent of those people will seek help, primarily because of access and stigma. A walk-in counselling clinic addresses both of those issues. We don't have "mental health" in our title, so people might come in and talk themselves out of a crisis with myself or my co-worker, Jasmine Lothien.
The Mental Health Commission, in 2016, reported that 50 percent of the population will experience a mental health illness by the age of 40, rising to 65 percent by the age of 90, which are astonishing numbers, and one in three are struggling with mental health due to COVID.
I couldn't find any statistics with regard to the wildfire situation in B.C., but I'm sure it's not helping either. I live in Creston. We were threatened 50 kilometres away, and despite being in the business, I got stressed out. And we have a doctor shortage in rural B.C. It's difficult to get a referral for counselling without having a GP accessible. The walk-in counselling clinic provides counselling for people in a crisis. It eases the burden from mental health and addictions groups.
What do we do? We provide single-session counselling. We address a wide range of concerns: anxiety, depression, anger, difficulties at work and in school, relationship issues, parenting concerns and other issues. We can deal with 1,000 sessions a year when funded. The only other free, community-based counselling in our area has a four- to six-month waiting list.
We are able to respond quickly because we just do short-term counselling to get somebody through a crisis. No-wait, short-term intervention cuts costs to mental health and emergency rooms through less need for those services, and people are more apt to come to us when their problem is small, because they don't want to burden the emergency room with something that they see as being insignificant. The CCPA, the Canadian Counselling and Psychotherapy Association, has found walk-in clinics to be a useful piece in the larger mental health delivery system.
The other issue in our area in the Kootenays of B.C. is that we have numerous populations that are at an increased risk because they harbour distrust of government organizations. We've got a significant native population. There are Doukhobor settlements, fundamentalist Mormon enclaves, anarchist and pacifist groups and American war resisters. All of these people are highly skeptical of government services, so if they can come and see me, we can chat through their issues.
I've got a few quotes from people we've served. Jasmine, my co-worker, has a client who felt respected –– the first time since that client had left the FLDS that anyone has actually listened to her. Somebody else said they'd had no one to talk to about private matters. In her culture, women were not allowed to tell, so it felt like a relief to speak to somebody.
I had a fellow walk in one day. He was waiting for another provider, hadn't even come in for counselling, and suddenly he was unburdening himself in my office. He said: "You know, you look like a white guy I could trust."
That's all we do, right? We just listen, pump up their tires and help them come up with a short-term solution. But the problem is…. I mean, we've got that need in the community. Obviously, these clinics are an accepted part of the solution.
We've been in this community for several years. I started there in 2018. But we can't do it without funding. That's our biggest problem. We've had to open and close our doors several times because we've not been able to get core funding. It's always been short term. I volunteered for ten months, two to four days a week, to keep the doors open.
J. Routledge (Chair): Excuse me, Gary. You're out of time. If you could just, maybe in one or two sentences, wrap up your main point, and then we'll open up for questions.
G. Eisele: I guess the main point is that walk-in clinics are a valuable part in the mental health delivery system, but we need funding. If you could fling us a few bucks, we would be eternally grateful, and our clients would as well.
J. Routledge (Chair): Now we'll open it up for questions from the committee to the three of you as a panel.
M. Starchuk: Thank you to all of you for what you do on a daily basis for those people that are in need.
My question is to Jonny. I'm interested in what a stabilizing facility would look like.
J. Morris: Thank you so much, committee member. A great question.
We've got two jurisdictions that have launched initiatives under the banner of recovery hubs or recovery cafés — the United Kingdom and Australia. These settings are non-clinical settings. They're not shelters or housing units, but they're often residential spaces in community that are resourced by peers — so people with lived experience of mental health or substance use problems — alongside trained professionals: mental health nurses, psychologists, other behavioural care specialists.
What they've noticed in these settings is significant diversion from the emergency department, much like my two colleagues have described here. For someone who's in a suicidal crisis, it's a space where they can go, connect for care — as my colleague was saying, perhaps be talked out of the crisis, stabilized. They may stay a little while, they may stay overnight, and then they return back home to their community.
It's remarkable the success that these settings are having in both Australia and the United Kingdom. It's outside of hospitals. It's de-institutionalized care, delivered in community and really reducing the impacts of stigma in seeking that kind of care in crisis.
I hope I've answered your question a bit. I can flag that in our submission so you can look further into that.
M. Starchuk: Just for clarity, would this be like a residential unit in a residential community? If that's the case, then how does it work in other jurisdictions when you've got the NIMBY attitude?
J. Morris: These, remarkably, in the examples I've seen in both Australia and the UK, in so many ways resemble a house. They're not deemed a clinical setting, like, "Well, that's the shelter" or what have you. They're, in so many ways, like what we see in the women's shelter movement: a kind of house where people take shelter and take care. It's not a shelter.
From the media I've read and the reports I've read, they haven't had to grapple with the challenges we've seen here in B.C. of NIMBYism and not wanting that kind of support in my backyard. They've actually been able to mitigate that and avoid that. It's not set apart as something distinct and institutional. It's set as a place to go, often in a residential setting.
M. Starchuk: Okay. Thank you, and good luck.
P. Alexis: Along those lines, can you talk a little bit more about the civilian-led crisis teams? Talk about the civilian part for me.
J. Morris: Absolutely. We've been very grateful to receive some seed funding from civil forfeiture. Then a couple of weeks ago the city of Victoria was granted some moneys here. Much like Toronto…. The city of Toronto is piloting this right now.
You might have heard of examples in Eugene, Oregon, where, basically, a team is assembled, again comprised of civilians: a peer, someone with lived experience who has experienced the system and mental distress, alongside a trained, caring professional. They respond to crises. They would go out — they do this in Toronto, and they've done this in Eugene — without police.
Police are part of the response. They're aware. They know. There's an integration with the dispatch system because, of course, there can be incidences when police are needed. They are required to attend. But there's a whole number of crises that happen where police are not required, and currently, today, they attend those crises. Their presence isn't needed or sometimes isn't helpful. It can escalate the situation.
This is a team that's led by civilians. They're not police. It adds to the existing continuum. Currently we have police alone in lots of rural communities. That's all that's available. The RCMP go, a co-response — so police alongside a mental health professional. What we're seeking to do is expand the other end, which is civilian only.
What we know is so many crises, like you've heard from my fellow panellists, are housing-related, health care–related, food-related. They're crises that hospitals and police departments aren't as well set up to respond to. We've seen good success with civilian-led teams, which ultimately save money because you don't deploy the police as much and you're not sitting in an emergency department.
That's the model. We're very excited. We're piloting right now and hoping, with this budget and fiscal plan, to actually pilot in a number of additional communities. The hope is that it takes root here in this province as well.
B. Stewart (Deputy Chair): I just, Jonny, wanted to commend, in my riding, Kelowna, Shelagh Turner, who is the one that heads things up there. We've had all sorts of new facilities. But it's clear that it's not helping the people that are needing counselling, the help that Lesley and others in her profession are providing.
We canvassed this during estimates with the Minister Responsible for Housing. The word is that there are these super-complex care options being considered. I don't know what it is, and I think there's still a gap in terms of articulating what that really looks like to the government so they know what it is that they do and have, etc. I do think they recognize that there's a gap.
What I'm wondering is what's holding…. I mean, you've talked about funding, and in term's Gary's point, maybe a little bit of help would be helpful in terms of dealing with the community issues. But more importantly, what's stopping the three groups that you represent from connecting and working together? Is there no cohesive plan? Where do we need to start on this?
J. Morris: It's an excellent question. I think the term "complex care housing" — I'd love for my two colleagues here to chime in, if they wish to — is a relatively, for us, anyways, in the non-profit sector, recent coinage of term. It's a new term.
We're very grateful that within the bureaucracy of the Ministry of Mental Health and Addictions specifically, we've been actively consulted, and Shelagh, who's the ED at the branch, has been part of some of those conversations. The policy framework around complex care is designed — we think, anyways, from our understanding of the thinking that's happening — to add in the extra layers of supports that are needed for folks that are experiencing increased complexity and acuity in community, in a bid, hopefully, to avoid any return to re-institutionalization, like the days of Riverview.
