The committee met at 8 a.m.

[B. D’Eith in the chair.]

B. D’Eith (Chair): Good morning, everyone. My name is Bob D’Eith. I’m the MLA for Maple Ridge–Mission. I’m also the Chair of the Select Standing Committee on Finance and Government Services. This committee is a committee of the Legislative Assembly that includes MLAs from the government and opposition parties.

I’m thankful today to be joining you from the traditional territories of the Katzie and Kwantlen First Nations. I also want to recognize that members and presenters are on traditional territories throughout the province.

I’d like to welcome everyone listening and participating to this virtual public hearing for Budget 2021 consultations. Typically, the committee travels around the province to hear from British Columbians about their priorities for the next provincial budget, but of course, due to the COVID-19 pandemic, all public hearings are being held virtually this year.

Our consultation is based on the Minister of Finance’s budget consultation paper that was released to the public on June 1. We invite all British Columbians to participate by making a written submission or by filing an online survey. Details are available on our website at bcleg.ca/fgsbudget. The consultation closes at 5 p.m. on Friday, June 26, 2020.

Of course, we will carefully consider all of the input made and make recommendations to the Legislative Assembly on what should be in the budget for 2021. We hope to have our report out sometime in August.

As far as the format, presenters have been organized into small panels based on theme. This morning we have our third public hearing on health care, and we’ll also hear about literacy.

Each presenter has five minutes for their presentation. Following the presentations from all panellists, there’ll be time for questions from the committee. We would please ask you to stay within the five minutes allotted.

Today’s meeting is being recorded and transcribed. All audio from our meetings is broadcast live via our website, and a complete transcript will also be posted.

Now I’d like to allow the members of the committee to introduce themselves.

N. Simons: Good morning, everyone. Nicholas Simons.

I’m up in Powell River in beautiful Tla’amin territory.

I represent Powell River–Sunshine Coast.

R. Leonard: Morning, everyone. Nice to see you all here so early in the morning. I’m Ronna-Rae Leonard. I’m the MLA for Courtenay–Comox.

I am sitting here in the territories of the K’ómoks First Nation.

M. Dean: Good morning, everybody.

I am coming from the traditional territory of the Songhees, Esquimalt and Scia’new.

I’m the MLA for Esquimalt–Metchosin.

D. Barnett: Good morning. I’m Donna Barnett. I’m the MLA for the Cariboo–Chilcotin.

R. Coleman: Good morning. I’m Rich Coleman.

I am in Kwantlen territory.

I am the MLA for Langley East.

B. D’Eith (Chair): Last but not least, the Deputy Chair.

D. Clovechok (Deputy Chair): Good morning from the Kootenays.

I’m on the traditional territories of the Shuswap and Ktunaxa Nations.

I look forward to your presentation.

B. D’Eith (Chair): Thank you so much.

Also assisting us today are Susan Sourial and Stephanie Raymond from the Parliamentary Committees Office and Dwight Schmidt from Hansard Services.

First up in our continued health theme, we have Christine Basque from Arthritis Society, British Columbia and Yukon.

Please go ahead, Christine.

Budget Consultation Presentations
Panel 1 – Health

ARTHRITIS SOCIETY,
B.C. AND YUKON DIVISION

C. Basque: Thank you so much for the opportunity to present to you this morning. By way of introduction, I’m the executive director of the B.C and Yukon division of the Arthritis Society, which is a national health charity that gives voice to people who are living with arthritis.

[8:05 a.m.]

Arthritis is a collection of conditions that affect the joints and tissues, and there’s no cure for it. It causes significant pain, severely restricts mobility for people who have it and significantly diminishes their quality of life. Because of the health care needs, arthritis patients require allied health services to manage their symptoms, as well as pharmacological treatments, which play an important role in the management of the condition.

I think we all know that B.C. is contending with a growing and aging population that’s going to have a significant impact on the health care system, and the number of arthritis patients is expected to grow. By 2035, we expect over 1.2 million British Columbians will have arthritis, and we do know that people with arthritis who are working age are less able to continue to remain employed compared to others. So we’re pleased to provide you with three detailed recommendations this morning to support the over 750,000 British Columbians who have arthritis today.

Remove the provincial sales tax on medical cannabis; ensure there’s a range of treatment options for British Columbians who have arthritis.

Second, increase access to arthritis-specific primary and community care with specialized and subspecialized services, including allied health care providers, rheumatologists and nurse practitioners.

