Children and Youth — Issue No. 3 — Monday, November 4, 2013 (HTML)

Present: Jane Thornthwaite, MLA (Chair); Carole James , MLA (Deputy Chair); Donna Barnett, MLA; Mike Bernier, MLA; Doug Donaldson, MLA; Maurine Karagianis, MLA; John Martin, MLA; Darryl Plecas, MLA; Jennifer Rice, MLA; Dr. Moira Stilwell, MLA

2. The Representative for Children and Youth provided the Committee with an update on the work of the Office of the Representative for Children and Youth.

3. The following witnesses appeared before the Committee and answered questions regarding the report entitled 2012/13 Annual Report and 2013/14 to 2014/15 Service Plan of the Office of the Representative for Children and Youth — September 2013

• Melanie Mark, Associate Deputy Representative, Advocacy, Aboriginal and Community Relations

5. The following witnesses appeared before the Committee and answered questions regarding the report entitled Still Waiting: First-hand Experiences with Youth Mental Health Services in BC — April 2013

7. The Committee continued its review of the report entitled Still Waiting: First-hand Experiences with Youth Mental Health Services in BC — April 2013

8. The following witnesses appeared before the Committee and answered questions regarding the report entitled Much More than Paperwork: Proper Planning Essential to Better Lives for B.C.’s Children in Care — March 2013

The following electronic version is for informational purposes only.
The printed version remains the official version.

REPORT OF PROCEEDINGS
(Hansard)

SELECT STANDING COMMITTEE ON
CHILDREN AND YOUTH


CONTENTS
Page
Office of the Representative for Children and Youth: Update	31
M. Turpel-Lafond


Office of the Representative for Children and Youth: Annual Report and Service Plan	39
M. Turpel-Lafond
J. Greschner
M. Mark
B. Naughton


Representative for Children and Youth Report: Still Waiting: First-Hand Experiences with Youth Mental Health Services in B.C.	49
M. Turpel-Lafond
M. Wong

Representative for Children and Youth Report: Much More than Paperwork: Proper Planning Essential to Better Lives for B.C.'s Children in Care	61
M. Turpel-Lafond
J. Chow

Other Business	70

J. Thornthwaite (Chair): Good morning, everyone. I know our clock says it is seven minutes after ten, but we realize that the daylight savings left us at two o'clock on Sunday morning, I think. Anyway, we're not actually more than an hour behind. We're only about seven minutes behind.

Welcome. We have an exciting meeting today, a full meeting today. I wanted to, on behalf of my co-Chair, Carole James, welcome everybody to our meeting for the Select Standing Committee on Children and Youth.

Why don't we do just some brief introductions? One of our members is actually on the phone, and we also have somebody that's coming later. Donna Barnett is coming later, in the next hour and a half, and our colleague…. Moira, do you want to introduce yourself, because you're the one that's on the phone?

M. Stilwell: Hi. Moira Stilwell, MLA, Vancouver-Langara. I'm in Vancouver. I will put the phone on mute, just because there will be some background noise. If I take a bit to respond, you'll know it's because I have to rejig the mute.

K. Ryan-Lloyd (Deputy Clerk and Clerk of Committees): Kate Ryan-Lloyd, Clerk to the committee.

J. Schofield: Josie Schofield. I manage the committee research services, and I'm replacing Byron Plant just for today, as he's busy writing something very important.

C. James (Deputy Chair): Carole James, MLA for Victoria–Beacon Hill and critic for children and families.

D. Donaldson: Hi. Doug Donaldson. I live in Hazelton on the Gitxsan territories, and I'm the MLA for Stikine.

M. Karagianis: Maurine Karagianis, MLA for Esquimalt–Royal Roads. Pardon my croaky voice today. I'm under the weather.

J. Rice: I'm Jennifer Rice. I'm the MLA for North Coast, and I live in Prince Rupert.

B. Naughton: Bill Naughton. I am the chief investigator for the Office of the Representative.

M. Mark: Melanie Mark, associate deputy representative for the advocacy, aboriginal and community relations portfolio.

M. Turpel-Lafond: Mary Ellen Turpel-Lafond, Representative for Children and Youth.

Welcome, Mary Ellen, to the Douglas Fir Room. We're looking forward to your update. Maybe what we'll do is just start off right away.

The first agenda item is the update on the work of the Office of the Representative for Children and Youth. As Kate mentioned earlier, we have, actually, paper copies of all of the reports that the representative is going to be discussing today, but I understand that everybody's probably got them already and, obviously, have read them.

Why don't we just let you go ahead, Mary Ellen, and take over. I've got you down here for about 30 minutes.

M. Turpel-Lafond: Thank you, Madam Chair. First of all, I'm pleased to be here. This is my, I think, 26th meeting with the committee. I'm very grateful for this opportunity and also to have a fairly extended period of time to catch up more in time on the reports. We'll be dealing with three today — first of all the annual report, then a report on mental health and a report on planning for children in care.

Just to update you since we last met on September 23, there were two additional reports released by my office. One is the annual report and service plan, which I actually brought with me on that particular day.

Since then, on September 17, I had just released a report on an aboriginal child who was transferred to a grandparent in another province. That report looks at the issues of interprovincial transfers of children in the child welfare system. We, I'm sure, will have an opportunity to speak about that in an upcoming session.

In terms of the annual report and service plan, I'm going to be presenting some of the highlights and be involving my colleagues in speaking to you about our different program areas and the work that we've completed
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in the past year and the work that will be in the runway in the future.

In terms of a few items, though, before we get to the annual report and service plan, I want to indicate to the committee that the new advocacy mandate to allow the office to advocate for young adults between the ages of 19 and 24 was launched on September 30. I'm grateful for the fact that the Chair was present at our launch in Vancouver. We had a very good event, and there were others present as well. Jenny Kwan from the opposition was present. We had a very positive event with CLBC and members of the community.

In terms of the target of that advocacy, as you know, we are looking to support young adults with developmental disabilities, autism spectrum disorders and fetal alcohol spectrum disorders; young people transitioning out of the child-serving system into the adult services; and those who may be eligible to receive services from CLBC.

We really only have one month under our belt in terms of our experience, but I want to, first of all, recognize the hard work that the staff did — particularly under the leadership of Melanie Mark, who is here — to get the agreements and protocols in place. I also want to recognize that we had very strong and positive collaborative relationships with Community Living B.C. I want to acknowledge the very positive leadership provided by their acting CEO, Doug Woollard. CLBC and my office have had weekly telephone check-ins. We have been working together, I feel, very positively, and I hope that does continue.

In the first month we opened 19 cases. Of course, we fielded many calls from families and others, but we opened 19 cases. Of the 19 cases, I would call 15 as complex cases, complex meaning the client is deemed to be at a high risk either of harm to themselves or high-risk lifestyles — for instance, homeless, not employed or in education or otherwise supported.

The other factor that goes into deeming something complex is that there is an imminent deadline pending — an assessment deadline or an application for service deadline. So 15 of these 19 cases are in that category. Again, it's giving us an opportunity to work with young adults, their families and supporters, where they have supporters.

The most common issues we're seeing so far out of the starting gates are issues relating to transition planning and accessing adequate resources. This isn't surprising, I think, to those around this committee table who have been involved in this issue for some time, as these issues have been well documented in recent years.

As we get into the individual cases and attempt to do our best as advocates to support young people, I think we will have a much better understanding. I'll be sharing that with the committee as we go forward.

Some of the issues are the MCFD and CLBC collaborative practice and planning, issues arising about the Ministry of Health and CLBC collaborative practice planning and cost-sharing agreements, and service planning for individuals with complex health conditions and where there are also behavioural and mental health challenges.

As we predicted, these cases are requiring a great amount of advocate time. Due to the communication issue and the number of individuals involved, I anticipate that our caseload is going to grow. Furthermore, we are in a pretty active outreach phase. Between now and the end of March we are going to provide information sessions in 30 communities across British Columbia to make sure that we get the target population in this advocacy caseload.

We are also taking out — and you will be seeing in some of your constituencies — newspaper ads making sure that affected families are aware of the fact that we can provide these advocacy supports. I'll continue, I think, periodically when we meet to keep you up to date on this and perhaps have an opportunity in our next annual report to speak a bit about some of the cases in which we're advocating.

Furthermore, since our last meeting…. I had reported that I was active in a campaign to promote the idea of tuition waivers for former children in care. I was very delighted that Vancouver Island University was the first institution to implement a tuition waiver program for former children in care and to see a cohort of former children in care enter its admission class in September.

This past weekend there was a very valuable, I felt, article in the New York Times Sunday edition on the experience in the U.S. of children aging out of foster care and being supported on the post-secondary side. I've actually asked that a copy be made and circulated to you today at our meeting.

You will see the amount of effort and energy that is going into the issue in some key states in the U.S., like in the state of California. Different U.S. states have had very dedicated collaborations between government and the non-profit sector and have involved former foster youth in seeing that the cohort of young people eligible attend and are successful in terms of their college participation.

I think you'll find it quite interesting, particularly the California experience, where they have seen some very, very good results. These results only happen because there is strong advocacy and collaboration. It will not happen without that type of advocacy collaboration.

Since we last met, I'm happy to report that the University of British Columbia has now met. The board of governors has approved tuition waivers for former children in care. I'll be working with them and supporting them in terms of identifying students and also as they go forward to implement that. I think that's very exciting.
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As you know, University of British Columbia is among our largest post-secondary institutions in British Columbia, with an enrolment of almost 40,000 at their multiple campuses between the Okanagan and on the Mainland. This is a very positive development, and I have indications from other institutions that they will be stepping forward in the same vein.

I think this is extremely positive. I would like very much to see in British Columbia an approach that the British Columbia way is to provide those tuition waivers and to provide that collaborative support between government, the non-profit sector and community to make sure that young people in care, where the state really is the parent, are having that opportunity to transition into post-secondary.

There's been a lot of interest in the initiative in B.C., including interest from the private sector. I'm planning a stakeholder workshop later on this month with some leaders in the corporate community. I think it's very important that we explore options of how we can in British Columbia develop a foundation, or partner with a charitable foundation, to make sure that the living and other expenses for foster children are covered as they transition into post-secondary.

There is a lot of opportunity for members of the select standing committee, in your constituencies and in your role on this committee, to play a part in this initiative. So I just really wanted to keep you updated but also suggest you think about ways you can do that — join me with leaders in the corporate community.

In terms of the role of the province of British Columbia, the province has not yet fully determined what its position will be on this initiative. It's supportive, certainly. I'm encouraging them very much to do a few things.

One is to make an investment in post-secondary education for children leaving care that will be effective, that will not be a bureaucratic program. For instance, we do have a program now, the youth leaving care program. In my respectful view, it's too bureaucratic. It requires too many applications. And it's dealt with by the Ministry of Advanced Education; it's not dealt with inside the Ministry of Children and Families or in community organizations. It really needs a rethink to be more effective, because this is really not about a program, a bureaucratic program; it's about a collaborative effort.

I'm hoping that the province of British Columbia will develop and participate fully in this but develop a program that will be meaningful, including some transition supports for young people, some transition social work supports, but also some meaningful assistance around some of the living and other costs for young people leaving foster care.

As I've said before on this subject, these issues always drive us back to key things like how children in care are doing in the K-to-12 system, and it encourages us to stay focused on that issue, which I think is so important.

I look forward to giving you an update again on this in the spring. Just putting out the important invitation that we will be working with the private sector, and we will be working very collaboratively on this issue. My goal as representative is to see us establish a firm and enduring program — not a one-year or two-year initiative but a long-term, enduring program that will see some real, significant change from now, where we have 1 or 2 percent of children in care attending post-secondary. I think it's very important for us to set much higher standards, to see 20 to 25 percent, going up to seeing full support for children leaving care in the future.

I also wanted to update you that in the last week of September my office hosted the Biennial Staff Training Conference of the Canadian Council of Child and Youth Advocates. That involved about 80 staff from ten provinces and territories that gathered for two days in British Columbia to learn from experts and each other about advocacy, investigations and child rights.

In addition, the delegates from across Canada were able to participate in the sixth annual awards of excellence — the representative's awards of excellence — which were hosted by Her Honour our Lieutenant-Governor, Judith Guichon, at Government House. Some of our visitors from away had the opportunity to meet the Chair and the vice-Chair of this committee, who were in attendance and presented. I thank you for that.

It was a very positive event, particularly to recognize those who give so much of their professional and personal time to support children and youth in this province. I encourage you to read about the people who received the awards of excellence, on our website.

Some of them are your constituents. In fact, many of them will be your constituents, because this year as we gave out the youth award, we recognized the leadership of young people from all over British Columbia who have participated in the Red Cross programming and leadership and development. Instead of recognizing one or two young people, we recognized quite a group of young people — I think probably represented from almost all of your constituencies.

In terms of the work ahead, before I get into the annual report. During the next couple of months I'll be finalizing and releasing the following reports that I'm sure we'll have an opportunity to discuss later. First is a comprehensive review of aboriginal child welfare in British Columbia, looking at more than a decade of aboriginal child welfare policy, practice and discussions and to answer the question as to whether or not aboriginal children and youth outcomes are improving in British Columbia. And if so, why? And if not, why?

There'll also be a report of an investigation into the suicide death of an aboriginal youth in a remote community. I will be publishing a review of MCFD's program in the area of adoptions, and I will be reporting on the in-
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vestigation of a critical injury of a child in the context of parental addictions.

In addition to that, we're working on a number of other analyses and reports that are underway at the moment: an aggregate review of sexual assaults on children served by the Ministry of Children and Families, an update on our report Growing Up in B.C. We will be preparing an analysis of the recommendations in the reports to date, beginning with a large number of the recommendations and providing an assessment to the select standing committee as to whether or not the recommendations have been fulfilled or are underway and their status.

We will continue monitoring and probably reporting to you and others on the issue of residential services and the residential redesign project within the Ministry of Children and Families and on the information system undertaking the ICM project, which continues to plague us with concern. We will also be speaking to the ministry's performance and strategic management plan. They have a three-year operational performance plan that was developed, and we are tracking that and tracking their reporting on it.

Just with respect to ICM, at our last meeting I told you that the new ICM system remains an issue of deep concern and that I had public safety warning as a result of the problems with this information and recordkeeping. I continue to monitor it and will report on it, and I have not yet lifted that safety warning in terms of the integrated case management system. There continue to be functional difficulties and service difficulties with it. I am receiving reports regularly from the Ministry of Children and Families, but at this point I am not satisfied with the status of that item, and its impact on services to children and youth continues to be troubling.

On another issue, the committee has been kept apprised from time to time on the work of the youth who participated in our 2011 summit on immigration and refugee youth. A delegation of these youth appeared before a former version of this committee. They've been working with ongoing support of the Vancouver Foundation, and recently they published their own report from our immigrant and refugee summit. Their 2013 report is called Fresh Voices.

They've launched an on-line petition called the Make It Count campaign. They already have about 2,000 signatures in support of making English-language-learning classes count as a credit in the B.C. secondary system. In their words: "When a high school student in B.C. learns a new language, they get credit toward their graduation. Unless they are a migrant student learning English." They're very keen to see that change, and I urge members of the committee to support the recommendations in the report. I think they're sound and they're wise. They're primarily directed at the Ministry of Education, and I'm hoping that collaboratively we can see that change made to recognize their effort and their scholarly endeavour of learning English as a language, particularly as immigrant and refugee young people in our province.

One other item that's a bit of a standing item with respect to my reports to the committee is in the area of domestic violence. I reported to you at last appearance that I was concerned that the government has missed its deadline to produce a comprehensive plan on domestic violence as a follow-up to the report into the homicides of the Schoenborn children.

The government had committed in September 2012 to have a comprehensive domestic violence plan prepared and made public.

I regret to report that this continues to be an outstanding item and an item of concern. I do carefully track recommendations that were made, both in the Schoenborn reports and in an earlier report I did into the homicide of Christian Lee. In some recommendations there have been actions; in some, there have not been. I still feel concerned that we don't have that comprehensive plan but also that we're not receiving regular meaningful reports about how services have improved to those who are experiencing situations where they are not safe as a result of domestic violence.

For instance, we made a very concerted effort to improve our family law in British Columbia. A new family act was proclaimed in March of this year, which would allow for a simpler, arguably more comprehensive approach to safety orders, protective orders for victims. I'm certainly a bit worried about that situation in that I haven't got easy access to reliable data on how many of those orders have been issued since March on a monthly basis.

For instance, the average I'm receiving reports on…. The government isn't reporting itself. I'm investigating and obtaining these reports. Approximately 100 such orders are made each month, which in my view is very low considering the rate of reported incidents of domestic violence in British Columbia. It's the second-largest area for reported criminal activity after issues relating to impaired driving. So only about 100 orders are being made each month.

And it's not just what orders are being made; it's what happens when there's a breach of an order. This is where, really, you do work to protect the safety of a victim. You have a protective order. The enforcement of the protective order means everything. We saw that in the case of Sunny Park, who was the victim of a horrific homicide here in south Vancouver Island, and we saw that with respect to the Schoenborn children — the ability to protect victims by enforcing protective orders.

Again, the government is not reporting on this. They are not collecting the data and reporting. This is what happens when you do not have that comprehensive domestic violence strategy — that you do not track it carefully. There isn't a lead responsibility looking across the
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system.

So my understanding is that of these 100 or so orders made each month there are only about 30 reports of breaches for the period from May till August, which, again, I find quite staggering — that there would only be 30 breach reports. And I can't tell you if there has been a single successful prosecution of one of those breach reports.

It's very important that when there's a reported breach there is quickly a consequence, that there is an accessible court process, that there is that safety and support for a victim. I'm sure there have been some. I simply can't go to every court registry in the province and track this as Representative for Children and Youth when I have asked the government to have a comprehensive domestic violence strategy and not only announce it but actually take leadership and report on it frequently.

So I ask myself regularly the question, which is: are the changes that we made to the family act having the intended effect of making women and children safer in British Columbia? Unfortunately, today I have to tell you we do not know. There certainly is a disconnect between the uptake on those protective orders, prosecutions and consequences.

I will continue to advocate that the government do the right thing and have a comprehensive domestic violence strategy in British Columbia and that it report itself regularly on this very subject. Until such time as it does, I'm going to continue to monitor the situation closely, and I am considering whether or not I need to do a special report on child safety outcomes of these new measures.

J. Thornthwaite (Chair): Mary Ellen…. Yeah, I was just going to say I'll give you a little warning that we'll let the folks ask questions if they need. But if you could finish your remarks shortly….

M. Turpel-Lafond: Yes, I'm finished now, Madam Chair, with respect to the general sort of introduction. So I'll just open the floor if there are any questions.

M. Stilwell: I just wanted to thank you for bringing up the article in the New York Times, which I also read. I do think it would be very helpful to have it distributed.

It really brings home the point that the state is the parent of these children and, as you say, the collaboration and the results that have been got in areas where they really took the bull by the horns.

M. Turpel-Lafond: Yes, I think it's helpful, and I think it also speaks to the issue that I'd like to see in British Columbia, not only that we have a strategy that we all work together on despite whatever political affiliation or what have you. We all agree that this is so important, that we collaborate. But I also think it's important that we track and report on college and university programs for children in care. How are they doing?

Again, I'm trying to do some of that with respect to these early programs, but I would like to see us launch a serious, obviously, partnership with the private sector that has been very interested and willing to step forward and support children leaving care. But we track and see if we're making progress. I think we have a really great and unique opportunity in British Columbia to do well.

I realize, as well, that in difficult financial times it's no small measure for universities and colleges to waive tuition at their own cost. I think that's very important, though. What has happened in the United States and elsewhere…. Some of the most successful programs when we look around the world are ones where universities and colleges actually have, as we say, some skin in the game. They actually make a commitment to it, so it isn't just a cost recovery basis where they expect, for instance, government to pay that back. So they're stepping forward, and I really, really think that we have a good opportunity to be successful.

In the United States, of course, there are some major granting organizations. They also have some federal legislation in the U.S. where a state that has some good outcomes around child welfare can get incentives. We don't have any real good performance measures in Canada where we get some incentives for doing well. In fact, sometimes there are disincentives for doing well.

But I will likely be producing a report for the committee on transition of young people out of care, giving you an idea of what actually is available. As we're planning these new things…. I mean, these are coming forward. Obviously, we have lots of advocacy hopes and dreams for better programs and services, but I will produce a report in, I hope, early 2014 on transition of young people out of care. What are they eligible for? What do they receive? There is always a gap between having a program and what they actually receive and benefit from. I'm hoping you'll have a better picture of that.