It's really trying, at least from my understanding, to realize that imagination of the kind of care that can be provided, because ultimately, CMHAs like us are providing complex care. It's just not called complex care. They're doing that in community.
I think there are great opportunities for organizations like the ones that my two panellists represent — actually, I think Lesley and I have been in touch — for us to connect around what we can do together in community, with or without funding, to meet some of the challenges. We're doing that in the policing file, I think the work of primary care integration. And on the note of community counselling, we're in the thick of that, too, with our partners at the Community Action Initiative.
That could be a very nice consequence of presenting to you today — that the three of us connect in from our respective organizations and see what we can do together whilst government continues to establish and define the policy framework around complex care.
Lesley and Gary, I've taken some air time there. I think the question was directed at the three of us, and I would want to give you space, too.
L. Lutes: Yeah. I think that there's no one answer, right here, to the problems that we're seeing in front of us, both mental health– and physical health–wise, today. So it's going to take a multitude of interventions from all different avenues. I am a professor at UBC on the Okanagan campus, and I love the work that Shelagh Turner is doing.
In 2018, actually — I couldn't agree more with you — without funding, I started a walk-in well-being clinic and a five-week unfunded pilot with no money. Within five weeks, we had homeless meth addicts. We had suicidal transgender individuals in addition to graduate students, undergraduates and community members.
When COVID struck, we actually moved that clinic online. We have seen over 500 patients in the past year. A private donor came forward and gave me $100,000 with the only request to make it permanent. UBC stepped in this past year. They've made it permanent. We've expanded that service.
I couldn't agree more that we need to do everything we can. I actually have a half-million-dollar grant going into UBC next week, specifically about engaging our partners in mental and behavioural health across the province with the dean of medicine; Doctors of B.C.; the Ministry of Mental Health and Addictions; and nine amazing colleagues that specialize in mental health and substance use. We want to help work together to absolutely change the tide.
We are so supportive of everything that the government is doing. I know that you hear us about the crisis we have currently and that we're talking about it more than ever. But we need to have a multi-level intervention looking from primary intervention to prevention to triaging of care to acute care, but also closing the loop after people get out of the hospital, when they're told to go back to their primary care physician's office. We have to close the loop.
I'm happy to work with Gary and Jonny, absolutely.
B. Stewart (Deputy Chair): Thanks very much.
Oh, sorry. Go ahead, Gary.
G. Eisele: I'll just make a quick comment. Our Community Connections Society has been running the Travelodge homeless shelter in Cranbrook for the last year. We rented half the Travelodge in downtown Cranbrook because there's no homeless shelter.
We've had quite a few…. Unfortunately, I've neglected to address that issue. But we're building a homeless shelter onto our facility. So we are currently, in probably a less formal sense, doing an end-to-end for a lot of really disenfranchised folks. I've been counselling the working poor as well.
Anyway, thank you.
J. Routledge (Chair): Lorne has the last question.
L. Doerkson: All right. Fair enough.
I know that time is tight. The question is for you, Lesley. You referenced a successful program in B Well in Burnaby.
L. Lutes: Yes.
L. Doerkson: I wondered if you could just give me a really brief outline of what that program looks like and tell me how it's funded.
L. Lutes: Absolutely. It's consistent with the Canadian Medical Association's new guidelines released this past year suggesting that people needed tailored cognitive behavioural weight-management interventions looking at the root causes or drivers of their weight challenges and not just prescriptive exercise and nutrition programs.
So with that, I've been doing research in small changes and alternatives to traditional dieting for over 15 years in numerous clinical trials. I gave the program to Burnaby for free and said that I would help them set it up, and as long as psychologists were helping supervise the provision of the care, we could hire undergraduate level coaches, as trials have shown that to be effective.
They reallocated budget from other areas in order to hire two psychologists to get the program up and running. Undergraduate and master's level clinicians — there are five of them that I hired — deliver the behavioural coaching to the patients, and there are two registered psychologists that oversee the program. They do consultations with the physicians in real time as needed, and since it was launched during COVID, the entire program was virtual and online, one-on-one with patients.
Now we're adding in group programming, because Burnaby, as of this Monday night, voted unanimously to expand our role within the Burnaby primary care system. Actually, they said that if this funding goes through, they want to be the first one to have psychologists in all the primary care clinics, because right now this is just a behavioural medicine service, not the integrated primary care that is really the gold standard.
Burnaby has been amazing. Their team has been fantastic. The funding comes out of their PCN, but they've had to reallocate money from other areas in order to hire these two psychologists and five health coaches to deliver the program.
L. Doerkson: Thank you very much, Doctor.
L. Lutes: You're welcome. I do….
J. Routledge (Chair): Well isn't this….
You can say one more thing about Burnaby.
L. Lutes: I know that's personal to your heart.
As I think everybody might know, during the pandemic we know that people have gained an average of a pound a month. Increased anxiety, depression, decreased nutritional intake and physical activity. The patients in B Well objectively have increased their physical activity by 40 minutes per day, decreased their caloric intake by 400 calories a day, significantly decreased anxiety and depression and report improved life satisfaction during the pandemic.
These are not small indicators. These are significant and in the opposite way to what we're experiencing in the rest of the province.
J. Routledge (Chair): Thank you so much. Really, seriously, I think that this is an incredible note on which to end this panel and this panel discussion.
I think that the Burnaby primary care network is a hidden treasure. I became really familiar with what they were doing, what their role was, right at the beginning of the pandemic. The way they kicked into gear and the way they defined themselves as a community-based network…. I really think it's an important model, and I thank you for the shout-out. I think that it's very inspiring.
B Well — this is the first I've heard of this, but I’m going to go back and dig into it some more.
I think I speak for everyone. This has been a very inspiring presentation. I see nods around. We thank you for your passion. We thank you for your vision and your sense of the future. It's a pleasure to listen to what you've all had to say. Thank you. We'll say goodbye to you for now.
We will recess for five minutes.
The committee recessed from 2:37 p.m. to 2:49 p.m.
[J. Routledge in the chair.]
J. Routledge (Chair): Our next presenter is Bernice Budz, Midwives Association of B.C.
Bernice, you have five minutes to make a presentation, and then we'll ask you questions for up to five minutes. Over to you.
MIDWIVES ASSOCIATION OF B.C.
B. Budz: Good afternoon. Thank you for the opportunity. On behalf of the Midwives Association of British Columbia and the over 300 midwives who are our members, we appreciate this opportunity to share our perspective with the Select Standing Committee on Finance.
Registered midwives have been essential primary maternity care providers in British Columbia for over 20 years, with a proven track record of positive perinatal health outcomes for birthing people and babies. Registered midwives provide primary maternal and newborn care in both hospitals and community settings. For many B.C. families in rural, Indigenous and northern communities, access to midwifery care can be the only way to avoid having to travel long distances to give birth.
All over British Columbia, the demands for midwives is increasing, and our services are well supported by the public. In recent years, B.C. has experienced one of the highest rates of midwifery-involved maternity care in Canada, at 26 percent. Indeed, the demand for midwifery services is only expected to grow as the number of births in the province is expected to reach over 50,000 by 2025.
Throughout the pandemic, B.C. midwives have continued to step up to the challenges of delivering services to British Columbians in immeasurable ways, including participating in our province's vaccine rollout plan. Perhaps unsurprisingly, the demand for home birth has increased significantly as a result of COVID. Access to midwifery care can reduce pressure on hospital resources and has helped support COVID containment measures by facilitating early discharge from hospital and by enabling families to receive essential services in the safety of their homes.
We're pleased to see the government of British Columbia's ongoing commitment to expanding care for people closer to home and to supporting health care providers around British Columbia. The creation of the midwifery advisory committee has provided a forum to discuss the ongoing needs of our members throughout the pandemic and beyond. And there's much work to do together ahead.