Thirdly, work with stakeholders, such as ourselves, to reduce wait times for hip and knee and joint replacements.

Just quickly, a few points. Many people who live with arthritis use medical cannabis as an important pain management option. They don’t have access to PharmaCare coverage for that, so they’re paying out of pocket. Our concern is that that could drive them to use the illicit market cannabis, which puts them at risk, because it’s produced and sold without any regulatory oversight.

Particularly during the pandemic, we see a strong opportunity for the government to help them in this time of need by supporting the removal of the tax. Then it would also underscore a clear and distinct distinction between medical versus recreational cannabis, which then could pave the way for it to be recognized as medicine.

Also, in terms of the range of treatment options, like other folks who have other medical conditions, different treatments work differently for people with arthritis. Biologics revolutionized arthritis care, but we know they’re very expensive, not just for the person who’s receiving those medications, in some cases, but for payers, private as well as public.

So it’s our position now with new biosimilars on the market that those biosimilars that are approved by Health Canada have a role to play in the care and management of people who have inflammatory arthritis.

We were really pleased to be part of the consultation and announcement at the B.C. biosimilars initiative plan back in May of last year, and we look forward to continuing to work with the Minister of Health and B.C. PharmaCare on that. We would say it’s critical that the savings that are triggered from the transition to biosimilars be reinvested to ensure greater access to treatment and improving care for patients.

With respect to the second recommendation, I think my main point there is that a team-based model of care is important for people with arthritis. They need occupational therapists, physiotherapists, social workers, rheumatologists, nurse practitioners, general practitioners. We have a tool that we’re just developing with PHSA and with Vancouver Coastal Health which is an electronic arthritis triage tool that will triage arthritis patients to the right care pathway. It’s the earliest detection and most immediate way to receive the right treatment. We would just urge government and the Minister of Health to continue to work with us to continue to develop the tool and to implement it through PHSA.

Then lastly, arthritis is the leading cause of joint replacement — over 99 percent of knee replacements, 80 percent of hip replacements.

In closing, thank you for the announcement on your plan to address the backlog. We can appreciate it’s been a challenging time, so thank you so much for that. We would like to continue to work with you and invite you to work not just with the Arthritis Society but all other stakeholders so that we can support you as you look for options to address that.

Again, finally, the electronic arthritis triage tool could have a significant impact on that backlog. Also, it could trigger cost savings for medications, as well as the need for surgeries downstream.

That’s it. Thank you so much.

[8:10 a.m.]

B. D’Eith (Chair): Great. Thank you very much, Christine. I’ve got my Whitehorse mug here, recognizing the connections between British Columbia and the Yukon. Thank you so much for that.

Next up we have Sage Stobbe from JDRF Canada.

Please go ahead.

JDRF CANADA

S. Stobbe: Thank you for the opportunity to present to you this morning. My name is Sage Stobbe, and I’m a volunteer advocate for JDRF.

I have lived with type 1 diabetes since I was five years old. As a volunteer with JDRF, I have had the opportunity to visit Ottawa to meet with Members of Parliament. I have also connected with my local MLA in Saanich. I am a strong advocate for the type 1 community, because I believe we need more support.

The B.C. government should cover funding for better glucose monitoring systems such as CGM and flash glucose monitoring. This would greatly improve the lives of all living with type 1 diabetes. Not only does this technology make living with T1D easier for tens of thousands of British Columbians, but it is more affordable for our health care system. It would also make it easier to use virtual care during this pandemic.

Virtual care, as you know, is now a reality as a result of COVID-19. Digital health technologies will help doctors treat their patients more effectively. Investments should be made into these technologies when considering the changes that need to be made within the health care system. With this new technology, it is possible to improve the health outcomes of those living with type 1 diabetes.

I was diagnosed with T1D just after my fifth birthday. For those of you who aren’t familiar, type 1 diabetes is a life-threatening autoimmune disease. It is not a result of poor lifestyle. Just as it is not caused by lifestyle, it cannot be treated with diet and exercise. It is a brutal condition to manage and can be life-threatening even if well taken care of.

Being diagnosed was an abrupt, scary change to my life. For the next seven years, we faced battles of unpredictable high and low blood sugars. This made it hard for me to go to friends’ houses and for my parents to sleep through the night. Two years ago that all changed. A local Victoria charity covered a flash glucose monitoring system for me. This allowed my family and I to better understand how to control these more predictable highs and lows.