The U.S. has done a much, much better job of tracking that. So I think we can find some good guidance in those programs and services.

C. James (Deputy Chair): A couple of questions around education, as well as a follow-up.

I found the article interesting, as well, and I think a couple of things stood out for me. One was the tracking that's done after children leave foster care and how valuable that information is. But the second piece was the focus also on the K-to-12 system, because if we don't do tracking in the K-to-12 system, we're not going to have the information and the support we need to be able to have students go into post-secondary education.

I wondered if you could tell us a little bit about any
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work that you know that's going on in the K-to-12 system to even identify and support children in care to be able to go through the system.

Then the second piece is: how are students right now being identified for those waivers, for the opportunity?

Then my last question is just around the education piece. Has there been any discussion around the student loan program? Will this have any impact? Just to make sure those students are still able to access resources for living expenses. If they have a tuition waiver, will they still be able to access student loans in that process?

M. Turpel-Lafond: Right. First of all, I'll deal with the K-to-12 issues. For children in care….

We have to remember that sometimes it's a child that's coming into care for a period of time and then returning to a placement. Sometimes they come in and out over their childhood.

In British Columbia we do have…. We made a recommendation a number of years ago that there would be a person in every school to pay attention to the education status of a child in care. That was accepted. Now, that could be everyone from the school secretary to a teacher to a vice-principal to a janitor. It's not really prescribed who the person is. But at least it brought a level of awareness, which was helpful.

In terms of where the responsibility rests, I think we'll be able to have a very good discussion of this later on this morning when we deal with the report that we are discussing on planning for children in care because it will bring up these key issues of who actually is responsible. I certainly promote the prudent parent model, which is….

Anyone around the table who has been a parent or is a grandparent will know that it's really about the basic things like who is preparing the child for school, who is attending the parent-teacher interviews, and so forth. Who is monitoring and tracking progress if there are delays? Who is accessing remedial and other supports? Who is attending the IEP meeting, if there's an IEP?

These are really the basic issues of how children do well. What I'm certainly seeking as representative is a model or a system in British Columbia that takes that prudent parent approach and can speak to that. Unfortunately, within the Ministry of Children and Family Development there is still a pretty profound lack of clarity on those issues.

The work that we've done with foster parents, for instance. Is it the foster parent that's responsible for the education outcomes, or is it the guardianship social worker? A very key issue, not yet resolved.

I see some differences from place to place. I see some very savvy and experienced foster parents. In fact, when we had the representative awards recently, the advocacy award went to an individual from Prince George. He and his spouse have fostered many young people, including young people who've gone on to university and done well.

The magic ingredient is that he and his spouse treat children in care in their home as if they're their own children. They attend the parent-teacher interviews and so forth.

We do have some very serious gaps in that approach. We'll talk about around planning. Very serious gaps. The big ones are: who is responsible, and are they doing the right things? The other is the fact that we have yet to get the Ministry of Children and Families staff to work differential hours, which are appropriate.

The parent-teacher interview is at seven o'clock at night. If there's no guardianship social worker at seven o'clock at night, that means that child has no parent-teacher interview. No one's attending for them. If the foster parent is not really seized with that and responsible for that or the child is in a group home or what have you, there is no monitoring.

These are very practical things. If I or my husband don't show up for my four children's parent-teacher interview, who shows up? No one else shows up. The basic thing is you have to show up for young people. And when you show up and pay attention, things happen.

We'll talk about that around planning for care, but it isn't working quite as effectively as it could and should.

In particular, I note that the Ministry of Children and Families put out its second performance report, if you like, on its operations. They are no longer publicly reporting on education outcomes of children in care, despite multiple reports from my office saying: "You must continue to publicly report."

Their view is: "Well, if you want a report, we'll generate a report." Well, no. That's not "if you want a report." You must regularly report. I've brought those concerns to the minister and the deputy and said that I want this initiative much stronger.

The tuition waiver issue is extremely important, because it does reflect us all the way back to the K-to-12. People don't just show up at 18 years old ready to take on post-secondary if someone hasn't paid attention between kindergarten and 12.

On your final question with respect to student loan programs, we're looking at that. I don't think there is any prohibition on applying for and obtaining student loans, when there's a tuition waiver, to cover living and other expenses. However, I really would like to see a charitable foundation either identified or expanded to support that.

The young people we're working with…. The idea of taking out a loan of the magnitude that they need to take out is so beyond their financial experience and capacity. Even though we all know that's a fantastic investment and it's certainly affordable, it is so prohibitive to them that they don't apply for it. I think they will take out some of that, but I would like to see some foundation support — also, the complexities of doing it.

On the identification. We've been working collaboratively to identify and confirm that it's a child in the child
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welfare system. And we will need to have those sorts of informal arrangements in place, because we don't want the child in care who's going to university to feel like they have a stamp on their head: "I'm the child in care." We want them to be a part of the student body. It's a discreet process, and we want that to continue.

M. Karagianis: Mary Ellen, I wanted to talk a little bit about the domestic violence strategy. This is not a new topic. You have brought this topic up to the government several times in the past. Do you have any idea what the impediments are at this time to fully engaging initiatives around the province?

I know there was some attempt here in the south Island. I'm not sure how successful it's been. What are the impediments at this point, as you see them?

M. Turpel-Lafond: In the south Island after the Christian Lee report was issued, I was very pleased that the Victoria police department stepped up and said that they would work toward an integrated domestic violence committee with social work, transition house, victim services and others. They made a commitment to do that and put two officers into an initiative. They last year pulled one officer out because they felt they couldn't financially manage that.

That is important. We have some of these regional committees around British Columbia — we have a handful of them — which actually try to collaborate to identify the high-risk cases. This work is really important — that that exists in all communities. That hasn't been fully rolled out. Not only is it not fully rolled out, but it's not being evaluated effectively.

Not surprisingly, around the province in my role as representative, we're called in by some of these committees saying: "Can you help us get victim services here? Can you help us get sufficient resources so that these committees will work well to be able to provide safety and support in tracking and monitoring of these high-risk cases?" So there's good innovation in terms of people in the front lines of the system, but they can only do so much without an integrated strategy and plan.

We need some consistency. If someone wants to initiate one of these strategies in a new place…. Let's say Kamloops decides they're going to have an integrated strategy. What can they learn from what has happened in Victoria? Has it worked?

Other provinces, like Ontario, have an annual meeting on their high-risk protocol — of all their police agencies, victim services, child welfare staff — where they meet together. They have in place some very strong policies but also strong regulations. We don't have anything like that in British Columbia. We're far off of that.

What is needed is…. What has been recommended is an actual provincial strategy to tackle the domestic violence issues involving the key partners in policing, victim services, child and family services and some peripheral support around education, social assistance and health. You need to really launch it, and you need to report on it. You stay focused on it.

We do have a provincial office of domestic violence, which was created after the Schoenborn report. That office has been assigned some leadership responsibility, but in my respectful view, this really needs to go and get the support of our provincial cabinet and be rolled out with some clear leadership and some clear accountability. It may need some additional resources or realignment of resources. But we can't just amend statutes like Family Law Act and expect things to change if, as they say in the policing world, there are no boots on the ground.

Someone has to actually be out there making sure safety is meaningful. A section in a statute that allows for an easy protective order means nothing if you're not getting that protective order and enforcing it when there's a breach. If women in particular, who are disproportionately the victims, don't feel that those orders protect their safety, then that is a failed measure. When you have a new statute, it's your opportunity to really get out there and work hard at it.

I'm concerned our time is lapsing and we're not effectively out there. So I'm urging the government, "Regularly meet with provincial office of domestic violence," and urging the minister and others to push harder on this issue and see this happen. It's overdue.

D. Plecas: Perhaps if I could just ask again about the domestic assault concerns that you have, in particular regarding the lack of an integrated approach. I'm wondering if that's really nothing more than a reflection of what's going on in the criminal justice system in general. We've been talking for years about the need for an integrated approach across the board, and that just hasn't happened.

I also wonder if — at least in my experience — it's been more a function of players on the ground who really just can't get it together in terms of working together with other stakeholders. I would say, in my view, one of the biggest offenders is prosecutors. They can make things happen.

We've been talking about their need to make things happen for, again, decades, and it's just talk, talk, talk. So while the government certainly can provide some encouragement to do this…. Everybody's been talking about the need to do this. What you're telling us is what everybody has been saying, and nothing, nothing, nothing happens. What would you suggest we could do?

M. Turpel-Lafond: Well, first of all, I probably would disagree with a few points. With respect to the role of prosecutions, prosecutions plays a vital role. For instance, if there's a breach, they receive the report to Crown that
[ Page 38 ]
police investigate, and they have to decide to proceed. They need to have clear instructions that these are important offences that should be dealt with in an expedited fashion and that they're a priority for government. Government sets the priority.

We had a very successful project in the Lower Mainland. Prosecutions had a special DV prosecutor to fast-track and make sure that these breaches happened. That prosecutor was reassigned to the Vancouver courthouse during the Olympics because it was important to take care of some of those priorities, so we lost that because of the different political direction that came to the fore a few years ago.

I think that speaks, in my experience, to the fact that government does set the priorities. The prosecution service in British Columbia is a strong and effective service, but you know, they do what they are told, effectively. If they are told that gang activity is the number one thing you're going to be doing or covering over the Olympics because courts are going to be shut down, they will cover their responsibilities. They are contracted by an employer, and their services are acquired, so their working environment has to be clear that this is a priority.

Specialized prosecution resources to understand how domestic violence situations really do affect communities are crucial, but they have to be supported, and they can't just be reassigned constantly, which has been a concern over the last number of years.

Around the direction they receive, I agree with you. We have had some confusing direction in terms of the criminal justice issues. The former Attorney General commissioned a report by Mr. Geoff Cowper, QC, looking at administration of justice in British Columbia to make some suggestions. He made two recommendations. One was to strengthen the domestic violence protections, including having a provincial domestic violence plan, which I was pleased to see.

He also recommended that we streamline administrative offences out of the criminal justice system, which I wasn't very keen about because breaches of protective orders can be considered administrative offences, which you don't want to have taken out of the system because you need real enforcement. Prosecutors, I'm sure, scratch their heads like I do and say, "Well, that doesn't really make any sense" — on the one hand, streamline these cases out, and yet on the other hand, that is the stream for security for victims. There has to be a clear strategy.

One of the reasons why I'm pushing hard for a provincial-wide domestic violence strategy, so it's clear and on paper, is: what is the direction of the government of British Columbia? Is it to stream these cases out, meaning there won't be breach prosecutions? Or is it to deal with them? I think this is where you have to land on a position and take it out and take it forward.

Clearly, for both Sunny Park and the Schoenborn children, the criminal justice system did not work. For Sunny Park, in particular, there was no safety for her, and the Schoenborn children…. You know, the telebail hearing that led to the release of Allan Schoenborn and then the murder of his children was nothing but a joke. People didn't even know who was speaking. It was because you didn't have a proper judge sitting in the place working and didn't have a priority on domestic violence.

The domestic violence issues require a lot of serious work. You know, I was hoping that by now, 2013, there would be a presentation before this committee of the provincial office of domestic violence telling you what they're tracking and reporting. They would just routinely tell you how many orders were sought, how many prosecutions were held, what was the consequence, what kind of safety…. How can we indicate there's a better standard of safety? This is about your constituents being safe and when there is a situation of violence. I'd like to think there's been some innovation, but it hasn't been consistent, so direction has to be brought to this area. It takes leadership to put that direction in the criminal justice system.

D. Plecas: Again, I would just say that I think it would be helpful if you could put under a microscope, you know, the efforts for family violence, domestic assault courts.

It's just been my observation that they don't operate as they're supposed to operate. I would say that, again, it is my experience — and this is from seeing people trying to move heaven and earth to get people to work in an integrated, holistic fashion — it just never happens. It's certainly not for a lack of effort on behalf of police. It is, over and over and over again, people from courts who are not ensuring that people are held accountable. Like, breaches are not prosecuted. For the most part, it's an exception if they are.

I think if you drill down on that, it would…. The finger needs to be pointed more strongly at our courts, because they can, as a stakeholder, be a major force in making things happen. I know where individual courts have done that, they have made a difference. They are the ones who can spark other stakeholders to work in an integrated, helpful fashion. At the end of the day, they will yell and scream that there's a need for this. They'll say they're doing it, they'll say how important it is, but they will not do it.

Again, it's just so unfortunate that we're having to talk about this now, because all I'm doing is saying what people were saying 30 or 40 years ago. My fear is we're going to be saying it again 20 years from now. While we can discuss and talk about it, we need people to get off their butt and actually do it.

M. Turpel-Lafond: Well, I couldn't agree more with
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the last comment in particular. I think that your comment about courts and so forth…. You know, we called, in the Christian Lee report, for domestic violence courts to be initiated, to be effective, to deal with breaches promptly — what is a DV offence? — to have that type of priority commitment to the victim and focus.

Those initiatives have been very successful in Calgary, Edmonton, Saskatoon, Regina, North Battleford, Winnipeg, Toronto and Thunder Bay. I can name many other places where they've been launched, they've been evaluated, and they work. They are not in British Columbia, so there is definitely a problem with why it does not happen in British Columbia.

I mean, in every instance, those initiatives have been a collaboration of people in the front line of the system — whether it be judges, prosecutor, police, victim service people — and government. We have to have that movement in British Columbia. We have to get it going. In the meantime, I may need to do a special report looking at safety.

But I do need the cooperation of the criminal justice branch reporting in a transparent way on its enforcement efforts. I mean, how many charges are approved for breaches of these orders, how many are prosecuted, and what's the result of that prosecution? It's an A, B, C issue: how many come up; how many are approved; how many are convicted? I just want to know the numbers. Is it one case in all of British Columbia where there's been a conviction for a breach of a safety order? If that's the case, it cannot possibly be enough.

These are the hard facts that I think you need, as a committee, to know whether or not this is improving. It isn't about whether we feel safe or we're talking about it. All of that is important, but it's whether or not the systems work on the ground in a coordinated way, and that requires a detailed focus and analysis and leadership in a single-point government reporting regularly.

If they don't even have a plan to be reporting on, we are months and months away from progress, and they're already more than a year beyond the plan. They need to bring it back in and get that accomplished.

J. Thornthwaite (Chair): Okay, we have time for one quickie little question, and then we have to move on to the other topic.

C. James (Deputy Chair): Just a comment more than a question. I just want to follow up on that. I think we talked at our last meeting about the fact that in the future…. I think it's at our meetings at the end of November or beginning of December — I forgot the dates — where we'll come back and have a discussion about recommendations that are coming. I think it's just important in this discussion and in the discussion that the member has raised that we ensure there is a place for those recommendations to come back.

I think we all agree that that work needs to happen, but it also needs leadership. There have been recommendations in place that could be followed to actually move this along.

I agree it takes everybody in the system, but I think the leadership has to come from the top. We have recommendations for government to look at, to follow, to report out on, and they haven't been.

I think it is critical that we remember that when we have our discussion around how recommendations come to the committee and how we could, in fact, support that and support the representative in following up on those recommendations and, hopefully, giving a push to make sure that they do so.

I know that'll be a future discussion, Chair, but I thought it was just important to raise it in this context.

J. Thornthwaite (Chair): Yeah. The ministry has also agreed to come, and we will be discussing that format as we move forward. Thank you very much.

I think we should go on to the next topic — No. 2, the annual report and service plan of the Office of the Representative.

Mary Ellen, we've allotted 30 minutes for you, but obviously, there seems to be a lot of interest in questions, so just keep that in mind when you are going along.

Office of the Representative
for Children and Youth:
Annual Report and Service Plan

M. Turpel-Lafond: Thank you very much. This is our annual report for 2012-13 and service plan for 2013-14–2014-15.

First of all, this is our second combined report, where we do both a service plan and an annual report together. I'm very pleased with the format. This was recommended and suggested by the standing committee — that we combine the two, mirroring some other independent offices, like the Office of the Auditor General. I think it's been quite successful.

I again want to express my thanks to members of this committee and the former Chair of the committee, who was very keen to see that there be reporting on performance measures for independent offices such as mine.

We have a very helpful process to identify what you can you report on when you are an independent office such as ours and what kinds of measures we can see to make sure that the work is happening with the public, with children and youth, but also that these offices are an effective use of resources and really pull together the initiative that we are expecting there to be in terms of achieving a mandate and a vision and measuring goals that are set and approved and submitted before this committee.

I'm really very pleased about this report and this style
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and format — and the accountability. I can say that with respect to the staff…. You know, we have some 45 people working in three offices. We are a small office, really, with a relatively small budget considering the size of the ministries that we monitor and report on, but the performance measures provide some really clear targets for staff as well. It gives you that motivation in understanding that commitment that we have to report on the response times.

We really have our key outcomes being: are we relevant, are we responsive, are we accountable, and is there excellence? That comes down to a personal level. So again, I'm always very grateful, as representative, to have excellent staff, committed and working together and coming together to achieve this, and the unique relationship we have in British Columbia, where we have a strong Select Standing Committee on Children and Youth that plays an active role in this and that we report to regularly.

What I'm going to do on the performance measures is ask my deputy, John Greschner, just to walk you through the performance indicators and our targets and some of our secondary indicators. If you start, I would say, on page 41 of the report — probably a good place to open to — we'll walk you through what we're reporting. Then I'll speak a little bit about what we're going to be doing. I'm going to invite, also, my colleagues Bill and Melanie to speak about their program areas.

J. Greschner: Thank you, Mary Ellen. It's important to understand, as I'm talking about this, that in each of the four outcome areas, we identified one — and, in one instance, two — key performance indicators. Then we have some sort of secondary ones. The key performance indicators are reported on page 48 in a table, and the secondary ones are reported starting on page 41 in the text of the report.

We do call these outcome indicators. They're not outcome indicators in the sense of: did the system change? We make recommendations, we do analyses, and we report publicly, but we do not have decision-making authority or budget-making authority over the programs and services. So these are our outcomes, within our office, of the work that we do.

For the first of our key performance…. I want to mention also that the data that we base our reporting on here comes from three sources. One of them is our internal management information systems. The second one is publicly available reports, and the third is third-party survey data. In some, we've done some surveys in order to get at the issue that we've identified.

To start with the relevance outcome, the key performance indicator here is the proportion of reports undertaken by the office in response to issues raised; matters brought to the office's attention; or questions from MLAs, the public and stakeholders. The target that we established for that is 40 percent. We achieved 60 percent, but we put the target back to 40 percent.

This is a bit of a skate here, because we want to be responsive to MLAs and stakeholders and the public. However, if you read the statute, we don't have a representative to do just the bidding of other people. There's considerable discretion there and, in fact, requirements to take action on issues as she sees them. So we don't want this to be 100 percent. We don't want it to be 10 percent. We want it to be moderate and account for maybe around half of our work.

In the relevance area we have a few other indicators that are not the key one. They include public accountability for the reviews and investigations function. We do that by ensuring that we report regularly to the public. We have, since the beginning of the office, done a report every four months. It's posted on our website; it's published and so on.

Progress on recommendations is another indicator of relevance, through ongoing monitoring and tracking. You have a table in the report that gives an update on the status of our recommendations. In addition to that, as Mary Ellen indicated earlier, we plan to do a deeper analysis of this and make it the subject of a report later in the year. It gets pretty complicated, actually.

Although it would seem to be a simple task to figure out if a recommendation has been achieved or not, sometimes there are areas where there's been some weaving and dodging or alternative actions taken. So we're going to go deeper and take a look at that in the coming year.

Relevance to the public is another indicator of relevance for us. One of the ways we get at that is taking a look at what goes on, on our website. In the last year there were 590,000 hits to our website, which was 18 percent over the increasing year. Although this doesn't answer the question fully of if we are relevant to the public, it gives us an indication that there's a lot of action on our website and there's a lot of interest in the work that we do, so we must be relevant, at least to some people.

Relevance to stakeholders. Here we did a stakeholder awareness survey, and we sent it out to 712 stakeholders. We got 202 completed surveys back, and 93 percent of the respondents had some knowledge or knew a great deal about the representative's mandate, more than 80 reported they were aware of the representative's three core mandated functions, and more than 88 percent felt that the office addressed issues of significance to the mandate.

Seventy-six percent felt that the representative's reports were objective, 83 percent felt that they were independent, and 84 percent felt that they were credible. We're going to fiddle with these questions next year, because we're having some difficulty figuring out how 84 percent rate them as credible but only 73 percent rate them as objective. We have a number of explanations, but we have to get in there with a bit finer analysis.