As the government seeks to address critical issues affecting health care delivery across the province, midwifery can also provide solutions to address inequities, reconciliation and anti-racism in the health care system. We recommend that the government of British Columbia invest in four key areas.
First, Indigenous midwifery. A secure stream of funding to enhance programs for Indigenous midwives that meet truth and reconciliation targeted action items and promote Indigenous People to gain access to Indigenous midwives.
Second, rural maternity. Expand programs aimed at attracting and retaining midwives to rural and remote communities to increase access to reproductive and sexual health care and minimize travel for families and stabilize maternity services.
Third, addressing the gender pay gap. Include B.C. midwives in equal-pay legislation and any related work to close the gender pay gap, as the primary maternity providers providing care for over 25 percent of B.C.'s birthing families.
Finally, midwifery education. Increase access to midwifery programs through the addition of creating bursaries to fund qualified midwifery students.
We look forward to working with the government to ensure that B.C. families continue to receive high-quality primary maternity care and to ensure the long-term availability of midwifery services for all British Columbians.
Thank you for this opportunity. I certainly welcome any questions that you might have.
J. Routledge (Chair): Thank you, Bernice.
We're now open for questions from the committee.
H. Sandhu: Thank you, Bernice, for the presentation and highlighting the key areas which can be really beneficial to our health care system.
Can you tell members of the committee what the midwifery program here looks like and how much extra schooling people need to do? The reason I'm asking…. I know that the program I was trained in — I did my nursing and midwifery in India. They do similar in Australia, I believe. It was another extra year embedded, solely focused on midwifery. We did go to rural communities with a lack of resources.
I always wonder. I know a lot of nursing colleagues want to go, but there is education. There's a cost attached to it. I know a couple had to move to Australia as well.
Are there any suggestions you would like to recommend? If you can just highlight what the program looks like, when you talked about education. How can health care or nurses be supported if they want to go that route? They are a very beneficial and integral part of our health care system. If other countries can do it, why can't we just do that here?
B. Budz: Absolutely. Well, thank you very much for the question. As a registered nurse, I certainly appreciate that and see that there is a potential.
Currently the program that exists for our basic midwifery training is based at UBC. It's a four-year degree program. There is no direct access for nurses to advance into the program, but I think that's an opportunity that could be created, a bridge between the nursing programs in the province to be able to access the midwifery program. I don't know if that's been looked at in the past or not, but I think it is a good time to create that type of opportunity.
I think there are many nurses who would be interested and have the right skill set that, as you say, can provide maternity services. They may be already specialized in obstetrical care, so they bring a wealth of knowledge. Often midwives are providing some training to help support nurses, so it's a good partnership. I think where we could make the combination, it would be a good step forward.
I think a discussion with the UBC program and the faculty of nursing there, as well as perhaps other nursing programs in the province, could be an opportunity to have some dedicated funding to do that curriculum adjustment.
As well, with the clinical placements, practicums are always important. Given that midwives are around the province, it's a great learning opportunity for nurses to be able to learn in their local communities, particularly Indigenous People, and to be able to stay local.
There are currently at least 18 nursing programs around the province, so I think a bridging program — and now that we do so much virtually — certainly could be an answer. So I think what you're asking is something that could be very feasible in Canada and particularly in British Columbia.
H. Sandhu: Right. Thank you, Bernice. The reason I ask is it's sad to see that when we have colleagues that want to go to other countries to finish — and they've been in nursing and even in obstetrical care for years — they end up staying there, so here we're losing that talent.
Midwives can really help to fill the gap in rural communities, as nurse practitioners are doing. That's why I have tried to take a look into that, because my certification won't…. I will have to do another four years again, even here, as I had to do five years for nursing again. So I tried to have a conversation with some people around…. But there hasn't been, to my knowledge, any discussion. I thought maybe you were aware about certain discussions.
I think it's worth exploring. It will benefit many communities, and we'll get to keep the talent here as well.
B. Budz: Absolutely. I would be very happy to partner with you on that agenda. I think there's a great opportunity there. As you mentioned, it would create sustainability and keep people within the province so that we're not losing our talent and experience and are actually supporting all our patients and families in B.C.
H. Sandhu: Agreed. Thank you.
B. Stewart (Deputy Chair): Thanks very much, Bernice. We had a presentation earlier this week, and we were talking about health care in remote communities. We were actually speaking about Fort Nelson.
I guess the question is…. You mentioned that the midwifery training is at UBC. I'm assuming: is that the only location that it's being done?
B. Budz: Unfortunately, yes.
B. Stewart (Deputy Chair): I know that this is a territorial issue with some of the people that are taking maybe a different route in health care. But I guess the question is…. We've got a distributed program in medicine in places like Prince George, and I'm thinking it's more likely we're going to get and retain and recruit people if we could do that program. I don't know what it takes to educate, but it seems to me that there is a huge need, and you just mentioned First Nations.
Anyway, I just want to comment that part of the solution is making it accessible. Certainly, I think, that for many people, getting access to one or the other…. Well, actually, there are three, right? UVic, Kelowna, UBCO and then UNBC. Anyway, just a comment that we need to do better.
B. Budz: I would really support that opportunity. I think there are many people that are needing to travel for education. They could get their education locally. Again, some of that training could be done virtually.
Here at MABC, we have actually created a position of a rural and remote lead midwifery expert to help with the clinical training in rural and remote areas. She's located in Haida Gwaii, and she does travel to various communities to help people with learning, not only midwifery students but also other members of the health care team, to really support maternity services. We would be happy to partner with any institution around that type of programming.
J. Routledge (Chair): Okay. Well, thank you very much, Bernice. I think you've piqued our interest, and you've made some allies in this room. Thank you for your time, and we'll probably connect again.
B. Budz: I'll certainly look forward to it. Thank you very much for the opportunity. Have a good afternoon.
J. Routledge (Chair): Our next presenter is Genesa Greening, with the B.C. Women's Health Foundation.
Genesa, if you're ready, you have five minutes to make a presentation and then five minutes for questions from the committee.
B.C. WOMEN'S HEALTH FOUNDATION
G. Greening: Thank you, everyone, for the invitation to participate today.
My name is Genesa Greening. I'm the president and CEO of the B.C. Women's Health Foundation. We're the largest non-profit organization dedicated to advancing the full spectrum of women's health here in British Columbia. We're committed to working with you, the B.C. government, to deliver a provincial women's health strategy. We'd like to see that start with a comprehensive sexual and reproductive health framework that supports both women and our economy in becoming, being and staying healthy.
As I know we're all now aware, we need healthy women for a healthy economy, and we need to recognize that this pandemic has had a detrimental impact on women and their health across the spectrum. Women make up over 50 percent of the population in B.C. and almost 50 percent of the workforce. These realities affect all of us — our future generations, communities, businesses and essential services — and, thus, our wider economy.
As we have come to starkly understand during the pandemic research, the economy and health are inextricably linked. Data from the 2018 report that we conducted as a foundation showed that if women are able to stay healthy, we can save up to $2.6 billion in lost worker productivity in the province of British Columbia annually. We also know that there was a study in 2017 that found achieving gender equality would increase the growth rate of output by 9 percent in B.C. over the next decade.
We enjoy our reputation here in British Columbia as a leader. Before this government today, there is an opportunity to build on that legacy by developing a provincial women's health strategy that integrates gender equity, technology and the provincial economy within it.
We undertook some research during the pandemic, and we released a report called Unmasking Gender Inequity. Some of the key recommendations for policy-makers that we included therein are to acknowledge the long-standing gender inequities that have been exacerbated by COVID-19; incorporate the implementation of gender-conscious economic recovery policies that will support women during and beyond the pandemic; commit to funding women's health research and ensure that the influence of sex and gender is fully considered in scientific studies and organizational policy and practice; and adopt a gendered approach to health care in B.C., including the women's health strategy, which reflects the distinct equity issues affecting women's health and well-being in our province.