On the responsiveness issue, the key performance
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indicator here is timely and effective responses for assistance and support from vulnerable children and their families. Then we have a second KPI that deals with the screening and review dispositions of reports that we receive on deaths and critical injuries.

In terms of the percent of cases in which we respond to requests for advocacy within the established three-day response time, we've set a target of 90 percent, achieved 99 percent, and because of the importance of this, we've set the target next year for 100 percent.

In terms of the percent of screening and review dispositions of reports that we receive on deaths and critical injuries and the degree to which there's a disposition decision made in our office within two weeks, we set a target of 85 percent and performed at 100 percent. We saw no reason to shoot lower than that in the future, so we have set the target at 100 percent.

The associated performance indicators on responsiveness have to do with responsiveness to advocacy calls. Now, this is youth requests. Previously we were talking about general requests. Our goal is to ensure that all youth who come into contact with our office have an initial response to their contact within 24 hours. In the last year we achieved that 100 percent of the time — 254 calls in total — and 94 percent of the time the calls were responded to on the same day that they were received.

We also did a satisfaction survey. The target rate that we had was that 75 percent would be satisfied with the response time. What we got out of our survey is that 66.9 percent were satisfied with the amount of time it took to respond to their inquiry. Again, I think we have a problem with our question, and we have to fine-tune it a bit, because the result doesn't quite make sense — the two of them together.

Community relations and stakeholder engagement are another way to look at responsiveness in our office. We track the number of appearances or presentations that our office does — Mary Ellen or staff appearances at community events and so on and so forth. In 2012-13 we attended meetings with 100 organizations, went to nine community and stakeholder events and conferences, had 14 special speaking engagements and visited 33 communities.

Aboriginal relations is another area where we make an association with their responsiveness. In this instance, we met with 20 aboriginal organizations and individual First Nations in the last year and heard a lot about the federal government's directive 20-1 in the process. That's the way that federal government funds child welfare services on reserve. We remain also engaged with the 23 delegated aboriginal agencies through the First Nations Directors Forum. As Melanie will tell you when she's talking about our plans for the coming year, the year that we're currently in, a lot more activity in this area is planned.

Finally, we look at relevance from the perspective of youth participation. In 2012-13 we involved youth in the work of our office in a number of ways. We got formal input from youth to three audits or reviews that were done, and we had an on-line youth survey. We continue to be involved with various youth forums, including Gathering Our Voices Aboriginal Youth Conference, Federation of B.C. Youth in Care Networks and a cross-ministry Youth Engagement Networking initiative.

Our third indicator is accountability, and our key performance indicator there is the number of reports that we receive. Our stock-in-trade is reporting to the public and to government about what's going on in the child welfare system. We targeted five reports. We delivered seven reports, and we're targeting five reports again. So far it looks like we're going to be outstripping that one again too.

We have another indicator of accountability, which is the number of times the representative makes presentations to this committee. It's not entirely, of course, under her control, but in 2012-13 the representative appeared before the committee four times and presented seven reports that she had previously released, including last year's annual report and service plan. At each of these meetings, as is our practice, the representative also provided updates on the work of the office and general issues of concern.

Our final indicator has to do with excellence. Here we really focus on what is going on with our staff and what we can measure and encourage in terms of confidence and skill-building. Our key indicator in this area is the percent of permanent and part-time staff who participate in professional development activities. We set a goal, a target of 78 percent. We achieved 82 percent, and we upped it to 85 percent for this year. That's what we'll be hoping to at least achieve, because that is so important.

The other indicators of excellence here are staff contributions to meeting the mandate of the office. We did our first staff contribution survey in 2012-13, conducted by an independent firm, and it found that the vast majority of staff are proud of the work they do. They understand how their work contributes to the work of the office. There was a high level of employee agreement that the work environment in the office is conducive to learning and development and that staff are well-informed and consulted on decisions affecting their work.

Generally, employees reported there's a positive work environment, that we value diversity and work-life balance. The areas that we've identified for enhancement include how we recognize staff and the timeliness of communication of decision-making between executive and staff, which is an ongoing challenge.

We'd like to improve teamwork in the office. Although we do a lot of teamwork, we don't do it so much formally, and we're looking for ways to do that as a way to improve the excellence of our work.
[ Page 42 ]

We also looked at health, safety and well-being of staff, demonstrated by events that happen in the real world — such as a quick, competent and thorough response to a gas leak we had in our Prince George office and access to early intervention and return-to-work programs to support employees who have had significant illnesses or injuries. For health and well-being, we like to participate as an office in things like the Times Colonist 10K and Bike to Work Week.

Ongoing compliance with core policies is the final way that we look at excellence. That's measured through the degree to which our office policies and procedures adhere to applicable core government policies, standards and practices, and meeting budget and audit standards and requirements. We again in the last year had a successful audit result, and we were found to be in full compliance with core government policies, standards and practices.

So that is performance indicators. It's been a useful thing to do. It was worth all the work last year to try and figure out what we would measure and how we would deal with it. We did that in collaboration with the Chair and Deputy Chair. It took a while to get these hammered out. We'll report on many of the same of them in the coming years.

I'd like to turn things over now to Melanie Mark, who is going to talk about the expanded mandate and the advocacy program. There's a little bit of complication here because we've already spoken about the expanded mandate. Now we have to put ourselves back in time, because this is our annual report from last year.

M. Mark: I'll speak briefly to our biggest change for the office for 2012-2013, when amendments were made to the RCY Act and proclaimed on March 14, 2013, of this year.

Essentially, what it meant was that we would now be able to do advocacy for young adults between 19 and 24 years old with developmental disabilities who are eligible for CLBC services, along the FASD and autism spectrum disorders. Operationally, this meant hiring staff and making some changes to our advocacy program area.

With respect to the advocacy program area, we're mandated to provide information, advice and assistance to anyone who contacts our office. Our role is to help them navigate the system.

In last fiscal we opened 1,811 advocacy cases. A big systemic issue that we're seeing across this program area is the transition planning for those in the child-serving system into the adult-serving system — if they're eligible, if the service exists, if they have an adult to support them along that process.

We've launched a youth survey project to look at how young people are grading our services when they're engaging with the advocacy team. That was launched in January 2013. We've had to use on-line resources. We've text messaged the survey to the youth and mailed them if they're in youth custody, to ensure accessibility.

We're continuing to work with youth at the custody centres in Prince George, Burnaby and Victoria. That includes a monthly outreach clinic so that they're aware of our office and that they can access our advocacy services confidentially.

We continue to do advocacy outreach. This includes giving information sessions, being at booths, providing child rights workshops. In last fiscal we visited 29 communities and provided eight child rights workshops.

Last fiscal we also took part in and launched a cross-Canada collaboration teleconference meeting with the other independent offices across the country, just to have a handle on how they're approaching advocacy — what issues they are facing, how we can share notes and look at best practices together.

We are into the second year of the child rights public awareness campaign. That was led by the Society for Children and Youth of B.C. and the RCY, as well as the B.C. Centre for Safe Schools and Communities and Reel Youth.

It builds on phase 1 of the public awareness activities by providing child rights education and advocacy supports to caregivers, children and youth, and aboriginal and immigrant and refugee communities across the province. An example of this activity is awareness campaigns all throughout the bus stations and the SkyTrain banners, just to raise awareness around child rights.

I'll jump into our involvement with the aboriginal communities, as this is a part of my portfolio. Outreach and engagement with aboriginal communities are a high priority for our office. For those of you who understand that we've got 203 First Nations in B.C., 23 aboriginal delegated agencies, it's quite an undertaking to be physically present throughout the province. However, I take every opportunity that I can to meet with the delegated agencies in person to have an understanding of some of the issues that are facing them as well as their best practices.

We regularly attend the First Nations Summit meetings and take part in the First Nations Directors Forum partnership table. We continue to collaborate with the First Nations Education Steering Committee and are in the process of developing our aboriginal outreach strategy with the aboriginal agencies, the aboriginal leadership throughout the province.

I do have to take note that I started in January, so those three months into fiscal we were well into planning and developing a strategy that makes sense for a provincial office like ours.

With respect to youth participation, which is also a part of my portfolio, we're keen to get young people involved with our office. That includes children, youth and young adults for our new mandate.
[ Page 43 ]

We developed a youth engagement strategy. We interviewed youth in care with respect to our adoptions review, which we'll speak to. We've conducted surveys with youth in care, and we talked to them about the plan-of-care audit that we'll be reporting on later this morning. We continue to work with the Fresh Voices Youth Advisory Team as follow-up to the October 2011 Champions for Children and Youth Summit.

Our focus for the year ahead. We've got a youth engagement coordinator hired. We continue to want a presence with social media on Twitter, Facebook, YouTube. We're enhancing our child rights workshops and working closely with the cross-ministry youth engagement networking initiative.

The critical injury review and death function, or program area, within our office obviously continues to review critical injuries and deaths of children who are receiving reviewable services or who are children in care of the province. We continue to produce investigative reports on individual cases as well as aggregate reviews of trends in critical injuries and deaths to inform important improvements to the health and well-being of children in B.C.

During the period covered by this report 100 deaths and 300 critical injuries of children and youth were reported to our office. This is approximately double the number reported in 2010-2011. This reflects significant efforts on our part, as well as the Ministry of Children and Families, to provide more accurate reporting with respect to this very important issue for children in care.

Of the 400 death and injury reports received, initial screening resulted in a total of 225 cases — 32 deaths and 193 critical injuries — which met our criteria for further review. The 225 cases stand in stark contrast to the 116 that we looked at in 2010-2011. So you can see that effectively, our workload has essentially doubled as a result of the changes to our reporting practices.

More than half of the 225 cases selected for review involve aboriginal children and youth, which reflects their general overrepresentation in the child welfare system.

Activities in the program area in 2012-2013 included the release of our report Trauma, Turmoil and Tragedy: Understanding the Needs of Children and Youth at Risk of Suicide and Self-Harm. That was released in November of 2012.

This was an aggregate review. It looked at the circumstances of 15 youth who died as a result of suicide and another 74 youth who were engaging in self-injury behaviours over a three-year period.

If you look on page 21 of the report and look at the table titled "Number of critical injuries by category and gender, 2011-2012" — again, on page 21 — you'll see that suicide and self-inflicted injury represent a very significant proportion of the number injuries reported to us. So again, looking at those sort of trending events where we want to place particular attention on issues that we see emerging as a result of our ongoing monitoring.

We also released the report Who Protected Him? How B.C.'s Child Welfare System Failed One of Its Most Vulnerable Children. That was in February of 2013.

The incident that sparked this investigation was the tasering of an 11-year-old child with very complex special needs. This report reviewed his entire life — the spectrum of services he and his family received — and it placed particular emphasis on the issues associated to the residential care system and gaps in that system that we identified across the province. We remain connected to this child via our advocacy program to this day.

The representative referred earlier to our special report Out of Sight. This related to an issue of interprovincial transfer of custody, where a young girl was placed with a grandparent in Saskatchewan with very tragic outcomes. That report was released in September, and we'll be presenting it to this committee at a future meeting.

Internally, we have initiated a number of changes to try and cope with our increased workload. We have eliminated a director position.

I should point out that the investigation section is now a team of ten, led by myself — four investigator positions, three research analyst positions and two administrative support assistants. So we're a small and tight team, but by eliminating the director position, we were able to fund an additional analyst position. That's great assistance in terms of dealing with that doubled workload.

We've also been making regular outreach efforts with other offices across the country. We've been initiating regular teleconferences with other advocate's offices across the country to share information on current investigations, investigative techniques and other areas of common interest.

In terms of our plans for 2013 and 2014, the representative has already, I think, highlighted some of those activities. We have two aggregate reviews in process at this point. One relates to group homes. This is, to a degree, a follow-up on the report Who Protected Him?

The other relates to another trending issue we're observing, which relates to the sexual victimization of children who are in care or who are receiving services from the ministry.

We have currently four investigations underway. One is examining the issue of child protection. That's in the context of parental substance abuse, which we know is a very important topic in this province. Another relates to the suicide of an aboriginal youth in a very isolated community in the province. A third focuses on the circumstances of a youth who came to the attention of
[ Page 44 ]
our office after nearly dying of a heroin overdose in the Downtown Eastside. Our fourth and most recent investigation is focusing on child protection in a context of parental homelessness.

D. Donaldson: Thank you for the report. Having been Deputy Chair of the Finance Committee for three years, I can say that your reports from your agency were always in top shape and really well laid out, and this one is similar in that aspect.

I had a couple of quick questions. One was on the expanded mandate and the number of advocacy cases. I think you quoted 1,811 advocacy cases that were covered by the representative's office last year.

Given the expanded mandate that became effective the end of September, have you and will you be applying for additional funds in the staffing line item in order to handle the anticipated increased workload? Maybe you could give me a timeline on when that's going to the Finance Committee for approval.

The other question I had was on the report of critical incidents, on page 19, reported to the representative. Maybe you could expand a little bit on, again, that pretty significant jump from 2010-11 to '11-12 and '12-13. I mean, critical injuries going up from 136 to 413, deaths reported going from 88 to 100 — that's a 25 percent increase. I think I caught the drift that it was perhaps a change in how things are reported, but obviously, those kinds of numbers jump out at you when you're looking at an annual report. So if you could expand on that a little as well.

M. Turpel-Lafond: Sure. Let me first take the first question with respect to budget and so forth. Around the expanded mandate, as I reported at our last appearance before this committee, we did make a special appearance before the Finance Committee and got an interim lift, which was about a $300,000 lift. We did hire six additional positions to support us with the new work.

At this point I'm not anticipating asking for a significant increase with respect to the budget of the representative's office when we do table our budget next month. There may be some capital costs associated with housing those people, particularly in our Burnaby office, but the attitude that I have at this point is one of the cross-government attitude, which is that we have to try and hold the line here with respect to the work that we're doing. We're trying to get maximum value for what we have, so I think we're in a year where we're going to track pretty carefully what the demand is.

With that lift — which was just recently confirmed — to the budget, I anticipate we're probably going to be coming forward with pretty much a stand-pat budget, except for some capital variance. My judgment is that we need to work within that for the next year, so I've been pretty clear with the staff.

There have been some clear policies across government around things like freezes and so forth. I think that while we have to get our work done, we also have to be mindful of that. We have to work in that spirit. That is the kind of team attitude that we have in the office. So you will receive and see the budget, particularly if you're also on the other committee, next month, but you're not going to see a significant request, except possibly some small amount on the capital side.

On the second question, which is on the increase, I'm going to ask Bill to speak to the issue of why the numbers went up and what we're doing with that and the policy issues around the ministry reporting its injuries to us.

B. Naughton: You're exactly correct in your observation that this reflects, I would suggest, not a change to the level of injuries or deaths but, in fact, significant changes to reporting prospects.

The genesis of this change came about as a result of a report we became engaged with called Isolated and Invisible. It dealt with the circumstances of a young girl with Down syndrome. She was living in a trailer park with her mother in the Lower Mainland, and her mother passed away. The girl was left alone in the trailer with the body of her mother for a period of approximately a week.

We became aware of this via media reporting, but we did not receive a reportable from the Ministry of Children and Families because their view was that she had suffered no long-term, sustained physical injury as a result of this.

It was our view, of course, that this young woman had experienced very significant trauma. As a result, we issued a special report dealing specifically with the issue of reporting these kinds of emotional injuries and these kinds of trauma-related injuries. That resulted in, as you said, the very significant spike in the number of reports that have occurred.

We're still in the process of attempting to finalize our reporting protocols with the ministry. That's been a work in progress for quite some time. It's been stalled to a degree by issues related to ICM as well.

I would say, for the purposes of the reports to the committee, what concerns me is that despite the enhanced levels of reporting we do see, examination of any number of files that we are reviewing usually reveals to me a number of, again, unreported critical injuries, many related to traumatic events that are very significant. So I am concerned that there is still a systemic issue with underreporting, and that remains an issue of some concern to us.

Melanie, it's great to hear of your advocacy efforts and
[ Page 45 ]
the report on that. Can you tell us something about what the results of those efforts have been?

D. Plecas: Across the board. Like, you have X number of instances where you advocate. What is the net impact of that? I ask that because so often people in general seek to advocate for children and others having one issue or another, and more often than not, nothing happens.

M. Mark: I think that our efforts result in positive outcomes for children and youth. Section 10 of our act really allows us the access to information. Information is power. It helps us to understand how a decision was made and who the players are making the decision. Those 1,800 cases are getting longer. It takes longer to result in a positive outcome when we're getting involved.

I can say that because I've been with the office since the beginning. Sometimes resolution could happen in a month. Now it could take three to six. I don't want to give a quote, because it depends on the type of circumstances, but out of those 1,800, I would say that we get positive results. Does that mean we have to get an exception to policy, or does that mean it has to go to provincial office? Where does the case have to go? It's an area that we have to look at systemically.

For Bill, on page 21 of the report I notice the one figure that shows the number of instances, in table 5, of undetermined cause of death. I was surprised to see that we've had 11 cases in 2012-13 of undetermined cause of death. That seems staggering to me.

B. Naughton: In a lot of cases the undetermined nature, of course, relates to findings from the coroner's office. That's their categorization, for example, and it reflects some issues around the availability of coroner services that are variable across the province.

It also reflects in many cases, for example, incidents of sudden unexpected infant death. In these cases, coroners are now making findings related…. They're calling those cases undetermined. That may explain, in part, the jump you're seeing in that particular category.

D. Plecas: If I could ask, too…. It would be helpful in future if those numbers could be broken down by aboriginal and non-aboriginal. I guess for the present, if you could tell us, as I would suspect, if the aboriginals are grossly overrepresented there again, and even more so than in other categories.

B. Naughton: I think if you refer to table 3 at the top of page 21, you'll see that we break down deaths in the 2011-2012 period into aboriginal and non-aboriginal. As you suspected, in fact, it's almost identical — 15 non-aboriginal and 14 aboriginal.

M. Turpel-Lafond: Just a follow-up on that question. We also put out quarterly reports. In addition to our annual report, we do quarterly reports. They're a little bit more detailed on the critical injury and death files that come in. We break them down by gender and status as well.

Just on that issue of undetermined, while we have the undetermined category, sometimes in a year it will say undetermined, and it will change the next year because we have, for instance, a toxicology report or what have you. There are occasionally some in that file where it will change in the next year. That just represents the timeliness.

After there has been a death, under the RCY Act, we have to give the coroner a year to do their work. If their work is incomplete within a year, we can go ahead. In some instances it isn't completed in a year. There is timeliness in some places but not everywhere. We, occasionally in our reports, are not able to be accurate because we are relying on them and they won't have completed the work, or the year will pass and we'll commence. Sometimes we do commence an investigation, and our report is in draft form before the coroner has completed theirs.

So this is very important. While we report, there are other public bodies that have a key role here, and we collaborate with them, but we're sometimes responsible to report out on their categories, which are not entirely clear in terms of what may have happened to a young person.

C. James (Deputy Chair): I want to echo the positive comments that have been made on the report as well. I like the mix of the annual report and the service plan. I think it gives the committee and certainly gives the public the information they need to be able to look at both the work and the focus of your work but also the data behind it. I think it's a great mix.

I also think the performance measures are terrific. I think, again, it provides some very clear information. It'll help guide the work of the committee as we look at…. If we end up taking on special projects or other things, this provides us with some information and some data that we may be interested in taking a look at. I think it's very helpful to the committee to have this kind of information as well.

Just a follow-up question on the advocacy work. Again, it's just more information. Do you keep track of where the calls come for the advocacy work? I'm just curious. Do you get the majority of your calls from youth them-
[ Page 46 ]
selves? Do the calls come from organizations, from foster families? I'm just curious whether you do any kind of breakdown around where the calls come in.

Then also, I think more back to the systemic work that you do based on the advocacy work. You mentioned transition was a large area that you focused on. Do you also do a track on whether you get a lot of concerns coming from particular regions or particular areas? Again, I'm just thinking about follow-up work for the ministry. If there are a lot of concerns coming from one particular area or one particular region, it provides them with some data that they perhaps could use to improve services. I'm just curious whether that kind of information is kept.

M. Mark: It most certainly is. Twenty percent of our calls are from young people themselves, and we do track by region, by community and by district office. We had to change our system to reflect the CLBC regions because they're not in line with MCFD's regions.

The bulk of our calls come from Coast-Fraser. We don't get that many calls, relative…. We get about the same 20 percent across the Interior, the north and Vancouver Island, but the bulk of our calls come from Coast-Fraser. We do track who initiated the call. The bulk of our calls also involve aboriginal children. Yeah, we do track it.