A gender-equitable strategy that encompasses women's mental health, gender-based violence, caregiving considerations, workplace safeguards, culturally appropriate care and rural access were common threads in Unmasking Gender Inequity that we saw in those reports.
We do believe that we need to develop an updated women's health strategy for the province to ensure equal treatment, representation and access to all health services, including reproductive health, and we have an opportunity to champion the innovation that we see here in our province and health research infrastructure to build a comprehensive women's health strategy.
We look forward to working with the B.C. NDP government that is committed to gender equity and gender equality reconciliation and to ensure that all women across the province of British Columbia get the health care that they deserve. We are continuing to advocate for a comprehensive provincial women's health strategy that represents an equity opportunity to lift up half of the province.
Improvements in women's health research will also have a dramatic effect on Canada's economic recovery efforts. We have a real opportunity to help close those gaps together in women's health care.
J. Routledge (Chair): Thank you, Genesa.
And what's your name?
G. Greening: This is my son, Nnamdi, who starts school next week, which I'm very grateful for.
J. Routledge (Chair): Okay. Questions from the committee.
P. Alexis: I just want to say you're amazing that you could continue this regardless. It's amazing how we have learned to adapt through COVID on Zoom calls and what to expect and everything else. Kudos to you.
You spoke really, really quickly, and I tried really hard to write down everything you said. I don't think we got a submission in advance, but could you make sure that if there are very specific things, asks, they're in your written submission?
G. Greening: We will, for sure. Thank you. If anybody does have any follow-up questions from that submission, do reach out to us as well, because we have comprehensive data and reports that we can provide. In that submission, we'll also provide links to the reports that we completed over the pandemic that show the importance of a women's health strategy in order for us to actually see the necessary economic recovery coming out of this pandemic as well.
J. Routledge (Chair): Well, if it's fair to ask at this point, can you give us some examples of what is missing now in our approach to health or women's health that would be part of the strategy?
G. Greening: Yeah, of course. One of the things that we were tremendously excited about and we want to give compliments and kudos to the government for ensuring is a priority is the fact that there is the hope for universal access to free contraception. We know that is something that is in process and that, within the Ministry of Health, there is a hope to be able to create a sexual and reproductive framework that actually looks at more than just contraception, that women could get equitable access to quality health care.
In large part, we actually haven't dedicated a strategy that understands women's unique health care needs across the life cycle, so looking at sexual and reproductive health specifically is really important, not just contraception but also looking at education, looking at making sure that we have health services that are specific to women's health care needs.
We also would like to see greater investment in mental health especially. It was just alluded to that I was able to get through this presentation with a five-year-old underfoot. The pandemic has only shown more and more that women's mental health has been impacted, and we really need to be thinking about a gendered approach to that. That also includes reproductive mental health care, which is pre-pregnancy, pregnancy and post-pregnancy care. That needs to be considered.
We also have substantial gaps in mature women's health care in this province, in large part because the funding for research has been so limited — wherever the province can help with that. There are some very specific recommendations that we're working on with staff within the Ministry of Health that we do hope will be incorporated in a larger strategy that looks at gender in health care, because there is a difference in how women need to receive their health care specifically.
J. Routledge (Chair): With that, we will thank you so much for your presentation. We look forward to your brief. I'm sure we will have follow-up questions. I think we've also already talked about, when the time comes when we can be face to face, inviting you to come to an all-party women's caucus meeting.
G. Greening: Yes, thank you. I would love to do that. That would be fantastic. Thank you again for that invitation.
J. Routledge (Chair): Our next individual presenter is Margaret Little, and she is with Save Our Northern Seniors.
If you're there, Margaret, you can begin your presentation. You have five minutes, and then we will ask questions for up to five minutes.
SAVE OUR NORTHERN SENIORS
M. Little: Thank you very much. My name is Margaret Little. I am with Save Our Northern Seniors, or as it's called, SONS. The group began in about 1999 when concerned citizens got together to talk about issues for seniors and for health.
First of all, I would like to say thank you to the committee for providing this opportunity to present to you and to also provide written information. But I'd also like to say a special thanks to the staff for putting up with all my questions and making sure I got online. I'd like to bring greetings to all of you from the northeast part of the province. We have been having a major problem with our Internet connections, so if you lose me, that's okay.
We believe that to make a difference, the government of the day must understand that facilities, staffing and support systems are of utmost importance for our seniors.
SONS issues are facilities. This summer we almost had catastrophe with the heat wave that we had, and it's not going to change over the next few years due to climate change. As the Hon. Adrian Dix said, we have to be brought into the 21st century.
When Peace Villa was built, they said: "Oh, we don't need air-conditioning. It never gets very hot here in the north." Well, wrong. This year and last year have proven that we do need to have temperature control in our facilities, and we have to have air-conditioning, along with a few other things.
One of the other major issues is staffing, particularly at Peace Villa and our care homes. The 3.36 hours allotted per day, per resident in long-term care must be improved. Divide 3.36 hours by 24 hours, and how much time does a resident really get? If we believe, as a society, that our seniors are a gauge of our society, then we need to have a look at how we're looking after them. The staff is excellent. However, there's not enough time to go around.
We need to have decreased wait times for emergency, doctor appointments, lab times and facilities, and we also need to have increased staffing for our support systems.
The support systems in Fort St. John are really good. However, they cannot do it all alone. Part of it must come from the government. We must have more support and more time and more money put into the system to provide support services such as mental health and grief counselling.
The second to last thing I want to mention is that we need to have improved cell phone service and Internet services. It is not good enough to say: "Oh, go online. Get out your cell phone." We do not have a total reliability of cell phone and Internet services in the northeast, and that goes all the way to the Yukon border. Especially now that we're going to have to provide a vaccine pass, it is critical that the Internet services be improved.
Lastly, I'd like to mention the fact that transportation and accommodation for people who live far away from major centres needs to be improved. Somehow as a society we have to provide information for people that are going to the hospitals or for medical treatment.
I just want to say I'm very proud of our community and the way they've stepped up to help out in the latest crisis for COVID, and I do appreciate all the efforts that have been put into it by the health profession. Thank you.
J. Routledge (Chair): Thank you, Margaret.
Questions from the committee?
P. Alexis: Thank you, Margaret. You really did a great job on your submission so that I could easily follow. So you obviously have that nailed. Maybe you asked staff for help, but I think you had this down. Thank you for sending that along.
I'm just curious. What did the high temperature get to in that horrible, long four-day period with high temperatures in Fort St. John?
M. Little: They were over 30 degrees Celsius.
P. Alexis: Wow. Okay. Yeah, that's unusual for sure.
Thank you so much, Margaret — and a great presentation.
J. Routledge (Chair): Any other questions from the committee? Well, I think everyone concurs with Pam that it was a great presentation. You covered all the bases and made it very clear — what your situation is and what you need to improve it for seniors in the north. Thank you very much for your time, and all the best in the future.
M. Little: I would just like to add to this that on pages 2 and 3, I have written out our recommendations, because I knew that I wouldn't have time. So I've given you a little bit of background as to where we're headed with these recommendations. These recommendations keep coming forward every year in different forms. On the very last page are the facilities that are in Fort St. John, and it's quite clear that we need more facilities.
J. Routledge (Chair): Thank you for pointing that out to us. We'll take a very close look at that — very close. Thank you.
We will take a two-minute recess now.
The committee recessed from 3:16 p.m. to 3:24 p.m.
[J. Routledge in the chair.]
J. Routledge (Chair): Our next panel is on youth, and our first presenter is Corina Carroll with Big Brothers Big Sisters, followed by Steve Mathias from Foundry.
Each presenter has five minutes, and then we'll open it up to questions after that for roughly ten minutes.
Corina, whenever you're ready.
Budget Consultation Presentations
Panel 7 – Youth
BIG BROTHERS BIG SISTERS
C. Carroll: Thank you. Good afternoon, and thanks so much for this opportunity. I am speaking on behalf of the 11 Big Brothers Big Sisters agencies in British Columbia, and it's quite timely, because this month, September, is actually Big Brothers Big Sisters Month across Canada, so it worked out very well.