M. Turpel-Lafond: Just on that, while this is our public report of our annual activities, we do…. For sort of like an 80-20 relationship, 20 percent of the public reports, our effort goes into that; 80 percent of our effort really is in working with the ministry on a daily basis.

For instance, if we learn that there is an office, let's say in Fort St. John, where there's no one working for whatever reason — MCFD can't operate the office — it will happen that we receive a bunch of calls. It might be from social workers, family members, youth, foster parents. We see this. We see hot points in the province. That would happen, and then we would pretty quickly engage in that region. I would engage with the deputy or the director of child welfare and say: "Okay, what's going on here?" It's almost like a systemic issue will emerge.

Then there are some systemic themes. Early on in our advocacy mandate we had a lot of cases around who pays for orthodontics for kids in care, for instance. We sort of solved that one. We don't get them very much anymore because it's solved. But then new things come up.

So when we see a systemic issue, it may become a report. But it likely becomes a discussion with responsible…. We'll be talking today about two areas. Mental health is one, as an example of where we see the systemic issues coming again and again. We will do a report.

Then when we produce a report, what will happen is we will occasionally get a spike in calls because there has been public attention to an issue. So if it's a mental health report, we will get a lot of calls around the mental health issues. The volume is affected by different things, but our engagement is obviously on the individual file — but also to engage with the ministry and service providers to say: "What's happening? We're seeing this." We do have kind of a multiple stage.

We don't include, in the annual report, how many times we engage with the director of child welfare and the deputy, because we assume that that's part of our business, and we want to keep that going. So 80 percent of it is that kind of work, and the 20 percent is the public reporting component.

C. James (Deputy Chair): That's great. Thank you. I think the last piece that I just wanted to mention is appreciation for the surveys that you're doing with your staff. I think, again, that's a good plus around a healthy organization.

Certainly, for an organization that deals with such difficult information, I would think health and wellness of staff is critical, with the kinds of reports that you're doing, with the kind of information that's coming to staff. That's a very important piece to be able to measure and a very important piece to be able to track. Just a thank you, and a thank you to the staff for the work that they do in your office as well.

D. Plecas: Again, I also would like to say I think your report is great. But I'm wondering if you have available…. I'm not saying this could be included in future reports, because it'll get to the point where it's too large for anybody to read. It seems to me it would be very helpful to have a breakdown of that data as a population rate.

I know that's complicated because we're talking small numbers to some degree. But I think it would perhaps highlight more…. Not that it needs highlighting any more than it is, but it might be useful in terms of…. At least, it's my understanding that the aboriginal population of youth is growing faster than the general population. It would allow us to be more attuned to what those numbers mean.

M. Turpel-Lafond: We always can break it down, and we can also send you a copy of the breakdown, because not everything comes into the annual report. We use it for other purposes, as well, and share it with the ministry, for instance. I can see that you receive some of that breakdown, if the committee would like to look at that further.

It's important, I think, with respect to the overall big picture, that we have a strong presence everywhere, that people know that the service is there. We're not just a Victoria-based office. It's really important that we are where children and youth are. I give great credit to Melanie and the advocates in particular, because they are getting out. It's a challenge to both carry a caseload — some very difficult cases that require you to sit and really problem-solve — and get out all over the province,
[ Page 47 ]
including doing outreach.

We have had consistently, over the last number of years, a strong aboriginal outreach. Eighty percent of the aboriginal population in British Columbia is off reserve and in major urban centres of Vancouver, Victoria, Prince George and Kamloops, and so we have a strong presence there.

But this does affect us. And the earlier question about the finances, which is….

You know, I can see, in the future, if we will be effective, we will need to expand into the Interior — Kamloops, Kelowna. We will have to have a stronger presence there to be able to serve that. When you look at the large populations there, where issues come from, we are serving them out of, largely, the Burnaby office. I'm just mindful of that, because when you think about healthy staff and being effective and being sustainable, it probably isn't sustainable in the long term to have that staff in Burnaby cover such a wide area of the province.

I know just for myself, travelling fairly extensively during my professional career — both as a judge in my home province of Saskatchewan, all over the place, and here in British Columbia — it's difficult to cover an entire province and to be close to the community in a way that you need to and be on top of it when something is happening.

So our office, I think, does a very good job, but I do feel we bump up against some important limitations, which are that we need to be there. There are places, particularly for the Ministry of Children and Families, where it just has not really ever operated effectively in some places in British Columbia. It's never really had a fully staffed, fully operational function. So these are bigger factors that I think are really important as we look not just beyond one year but into the future — how we can strengthen some of these services and supports to citizens who really do need them.

Bill, when you were talking about the data on critical injuries and death reports, I understood you to say that reporting out on this is still not completely effective. Is that in some part due to the ICM issues, or what do you think the impediments are to getting full details and information and a fully effective reporting system on both of those?

B. Naughton: I think, without having a databased answer to provide to that, my observations and things I've seen in the course of conducting investigations in the last two years…. I would suggest that workload plays a role in terms of reporting.

In many cases, workers, on interview, will reflect back to our investigators that although they perceived a situation to potentially represent a critical injury that would be reportable, that workload…. They're more concerned with trying to deal with the situation than they are with dealing with what they see as a somewhat bureaucratic process in terms of generating a report.

In terms of ICM, I think it's a given that the increased workload presented by ICM and the issues of navigating ICM simply exacerbate those existing stresses on the system. So I think there are a number of things that come into play. There's also clearly an issue of awareness and an issue around the necessity of our finally hammering down with the ministry and establishing an agreed-upon protocol that hopefully could be embedded into the ICM system to trigger reporting in a more comprehensive and accurate way.

It's a complex issue, and a lot of it relates to staff workload and to the additional challenges they face with the information systems.

M. Karagianis: With regard to the staff workload…. I mean, I know we've been through a crisis. I don't know if we've got…. Do you have accurate data on whether or not we still have a crisis at the front lines, where we have far too few front-line workers for the casework? And is this, again, part of the symptoms of the system? This would be a systemic issue, most certainly.

M. Turpel-Lafond: There is no question in my mind that there is a systemic problem with the workforce. It's always the issue of, you know, how many people doing what work, trained and accountable in what way. It's a combination of factors.

The challenge we have with the hiring freeze and budget issues is they have what you call underburn, which is that there are full-time employee positions, but they're not staffed. So as people have left, in attrition, many, many offices are unstaffed, and positions have not been filled.

Filling a position in an underburn situation requires a special permission process right now, given the freeze. While that might make good fiscal sense for a variety of imperatives that government is impacted by, it really is problematic when you have small offices that were already not really operating.

You know, one person is on sick leave. The other person has carried all of that person's load, and then that person leaves, and what happens? And you don't really have an emergency team that you can send in to cover because they're already covering things. So there's no question that the workload issues are significant.

The FTE underburn, if you like, inside the ministry is something that we try to monitor and report on. But it is, of course, something that they really are not too keen to share on a daily basis, and same with things like accumulated leave, sick leave, so on. The health and well-being of that workforce is very important. But it's most important that the office is open and someone is responding.
[ Page 48 ]

I think this is one of the reasons why we have not been able to achieve the issue, which we'll talk about when we deal with these reports in a moment, about differential work hours — getting people to work hours that are meaningful for children and families. You have to have someone working, to be able to work those hours, and it can't just be an FTE placeholder — that at some point we'll staff those up.

So there are really serious issues around the workload and the impact that that has on other people who are in the office working, because they tend to assume someone else's workload when there's no one else there. We have, for instance, Fort St. John, where you have a very serious issue of FTE underburn. Who covers that?

This is important to us, to be on the ministry, but the ministry needs to continually bring this up to the powers that be at cabinet and the Minister of Finance and others and explain that these services need to be functioning and why. We want to have that pressure inside the system that the story is being told.

J. Thornthwaite (Chair): I just thought I'd make a little shout-out to Moira, if she's still there — I don't want to forget you if you've got any questions — and to welcome Donna back. We're just finishing off the annual report and service plan, if you have any questions or comments.

I've just got one question. When you're doing the accountability performance measures and indicators like, for instance, on page 45, has there been any interest in comparing what you do in your office in British Columbia to what other offices of a similar capacity do in other provinces?

I would think that that would be of some interest to see how…. You're coming up with these reports, but what are you really comparing them to? Are you comparing them to yourself from the next year — going, going, going? What do you consider the value of comparing your office to the workings of others in a similar capacity across the country?

M. Turpel-Lafond: Well, I think it's valuable. I think it's very valuable to do that.

Unfortunately, we've mostly been in a position where we've been sharing our experience with the other offices, who are sort of in a different stage of their development. For instance, there really isn't another office that has a select standing committee on children and youth to report and have that scrutiny of not only the work that's being accomplished but, you know, whether it's being done in a way that members of the Legislature feel it needs to be done. I've certainly been really promoting that elsewhere — for people to consider that, because I think it's valuable to be able to do it.

We still see annual reports of child advocate offices being pretty much without key performance targets. There's service but not targeting. We've shared our surveying with some of the other offices and encouraged them to look at that, and then they're sharing it back with us — policies and so forth.

So we do quite a bit of that across the country, but I wish I could point to, say, Ontario and say: "Here it is." But in Ontario they don't do child investigations on child deaths. That's still with the coroners service. They don't actually monitor their child welfare function. They do youth participation, largely, and youth engagement. So it's hard to see…. They're like apples and oranges.

The Alberta one has got operational just in the last year, and we've done a lot of work supporting Alberta through the legislative stage, supporting the request for information from the government of Alberta as they created an independent advocate. They are doing a child death investigation function now. They've done one report. We were very supportive around sharing investigative techniques and so on and encouraging them to have robust public accounting. So that's been a very interesting relationship that I think will grow.

They are actually larger than we are in terms of the numbers. They are quite a significant initiative. They have a few areas that we don't have in British Columbia. They run a legal services program that makes sure that children get represented, and it's quite a successful program.

So this is a good point — that we look at them and we see if there's anything we can draw. At this point they're mostly drawing from us, but that could change in the future. So we always want to monitor that interjurisdictionally and see where it is. But at this point they don't use the key performance indicators.

Again, I give credit particularly to members of this committee who are here and to the former Chair, who was really keen to work on this. I think it's extremely helpful, not only for me but I think for all independent offices of the Legislative Assembly. While we're independent, we do report through committees and so on. But it is good to have this dialogue and also to have some measurement, and then to change.

One of the big things we reported on last year was the six recommendations of the standing committee to change the RCY Act. When that happens, government accepts it, but someone still has to advocate even for those — and so getting that done. It's an interesting collaborative relationship and a little bit mysterious to some of the people from other jurisdictions who don't quite understand how we do things.

I think it actually has some very good success. But if we don't report, including us, I don't think we'll be able to have that important dialogue.

I'm not seeing any more hands, so I guess what we could do is move on to….
[ Page 49 ]

M. Turpel-Lafond: Madam Chair, would be possible for us to just take a very short break? Five minutes is fine.

J. Thornthwaite (Chair): We are now going to move on to the third agenda item, Still Waiting: First-Hand Experiences with Youth Mental Health Services in B.C. On that note, I'd like to introduce — perhaps, Michelle, would you like to introduce yourself? — a new person.

M. Wong: Thank you. I'm Michelle Wong. I work at the Office of the Representative for Children and Youth as the director of evaluation and strategic directions in the monitoring, research, evaluation and audit area.

Representative for Children
and Youth Report: Still Waiting:
First-Hand Experiences with Youth
Mental Health Services in B.C.

M. Turpel-Lafond: Great. Thank you. We're going to turn, then, to the report called Still Waiting: First-Hand Experiences with Youth Mental Health Services in B.C. This was released on April 9, 2013. This report is a reflection of services in the area of adolescent mental health from those people who receive them — youth dealing with mental health problems, and their families, as well as those people who deliver the services on the ground.

In terms of developing, I'm delighted that Michelle has joined us at the table. Michelle was the lead from my office with respect to this report. It was, again, approximately a three-year endeavour to produce a report because there is not a single report in British Columbia that describes, on the ground, the experience for young people navigating the mental health system. I apologize to committee members that the report isn't as clear as it could be, in part because there is no system that is coordinated or seamless for adolescents in the mental health area. So the report describes that experience and describes the system.

But I want to begin by drawing your attention to a diagram in the report, which is a diagram from the World Health Organization, on page 31. It's hard to jump in without understanding sort of what you would look for if you were looking for a system of mental health services and supports, particularly for adolescent mental health. The WHO diagram is used. It's accepted by the government of British Columbia in terms of the Ministry of Health, the Ministry of Children and Families. It's sort of an internationally accepted diagram of what you have in terms of formal and informal services in a care system.

At the top of that, the peak of it, it's low, but there will be a need for long-stay facilities and specialist psychiatric services. Then there are psychiatric services in general hospitals, community mental health services. Then you have primary care mental health services that can sometimes be provided, for instance, by GPs in British Columbia. And then you have informal community care and self-care. You can see…. Just that diagram — it's a spectrum. It's a continuum.

When we look at mental health and we looked at the preparation of this report, what we were hoping to do would be to map and understand experiences by young people during a crucial period but also the service streams in British Columbia and how they were represented.

Now, a conservative estimate in Canada is that a mental illness will impact a citizen in their lifetime. The estimate is about one in five. About half of the lifetime cases of mental disorder begin by age 14 and three-quarters by age 24. So this period of sort of 14 to 24 is a very important period in terms of identification of early presence of mental health issues — whether that's mood disorders or full psychotic moments and episodes. The whole spectrum of mental health issues will generally present themselves in adolescence.

We know that sometimes they present much earlier. We look, in this report, at the child and youth mental health services and supports given to children up to age 14 and over 14. But this key period — the 14- to-24-year-old period — is so significant in terms of having an effective system, having a lifelong system of support in the mental health area.

We also know that that period of adolescence is significant because adolescents may engage in other high-risk activities during the same time that may have an impact on their mental health and well-being — such as polysubstance abuse and other activities. That might be an attempt to control or address a mental health challenge that remains unidentified. This is a major concern.

Again, we have very poor information in British Columbia about how frequently that happens. We have our own anecdotal experiences. There is no easily identifiable source in government. For instance, you don't just phone up the Ministry of Health in British Columbia and say: "Oh, please, can you give me the health map for adolescents with mental health issues so my constituents or my child can understand what is our pathway to care." There is no map in British Columbia.

Mental health services are delivered between two ministries. Ministry of Children and Families has child and youth mental health responsibility. Ministry of Health has, of course, these items on the upper end of the pyra-
[ Page 50 ]
mid — facilities, psychiatric services, hospitals and some primary care. So mental health services in British Columbia are the product of accountabilities in at least two ministries. There are a few others.

Then, of course, community agencies, non-government organizations — many non-government organizations of importance — operate in British Columbia. We have the FORCE, which is a provincial-wide organization that advocates. It's parents advocating for their children of any age that are experiencing mental health challenges. We also have mental-disorder-specific NGOs, whether it be the Schizophrenia Society or the OCD organization. There are many different NGOs that function. They are not necessarily service providers. They may raise awareness or provide support to parents.

What we've done in this report is we've really looked at the experience of families. How we did it is we did a number of…. The methodology involved a number of steps. First of all, mapping services to the extent we could and then putting ourselves and also surveying and engaging with those at the front lines of the system. What happens when the young person, the 15-year-old, presents with a serious mental health challenge?

Behind the report and not included in this report but in other work of our office are many examples of where young people are experiencing mental health challenges which result in, for instance, aggression in their families. So there is family aggression, and we have had cases in British Columbia. For instance, a parent is murdered by a child who is in a psychotic episode and who seeks support in a hospital, but there isn't necessarily an adolescent unit for the person to be in, and something very bad happens in the family. We've had homicides.

But we've had a lot more assaults, for instance, in the family — trying to manage behaviour in the family context, involvement of police sometimes and aggression. So these are situations where, in my office, we've had many engagements with families who are struggling to manage and find support for an adolescent who is having challenges. Frequently we're dealing with parents where they're: "Is this normal adolescent behaviour? Is this a mood disorder? What is the challenge that's happening here? Someone help me understand how I can support the young person." And there's a range of behaviours.

The approach to this report. While we've had many of these cases and we continue to have many of these cases, the approach was to try and map the services as we understand them, to try and delve into the complexity by carefully engaging with the Ministry of Health and its health authorities and the PHSA, the Provincial Health Services Authority, and with MCFD in its regions and its agencies to describe what will happen.

In the end, it's sort of a mishmash description because there is no uniform system. In some regions everything is contracted out to one agency. In others it's shared. In some instances there's a protocol with the hospital. In some instances there isn't a protocol with the hospital. The only overarching conclusion we can make about the system is that it's a fractured system that is chaotic and is confusing on the ground.

It's frustrating to navigate. Certainly, in the surveying that we did with children and families…. But we also did extensive surveying with health care professionals in the front lines of the system — emergency room physicians, psychiatrists, GPs, nurses, others. It's frustrating, difficult to navigate.

Well, long wait times — sometimes up to a year for a youth waiting to see a mental health professional of some kind for an initial assessment.

Lack of suitable acute care. This is a recurring theme. On page 60 you will see our best attempt to look at the numbers of beds in the province. We reported that there were 67 beds, if you look at those particularly for mental health — so lack of suitable acute care, specialized emergency care, community-based intensive intermediate care.

We also found poor transitioning from youth mental health services to adult services and a lack of communication, coordination and planning between and among service providers.

As I said, it's really not a system in the true sense of the word but a patchwork of services that's inconsistent from region to region — and many regions where there are no services available. In this prime window for prevention — 16 to 18, early adolescent years — British Columbia doesn't really have a system in place to reach out to that key developmental stage.

The numerous complaints, I guess, that we've received from families trying to navigate the system…. Of course, in this role we're approached frequently by families and community members who present a concern. We may open an advocacy file and assist them.

But maybe that's the experience in the Fraser — that they have this challenge — or maybe it's an experience in the north. Is it a broad-based experience?

In terms of mental health, I think it's fair to say — based on our mapping, our surveys, the focus groups that we conducted throughout the province with consumers, providers in the mental health system, youth, parents and caregivers; 853 surveys — that this is a provincial problem, that there is not an adolescent mental health care system.

You know, this report represents the broadest report in terms of direct feedback from those providing service — 338 child and youth mental health practitioners from MCFD and health authorities, 82 adult mental health clinicians, 91 community social service practitioners, 85 physicians, 94 parents and caregivers. They all responded in detail to provide the feedback, which is that the system isn't working for them, from a provider perspective,
[ Page 51 ]
from a consumer perspective.

What has happened as a result? As we all know, there has been a significant effort in the past decade to destigmatize mental illness, to understand that mental health challenges are like any other health challenge that requires support and that one doesn't hide the mental health challenges in a family and avoid services and support. We bring them out, whether we're a parent or whether we're a young person, and so forth.

The campaigns to eliminate stigma in mental health have been very important, basic campaigns. The only challenge is that in British Columbia we had some very good campaigns, but we did not provide services. When people come out — and some 20,000 people make a request for mental health services in a year — we can't respond to the requests. We don't have a system defined.

The emblematic experience that came out of our report, in our collection of information, was the direction of a young person, with or without a family member, to go to an emergency room. Appear in the emergency room, and they say: "Well, yes, you're experiencing a mental health issue, but we can't support you because we don't have adolescent mental health here. Maybe we'll put you on a pediatric ward. Maybe we'll put you on a maternity ward for a day. But we're not going to get any support, so you're going to be released to go back to some sort of community professional." Then you will be placed in a referral circus, waiting for a year or what have you to get some kind of support.

Will the support that you receive actually be consistent with what your needs are? It's not one-size-fits-all. It might be a mood disorder, where there are some depression symptoms. Or there could be a full psychotic episode happening, where a young person is hearing voices in early-onset schizophrenia. There might be some drug use.

There is a whole range of issues. However, the pathway — it's not the pathway mapped by the ministries but the actual lived pathway — for citizens is generally through an emergency room, the emergency room staff saying, "We can't cope with this because we have no resources," and occasionally certifying a young person under the Mental Health Act and keeping them, if there's a bed to keep them in, or sometimes certifying them and keeping them in a place that is not an appropriate place, like a maternity ward.

Youth, parents and caregivers told us that, first of all, service providers failed to recognize sometimes the severity of mental health symptoms. But more failed to respond, didn't have the tools to respond to them. Sometimes young people were told, "Just stop what you're doing" — the cutting behaviour or the mood issues or hearing voices. People can't just stop having mental health challenges, when one in five Canadians has a mental health challenge.

I put it to the committee that we have destigmatized mental health, but we have not provided an adolescent mental health system — from the views of those surveyed and engaged with, who took a very strong view with us that mental health should be like any other health condition.

If a young person is presenting with type 1 diabetes, they get a quick assessment. They may become insulin-dependent. They receive a good program of instruction on how to self-administer insulin, how to check the blood sugar level, how to stay connected to physicians, nurses, endocrinologists in school, and so on. We have a program, right? It's diabetes. We understand that we will support it. It's a health care initiative.

If it's a mental health issue, and someone is presenting with severe depression, there is no passport to care. Really, it's: "You're just going to have to go home and stop doing what you're doing" or "Good luck to you to find someone who will help you."

We see lots of shortages of services. We're not having the psychiatric services, not necessarily having a clinical model in British Columbia and not really having a community-based model.

Half of the parents and caregivers that were surveyed said their child was placed on a wait-list, and most of them said those wait times were significant. The youth spoke of waiting for a year. Forty percent of physicians indicated that wait times of six months or more are typical just for assessment.

The way services are delivered can represent significant barriers in terms of where a youth has to go and how they're served. As I said, there's no single set of core services across the province. Everything varies by region, and community delivery mechanisms differ, leading to great frustration for parents and family, who can frequently be overwhelmed.

When we asked if the services are easy to find and access — mental health services for youth — two-thirds of the respondents, particularly the youth, said they disagreed or strongly disagreed that they were easy to find.

Parents and caregivers indicated that they didn't feel well supported when trying to help their children with mental health problems, and one-third said they did not have access to any parent support services — namely, the sort of family model of helping a family prepare and support their loved one, whether it's a child or a sibling. There are significant gaps.

At the top of the system the gaps in terms of the beds. I directed you to page 60. Really, if you look at the population of young people and project what the number of beds should be, it should be more significant than what we see here. There's not a simple formula, but other provinces and jurisdictions have a different arrangement.

We have these two top units — you know, B.C. Children's Hospital, its adolescent psychiatric unit with
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ten beds; and then our Maples Adolescent Treatment Centre, which is an MCFD centre that has some 20 beds — but it depends on the time and the place and who's in there and so forth. They're very small, small resources and short-term resources — in-and-out resources, in terms of the in-patient support.

How you get in, how you get supported and how you go out is a constant challenge, and no services have been harmonized or organized in a seamless way.

Around this issue, the concern that many family physicians and clinicians had was that because the pathway is through the emergency room, what did they find out about their patient? Let's say that the young person has a family practitioner. Does the family practitioner then get a report from the emergency room? Does the family practitioner get a report from a school counsellor or someone working with the young person? A lot of concerns about not finding out what's happening. One physician told our review: "I don't know what they're doing with my own patients."

There were mixed reviews when someone is actually in in-patient care, whether it be the adolescent unit or Maples, about when they return to community. Mostly there's planning, but they can't be sure that the community has transition supports to assist them when they return back home. This is particularly true for rural areas where there's no transitional planning happening because there's no service or follow-up care available in the community.

Mandates on mental health in British Columbia are not based consistently across these services. The health authorities have different mandates, age mandates. Even identifying how old or young you can be to be in an adolescent unit varies by place to place. Some places you can be 12. Some places you have to be 14. Some places you're not allowed to be there after 16.

In many places, between 16 and 18 there's nowhere to go. You're assumed to be in the adult system, but people are not comfortable in the adult system, and they will not stay or participate in the adult system, because they feel frightened or intimidated by it.

Most community mental health services funded by MCFD, for instance, only go to the 19th birthday. Then you're in the adult system. How is that transition from the 19- to 20-year-old, between the youth and adult?

Most of the youth told us, sort of consistently, the same view, which was…. One youth told us: "I was left at the edge of a cliff with nowhere to go, and it was, 'Good luck finding support in the adult mental health system.'" You don't actually get a referral to a person or a place. Now that you're 19, you're not over here — if you got in the door over here to begin with.

Transition protocols are supposed to begin a transition process at age 17, leading to age 19. Those protocols are not all up to date, they're not consistently followed and understood, and there's not a lot of accountability around them. As one physician told us: "Youth are not transitioned in this province. They're forced to leap over a massive gap in services, and most of them don't make it."

If you look at page 62 in the report, we just tell the story — again, which we felt was emblematic of the experiences that young people have — about a youth that was transitioning to age 19. At 17 he was placed in an MCFD group home because his mother wasn't able to manage the behaviour, because there was some aggression. MCFD was there to support him until he turned 19. They felt he was stable. He had medication. He had some support, was receptive to services.

Six months prior to his 19th birthday his MCFD social worker and his child and youth mental health psychiatrist began planning for him to transition to adult services. They kept inviting someone from adult mental health to come and attend the transition meetings. No one attended.

When he turned 19, there were no adult systems in place. There was no support. His care team was told that his only option was a temporary placement in a hospital adult psychiatric unit. He was not very comfortable with that. They felt it would be detrimental to his progress.

He was no longer eligible for youth services, and he was escorted by MCFD staff to a homeless youth shelter. His transition to 19 was to go from a supported mental health support, basically, to a homeless shelter, to the street.

This is not an uncommon experience. Of course, supportive parents…. But supportive parents that cannot manage the behaviour in the home without a supportive mental health system….

The recommendations in terms of this report…. It was a matter that we certainly looked at quite closely.

One of the biggest challenges with the mental health issue is that we have these two ministries. The Ministry of Health — its health authorities — and the provincial health services agency. In the provincial health world, there is a patient complaint process. If you go to an emergency room and you're not very happy, you can make a complaint to a patient quality board. They'll look at the issue. There's a process for patient complaints, if you like.

Certainly, it wasn't our view that young people were going to use that process, and their families weren't really using that process. We didn't report on it in length, but we have since looked a bit at the patient quality report process. I would say that whole area is in transition and flux.

They've done their own review. Is it effective? Do they report on patient complaints and patient experience? In terms of looking at services from the lens of adolescence and how they experience it, I would say that's probably not been successful on the Health side.

On the MCFD side they have the child and youth mental health community-based service, if you like. In some
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places they have worked very hard to develop strong teams and have unique service streams. They're a very dedicated group of some 200 full-time employees across the province. They're pretty much overworked and overwhelmed with their workloads. How they connect into those health authorities is quite creative in places but not consistent. The recommendation really came to this issue of: there's no point of accountability.

There has been in British Columbia a number of cases where there have been suicides by young people — for instance, including high-profile suicides, where family members have been not afraid to talk publicly about their challenge to get support for their child. Of course, behind the scenes we work…. We respect the privacy of families, so we don't name children, or we've infrequently named children, but I think many of you around this table will be aware of some of those families.

I certainly worked with them and talked to them about what their needs and their concerns were. Some of those families presented to the government a petition with 70,000 names requesting better services for adolescent mental health. I was quite impressed by the efforts of these family members who have taken these horrible circumstances that affected their own child and their own families and stepped out from behind the stigma, really feeling that they needed to ask for better services. I thought they did quite a remarkable job.

When they were meeting with government representatives with their petitions in the spring of 2013, it really struck me, when I was meeting with them, that they would meet with the Minister of Health, who would send them to the Minister of Children and Families, who would send them to the Minister of Health, who would send them to Minister of Children and Families, who would send them to the Minister of Health, who would send them to the Minister of Children and Families.

I think you're getting my picture here. They got the runaround. They're very respectful citizens of British Columbia who were happy to have time with the minister. Eventually they said to me: "Well, I don't know why they keep sending me from place to place to place."

Obviously, there's no single point of accountability for mental health in the government of British Columbia. We have a Minister of Health, a Ministry of Health and health authorities. We have a Minister of Children and Families. They do not work together. There is no single point of accountability, and when there's divided accountability, there are divided services.

While that's just a parent experience, I felt pretty strongly, in looking at the system, that there has to be lead accountability, so the recommendation was a simple one, which is: there should be a minister of state for mental health — particularly, I was hoping for youth mental health, but even a minister of state for mental health — which would mean that there's somewhere for people to go and that there is some accountability and leadership to look at that issue.

Now, obviously a government creates its cabinet positions and its priorities with what it chooses to do. I'm simply an advocate. I'm just saying that I think it would be very helpful if there was. It didn't come to pass.

We did get a government. There was an election. There is no minister of state for mental health, so we'll meet with the Minister of Health. We'll meet with the Minister of Children and Families. We'll meet with the Minister of Health. We'll meet with the Minister of Children and Families. We'll meet with the head of the PSA. We'll meet with the heads of each of the health authorities. We'll meet with every regional director of Ministry of Children and Families.

As we do, it becomes abundantly clear to me as representative that the people in the Ministry of Health do not know what the people in the Ministry of Children and Families do, and the people in the Ministry of Children and Families do not know what the people in the Ministry of Health do, because they do not collaborate and work together.

Back to the analogy. We have a child that has diabetes. Do we say to that child: "Oh, you're going to be assessed over at that ministry. We don't really know how they do it or what they do, but when you get assessed, come back over to us, and we'll actually begin the protocol with you to teach you how to use insulin"?

Then you come to another ministry where they say: "Okay, we're the ministry for insulin. We're going to show you how you how you get your insulin and how you administer it." Then they, in turn, send them to another ministry, where they're going to learn how to cope in work and school with those issues.

I say that as an example to say that that would be absurd, wouldn't it? We wouldn't take a child with diabetes and say: "You're going to go to four or five different locations to receive your service." There's a seamless system. But when it comes to mental health, there is no seamless system in British Columbia. It doesn't matter how well educated the parents are, how active the parents are. It doesn't matter if the parents are Liberals, NDP, independent, Green, red or orange, there is no mental health system.

I put it to the committee and say that this is a very significant challenge for British Columbians and for young people. The parents are really quite upset about this. I mean, 70,000 signatures were obtained and submitted to the government asking for something to happen in adolescent mental health. As far as I can see, from the time this report has been tabled, there has been no action. That's a really very serious concern.

Is it a clinical model? Is it a service model? Is it no model? What is the model in British Columbia? Until we get a point of accountability, we're likely not going to have a model.
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We also recommended some immediate steps. If you look at the recommendation, we had some detail on the recommendation on page 71 of that report. There are some areas where immediate improvements are needed. Forget about just having a lead accountability — immediate improvement. We thought a single deputy of those ministries should take leadership immediately. We said the deputy of MCFD…. He's now the deputy minister of the Ministry of Health, a wonderful and committed person. Someone has to be responsible.

Make some improvements around service provision and priority for government. For instance, we wanted to see those tertiary treatment beds addressed, points of access addressed.

We wanted to see immediate supports around emergency acute and community-based intensive intermediate care. That's a key, key area. When those parents presented these 70,000 signatures on their petition, they really spoke to that experience of: "Why are we going to emergency rooms and not getting support?" That was a key issue and requires improvement.

Have there been improvements? I think this is an area where the committee may want to consider in the future looking and probing more carefully around the issue. We are certainly monitoring these recommendations, but there is no point of leadership. Until we have a single point of leadership, I cannot see there being significant improvement. It's a very simple recommendation around the machinery of government.

I will continue to meet with the Minister of Health and the Minister of Children and Families and others, but even in preparation for today to try and get clarity, what the Ministry of Children and Families told me and what the Ministry of Health told me were two different things, even just as I came to see you today about what the plan was around the report, which tells me that they are not aligned. Is it because they don't have the time, the priority, the focus? I don't know what it is, but they're not aligned to respond to these recommendations as they would be in other instances when they have sole accountability.

I'm going to leave it there and invite any questions that you might have with respect to the findings and the analysis. The overall finding — it's a rather harsh finding, but it's a significant one — is that there is a failure of provincial leadership in quality assurances for mental health services for youth in British Columbia, a failure at this time.

D. Plecas: Once again, this is another one of your reports which I think is mistitled. I think this one should be called "Why Are We So Stupid?" I mean, this really, in a word, can be summed up as a colossal disgrace.

I guess my question would be — two. As a disgrace, how does it compare to other jurisdictions across Canada? Where do we sit?

Secondly, I think it would be useful for someone to do an analysis, a cost-benefit analysis, to show how much we could save by being attentive to these mental health issues now and early on for people. I'm not telling you anything you don't know, but part of why we have this situation is a failure to act early, act now. Honest to God, it just boggles the mind.

This report, which we also know, is about youth. But you could take the word "youth" out of there. It's the same situation for mental health services in general, so yeah, the two questions.

M. Turpel-Lafond: First of all, the issue about where it is working. On things like acute beds in emergency rooms, it does work more effectively elsewhere. While this isn't an interjurisdictional report, we certainly directed government very strongly to look carefully at clinical models that exist elsewhere. Or even just based on a formula, you can see how many beds we will need.

One of the challenges I faced in this report was, for instance, representatives of the ministry saying, "Well, you need to count other beds that you didn't count," like addictions beds, which there are not a lot of, but addictions beds as an example. It was very hard for them to understand when I would say: "But we're not dealing with people who are addicted. We're just dealing with young people that have mental health issues." "Well, some of them might use drugs." "Well, yeah, but they're not. They're not experiencing an addictions issue, but a mental health issue that needs support."

Even the relationship in the minds of those responsible to design the system between addictions and mental health…. We do know from the adult side that that can be quite relevant. The adolescent side, no. Again, when someone comes forward wanting insulin, we don't say: "Sorry, we're not going to give you insulin for your diabetes, but we're going to actually give you chemotherapy." You treat what people are coming forward with, so it was really challenging for us to understand that and say: "Should we just put people in an addictions bed to kind of warehouse them because we don't have a mental health system? Is that what you're suggesting?" This was very problematic.

I want to be clear, though. When I talk about having a lead accountability, I'm not talking about merging the ministries. I'm talking about actually having accountability across ministries and a lens and a focus that's pretty unflinching, because you're right. It seems to be not the most cost-effective.

When you talk about the cost-based analysis — I'll ask Michelle to speak to this. But I know that the Canadian Mental Health Association, the public health association of Canada and others do talk about the implications of not having mental health services, because this is a window of opportunity when major mental health issues present. What is major? What is minor? It's very
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much in the eye of the beholder. A family coping with an adolescent with a serious mood disorder seems major, but I'm talking about a psychotic-based major mental health episode.

It may have its first onset at age 16. Having that positive connection to a health care system, to supports, to medication, is really critically important, rather than having, say, a court order that you take your medication — which is unenforceable in Canada, by the way, anyway — but having that later becomes coercive and a struggle, as opposed to a positive health care system.

You want a very positive model of engagement at this time, as opposed to a punitive model later, where you're ordered to take medication. It's just the idea that this is a key opportunity. I'm going to ask Michelle to speak about the issue of costs and the modelling that has been done.

M. Wong: There has been some external research done around the burden of cost to Canada as a whole with regards to mental health and illness. The projected cost is $50 billion per year, which is impacting our Canadian economy due to mental health problems and illnesses.

Within B.C. alone, we spend more than $6 billion annually on mental health services — that's MCFD and the Ministry of Health budgets combined. This does not include costs that come out of the criminal justice system, the child welfare system or the education system. You can see that there is a large economic impact.

D. Plecas: I'm sorry. I'm not sure my question was answered with regard to: how do we fare compared to other jurisdictions in Canada?

For example, is there any jurisdiction in Canada, is there any jurisdiction in North America, where there is — and I agree — a lead, where there is, like, a ministry of mental health?

M. Turpel-Lafond: Yeah, there are, which is why we recommended that, and that there are clear accountabilities around mental health.

If you look at the other large provinces, Alberta and Ontario, as examples, their organization of services and investment is different than ours, for sure. I'm not recommending that we have a solution brought from somewhere else. We have to make it work with our health authorities in British Columbia and our population and our needs.

We have — ironically, I think — in British Columbia been a leader around destigmatization. We've had a lot of leadership around destigmatizing mental health and addressing mental health and addictions issues, possibly because of our very significant work in harm reduction on the adult side.

But in family mental health, parental family mental health, other jurisdictions, particularly in Australia and elsewhere, have more durable models, in terms of what's equivalent to our size and our scope, of what would be practical and possible.

We did host and invite representatives from Australia to come to Canada to meet with senior officials in the B.C. government to talk about some of their programs and services and the organization of that. Again, I think the challenge, after we have a close look at it, is what we can compare. What initiatives will be well supported, given our geography and our population?

We have this terrible divided accountability. Who follows up on it? Who brings it up to the cabinet table and then out to the service delivery system? That's a really big challenge, and if there's no lead, there's no lead. I mean, it's very important that you have that process of accountability to put the pressure to improve your services.

Michelle notes that the expenditure is enormous. The outcomes for some of these families who have lost their children…. They are so frustrated, and they feel so strongly that their experience should not be replicated. I certainly, as representative, stand fully with them, because I think they're making a very good point — not to mention all of those people trying to come into the system.

It should be a seamless, easy system. It shouldn't feel like you have to go to some back-alley care provider to get support. Or dependent on if your family has a private health care plan so that you can buy some counselling services, for instance, even what services you could buy are not integrated into a system. The qualifications and skills of the counsellor that you may have for your child may not be appropriate for a child showing early psychotic symptoms, for instance.

Many of these issues need to be resolved in a professional and appropriate way with the type of collaboration that existed, for instance, for juvenile diabetes, which we have a pretty good care system around. It's a major cost as well, but we know if you intervene, you can keep it down. Nobody hangs their head in disgrace because they have diabetes, and no one should hang their head in disgrace because they have an early onset mental health issue in their adolescence. But they do.

So you're right. We do need to look at what happens elsewhere to inform what we do here, but we still need to get the ABCs of the WHO diagram in British Columbia. Every system has those ABCs — tertiary, intermediate and community care. They have the same pathways in an international approach. How strong is it? In British Columbia it's extremely weak, and not only at the top. From the top to the bottom, it's weak.

C. James (Deputy Chair): I want to thank you for the report, and I wish I could say that it was the first time that we've been hearing these kinds of concerns. I think all of us around this table know that these concerns have been arising, and I would describe it as a crisis. I do hope that
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the committee takes on the issue of youth mental health, because I do believe it is a crisis right now in our province.

I met with that group of families both before and after the election time period. Anyone who spends time with those families, hearing the kinds of concerns that they're expressing…. These are families who are going through a crisis in their own family lives yet, because of what they're facing, are still taking precious time and resources to be able to advocate because they don't feel they're hearing leadership.

I also want to express my frustration. I agree with the recommendation around "lead," but I believe it goes beyond that. I believe it's leadership that is missing. It's leadership from government that's missing, to be able to say: "This a priority, and we're going to do something about it." It's not simply good enough to say….

I appreciate the member saying a study around how much money we can save. We know that. I mean, we can list right now all of the issues that we're dealing with across ministries, across government and in communities that are related to youth mental health and a lack of services and supports — everything from education, to bullying, to self-harm, to the health care system, to the justice system, to children in care. We don't need another list of pressures we are facing because we aren't dealing with these youth mental health issues.

I asked questions in estimates in July of the minister and of the ministry. I have to tell you it was embarrassing to say that the only indicator that the ministry is using around youth mental health is how many telehealth calls have happened in this province. Well, a telehealth call tells us nothing. It tells us nothing about whether that was a successful intervention or not a successful intervention. Great that we've got that service there, but it's not providing the support.

The minister admitted that eight months is an average wait time right now for youth mental health. Well, if you're a family and you have a child who needs youth mental health right now and you're told, "Eight months. Go to the emergency room. Here's your medication. Go home. Call us again if there's a crisis," it's simply not good enough.

We're not serving these young people, and that will cost us in the system later on, but most importantly, it's costing those youth and those families. It's putting pressure on the children-in-care system.

Many of those families feel that the only way they can try and get support is to have to give up their child to care, knowing that that's not going to provide them with great service either, because the family is at the end of their rope, or the siblings that they're also caring for are also facing real struggles.

To me, it's an issue, yes, of a lead, but it's an issue, more importantly, of a lack of leadership. It's an issue of a lack of priority. If I look at the kinds of things across government that we put ministers of state in charge of and that we put people as responsible for, surely we could take youth mental health and give it a priority and start putting some of the resources.

The last piece that is important…. Again, I hope this committee will ask questions of the ministry when they come to present to us. When I asked where the resources were going to be for a youth mental health plan for the ministry, I was told there were no additional resources this year. Again, the government committed to putting additional youth mental health beds in place, but with no new resources, we're not going to see any additional services.