I'm always proud to speak about what we do across Canada and, in particular, in B.C. I've been in the field of child and youth care for 29 years, barely starting when I was a teenager. I started, actually, working on the Downtown Eastside, working with youth with significant trauma, addiction and life-threatening relationships because they were vulnerable. It seemed like, every day, there was a new young person who was looking for a place to belong or people to connect with, and they found themselves on the street.
The need to belong is in all of us, and for some young people, there are limited options, which leaves a void. That void was something those youth were always trying to fill. They were all unique, all with their own life story, but one thing they shared in common was not having an adult in their childhood who they could trust, an adult who was their champion and saw their potential. This is what a mentor can be to a child.
For children who have a caring parent or caregiver, having a mentor can add value to their lives, especially for single-parent families or families who have challenges and are unable to be everything they want to be for a child. I think one of the most selfless things we see parents do is admit that they can't do it all and ask for a mentor.
Every year across our province, over 3,200 Big Brothers Big Sisters volunteers ignite potential in more than 7,000 young people. We are in 60 communities and 32 school districts. Research has consistently shown that mentoring makes a difference. More recently, with help from UVic and York University, we confirmed that during a year when so many young people struggled with unpredictability, stress and mental health challenges, the presence of a mentor made a huge difference.
The research conducted across Canada showed that contact with a mentor decreased symptoms of depression and anxiety and that having a mentor was a protective factor against mental health challenges. Children who are mentored tend to do better in school and demonstrate healthier behaviour overall.
Mentoring doesn't just support the children and youth who are being mentored. It has a positive influence on the mentors, who represent the diversity of the communities they serve in. Mentors tend to be more civic-minded and engaged in their communities. In turn, mentoring relationships change communities. Communities with high levels of civic engagement have lower crime rates, and members feel more connected and healthier.
Mentoring matters, and our mentoring ignites potential. Our work is based on a foundation of developmental relationships. Our volunteers are recruited based on the emerging needs of young people, and matches are made with intention. The mentoring relationships are intended to develop socioemotional intelligence, improve mental health and well-being and increase educational engagement and career readiness.
I don't feel like I'm exaggerating when I say Big Brothers Big Sisters mentoring is the gold standard of mentoring, and we do all of this with very little government funding. In fact, most agencies only receive gaming funds with no other funding provided provincially or federally.
You've heard what our impact is. Imagine what we could do with dedicated funding. I think $1 million in annual funding to be distributed amongst 11 agencies could make a huge difference. They would increase our numbers served year over year. Children and youth on our wait-lists could be matched with mentors. Lives could be changed. Potential could be ignited. I hope you will consider an investment in mentoring. Thank you.
J. Routledge (Chair): Thank you, Corina.
Steve, over to you.
FOUNDRY
S. Mathias: Thank you. I'm Steve Mathias. I'm executive director of Foundry, and it's my responsibility, pleasure and honour to be responsible for the implementation of the Foundry network. Foundry is part of the Pathway to Hope strategic plan put together by the Ministry of Mental Health and Addictions and released just a year and a half ago.
This is a non-partisan initiative. This was first started as an initiative in 2016 and continues to this day. At the moment, Foundry is a network of 11 centres, as well as our virtual care service. Foundry offers a one-stop-shop model of, effectively, all the services a young person would need between the ages of 12 and 24. It's quite a unique model, with only Ontario having a similar model, and we continue to see other provinces in Canada adopt the same model as we have here in British Columbia.
Our service offers mental health, substance use, walk-in counselling, as well as physical health, peer support and social services. Those social services are typically predicated based on what the communities see their young people requiring.
We also have our virtual service, which offers similar services, and those services are available to young people around the province. That was launched in April 2020, along with an app that I think this province should be really proud of. It was a huge step, and it's a technology that doesn't exist anywhere else, and so we're really pleased with how that's worked. Well over 4,000 young people have used that service since we launched it.
Since we started serving young people and really keeping data, we have served close to 27,000 young people in this province. Our most common service is mental health, as well as substance use, and we also provide the walk-in counselling, solution-focused brief therapy, which is something that is now offered in our 11 communities.
We've provided almost 200,000 services since we've started, in terms of service visits and contacts. That said, in any given year, there are 725,000 young people in this province between the ages of 12 and 24, and one in four of those young people will have a mental health or substance use concern in any given year. Obviously, we're really concerned with COVID, the impact of COVID, but we're also concerned that this was something that pre-existed COVID and that we'd had a lack of resources for young people in this province.
So the commitment from government to continue to expand the network was really something that we'd been pleased to see. We have 11 centres open, and we have 12 more that we're developing. Eight are expected to open between the years '22 and '23, so starting late this fall and in the next 18 months, and there have also been another four allocated in the past budget.
Our issue for us today, really, is that when we set an expression of interest to see how many communities were interested in receiving a Foundry or building out a Foundry, we had 40 communities apply in this province, and we have current funding for 12. Our funding currently works on a cycle of three years, obviously, with the service cycle that we have.
What we're really asking for is a commitment from both parties on both sides of the aisle to see Foundry through in all the communities that are looking to have Foundries supporting their young people, to really consider the buildout of 30 to 35 of our centres and to allow us a longer runway so that we can plan into 2026 and 2027, so that we can, with assuredness, know that we'll have Foundries being built in the communities that are looking to have Foundries built, and that we can also start working with the municipalities and other non-profit organizations and organizations like B.C. Housing to really create sustainable models and identify the spaces where Foundries would exist in advance so that we have a longer runway.
In effect, we're looking for a four- to five-year runway to build this model out rather than what we have currently, which is two to three years.
In summary, we know that there are probably another 20 to 25 communities looking for Foundry centres, and we are hoping to work with the Finance Committee over the next year to two years to see this model through so that we can maximize the impact for young people around this province. Thank you very much.
J. Routledge (Chair): Thanks, Steve.
I'll open it up to questions. We've got about ten minutes for questions for both of you.
P. Alexis: Big Brothers Big Sisters –– I have been very familiar with your organization. As far as funding goes, I know you've said $1 million would be divided up in 11 centres. Do you receive funding now from gaming or from any other provincial source?
C. Carroll: The only funding we receive consistently is B.C. gaming funding. We operate in schools and in communities without provincial or federal funding, aside from gaming.
P. Alexis: Thank you for that.
Steve, and Foundry, I'm familiar, as well, with your program. It's just absolutely marvellous. I can't say enough about it, and I really want one for my community. I see we're green on the list.
Question. Through COVID, how did you manage through the height of it, when we weren't able to meet and those kids needed services? I know that I've heard reports of where kids were not necessarily comfortable doing things online because they were at home and, perhaps, sharing information that they didn't really want shared and that kind of thing. How did you manage through COVID, through the part where we couldn't meet?
S. Mathias: We were really pleased that we were able to keep all our centres open, except one, in terms of physical locations where young people could come and receive services. Unfortunately, the one that wasn't had been opened a week before COVID struck, so they were just getting their feet under them. So it was understandable.
All 11 pivoted to virtual care within two weeks of COVID's limits being put in place, and they supported the creation of our virtual services. Those virtual services continue today out of each centre, as well as our central service. Unlike some other youth clinics that unfortunately had to shut down, we were able to stay open and, I think, really innovate to reach out to those young people who were struggling.
S. Mathias: We have 11 open right now, and we have an additional 12 that are funded. Are you looking for dollar figures?
S. Mathias: Each one requires approximately $1.5 million to $2 million in capital costs to build the centre out. You can see one behind me. Typically, the government's capital costs are matched with philanthropic capital costs, so we bring in donors to match those costs and offset them. Lots of fundraising happens as part of this model.
Then, in terms of annualized operating dollars, each centre, depending on the size…. In the case of Williams Lake in Cariboo-Chilcotin, they will receive $700,000 a year. That allows the community, then, to purchase additional services.
The purpose of Foundry is to bring existing resources together into one space. This is not all net new. I think part of the charm, and the reason why this works well, is that we create partnerships. We bring and co-locate all those resources that are behind eight or ten different doors into one space, identify the gaps and then top them up with money so that the community, specifically, can purchase the services they're missing.
L. Doerkson: Absolutely. Yeah, I think the program is incredible. I commend Vanessa Riplinger, with her real effort on this to get this forward for us in Williams Lake. How many jobs will it create in our community, or how many could we expect? I know that it's services, but….
S. Mathias: I think that for each one, you can expect anywhere from eight to ten jobs to be created out of that $700,000. One of the things that's really exciting for us is that young people become employed through our peer support model. These are young people with lived mental health experience, who are trained, then, as support workers. Then we see a lot of those young people go on to college and really get into the health services later on.
L. Doerkson: Thank you very much.
M. Starchuk: Corina, you've thrown out the $1 million number. It was, I think you said, to improve wait times or remove the wait-lists. What are the wait-lists at?
C. Carroll: On any given day, they change. We had estimated…. We serve just over 7,000 children and youth a year. With a $1 million investment annually, we would be able to increase by about 5 to 7 percent. We have more than that on the wait-list.
In the Fraser Valley right now, we have, I would say, about 60 young people waiting. We have some that have been waiting two years.
B. Stewart (Deputy Chair): Thanks, Corina, for that information about the Boys and Girls Clubs.
Steve, I wanted to talk to you about…. I recently was toured through a Foundry mobile bus that they have developed in Kelowna because of, maybe, resistance or the distance between that. Is that…? I guess that remains relatively unproven at this point.
It seems to me, with the nature of communities, etc., having a fixed brick-and-mortar type of facility, where many of the communities probably need something that's more mobile…. Is the plan to take it on the road? I guess it's what I'm saying. How many of those will there be out of the 40, or are they in addition to the 40?
S. Mathias: At this moment in time, I think the mobile model is one that we're going to evaluate, like everything we do. We need to see how it goes and then, also, whether it makes sense in terms of the cost. That was a gaming grant that came to CMHA Kelowna. We're really excited that they'll be working to serve young people in Westbank, and our anticipation is in more of the Central Okanagan region as well.
I think that we are open to really working with communities to identify what they feel they need. If it's a mobile service, then let's look to see and develop a mobile service. But if it's a pop-up or a satellite site, like many communities have spoken to, we'll also work with them there.
The idea of this longer runway is that it allows us to identify social amenity space that communities and municipalities may be working with developers to have in place. For us, it's really challenging to do that with an 18-month or two-year window. It's a lot easier to do it with a three-, four-year window, where we can start to support municipalities to create trade-offs between social space, social service space and, say, residential-commercial space.
That's really what we hope we can do. It's to try to advance the runway a bit so that we can, as you point out, better address some of these smaller communities where the young people can't come all the way into, say, a Foundry Kelowna.
J. Routledge (Chair): I'm not seeing other questions. I think that's because you've made very clear presentations. You've really made your case of the important role that you play in communities all over British Columbia and for the youth in our communities and for their futures.
Thank you very much for your time, and thank you very much for the work that you do and for your inspiration.
We'll go right to our final panel, which is on social services. We have four panellists. We'll hear from each of them, in turn, for five minutes and then open it up for questions from the committee to the panellists as a group.
Our first speaker is Jason Gordon, B.C. Association for Child Development and Intervention. When you're ready, Jason.
Budget Consultation Presentations
Panel 8 – Social Services
B.C. ASSOCIATION FOR CHILD
DEVELOPMENT AND INTERVENTION
J. Gordon: Good afternoon. Thanks, everyone. My apologies for no camera.
I'm currently camping in beautiful Squamish unceded territory.
It's nothing but three days of beard and everything else. I'll spare you the camera, but thanks so much for the opportunity.
The B.C. Association for Child Development and Intervention is a provincial non-profit. We have over 30 member agencies across B.C. that contract with MCFD to deliver services to children and youth with support needs.
What I'd like to talk about today are just some of the key areas of investment we'd like to see, moving forward, in the early-years sector. In particular, there's a program called early intervention therapies, which is physio, occupational therapy and speech therapy for birth to school entry. There's been over a decade-long lack of significant investment into the early intervention program.
What we currently face in the province are wait-lists of an average of about seven months, but three member communities at this current time having wait-list times of more than a year, up to a year-and-a-half. These therapists are challenging to recruit and retain, but also, one of the bigger challenges and issues is the high number of referrals coming to this program. We've seen an increase in that with the move to inclusive child care, and the number of child care spaces increasing.
Our first key theme is: early intervention therapies program. Again, about 2008 is the last time there was a significant lift to base contract funding. Every year that goes by without a new increase just adds to the wait times and the intensity of service challenges.
We've lost the history of that program in terms of what community gets what in terms of funding, so we start to see a lot of inequities within regions, where one community will have a certain number of FTE, and another community in the same region, similar size, will have a different FTE, which, again, contributes to a bit of an inequity across the province. We'd like to see the province shift to wait-time benchmarking, to try to establish a standard for what an appropriate wait time is for a family. It would help us flow new resources to the communities that need it most. We're proposing a three-month wait-time benchmark to access early intervention services.
The second key theme we have dovetails with child care. There are two key programs — supported childhood development and Aboriginal supported child development — that help children and youth with support needs access child care spaces. We've been pleased with the complementary funding and increases into those programs as B.C. rolls out its universal child care program.
Of course, just ensuring that we see the steady rise in investments into these programs so that for all new child care seats created in British Columbia, there's some equitable accessibility regardless of a child's function.
Lastly, the third key part we have. Right now a lot of the earlier sector is hinging on a new CYSN framework — a child and youth with support needs framework — that the ministers were working on for several years now. We've been blessed with the opportunity to participate in a lot of that work through the minister's advisory council, and have been really pleased with the sector input on the new framework.
What we are a little concerned about is…. In even last budget, there's no dedicated funding that we could see in the budget specific to helping with implementation of this framework. A lot of the challenges and barriers that the framework hopes to address…. Overall, in general, we're really pleased with direction. But again, a lot of those challenges the framework proposes to address have been created by the lack of significant investments in this sector.
We are concerned that a new framework itself is definitely not the answer. A new framework with significant investment into the sector, however, would provide an opportunity for effective implementation and help the framework be successful in addressing many of the challenges and barriers that have been identified, and are hopefully going to be addressed by the CYSN framework.
Just to review — the early intervention therapies program, supported child development, Aboriginal supported child development and, again, dedicated funding for the implementation of the new CYSN framework.
Thanks again for the opportunity to share our input into budget consultations 2022. I look forward to the presentations by my fellow panel members.
J. Routledge (Chair): Thank you, Jason.
Next, we'll turn to Rowan Burdge, B.C. Poverty Reduction Coalition.
B.C. POVERTY REDUCTION COALITION
R. Burdge: Good afternoon, all. Thank you so much for having me. My name is Rowan Burdge.
I'm joining today from the unceded territories of the Musqueam, Squamish and Tsleil-Waututh Nations. I just want to acknowledge the historical and present-day practices of colonization and recognize that poverty is deeply interwoven with settler colonialism, oppression and genocide.
The B.C. Poverty Reduction Coalition is an alliance of organizations that come together to raise awareness about poverty and inequity in B.C., through the call for comprehensive public policy solutions and a coordinated strategy that addresses the systemic cause of these problems.
We'll also submit a fulsome written report, because five minutes is quite short. We'll have that to you by the end of the month as well.
I'd like to start out by acknowledging the major strides that government has made to reduce poverty, such as the introduction of the first poverty reduction strategy for B.C., the adoption of the universal declaration for the rights of Indigenous Peoples in B.C. and the investment in free public transit for children under 12.
Given the impact of this year's wildfires, heat waves and the continuation of the COVID-19 pandemic, now is clearly a difficult time to prioritize, govern and lead. It's also a crucial time for making critical investments to help support the urgent needs of individuals, families and communities across B.C., many of whom are facing unparalleled difficulties, barriers and threats. For single parents, the cost of child care can be outstanding. For people like myself who live with chronic illness or disability, the cost of medication can also be devastating.