I want to say thank you for the report. I think Alberta is an important model to look at. There are a number of families who have expressed support for the approach in Alberta, which is that the service comes to the family. There is a one-stop shopping in parts of Alberta, where families can make one call with the youth mental health problem, and the services come to the family. They navigate the system for the family rather than the family having to fight and figure out the system.

These are families who have learned to be incredible advocates and have learned to try and figure out something that isn't there for their youth, and they deserve better than they're getting right now.

D. Donaldson: Thank you very much for the comprehensive report, very articulate. As you said, it hasn't been undertaken before, this kind of study, so I really appreciate it. It rings extremely true for the area I represent and for the north in particular. The lack of communication and integration between all levels in the pyramid under the World Health Organization diagram — I've witnessed that as an MLA. I witnessed it in the work I did before becoming an MLA and personally from my extended family.

The number of acute care beds in the north, and I think they put forward this type of adolescent psychiatric unit as being six in Prince George, is just unacceptable. We've seen the results of that in the communities around the north.

It's not just resources that are drained financially and emotionally and energy-wise from families, but those are the families who can actually do that. I think of the families who don't have the financial resources to access private options, for instance. Their children are just left out on their own. It's a total waste of human capital and a waste of people's lives.

You talked about a distinct lack of leadership in the report, and failure of leadership. While I admire the passion of the member opposite in speaking to this issue, there's been ample opportunity, I think, for a number of years. We only have one government in charge, so therefore it's a lack of leadership for the government of the day. We've had ample opportunity, as I said, to address this.
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I take his comments around looking at other jurisdictions from the perspective of looking for solutions. I don't think he was implying that if we can compare ourselves to be less disgraceful — that was the word he used — than other jurisdictions, then that would be a win. I don't think being less disgraceful is a win. I don't think that's what we should be shooting for in this issue and in this circumstance.

So my questions would be regarding the recommendations. Have you heard back regarding your recommendation for a minister of state? And then, specifically, on the last recommendation about conducting an assessment of hospital acute care beds for transition-age youth in B.C., you had recommended an answer by September 30, which is over a month ago now. Have you heard back on that?

M. Turpel-Lafond: The response…. Well, I get that the timing of the report was difficult, because I appreciate there was a provincial election. So the political leadership disappeared shortly after the report. You know, timing of reports — they have to get out. It's just the way they are. So in a way, I think maybe a fresh set of eyes post-election is what was needed to look at this.

In terms of the appointment, there is no minister of state for mental health. I'm disappointed about that. But, you know, pencils have erasers for a reason, and you can write something different. I'm hoping the Premier will reconsider, and I'm hoping everyone here will encourage the government to have a minister of state for mental health. That can be a unanimous thing because it's good for kids. It's not about a partisan thing.

But I think, also, the information has to come in through the system and go up through the two ministries. The Ministry of Children and Families and the Ministry of Health have been very clear to me to say: "Yes, it isn't working." So they acknowledge…. The receipt of the report on the ground has been acceptance of what we found.

There was some push-back that I received from the Health side, saying that the exit interviews from in-patient facilities said that people had a very good experience. But those were adults who went through in-patient treatment.

There's a survey when you leave. Sort of on your way out the door, you get a survey: "How did that work for you?" Most people on the way out the door said: "That was a really great experience. Please give me my belongings. I'm on the way out." So it wasn't evaluative in the same way. I'm not saying it was unhelpful, but Ministry of Health seemed to stand a lot on that survey, which I thought was interesting but didn't come to the youth side.

Within the Ministry of Health, I think that the senior leadership recognizes that this is not functioning as it should be functioning. We have to make the changes. In terms of the numbers of beds, I'm not satisfied that that has been tweaked. There has been a look at it, but I'm not satisfied that it's been tweaked.

We have the issues, for instance, with the Maples, which is MCFD's facility. It's our only adolescent facility. There's the adolescent forensic unit that's used in the youth justice side. It's a small part of the youth justice, just a very small number of beds. It's short-term assessment. But in terms of the Maples, I visited the Maples, and I'm in touch with them. I look at what their model is for the future, for now and into the future.

Do they have a model to serve this population, and is it within the WHO model? They do not. It is part of the residential services spectrum in MCFD, but it's also very much in transition. They haven't worked it out. Do they have a clinical director? I mean, do we need to have a chief psychiatrist for British Columbia who develops a youth clinical model?

There are all kinds of actions that could be taken here. But somebody has to step off home plate and actually say: "This is what we're going to do." Right now it's just been very silent, and there hasn't been an engagement.

I think we need to relieve the pressure on the ground of listening to families and young people. I don't mean in an artificial exercise, but I mean we really need to have the pressure on there. They really do not feel heard, and I have to side with them to say they're not being heard.

This does cross over into other issues — and I think it was raised earlier — like bullying and other concerns that have been out there. We can tackle a variety of issues and a variety of fronts of harms to young people, but if you don't have a mental health system, you know, you won't have a response for those who are experiencing mental health issues. So for someone who is experiencing a serious mental health issue, has no care and is being bullied on line, that can be a pretty lethal combination.

You can't end the bullying and fix the problem. You still need a mental health system. This is sometimes the diagnosis of what's going on in British Columbia. Everybody's all concerned about bullying, which I agree is a concern, but actually, it's the mental health system that's the real concern.

There's no mental health system. So why do people find themselves in the position that they're on line being bullied or seeking support on line when there's no mental health care? It's like the chicken-and-egg situation. The bullying is realistic, and it's a problem, but it's the mental health system that's the concern.

We're having the debate at a different level. You know, we may criminalize on-line bullying. There's some suggestion they will be criminal offences. We have the first prosecution going on Vancouver Island of a girl around some of these cyber bullying issues.

I think we're missing the mental health component of this whole issue. It would be helpful to take the pres-
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sure off families to talk about what it is that they really were seeking. Was it being turned away at the emergency room, or was it their child being on line at home and being bullied? What happened to people that they get so concerned about their mental health care?

I think it's valuable for the committee…. I'm sure in your own ridings you hear from your constituents, because they're everywhere in British Columbia. I think it would be valuable to have some type of a process where they can actually speak to their experience and their suggestions, because they are going to continue to speak, and we need to find a positive way for them to have input into policies and practices, I think, in the Legislative Assembly.

J. Martin: You spoke earlier about the major and minor issues, and obviously, any issue that is happening to oneself or a family member is a major one. But we've seen significant net-widening in the last 40 years in mental health. Psychiatry and the pharmaceutical industry have done a magnificent job of widening the net and including more and more pathologies to the diagnostic manual, literally adding, sometimes with the revision, hundreds of new mental health afflictions.

In an era of scarce resources, I'm wondering to what extent we have lost the ability to direct resources where they're most needed as we've seen this incredible growth of new mental health pathologies that all come with their patent treatment and their patent drugs and such. I'm not saying this defensively whatsoever, but I'm just asking to what extent this net-widening might be sucking resources away from those most critical cases that you do highlight in the report.

I wouldn't say everything that meets the standard of being considered a mental health issue is necessarily a crisis tipping point.

M. Turpel-Lafond: Right. Well, first of all, if you look at page 24, we look at the mental health classifications on axis I of young people in the report. The data is not very strong in terms of what is the assessed condition of the young person seeking treatment in British Columbia — first of all, because we don't assess. And we don't have any reliable recordkeeping in British Columbia. So our mental health system is not doing that well. What we could find, we tried to report on. I think the challenge is, if you look at….

The biggest categories are, really, mood disorders and anxiety disorders. Those are large categories in terms of support.

But I would push back on some of your assumptions, first of all around net-widening and so on. You know, the invention of insulin was a pretty good thing for diabetes, and having a good protocol to regulate diabetes by having insulin, diet, whatever, is not a bad thing. Nobody argues about net-widening on diabetes.

If someone presents with a serious mood disorder or anxiety disorder and needs cognitive behavioural therapy and/or medication and is resilient and rebounds, that's not a bad thing, is it? So the suggestion that somehow we have any type of campaign by the pharmaceutical industry or whatever to create a problem where there isn't one — we don't find any evidence of that.

What types of treatment modalities you engage in mental health are the subject of significant research. You can have the head of adolescent medicine from UBC come and talk to you about adolescent mental health, if you like, and talk about each of these axes and so on and what type of assessment and response is recommended and what works and doesn't work, because we are talking about a scientific-based, research-based methodology and modality around treatment and support for young people. We're not sort of just saying: "Let's just go invent it." We're actually talking about having a health care system.

So again, I push back a little bit because I hear this sometimes, and I don't think it's very informed around what the actual situation is.

You know, the 5 percent of young people that have schizophrenic-related disorders that are appearing at age 16 need a proper mental health response. They may be hearing voices. They may be experiencing delusion. They have very significant social and emotional disruption in their ability to function. To go to school, to function in their family, they need support, just as the kid with diabetes can't control the blood sugar and could end up being in a coma. I don't think it's a big difference.

You're right. Some are very acute — you know, the kid that hears voices and kills his sister because the voices tell him to kill his sister. It's a pretty dramatically bad situation. The child should have been certified and got support. The child with the mood or anxiety disorder may not pose that same type of violent risk to another member of their family or community, but their social and emotional functioning is not ideal, and it can be responded to.

I think, when it comes to mental health, we have to be equipped with good information and respond effectively. And we have had some good initial policy work in child and youth mental health. In 2003 we had a good child and youth mental health plan that got rolled out. It just stuttered and sputtered and stopped.

We had broad-based mental health identification in schools in British Columbia through the Friends program, an anti-anxiety program which was based on leadership, people coming in and running programs to identify kids that are showing challenges early. We don't even know how many of those operate anymore. How often does that happen?

What we do see are schools making requests for mental health services and schools overwhelmed with mental
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health issues and how they affect social and emotional development of their classrooms and their kids.

So I just push back to say: I understand your concern. We know things have changed. They have. Things have changed in the world of cancer, but we don't say: "We're only going to treat breast cancer, but we're not going to treat prostate cancer." We actually treat cancer, and we understand it, and we do it. In mental health, it's the same.

I think that for adolescent mental health, it's a valid public expenditure, which should be driven by research in a proper clinical and service model based on the WHO diagram. And I don't think we have any sort of nefarious move afoot to widen the net. I think we have an identified need that is not met.

J. Thornthwaite (Chair): I just have a quick question before we leave. Mary Ellen, your recommendation is, obviously, for the leadership and a minister of state, etc. I know Carole mentioned Alberta. You mentioned Australia, but that's federal. Do you have a jurisdiction that you would recommend as a good starting point?

M. Turpel-Lafond: Looking at the effectiveness…. The Mental Health Commission of Canada has looked at this issue as well, looking interjurisdictionally at what works and what doesn't work. We have shared, with the Ministry of Health and the Ministry of Children and Families, examples of where we think a family-based model, to support the different generational changes around adolescence and adulthood, can work.

And I think it's a good idea to…. This report doesn't look at the interjurisdictional review. We first had to decide, "What did we find?" and report on that, "How can we make improvements?" and, I think: "What types of outcomes do we want to change?" Well, we want a more accessible mental health system. We want it more normalized.

We've pointed to Australia because they have a "no door is a wrong door" approach to mental health. You can talk about mental health whether you're getting your teeth cleaned or whether you're at the local bank. I mean, it's a very different approach. No door is a wrong door. It's a good approach.

Would that work in British Columbia? I don't know. I think we really need to look at what we do, but we certainly need to look rather immediately at a single point of accountability to get that work done, and we need to look at the acute, in treatment, tertiary-level services that are missing — building those. Those are two beginnings.

The jurisdictional review, I think, is a good thing to look at, but it has to be looked at from the ground of: how do adolescents navigate the system? Where do they go today in British Columbia? How can we improve their current experience?

I'm not suggesting we have a magic wand and say: "Well, we're going to do what someone else did." We have to build it on the ground here and be informed and influenced by what has happened elsewhere.

J. Thornthwaite (Chair): Okay, thank you. I'm not seeing any other hands. Why don't we take our break now to get a bite and then come back in about 20 minutes. We'll recess for about 20 minutes.

J. Thornthwaite (Chair): Good afternoon, everybody. We're going to resume our meeting. We are now on item 4.

M. Stilwell: Jane, can I just make a quick comment? Sorry, I was kind of slow to comment.

J. Thornthwaite (Chair): Oh, yes. Thank you. We do want to get something on the record that Moira had mentioned.

M. Stilwell: I just wanted to kind of reframe with some small suggestions what the representative described that I think is important.

The first, as she said, is there does have to be a drive and a vision from the top with a specific person who is charged to drive forward the issue around youth mental health. I think it's really important.

I think also, as was stated, there have been good mental health plans published, as was remarked, in 2003 and then later, under the previous mandate, maybe in 2010. I mean, they were both good plans, so maybe it is a good time to assess the progress and find out what the reality on the ground is.

I think that it would be helpful, if we're going to take a serious look at this, to actually talk to child psychiatrists who are on the ground. There's a huge shortage of child psychiatrists everywhere in Canada, and with respect to the pressure on acute care beds, it's really something that we need to hear about. It's hard to really imagine having a child who is hearing distressing voices and whose behaviour is troubled and troubling, not being able to get the care they need.

I think it would be helpful for us to all be kind of on the same playing field and have questions like MLA Martin's answered about diagnosis and numbers and changes and what the real pressure is on for acute beds, which I hear, at least anecdotally, is very, very substantial.

The second thing is…. I think the representative also talked about how, at the same time, it also has to be community up. I do agree, and I hear it in my community. The parents who are beside themselves with anxiety and the
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stress of trying to hold their family together when there is a child who has serious behavioural issues, are either waiting for care or not being able to get the care they need. So make sure that there are not just acute care beds but community-provided care that meets the needs of families and parents. I think that to hear those issues together so that we're all on a level playing field can be productive.

Finally, the third thing is about other successes. You know, even as you try to do these big pieces of work…. In my experience, success is incremental. There are places in Canada that are doing great jobs as pieces of the puzzle. The representative talked about No Wrong Door in Alberta. Ontario has a long-established, outstanding child psychiatry telehealth program.

You do have to have the whole plan in view, but at the same time, sometimes you just have to chunk down pieces that you can have impact on.

J. Thornthwaite (Chair): Thank you, Moira. I think that's a really good point. I think the deputy minister was going to get us some information on the Australia model that you talked about.

M. Stilwell: Yeah, I would say that on paper, Australia is very successful. I've never been to Australia, but on paper they can provide some really good road maps about: is this what we're thinking of? Is this what they're thinking? Of course, there are a lot of similarities in the health care systems, so it makes it easy, sometimes, to transpose, given that.

I also just think that we have to hear the providers and the recipients. My experience is that the numerical kind of descriptors that come from the ministry are at such a high level, it's not really possible, for me at least, to figure out what is happening.

In each health region there can be lots of issues, like the rep described, where — I don't know how to characterize it; I won't say sleight of hand, because that's not fair — if you ask about addiction beds, they'll say there are ten. Then if you ask about child psychiatry beds, they'll say there are ten. But really, it's the same ten beds that are in the silos of what they're trying to provide.

I do think to hear from people what it's like on the ground trying to provide care just gives you a place to hang this data and an understanding of what it means.

J. Thornthwaite (Chair): Yeah, I think that's helpful. I know that that was one of the things that Carole and I had discussed, about possibilities of moving forward in a special project. That would be the excellent time to do that.

Being new to the committee, I never quite knew the extent to which they, from time to time, will become partisan and such. When I hear the problems being blamed on a lack of leadership in the government, I want to go on the record: I categorically, wholeheartedly, 100 percent disagree with that.

I find it somewhat ironic that we keep coming up with Alberta as a model of excellence that we should be looking at, when Alberta is able to afford doing these things because they took advantage of their natural resources, which we're fighting tooth and nail to do here against a magnificently organized blowback.

M. Stilwell: First of all, I just want to say certainly that was not what I said. My point was that if you want to drive something forward, it's important to know who is going to be charged with that task — right? I wouldn't want the suggestion on the record that I suggested there is a lack of leadership. What I suggested was that there had been leadership, and it was time to go back to those very good plans that came out of our government.

Let's move on to No. 4. After we're finished with this in particular — Much More than Paperwork: Proper Planning Essential to Better Lives for B.C.'s Children in Care — then, if we've got some time later, I'd like to take maybe five, ten minutes just to go through some items that the vice-Chair and myself have talked with our Clerk about, with regards to moving forward and getting the ministry here.

I just wanted to put that out there. Don't think that we're just going to finish right after No. 4, because there is other business that we want to take at least maybe five or ten minutes to discuss.

Carrying on, then, Mary Ellen, would you like to introduce your next person that you've got there as well?

M. Turpel-Lafond: Yes, I'm delighted that Janice Chow has joined us. Janice also works in my research, monitoring and evaluation section. She has been the lead in terms of the next report that we're going to address, about planning for children in care. Janice has participated in two audits. She also participated as lead in an audit of the Child in the Home of a Relative program, which led to a lot of changes with respect to safety for children. So I'm very fortunate that she's with us today, and she'll also be able to respond to any questions and provide any background information.

I also want to say to the Chair and committee members how much I appreciate the amount of time that you set aside today. It's very rare that we actually go through three reports, so I know it's an act of endurance, and I
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really value that. I recognize that Dr. Stilwell, in particular, has to be on the phone over there and not present. I think it's really great that we are getting through these reports and we're getting close to being caught up. That's a testament to the members of the committee.

Representative for Children
and Youth Report: Much More than
Paperwork: Proper Planning
Essential to Better Lives for
B.C.'s Children in Care

M. Turpel-Lafond: The next report which you've had, which was released on March 26, 2013, is called Much More than Paperwork: Proper Planning Essential to Better Lives for B.C.'s Children in Care. This is a report of an audit that examined the files of children and youth in continuing care in the government as of March 31, 2011. We looked at the ability and capacity and effectiveness of MCFD in meeting its mandate to meet the standards to prepare plans of care that were meaningful and engage with children that they serve.

We selected a group of children. An audit is a very different process than some of our other reports. It's a very rigorous kind of clean process, if you like. It's important. But before we get into some of the mechanics of the audit, I wanted to speak a bit about what this is pertaining to in the big picture.

Again, those of you around the table or by phone, if you could just step back for a minute and think about how you record your children's life experience and your grandchildren's life experience. If you're anything like me, you probably have a fridge with a bunch of pictures of your kids, and you have report cards. Sometimes it's stuffed in a box somewhere in a closet. Maybe you have their first outfit, their christening outfit or what have you.

You might have all kinds of things that remind you — their hockey cards and what have you. You have all kinds of things that remind you of your children's growth and development — pictures, stories, things that are material and things that you carry around in your head. You tell your children and your grandchildren stories about how they grew up and what kind of a child they were. What kind of temperament did they have? Were they a fussy child? Were they a happy child? How did they interact with their siblings and others?

These are such important things in children's lives and in our role as parents, grandparents and siblings. We always think about how we reflect on childhood.

The report that we're talking about today has a lot to do with this, because for children who grew up in care in British Columbia, whether they're in care and leave care, or whether they spend, as this group of children, their entire childhood in care, the only record that they're going to have of that upbringing is their life book.

They may have had a positive relationship with the foster parent that they connect with into adulthood periodically and talk to. They may have a positive relationship with the social worker that they connect with periodically and talk to. That's increasingly rare. Children who grew up in care have a lot of different placements, frequently end up in group homes, sometimes in independent living. They age out of care.

That life book that tells the story of what happened to them is really significant. It is kind of like the equivalent of that fridge with all the pictures and all of the stories and what have you. So the whole concept of planning for a child in care is more than paperwork. That's why that's called More than Paperwork. It's about having a close and positive relationship with a child in state care, where the state is the parent. The state has to be the prudent parent that tells the story, remembers the story and makes sure the child has every opportunity to grow and succeed as any other child would.

What we were looking for in this function that the state has, the Ministry of Children and Families…. One of its core responsibilities under the child welfare legislation in British Columbia is to maintain a relationship with the child in care, to have a relationship with those they are living with — foster parents or what have you — to make sure that the child's key domains are doing well. Just as a parent will make sure the child gets to the dentist appointment, proceeds well at school and grows and learns, the guardianship social worker has that responsibility in B.C.

What we wanted to look at was: how is the Ministry of Children and Family Development doing in meeting its mandate? Well, there are different ways to look at it. You can interview people and talk to people, and we certainly did have focus groups and interviewed people. We interviewed young people, brought focus groups of young people in care together, and we heard from them.

Fundamentally, we feel very strongly that this is an area where an audit is essential. It's rare that we exercise the full audit power, but it's important that we do it occasionally. An audit is important because you randomly pull files, you look at them, and then you have a chance to interview and see: what does it say about that planning for that child?