We also know that the pandemic has impacted specific communities in different ways and compounded strife for those who were already in poverty before the pandemic. Indigenous communities, people who use drugs, those who work in grey economies such as sex work and vending, homeless and precariously housed people, people who are institutionalized in prisons, residential care homes and mental health facilities, and many more who face social exclusions are experiencing magnified forms of pandemic vulnerabilities that need to be addressed in targeted, deliberate ways.
Our membership base has reiterated the importance of addressing poverty through economic justice and security rather than charity-based approaches; addressing food insecurity; increasing access to worker safety and rights; tackling racial and gender equality; housing and homelessness; living wages across industries; and, of course, addressing the impacts of climate change. Climate justice must mean full social justice for communities when it comes to equitable economic survival and resilience; access to clean land, air and water; and protection from the impacts of climate change that leave no one in the community behind.
Universal basic services, including health, mental health, education, child care, housing, transportation and access to democratic and legal justice for all those who call B.C. home are key areas of infrastructure that need to be centred in the conversations around the 2022 budget.
We have the opportunity to tackle the public health crisis of poverty and build resiliency through increasing investments in our poverty reduction strategy and building and strengthening publicly funded universal basic services. Budget 2021 did add funding in important areas, such as broadband Internet for rural communities, investments in mental health supports in schools and infrastructure investments that are significant and needed. However, there's much work to be done in terms of providing infrastructure and access provision to secure the basic needs of vulnerable British Columbians.
Though Budget 2021 did announce an increase in disability and social assistance as well as senior supplements, most income and disability assistance recipients remain far below the poverty line. We recommend an increase of income assistance and disability rates, increasing earning exemptions and the immediate elimination of spousal caps for income assistance and disability recipients, as well as access regardless of immigration or citizenship status. We must secure incomes and benefits that far surpass our lowest calculated threshold for survival.
We also recommend fast-tracking the expansion of the publicly funded universal accessible child care system, raising wages for this predominantly women-dominated labour force and also implementing living wages across industries, including government.
We also stand for strong investment in public K-to-12 education and continuing to remove financial barriers for post-secondary students through grants instead of loans, reducing tuition fees and expanding free public transportation to all ages across B.C.
We also echo the Vancouver Food Network's call for stronger poverty reduction legislation and policy, including the right-to-food principles, rather than fragmented, ministry-by-ministry food policy, because as we know, the pandemic has made access to food more difficult for many people, including Black, Indigenous, senior and youth communities.
Though there's a lot of work to be done to support sustainable poverty reduction work in B.C., we really believe this work is possible. B.C. is a wealthy province and absolutely has the economic and financial resources to reduce poverty ahead of the legislated targets.
We really appreciate the opportunity to speak today and share these recommendations. Thank you so much for having us on the panel.
J. Routledge (Chair): Thank you, Rowan.
Next, Adrienne Montani, First Call Child and Youth Advocacy Society.
FIRST CALL B.C. CHILD AND YOUTH
ADVOCACY SOCIETY
A. Montani: Good afternoon, everyone. Thank you for having us here today. My name is Adrienne Montani. I am the executive director of First Call Child and Youth Advocacy Society. We work with a broad, non-partisan coalition of over 115 organizations committed to B.C.'s children and youths' rights and well-being.
We will provide a full written submission later in the month, so today, I'm going to use my five minutes to just outline some key priorities that we want to get on your radar and thinking about. Some of this echoes some of the previous panellists.
We know COVID has disproportionately impacted women's employment, especially single mothers and other groups that were already overrepresented in child and family poverty statistics. Our 2020 B.C. Child Poverty Report Card showed that one in five children in B.C. were still poor — this was in 2018, pre-COVID — and that more than half of B.C.'s poor children live in lone-parent families.
The continuing legacy of colonialism is evident in the high poverty rates for Indigenous children. Other groups disproportionately affected by poverty are new immigrant and racialized children, children with disabilities, and youth leaving government care. The COVID-19 pandemic crisis has now seriously exacerbated these existing inequities and further marginalized poor children and their families.
We know poverty is one of the most powerful risks to healthy child development. Therefore, we start with a call for continued poverty reduction efforts to focus on raising incomes and reducing costs for families raising their children in poverty. Our recommended solutions include accelerated investments in quality, affordable, accessible child care; affordable rental housing; paying living wages; increases in social assistance rates; reducing post-secondary financial barriers for low-income students, as Rowan already noted; and substantial improvements for youth transitions from the care system, among other measures.
We note the efforts government has made in a number of these areas recently. The free transit for children is long awaited. The B.C. child opportunity benefit started showing up in families' bank accounts last fall, and we'll hope to see the impact of that on child and family poverty rates in B.C. in future data releases.
Many children's healthy development is also threatened by inadequate funding for crucial supports and services, as Jason noted. Wait times for assessments and early intervention therapies and children's exclusion from access to child care programs are huge problems for families raising children with support needs, and that CYSN framework that MCFD has developed must be funded to make the promised improvements real. Indeed, many other aspects of this ministry's work to support families and children and the youth in their direct care are in dire need of a significant funding increase to enable them to meet their goals in both prevention and intervention services.
Public school, where thousands of children spend their days, is another system in need of increased investment to restore lost programming and address the inequities created by relying on parent fundraising. At this time, increased funding is critical for the necessary health and safety measures for us teachers and students and for building capacity to respond to student needs that have arisen from their experiences in the pandemic. We're pleased to note new investments in multidisciplinary mental health teams in schools. We fully support this and also urge you to pay attention to the need for school meals for student nutrition.
First Call's partner organizations are also very concerned about the issue of violence against women and children. We're seeing a growing risk. The youth — mostly girls — are being lured and groomed into the violence of sexual exploitation at younger and younger ages. The service organizations engaged in preventative education with children and youth and raising awareness with parents and other professionals are doing heroic work, but they need additional funding to expand their reach and capacity to intervene to protect youth from predators.
An increase in child sexual abuse both in their homes and online is also a rising concern during COVID. The evidence to that effect is around. As recommended last year, responsive services such as the child and youth advocacy centres across the province need stable and adequate funding to be able to help children and families through the trauma of abuse and court procedures.
Similarly, women and children have experienced heightened levels of violence in their homes during the pandemic. The next provincial budget must continue to improve access to safety, emotional and financial support, and transitional housing for women and children fleeing violence.
I've just highlighted a few of our key concerns that our members have brought to our attention that need to be addressed in the next provincial budget. We have a number of more specific recommendations to share in our written submission later on.
I'm happy to stop here, and thanks for your time. I'm happy to take questions.
J. Routledge (Chair): Thanks, Adrienne.
Our final speaker today is Gerard Bremault with the Centre for Child Development of the Lower Mainland.
CENTRE FOR CHILD DEVELOPMENT
OF THE LOWER MAINLAND
G. Bremault: Thank you very much. I'd like to begin by respectfully acknowledging the Kwantlen, Musqueam, Katzie, Semiahmoo, Tsawwassen, Qayqayt and Kwikwetlem Peoples, on whose traditional territories the Centre for Child Development stands and whose historical relationship with the land continues to this day.
I want to thank the Select Standing Committee on Finance and Government Services members and Chair Routledge for the opportunity to provide input to B.C.'s budget consultations.
We are, in brief — founded by families as a registered charity in 1953 — B.C.'s largest child development centre and internationally accredited outpatient pediatric medical rehabilitation centre, serving the ever-growing South Fraser region, and one of the first accredited agencies of the first 100 since 2004. We serve B.C.'s largest population of children and youth with disabilities, special needs and support needs, and we're also home to Sophie's Place Child and Youth Advocacy Centre and Surrey's early years program. Thank you, Adrienne, for the point re CYACs.