We began this process. It took a little bit longer to report on than I would have liked, because initially we had to start an audit and stop an audit. We started an audit by pulling the files, putting them together and beginning the process. While we were looking through the files, Ministry of Children and Families staff were coming in and removing the files that we were looking at and trying to bring the files up to date and change the files.

In and of itself it's problematic, because it doesn't understand the audit methodology. That is, an audit needs to be an accurate picture of practice at the time. You don't, because someone is going to audit you, sud-
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denly bring everything up to paperwork, just kind of fill out a bunch of forms so it looks better. You actually want to see what practice is on the ground at that time. So we had a bit of a problem with the audit. We had to stop and pull again. So it took a little bit longer. It was a bit fractious, but we worked it out on the ground.

Certainly, the leadership in the Ministry of Children and Families was quite apologetic about it. But it did reflect a very important cultural issue that we've taken up with the ministry quite repeatedly, which is that the ministry needs to appreciate and understand the role of an audit, including its own quality assurance activities. It isn't about skewing results so they look good or bad. It's about actually confronting what the practice is on the ground in any given case.

It started out being a bit of a rough process, to have to remind people this is an audit. We have the file. We look at it. You don't come and change the file after we look at it.

I guess the bottom line in the audit certainly suggests that MCFD is not and was not historically — I'm hoping they've improved now — meeting their planning requirements for B.C.'s children in care.

We looked at 100 files selected on a stratified random sample. There were 53 girls and 47 boys, average age of about 12 years. The majority are on a continuing custody order. Because of the length of time in care, many of these files can be quite large and sometimes make up several volumes, meaning each file review will take a bit of time. Between three hours and a day per file it took us to review them, to carefully comb through them and look for other things.

When we calculate the audit results, we never know what the results are going to be. Of course, as representative, I'm always optimistic and positive and hoping that we're going to see some good results and learn from the practice and experience. I can say I was very disappointed when I learned that only 5 percent of the plans of care audited by my office met the ministry's own standard — a very low number.

So 95 percent did not meet the ministry standards. The ministry standards are not impossibly high or difficult to achieve. So there's lots of room for improvement.

Now, in terms of the planning function, as I said earlier about the fridge and the prudent parent, planning in child welfare is a staple of good child welfare practice. It's not an option or a luxury; it's a staple.

Front-line guardianship social workers know that they need to see children. They need to plan and ensure that they record not only what the child has done but what the plan for the future is for the child. So planning that the child will do this in 2014 would be uppermost in the minds of guardianship social workers today as they prepare plans of care for children, thinking about what will happen to them in the future. It isn't a retrospective; it's a prospective process as well. You see some recording of activities, and you see planning for the future. This is the nature of social work when you have a child in care.

Of the 100 files we examined, only five included a comprehensive plan of care that was compliant with ministry standards. The audit found scattered, ineffective documentation of planning as well as evidence of a lack of understanding about the importance and purpose of comprehensive and regular planning and intervening for vulnerable children and youth.

Sixty of these audited files were aboriginal children, 30 of them served by delegated aboriginal agencies. And of the aboriginal children, where there's an additional requirement to have a cultural plan — meaning steps taken to preserve their aboriginal culture, language and connection to family and community — we only found three cultural plans, and not one of the three was up to date.

The audit findings also showed very little participation in plans of care by the children and youth caregivers, birth and extended family members, or any other significant people in the lives of these children and youth. Many of the children and youth desperately need interventions and services. The files spoke to the fact that, for instance, a special needs assessment was required, an immediate mental health response was required, that the child had been failing school and needed support. Many of the files spoke to these desperate needs but failed to demonstrate a plan to respond to them.

My key finding in this report was that the current state of plan of care in B.C. is unacceptable and that it's not just bureaucratic paperwork. These are evolving life plans, and good-quality social work needs to be done.

It's a report where I made quite a few recommendations, ten in particular. I don't generally make that many recommendations, but because it so much goes to core child welfare practice, we did return and make some key recommendations in those areas.

I've spoken a few times today and previously about the idea of changing social workers' core hours to make it easier for them to meet regularly with children and families. I recommended this in part because I'm not seeing evidence that the guardianship social workers are seeing the children.

There is a requirement, a minimum requirement, of face visits. It's very low, a very low requirement. The aboriginal requirement is a little bit stronger in the aboriginal delegated agencies than in the ministry, but we're talking about a periodic, a few times a year, requirement to have face visits, and that's not happening. I can't emphasize how important it is that social workers see children — and not, for instance, to take them out of school to see them but to see them at times that are convenient to them.

Obviously, it's important that we review the cultural plans for aboriginal children to make sure that they meet legislative standards, because there are unique provisions of our child welfare law requiring aboriginal children to
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be connected to their culture, language and communities.

I also need to make sure that MCFD senior leadership takes a much more active role in overseeing assessment and planning for children — making sure there's qualified supervision, that the plans are meaningful and get completed, and that whatever workplace impediments might be there limiting the capacity of workers to do this job are addressed and removed.

Proper planning is about enabling social workers to develop important relationships with children. And I emphasize the word "relationships." It isn't about sending children out to resources, whether that be a foster parent or whatever, and just leaving them there and just hoping for the best. It's about the relationship.

So I called upon MCFD to make some key changes, including how it conducts care plans, how it reports and how it plans. Since this report was issued, there have been no new updated compliance audits or case practice audits to tell me how they're doing. However, I can say that I have had a very good debriefing on an ongoing basis with Janice and my staff and the senior ministry officials on this report. They did accept all of the recommendations in the report.

They have indicated to me that they will not likely be able to meet the timelines established in the recommendation. For instance, if we look at recommendation 1, one of the concerns I found when we were out…. After we'd completed the audit and then we met with key groups of staff in the field and they talked about why they can't complete the plans of care, there were the issues about whether there was adequate staffing, adequate resources and a proper supervision. These are key issues.

Recommendation 1 is about MCFD fully investing the resources necessary to enforce its own standards and ensure compliance, including having a detailed resourcing plan. If they need more funding, more staffing, be clear about what it is they need, where they need it and why they need it. Increase their capacity to report regularly on these issues around improving the well-being of key domains like health and education. We really saw some concerns in those areas.

I had put down as a time frame that I wanted to see some type of a plan or report by September 30, 2013. They have not met that deadline. I'm not all that concerned about it at this point because I know they're actively engaged in the issue. I just think it's very important that if they feel they do not have the resources to have the staff to meet the children to do the planning, they publicly acknowledge what that is and show a thorough analysis.

I've requested them to report to me — I'm not saying in public, but to at least report to me by this date. There are ongoing meetings and discussions, which I've been finding quite valuable, but still much more work to be done.

The second recommendation is really a big one, which is that they are more active and determined in doing this. There were a variety of templates around how they plan. It was important that they develop some consistent tools and that they develop a culture of practice around sustaining a quality plan, having that real relationship with a child and a quality of plan.

I was very concerned that there is a focus in the child welfare system on what I would call service coordination rather than direct service to children and youth — the idea that someone else is taking care of the child, as opposed to actually being engaged and having a relationship with the child through time. Several aspects of recommendation No. 2 speak to assessment, planning, intervention, making sure social work practice and supervision is consistent with improving practice — really, the core function of the ministry.

Recommendation No. 3 is on quality assurance and planning for children. Again, given how even the audit process was a bit rocky at the outset, it really spoke to the need to have a strong quality assurance process, that the practice is what it is and to make sure that things like the life book, which I talked about earlier, are maintained and contributed to on an annual basis — certainly, many of us contribute to our children's life books on a daily or weekly basis, at least on an annual basis — and that there be a positive relationship between social workers, the children and other adults in the life of the children.

The fourth recommendation speaks to the flexible work arrangements. As I understand it, these are under discussion at tables now between the ministry and the BCGEU bargaining units. I did quite a bit of work with the BCGEU talking to why I think it's important.

I'm not talking about overtime. I'm talking about differential hours: working hours needed. I appreciate you shouldn't be working eight to four and then see all the children in the evening and call that overtime. There should be hours that suit the lives of children and the clients served. I would like to see that implemented.

I wanted this to be completed by December 30, 2013. I'm less optimistic that they'll reach that deadline, because there are some cultural challenges around how these offices function and operate. In many ways, they've gone so far away from service to children that the supervisors and others don't appreciate the fact that differential hours will require a different work climate and work culture. I'm certainly promoting that and encouraging all parties — government, GEU bargaining units, service providers — to change their concept of when they're available.

Recommendation No. 5 speaks to some new planning tools. The ministry has developed new templates for developing plans of care. These are not now integrated with ICM, their new case management system. They are still paper-based systems, but they do appear on paper to be stronger. Again, the proof will be whether or not the social workers are using them. They're being trained and
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supervised to use them, and we can see the quality of those plans improve. There's still work to be done on that front, but there's some promising news to report.

On cultural planning for aboriginal children in care. Again, very significant concern because the Ministry of Children and Families reports that it's very engaged in supporting aboriginal children, yet we only found three plans of care, and none of them were in compliance. We heard from those working with aboriginal children: "We know they have good support. We're just not writing it down."

Again, I come back to that core issue: if you don't write it down, and the child changes social worker, changes foster home, moves around, there's no record, there's no planning. If you don't write it down, there's no planning. You have to write things down.

Important links between the aboriginal community and families and children. You have to have good links to the community to be sure that continuity can happen, and there's a great deal of work that the ministry has to do on that front. Even though it has run a number of aboriginal service transformation programs over the last decade, it appears not to have gotten down to this business. The recommendation suggests that they get down to this part of the business.

The seventh recommendation speaks to something that we were talking about quite a bit earlier around the mental health side, but the transition planning for youth…. And 100 files did not show the degree of transition support and planning that would be required by standards — the timing and so forth. There was not a proper and complete assessment of the young people in terms of their health, their need for continuing education and training support so that they will not transition out into, for instance, social assistance but transition out into employment, education and other pro-social activities that will equip them for independent adulthood.

Again, we talked earlier about the tuition waivers and other things. In part, some of those campaigns that I've been taking up were launched as a result of what we found in these files, which was such poor-quality reporting on education outcomes and planning for a better future for a child.

When we looked at the types of requirements in the former planning documents, it would be that the 17- or 18-year-old knows how to sort the laundry. Does the 17- or 18-year-old know how to cook two meals and sort the laundry? There's like a checklist of things that social workers were to look at. First of all, they weren't looking at that. Also, sorting the laundry and cooking a couple of meals might be quite important, but actually pursuing their education into a skill so that they can be independent is pretty darn important too.

Most young people these days, if they're given some skills and talents, can easily google how to sort their laundry and figure that out, but they actually need some help to navigate through post-secondary education training and skills, with real people helping them as opposed to the ways that they can find out their own information. A lot of the transition period material did not seem to really be transition material that would support a young person to actually move toward independent adulthood.

Young people are also not…. They're not working as intensively with young people. As the child in care gets older, less contact. Again, as anyone in this room will know, if you've parented a teenager or a young adult, often the parenting load returns to what it was in toddlerhood. It becomes more severe, not less severe. Some of the materials and equipment and planning and organizing the work that's done don't reflect the developmental stages and needs of young people, so I suppose it's not all that surprising that many young people are transitioning out of care to home insecurity or welfare.

The eighth recommendation, again, comes back to this education. We have a very concerted effort around education. We saw consistently that the school information was not up to date in our audit of the plans of care and children were not supported to be achieving at the grade level. There wasn't an adequate assessment about whether they're at grade level.

As I've indicated to committee members before, the ministry often takes the lens of: "Well, if you're nine years old in grade 4, then you're in the right grade." They don't actually look at if you're nine years old in grade 4 and can actually do grade 4 work. Whether or not you're capable of achieving within the expected academic requirements of that level is something that we keep missing the lens for these children. And I think, again, it fails to meet the standard of the prudent parent, which is you want to ensure that your child is at grade level achieving, or if there are challenges, interventions are taken to remedy that.

We saw lots of challenges where we see education delays being identified, particularly in early literacy and numeracy, and no clear plan for intervention and no clear prospective forward planning about the type of education opportunities that the child will be promoted to engage in.

We came back on that recommendation to those basic things, such as tracking, whether or not the CCOs are on track to meet provincial requirements for high school graduation within the expected six years. We want clear tracking of that. We want to know how the ministry expects social workers, parents and caregivers to collaborate with educators. Who's the lead, who is responsible, and how will it work forward? We're in ongoing discussions with the ministry, but there should be a much more concerted effort. It's not adequate, by any means, on that issue.

Recommendation 9. I sent the audit results to our Public Guardian and Trustee in British Columbia for
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them to look at the audit finding and to assess whether the failure to adequately plan for an entire group of children presents potential or real risk of harm to these children or subgroups of these children.

In particular, I drew to the attention of the Public Guardian and Trustee the placement instability, the lack of cultural planning, the unmet special needs for the development of the child, the unmet physical and mental health needs, and the lack of education planning, so whether the duty of care that's required under the statute with the standards is being met and, if not, whether this presents a harm in the lives of these children. The Public Guardian and Trustee have that file before them to look at. I understand they are on track to report back to me by December 30, 2013.

The final recommendation, recommendation 10, really speaks to the future. Because of the poor planning and the tools and the standards not being taken seriously enough and enforced adequately, I made a recommendation that the ministry look at the Child, Family and Community Service Act to think about whether or not the provincial director of child welfare…. They need to strengthen the obligation to care planning.

Section 7 of the act talks about the child having a right to be involved in their care plan. We may need to look at strengthening the legislation to be clear that there is an obligation to plan and make that planning explicit and responsible and to have some clearer direction from the legislators to those on the front lines of the system about the importance of this area, because it speaks so much to that core part of the function, especially around these key parts like transition.

We haven't spoken at length with the ministry about this. Their last round of changes to the Child, Family and Community Service Act were changes that came prior to the election and that addressed some domestic violence issues and whether or not children being in a home with domestic violence could pose harm. That was the last set of changes that they made, so they haven't really looked at this yet. I think it's a valuable thing to think about and begin reviewing, and I will be pushing them to do that.

I will stop there and then invite any questions that you might have about the audit or the findings of the audit or the recommendations. On a whole, I would say that the recommendations are underway and subject to a great deal of discussion and engagement. They're not implemented, by any means, but we're quite actively engaged with the ministry on them.

D. Plecas: Mary Ellen, I'm thinking in terms of plans of care and the audit showing that pretty much half the time there wasn't compliance in getting that done, and probably where that's even more so is the case for aboriginal children. At the end of the day, isn't it fair comment, then, to say that given that, it's a clear violation of subsection 70(b) of the Child, Family and Community Service Act? I'd say that when you talk about strengthening the act, it would appear as though the act isn't being followed as it is.

M. Turpel-Lafond: Right, so my suggestion was…. On the one hand, section 70 outlines the rights. Section 2 talks about the intent to provide children with a stable kind of prudent parent model. Any opportunity, I think, we have to strengthen the legislation to be clear that a plan of care is required….

I mean, obviously, before a child is made a CCO…. You have to file with a court in British Columbia a plan for the child when they are permanently in care and will not be returning to family. There is a document prepared for court purposes — like at one moment, a snapshot at that one point of decision. In a way, the ministry thinks that's the job, but the job of planning is a much more detailed job. Maintaining the life book, keeping an eye on the future as well as recording what's been happening are key to good child welfare practice.

I would say it's fairly clear in the act that they have to do it now. If it's valuable…. It's a workforce that changes. There are new people coming through, different experiences in schools of social work. Maybe they don't get the type of pre-employment training that they need. We can always look at strengthening the act to be really clear about the planning for children in care.

That might be valuable too, because the ministry can be captivated, sometimes, by flavour-of-the-month approaches like "we'll no longer have children in care," for instance. That's not realistic, but we have seen the pendulum swing in British Columbia where we just need to keep a good, steady solid centre ground on the child welfare issues.

D. Plecas: It's only that it would seem as though, given that the time period of your audit is seven years, this is a problem which has gone on consistently for all of seven years. One wonders how that could happen.

M. Turpel-Lafond: Well, I think this speaks to the core function of why we need an oversight agency with respect to children in care. When you can have people required and mandated by legislation to provide a service, you need some oversight to make sure the service is being done. Particularly when the citizens are vulnerable and are minors or what have you, you need to encourage a climate of active improvement and reporting.

I mean, obviously, if the ministry was reporting on audits of planning for children in care, I wouldn't be doing it, but they aren't reporting. Nevertheless, the bit they do on compliance shows very poor compliance. When we went out to do the focus groups, and I'll ask Janice to speak to this a bit more, the reasons they gave us for not having compliance spoke to some cultural issues
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that need to change with respect to how, even in a large workforce, people can sort of find ways to stray beyond the focus of children. It can become a focus on adults or other issues. You lose focus, so the foster parent will do it, or what have you.

I'll ask Janice to speak to some of the things that we heard in our focus groups. But there are real cultural issues if they don't stay focused on the task, to get the task completed.

J. Chow: From some of the comments that we did hear from social workers in trying to complete the plan of care, what tends to compete for that time is having to deal with crisis, which we're often hearing with some of their caseloads — having to deal with crisis first and then sort of work on their paperwork later.

In terms of plans of care, I mean, we're looking at this as a living document. They need to be focusing on them and that when circumstances change for the child, they are writing that down in the plan of care and thinking about how they're moving forward with that.

Another challenge, too, in terms of completing the plan of care, is also that it tends to be a priority among management when in fact your office is being audited. It all of a sudden becomes a priority, and then around the clock everyone is going at their plans of care, updating and trying to figure out what's happening to that planning. That's what we're hearing from the field when the importance of it comes to light.

The other part, too, is that with the new integrated case management a lot of the workers' time has been spent on trying to learn the new system and trying to figure out how to navigate through that as well. Definitely, ongoing challenges are happening in terms of completing the plans of care.

D. Donaldson: Again, an eye-opening report, and thank you for it. I've looked at a couple of things, and I have a couple of specific questions. The chart on page 17 shows that from 2006 to 2010, in four of the five reporting districts the compliance rates decreased, and in the one where it didn't, it was still only a 36.4 percent compliance rate. I think that's very, very telling.

It reminds me of the reports that were presented by the representative at our last session, the two special reports. In Trauma, Turmoil and Tragedy the ministry was not able to provide the information on how many times a child in care had been moved in and out of the system or within the system. Those are some basic numbers that I think, again, relate to this report as well.

In that last session the representative also brought up — perhaps it was in regard to either that report or the Who Protected Him? report — the potential legal ramifications of this kind of behaviour within the government, within the ministry. I know the member brought up, perhaps, violations of legislation. I think this question is opened up by this report as well.

Before I get to my two specific questions, though, I wanted to address comments by the member for Chilliwack previously. I think he should reacquaint himself that this is an independent officer of the Legislature, non-partisan. These are reports that have been taking multiple years. The one we'd considered previously I think was approximately three years, and this one took a year and a half, so lots of hard work done on them.

The findings in the last report were of a lack of leadership. This finding is of unacceptable audit reporting. I think to comment on those is fair comment. I think the member would agree that the buck has to stop somewhere. In this case, I think people at the top is where the buck should stop.

In order to say that you categorically deny any of these kinds of findings from an independent officer of the Legislature demonstrates, to me, a closed mind, and perhaps the member should think about where his time could be better spent.

We're struggling, as a committee, with the kinds of reports that we get here and with considering the solutions provided. Some of those solutions that are indicated in this report are legislative. Some of them are structural, as was indicated in the previous report about how a parliamentary secretary might be a solution. But those are things that we have to do. We have to consider real solutions, and we are considering real findings from an independent officer of the Legislature. I think the member should keep that in mind with his comments.

My final two points were around the chart on page 17. The zero percent reporting of the north regional district in 2010 — if the representative could elaborate on that a little bit more. There was a note, but it just said, "Zero applicable files," so I'm not sure what that footnote means.

Then, on the next page, on the delegated aboriginal agency case practice audits: the representative found agency results difficult to understand and interpret and seeks further explanation and details to fully understand the criteria used. Could she elaborate on those points, please.

M. Turpel-Lafond: First of all, in the north region the zero is because they didn't audit any files that year, so there were no files. There were no audits. There was no compliance work. Sometimes in the ministry, because it has different makeovers that it takes up at different times, it moves away from quality assurance, and it won't actually do any reviews. So for the north region we really have a complete gap. We don't know what it was.

This speaks to a key issue which is, again, that as a representative, Members of the Legislative Assemble and members of the public expect me to be able to say how care planning is happening in our region. The only way I can know that is if I look at something and then, in turn,
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they're looking at it.