Our population in this area represents 40 percent of the children and youth in B.C. and 41 percent of all children with special needs. For more than 50 percent of our families, the primary language is not English, and their self-identification to us is of more than 20 different languages, in a region with more than 60 to 80 different languages.
We fundraise to provide interpretation and translation services for every family who needs that. I mention that because that is equivalent to what our BCACDI membership would be if we were a member, but alas, as Jason knows, we are not. Sadly, we're unable to afford that because we devote our funds, in all forms, to direct service. I mention it because we also have some divergent numbers.
Because of that population size, our wait-lists are up to two years for essential services such as speech language pathology, which is desperately needed across many, many areas of disability and challenge. The 3,000 children per year that we serve throughout the South Fraser are but 10 percent of the more than ten times more that need our services, in a population of 29,000 children from zero to 19 with disabilities. Over 11,000 of them in the South Fraser have severe to very severe disabilities.
Population growth, as Jason rightly mentioned, has increased wait times over time, and there has not been commensurate funding — although we appreciate the funding that has been provided over time — to keep up with, particularly, the high growth in the South Fraser region, with a special note of Surrey and Langley.
We serve the most vulnerable, youngest, medically fragile children, such that, sadly, from April 1, 2019 to the present, 13 of our children have passed away from their disabilities — one of them, I'm including, from COVID. Of those, an even mix was between those in early intervention therapies and school-age therapies. Approximately one child every couple of months — it's the pattern — dies from their disabilities.
We provide the CYA services because we know the vulnerability of those children. Many of our children face a heightened risk of sexual assault and physical assault — in fact, five times more likely — because of their disability than children who are not disabled. Last year we served 232 children through Sophie's Place — some as young as two, the average age nine, two-thirds of them girls.
Our request is in keeping with some of the comments today about equity, integration and sustainability in funding distributions to keep pace with population growth, to provide desperately needed resources for children requiring multidisciplinary, evidence-based, medical rehabilitation and complex care, and to provide lifelong solutions to complex, lifelong conditions. Our current ask and specific request for the South Fraser for this population is $7.7 million per year in additional funding, just to address current wait-lists. That is a moving target, however, because we receive more than 2,500 referrals for service every year.
We have provided our submission to you in writing. I will defer my time now to the committee with thanks for the opportunity to present.
J. Routledge (Chair): Thank you so much. We'll now open it up for questions from the committee.
M. Starchuk: Thank you to all of you for your presentations on the plight, so to speak, that you're in.
My question is to Gerard. I'm looking at page 5, where you've got these lovely yellow umbrellas in all of those slots that are there. You mentioned Sophie's Place, briefly. That's there. Can you expand on just exactly what Sophie's Place is and on who it affects?
G. Bremault: Thank you, MLA Starchuk. Yes, Sophie's Place Child and Youth Advocacy Centre is the Lower Mainland's first integrated child and youth advocacy centre and comprises the RCMP officers on site on a regular, absolute basis, a contingent of MCFD social workers and Ministry of Public and Solicitor General victim services workers. These are actually government employees who work together with the staff of the Centre for Child Development in a holistic child and youth advocacy centre.
We served 232 children last year. Those are children and youth up to age 15, on site at the Centre for Child Development. As mentioned, it's integrated in the child development centre, which is the only one of its type in the province, so that children can come in, in a non-stigmatizing way, to receive services in a family-friendly environment.
This is common to CYACs, as Adrienne knows, as a model, the intent of them. We have a special and unique relationship between that and the child development centre so that we can also attend to the additional special needs of any of the children who might have been victimized, who have an experience of any disability that made them more vulnerable.
J. Routledge (Chair): I'm not seeing additional questions yet, but I'm sure there will be.
I have one for any or all of you. Speaking of wait-lists, we did hear from some parents yesterday who were very frustrated and distressed about the length of time it took for their children to be assessed so that they could then get the kinds of services and help that they needed. They suggested that part of the problem was that ministries were siloed and that that created a problem.
Do you have any observations about that, of how the ministries have been working together or could work together?
G. Bremault: I'm happy to respond. From the Centre for Child Development — I'm sure you'll hear echoes from our fellow presenters — yes, fragmentation, path-finding and navigation are extremely complex for all of our families. It's one of the greatest banes of their reality in navigating across all different systems.
We did research over the last several years. The truth of the matter is, just given the complexity of things, that many of our families who are the least able to navigate those systems lose out on many benefits they might otherwise obtain. Many of them simply can't navigate due to language challenges, poverty-related challenges, the complexity of things.
In fact, I would relate a story quickly. One of the most advanced, most educated families that we've worked with said: "I, frankly, can't figure this out, and I work inside the system. I have no idea on earth how it is that any family who doesn't could possibly navigate the complexity of our social welfare, health care and service systems."
We do our very best in our region to do this, but we're terribly underfunded for social workers and pathfinders to help navigate what are complicated systems. There are two chicken-and-egg problems: one, complexity; two, the lack of pathfinders. It equals three: the problem that parents rightly have advised you of.
J. Gordon: Thanks for Gerard's comments. Just to build on that, one of the hopes we have…. We've been pushing for more of a needs-based approach to service delivery, instead of the diagnosis-based model. There may be an opportunity to streamline some of the referrals to sources by moving away from diagnoses, specifically in B.C., for fetal alcohol spectrum disorder and autism spectrum disorder. However, if we still don't have adequate resources at the service delivery level, at organizations such as Gerard's, those wait times to access intervention will still persist.
The shift to needs-based has some potential to maybe mitigate some of the wait times for assessment, but all of those people are still going to be having issues accessing actual intervention unless we improve resources flowing through to the service delivery providers on the ground.
J. Routledge (Chair): I understand. Anyone else want to jump in on this?
M. Starchuk: Back to Gerard, I'm going through my notes, and I'm going through your presentation. You gave us a dollar figure, and I just want to make sure that we're clear. Is the dollar figure that you provided to us what is ongoing? And is there an additional ask inside of here? I can't see that inside of the presentation.
G. Bremault: I did add, in my verbal notes…. I'm happy to forward it as either a spreadsheet or a budget submission, on that last item that I mentioned, which was $7.7 million per year in additional funding.
We've broken it down into subsets of the different services. They cover the entire waterfront of early intervention therapies — school-age therapies supporting child development, family services, psychology — because we are a multidisciplinary, full-service, wraparound service.
It represents in the neighbourhood of 1,419 children waiting for each of those various services. It represents 65 FTEs. We are a fully unionized health care service provider, compliant with collective agreements applicable to Fraser Health and others serving in this area of service.
I can give that full breakdown to the committee as a subsequent submission.
M. Starchuk: That would be great. I just want to make sure that inside of there, when you talked about your waiting list and the length of time that was there, there was funding that was added into that to try to mitigate or shorten up that wait-list time.
G. Bremault: Yeah, that's the funding to do precisely that, MLA Starchuk.
J. Routledge (Chair): Okay. I'm not seeing other questions, so with that, we'll wrap it up for today.
On behalf of the committee, I want to thank you very much for taking the time to present to us. Your presentations and your briefs represent a lot of work, and I think we know from what you've described about your work that it took time away from other important work. We acknowledge that and appreciate that.
We also want you to know that we have heard you when you have said. We heard two strong messages. One is in the area of prevention — that if we can adequately address poverty, there will be fewer vulnerable children. But there still will be vulnerable children, and we need to have services in place that address their needs. We will be deliberating about that and making sure that we make a strong presentation about that.
Again, thank you very much for meeting with us today and enlightening us about the important work that you do.
I'll entertain a motion to adjourn.
Motion approved.
The committee adjourned at 4:13 p.m.
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- Select Standing Committee on Children and Youth - Thursday, April 11, 2024
- Special Committee to Review Passenger Directed Vehicles - Tuesday, April 9, 2024
- Select Standing Committee on Agriculture, Fish and Food - Monday, April 8, 2024
- Select Standing Committee on Agriculture, Fish and Food - Friday, April 5, 2024
- Select Standing Committee on Public Accounts - Thursday, April 4, 2024