Sometimes in my travels I will meet with local service areas and offices who say, "Things are going very well here. We’re very happy about things," and I'm very pleased about that, but I have to actually look at the kids. How's the planning for the kids? An office environment might be positive, and the adults may feel good, but what's the work? The only way we know is if there are compliance audits with standards.

With this one, a good example there is that we really have no idea what happened that year because there was no auditing, there was no compliance review. It's unknown.

On the delegated aboriginal agencies, there are 23 in British Columbia. Not all of them have the level of responsibility to do planning for children in care or guardianship. Only a smaller number of them do.

But there has been for some time a push-and-pull around what standards they have. They have their own standards, separate aboriginal standards, which are designed, as they say, to meet and beat the provincial standards. They require, for instance, more regular visits. We only applied the provincial standards in our audit. The results show that their files are pretty much consistent with elsewhere. The planning is not being done.

Now, in the delegated aboriginal agencies they'll say to me, on things like cultural planning: "Well, we're close to the culture, so we know they're getting it." But again, that's not really adequate, because often children will be moving all over the place. We have to look at all of these domains and see if they're actually meeting those expectations.

Some of the other material in the report — for instance, examples of some of the needs that the file showed for their children and the responses…. Those were pretty consistent across the board, especially, again, if you look at the education examples. There you'd see…. We included a table for you.

If you just look at page 50, this was actually pulled from the files as examples so that you could see what we were talking about. On page 50 take the second one, as an example. This is verbatim: "Child needs to keep working on developing his weaknesses." Desired outcome: "Child to continue working on developing his weaknesses." Description of services: "School personnel, foster parent and social worker to encourage and help child to continue developing his weaknesses." That's an actual file. First of all, I hope we don't encourage children to develop their weaknesses. We actually help them to overcome their weaknesses. It speaks a lot to the problem that we see in these files.

If you look at another one, a good example, the second-to-last one: "Caregiver to follow up with school on child's progress." Desired outcome: "Caregiver to follow up on school regarding child's progress." What happened: "Foster parent to meet with teacher, problem-solve…to do better in grade 6 if necessary." Basically, the planning was to put everything onto the foster parent. How do we know the child will even be in that foster home the next year, what the plan is, or if there is to be any follow-through?

These give you examples of specific actions that are needed. Again, for those of you around the table who are parents or grandparents, you know that if the child is not meeting the needs and something has to be done, you don't just look into it. You actually have to provide some service, an intervention, to make a change. These types of comments were there in the poor plans for the delegated aboriginal agencies and for ministry offices. This represents both of those classes of files: female, male, aboriginal, non-aboriginal, delegate agency and ministry.

C. James (Deputy Chair): A couple of questions. I'm encouraged that the ministry is engaging in this process, as you've said, but I think the proof will be in the specifics, and I guess I have a question around that.

When I look through the recommendations, the one that comes closest to me is recommendation 3, which says that supervisors will ensure that effective, quality plans are developed. From your point of view, do you see anything specifically that will give us an indication a year from now that better plans of care are developed? What will be the indicator? Is the ministry going to do its own audits? Will you as representative have to take on auditing again randomly in the next couple of years? I guess, just on that specific, is there something that you see that's going to ensure that those plans of care have improved over time?

Then my last question was just around ICM and whether you've had any indication about the impact of ICM on plans of care, whether there's any indication that that's going to be integrated as part of ICM. Obviously, if you're looking at keeping life books, that's not something that can be done on computer. That's something that you need to have some specifics for. I just wonder whether ICM had any impact or if you anticipate it having any impact on plans of care.

M. Turpel-Lafond: Right. First of all, in terms of recommendation No. 3 on supervision, this report has been very helpful for us with the ministry because we've seen issues around supervision across the board — for instance, people promoted into a supervisory role without any additional training, maturity, experience necessary to performance. It allowed us to have a good discussion with the ministry on this. If you're going to delegate someone to be a supervisor, it has to be something in addition to…. You know, they don't just cross the floor. They come to work, and in six months they're the supervisor.

I'm not saying it has to be a lengthy process, but there
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has to be competency and particular delegation into the supervisory role. It has been somewhat anathema to the ministry in the last number of years, to have anybody with special qualifications. It was sort of: "Everybody can do everyone's job." You know, sort of: "Butcher, baker, candlestick maker — you name it. We can all do the job."

I think it's the idea of being qualified and having competency, being delegated with that competency and then being accountable for that competency so that the supervisor trains the guardianship social worker, makes sure there is compliance and is in consult with them to say: "We have a child that needs special medication, has a major behavioural issue. I'm trying to plan. What should I do?" Well, the supervisor actually gives you some input to say: "Here's how we're going to integrate with child and youth mental health" or "We're going to integrate with school."

You're right. The supervisory part is crucial, so MCFD qualifying and developing the supervisory function is something that we've had a lot of discussion with them over the years. It was hard to get them to accept it. They've rejected it on an ongoing basis until this report. They really came back and said, "Okay, fine; we're going to work on it," and I'm quite happy. How it lands, I don't know, because the supervisors need to have the competency, the delegation and the accountability, and it just has to happen.

Your second question about ICM. I think it has affected it in some ways. It's difficult to get a lot of things done when they're struggling with their information system and trying to meet that request for service.

ICM has produced many, many distorted problems, like we can't tell who's an aboriginal child in ICM. It's very problematic. We can in MIS; we can't in ICM. These are things that have to be fixed.

But you are right about a life book. What we found in this audit was that of the 100 files we audited, in 35 we saw evidence of a life book, but only in 13 did we see where someone added something in the previous year. We're not talking pages and pages. We mean like a picture. We report on….

There's a 17-year-old. The last picture in the file was when they were 14. Now that kid is living independently. They're not going to have a picture except when they were 14.

Again, think about it in the context of your own children and grandchildren. If you couldn't show your own kids a picture from between the ages of 14 and 17, they're probably going to say: "Well, you certainly didn't like me. You liked the other sibling a lot more than me, and this just goes to show you." Right?

I think that the issue is so important. That's the only thing that child will have, so the life books will not be on ICM. It still requires creative work and really working with young people to create the record that seems so transient and unimportant at the time but becomes so significant as they become young adults.

Also, their siblings. Many of them had no contact with siblings, but they have a right to have contact with their siblings. They wouldn't even know, when they age out of care, that they had siblings because the work had been done so poorly — or where the siblings were or where the families were.

Some of that work — it takes time. It's not ICM-type work, but it takes time. It's not being recorded, and these are really important around proper support for a child. The life book has to be maintained and contributed to regularly. We put that in the details, and a supervisor needs to make sure that's being done.

If they look at the life books for the cases and see it's not being done, they need to go back and say: "Hey, we've got to stop here and get back and get that done." I think that's quite important. No young person aging out of care is going to be able to go back and re-create their life story. They're not going to go to school and say: "Oh, by the way, did someone take my picture in grade 5, and did someone buy it?" I mean, it's just not going to happen unless these workers can do the work and are held accountable to do it.

J. Martin: Recommendation 7 about the transition from youth to adult in custody…. It would seem that's just a classic…. Integrated case management should be addressing that. It never should be an issue. But there's got to be some institutional or structural obstacle if a case management plan can't handle that bridge. Is there something, as I say, structural or institutional that is preventing something that is so commonsensical?

M. Turpel-Lafond: Well, I think the challenge is…. Again, I think we'll touch upon it more when we report on transitions more generally. The challenge we find is that as someone approaches the age of 19 and they've been a continuing custody–ordered young person in the system, because we have such poor residential services — the subject of another report; the boy that was tasered, for instance…. Because we basically have sort of the mom-and-pop foster homes, but the children can't be well supported, by the time they're in their later adolescence, they're probably living independently very, very early.

So it is difficult to transition someone when you haven't provided good residential services, so you can't work with them. They actually don't have a relationship with a social worker at all, right? It's just a monthly check on a youth agreement. Or they're in a group home with an ever-changing cast of characters living with them, and they don't have that stability.

To do transition work requires some stability. I think one of the ways we may be falling down is because of the lack of stability. But you're right. A good information system will make sure…. Like, at 16 you begin that pro-
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cess; at 14 you begin that process. But you have to have stability with social worker and placement, and they have to see you.

My attitude with the ministry as the advocate is: go and find the kids. If you've lost track of them, go back and re-establish a relationship with them. It can be done. They can find our office. You can find them. If people don't have the skills, they need to get the skills to be able to do that. So the ministry has a high burden there, and they need to build that part of their work — as opposed to saying: "Well, they're now going to be transitioning away from us at 14 or 15." Strengthen some of those ties as they head toward transition.

J. Chow: I think in part of our audit it was…. With the whole transition of supporting kids from when they age out of care, a lot of the documentation that we found in the files was more a to-do list — like make sure we help them apply for social assistance or make sure they've got their B.C. identification card or know how to find an apartment to live in — rather than really focusing on: are they going to have the capacity to move on to adulthood? That was something we really need to take a look at and interview much earlier on — not six months before they age out of care.

J. Thornthwaite (Chair): I have a question. I also concur with my co-Chair with regard to your comments that the ministry seems to be on track with your recommendations.

My comment is more on the deadlines, because again, a lot of…. This report was published in March of this year, and everybody knows that we did have an election. Now it's just getting into November. A lot of these deadlines are, I would say, a bit quick, given that election period.

I'm pleased that — for instance, in your recommendation No. 9 — you did say that the ministry was on track for that deadline for December 30. I just thought there are a lot of other things that the ministry does besides having to meet deadlines by one report.

I'm just wondering if maybe your deadlines are a little bit too short for them to be able to accomplish them.

First of all, whenever we do a report like this, we go through a pretty rigorous administrative fairness process. So on this report we invited in the provincial director of child welfare quite early — and the deputy, frankly — and said: "What do you think?" They said: "It's a disgrace. We're really embarrassed about this. If we can't fix it, we can't do our job."

They were actually the ones that said to me: "We're not happy about this, and we want to have 100 percent compliance." I was saying to them: "Well, you've got 5 percent now. One hundred percent. Let's be realistic. You've really got to get something done." They're like: "No, you've got to keep the pressure on us."

It's one of those interesting relationships where they really want timelines for a reason. I'm disappointed they haven't met them. I know they're working on them, but we have to get it done.

They do have multiple other…. There are six service lines in the ministry, but what could be more important? What could be more important than looking after the children for whom the state is the parent? That was a refocus on what your job is. Get it done and get it completed.

You know, I'm sensitive to things like elections and so on. But I think one of the important things about the work of this committee and our unique approach in British Columbia is these are not partisan issues. I don't think we're going to have any disagreement at this table or with the member of the Green Party or an independent in the Legislative Assembly that we want good planning for kids in care. This is something that…. Even within the bureaucracy, elections should be irrelevant. It's public service. You should do it — no matter what. It's the right thing to do.

There's only so much I can tolerate the election excuse, because I mean, you're public servants. You're working to do the job, no matter who is there. It's a consistent commitment to get the statutory obligations met.

I agree that people think: "Is there going to be another big changeover?" This ministry has been the subject of a lot of makeovers in the last decade or more, but this is a core job. We have to get back to get it done.

I'm prepared to give people time on…. I'm not expecting the world to be fixed by September 2013, but just don't begin a new makeover project and forget this key work that you have to do. As I say, nothing could be more important.

I really preface those remarks with that issue about keeping that life book, keeping that record. We have to remember in this work that we're talking about real kids needing real service. It isn't just a bureaucratic makeover exercise. It's about getting out there and doing the work. If you're required to have a face time with the child every three months, for heaven's sake, that's not even a high burden. Make that face time with that child every three months.

They pushed back and said: "We want to do this. We've got to get them." They'll come. You can invite them eventually to come and speak to recommendations, I'm sure, here. I mean, I want to celebrate that they did it. I'd like them to get to 100 percent.

I'm aware of one delegated aboriginal agency that had results at 5 percent. They recently demonstrated to me that they've reached 97 percent of effective planning for
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the children in care. It's not a huge number. I think they have 17 — is it 17? It might be slightly more. Nevertheless, they got there because they were very motivated by this report to go out and get their plans and work with their kids. They brought it up to 97 percent.

I think that's a really good…. I'd like to see that across the board. They went out of their way to demonstrate it, do it, prove it and audit it — that the compliance was there.

I think the ministry can. I like to see that can-do attitude. That's what we need in that ministry: a can-do attitude.

J. Thornthwaite (Chair): Okay. Well, I'm not seeing any other hands up, so thank you very much, Mary Ellen, for reporting on your reports. We will be seeing you again…

We'll just let Mary Ellen gather her stuff, and then we'll have maybe five or ten minutes of discussion.

J. Thornthwaite (Chair): I know that the next two meetings are actually back to back in Vancouver. We've got November 26, which is a Tuesday, and we've got Wednesday, November 27, back to back. What we're going to want to discuss briefly right now is kind of the agenda items, which the vice-Chair and I have already spoken about, but also to get your feedback on how we want to go about…. I'm talking about when the ministry comes to visit.

The ministry is going to come and visit and give us an overview, an orientation of what they're doing. There is also going to be an opportunity…. And we don't have to decide this right now, as to how we would have them come back. They have agreed that they would come back and deal with either reports at a high level or recommendations, and kind of look at specific questions that the committee would have on specific reports — if you wanted to take this one that we just looked at — and just how you might want to think about the format that we would do and how much time you think that that would take.

There are a significant amount of reports that actually occurred before we came on board. The Clerk has just brought to my attention earlier on today that our committee actually does an annual report as well. We have to also report on what was done since the last annual report, which includes our time before we were actually, technically, on the committee.

So there's that work that's going on. I understand from Josie that it's not overly burdensome, because they're so organized. They're actually doing their job as it comes along. During every one of our meetings they're recording it and on top of things, so it's not as bad as you think it is.

Anyway, I just kind of wanted to throw that out to you. I'll get the vice-Chair to comment on this as well, from her perspective. We don't have to make that decision right now. But we do have two days, November 26 and November 27, at which we have at least two extra reports. One of them is the Out of Sight: How One Aboriginal Child's Best Interests Were Lost Between Two Provinces. The other one is this one that hasn't actually quite yet been released. It's going to be released this week. Then we have the overview from the ministry and any other business that we want to….

C. James (Deputy Chair): Maybe just a couple of things to add. I think it is important for us to clear the reports so that we're caught up. We've got a couple still, so my suggestion would be that we look at the first day of our two days and look at getting caught up on the reports so that we've got those pieces out of the way — get our usual update from the representative and then do those reports.

Then my suggestion would be that we put the second day aside and give the ministry a chance to come present to us — not put the time aside to deal with recommendations from the reports, that we save that for future. We just ask them to come and talk about their six lines of work, the work that they do, who's responsible for what, what their priorities are right now in the ministry. We basically just get an overview from the ministry. I think that's the best way to start.

I think if we have time, perhaps on the first day after we go through the two reports from the representative, we as a committee then could just have a conversation about what kind of responsibility we believe we want to take on around recommendations.

You remember we had a discussion. The Chair brought the discussion to our very first meeting about: do we want to take on responsibility as a committee for recommendations and ask the ministry to report to us on a regular basis on those recommendations? And do we want to take on a special project?

We might take that as our first day — get the two reports, then have just a little bit of a discussion with just the committee — and then the second day do an update with the ministry. I think that would give us a good overview and get us caught up before we get into the new year.

D. Barnett: When the ministry staff come to speak with us, or at us…. Something that the commissioner
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said I found very interesting: the ministry staff agrees with her reports in the entirety. That is basically what she said.

When they come to meet with us and talk to us or whatever, I would like them to explain why, if they are so agreeable to the reports, more hasn't been implemented. I would like to know why. And I think it's very important that we know why. Is it because there's no funding? Is it because staff doesn't want to move off their agenda? I would like to know the reason for it.

M. Bernier: Donna kind of went where I was going. I think it's really important for us. We need to hear from both sides of the fence, so to speak. You've got an independent representative who's making recommendations. We need to hear now from the ministry.

Are these practical? Are these accurate, from their side, and attainable? There's no point — I mean, I understand her role of making these — throwing timelines in if the ministry can't actually, arguably, come forward and say it's actually practical and we can do this. We need to hear from them as well.

To your point, if they're agreeing with this, then why are we not doing it? That's where I think we need to hear the other side as well. As a committee, that's the only way I think we can be functionally going in the right direction once we actually understand what the barriers might be.

D. Donaldson: I don't know if it was a joint timeline that the Chair and Deputy Chair came up with, but I agree with having that whole second day for the ministry and the first day as discussed. I think the member opposite talked about us having a chance to ask the ministry directly. I think that's a great opportunity to be respectful and find out what barriers and challenges they're facing.

I also wanted to make sure that it's on the record that I thought the representative…. What I heard is she was referring just to the last report that was presented, that the ministry was in agreement that they found it an unacceptable situation about the percentage of audits not in compliance and wanted to do something about that. But it was just in reference to that last report. It wasn't that they were in full agreement with every report that we've heard so far, which is, I think, what was sort of alluded to by the member.

J. Thornthwaite (Chair): I'm hearing, more or less, agreement. The only thing I'm not hearing specifically is what's happening on what day. What the Clerk just suggested was that we do the reports first, which is what you concurred with, but get an explanation, a general overview explanation, of where the ministry accepts or not, or what's practical, accurate or attainable — using your term, I think, Mike — on the second day with the ministry there.

Then specific requests on specific reports and specific recommendations we do at another time.

K. Ryan-Lloyd (Clerk of Committees): The ministry has quite a detailed process of responding, monitoring and tracking implementation of recommendations from the office of the representative.

It might be a helpful part of their initial overview presentation to you all, in terms of their organizational role and responsibilities, to spend some time explaining how they work in conjunction with the representative's office in terms of receiving draft reports, doing their fact-checking process with them and then stepping through the process of recommendation implementation, as they've provided the Chair and the Deputy Chair recently with a high-level overview of that. That would be, perhaps, a good objective for the ministry's presentation.

Then beyond that, depending on how many reports the committee might want to look at in more detail, perhaps tackle that at a subsequent meeting. There could be quite a few, since the ministry last appeared before this committee…. I can't quite recollect the date, but it's probably well over a year ago since the ministry has appeared.

J. Thornthwaite (Chair): I'm seeing lots of heads nodding. Is there anybody that is not nodding their head? Okay. So is that good for getting out our agenda items and letting the ministry and the rep know about the dates that we're…?

K. Ryan-Lloyd (Clerk of Committees): Just to confirm my understanding, then, is that on Tuesday, November 26, the representative would come and be provided with an opportunity for another general overview, update of her office, followed by the committee considering the special report called Out of Sight, with a presentation by the representative's office, followed by the forthcoming report on aboriginal child welfare governance, which is expected to be released this week — and that the ministry would be invited to cover off the other topics, just identified, on the subsequent day, on the 27th, and both meetings will occur in Vancouver.

J. Thornthwaite (Chair): Thank you very much, everybody. I know it was a long haul, and I appreciate your time. If I don't see you before, I'll see you in Vancouver on the 26th. We're adjourned.

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Chair:	* Jane Thornthwaite (North Vancouver–Seymour BC Liberal)
Deputy Chair:	* Carole James (Victoria–Beacon Hill NDP)
Members:	* Donna Barnett (Cariboo-Chilcotin BC Liberal)
	* Mike Bernier (Peace River South BC Liberal)
	* Doug Donaldson (Stikine NDP)
	* Maurine Karagianis (Esquimalt–Royal Roads NDP)
	* John Martin (Chilliwack BC Liberal)
	* Darryl Plecas (Abbotsford South BC Liberal)
	* Jennifer Rice (North Coast NDP)
	* Dr. Moira Stilwell (Vancouver-Langara BC Liberal)
	* denotes member present
Clerk:	Kate Ryan-Lloyd
Committee Staff:	Josie Schofield (Manager, Committee Research Services)

Witnesses:	Janice Chow (Office of the Representative for Children and Youth)
	John Greschner (Deputy Representative for Children and Youth)
	Melanie Mark (Office of the Representative for Children and Youth)
	Bill Naughton (Office of the Representative for Children and Youth)
	Mary Ellen Turpel-Lafond (Representative for Children and Youth)
	Michelle Wong (Office of the Representative for Children and Youth)

REPORT OF PROCEEDINGS(Hansard)

SELECT STANDING COMMITTEE ON CHILDREN AND YOUTH

REPORT OF PROCEEDINGS
(Hansard)

SELECT STANDING COMMITTEE ON
CHILDREN AND YOUTH