I now use a constant glucose monitoring system to take care of my diabetes. With CGM, I can now go to a friend’s house with them still knowing what my blood sugar is.

This technology would have been amazing as a newly diag­nosed child. I would have been able to go on that sleepover I wanted for years but didn’t get. These systems also allow me to have better control of my blood sugars, resulting in a longer, healthier life. These are cheaper than the test strips I would often use, as I would often test more 15 times a day, and each time I tested, it would have cost about $1.

This kind of technology has helped me avoid costly emergency room visits. Visits to the ER would have been a result of high blood sugars causing intense stomach pain and vomiting. That is only the beginning of diabetes-related complications. Using CGM and FGM can help avoid these trips to the hospital and, in the long run, help prevent amputations of limbs, kidney failure, heart failure and loss of eyesight.

I’m asking the B.C. government to provide access to these life-saving and life-improving systems. Please consider the JDRF’s recommendation to provide public coverage for CGM and FGM devices.

B. D’Eith (Chair): Thank you very much, Sage.

Next up we have Dr. Brian Bressler from the IBD Centre of British Columbia.

Please go ahead.

IBD CENTRE OF B.C.

B. Bressler: Thank you for this opportunity to present what we hope will be a real opportunity for patients in our province with inflammatory bowel disease.

A very brief introduction as to who we take care of. There are approximately 25,000 patients in British Columbia with inflammatory bowel disease, which comprises two diagnoses: either Crohn’s disease or ulcerative colitis. With regard to how common that is in relation to other sort of chronic conditions, it’s about as similar as type 1 diabetes or epilepsy and about twice as common as Parkinson’s disease or multiple sclerosis.

[8:15 a.m.]

One of the challenges of being diagnosed with inflammatory bowel disease and why it is a complicated and important problem that we have to address better is when it usually occurs. The peak onset of these chronic medical conditions without a cure is about the age of 25. Why that’s so problematic is because, as we can all attest to, in those few decades in one’s life, to have a chronic disease — when you’re starting out in your career, starting out in your relationships, becoming who you are — can have a formidable damaging impact that we cannot address with the current system that we have now in place.

We’ve had the opportunity to present this vision of ours to your committee for the past three years, I think, and it is very evident over the past three months what a crisis this really is. The reality is these are patients that could have debilitating disease that requires the most acute type of care that our system can offer. We have done our absolute best over the three months to manage patients as effectively as we can, keeping them out of our emergency rooms, keeping them out of our hospitals, in ways that I think…. We’re doing the best we can, but we have to do better.

There are many opportunities that this COVID-19 pandemic will present to our province — an opportunity to understand how we can deliver health care in an effective, convenient and efficient way. Reducing the burden of our acute care hospitals is obviously so critical and something we hear about now. We all hear about it on a daily basis.

How is the IBD Centre going to answer that? It’s going to give us an opportunity to reach out to patients, these 25,000 patients or as many as we can throughout the province, in ways that can treat them entirely. Address their mental health issues, working with psychologists and psychiatrists. Address their medical needs. Address parts of their disease that we think if we do better in reaching them, they will do better in their lives.

What we’re asking for…. To just take a quick step back, we have been asking for this idea for years. We’ve had the opportunity to have some support already from Vancouver Coastal, because the reality is that it’s the health authorities that are tasked with providing operational support for many initiatives in the health care system. So we do have funding from them for nurses, for psychologists, dieticians — the highlighted specialties that we think are most important for them.

We need a place. We need to be able to deliver effective telemedicine throughout the province, and we need a place where that can happen. As you can probably tell from my background, I’m doing it now from my house, which is good, but it’s not great. We need to be able to liaise with the other health care specialists in this to solve this problem for the patients.

One important issue that has been raised is this idea of the savings that we have worked with the Minister of Health for the biosimilar initiative. So this idea…. We’ve had a great collaborative relationship with the Minister of Health — with him and everyone in PharmaCare. To put that into perspective, the number one cost of PharmaCare up until now has been Remicade, which is a $40 million burden that the PharmaCare budget had to absorb annually. The majority of those patients have inflammatory bowel disease.

Switching our patients to the biosimilar version of it, at a 50 percent reduction, has saved our health care system $20 million. As of this morning, from what I heard from an update, we have transitioned 80 percent of our patients now on to that biosimilar. We have taken $20 million out of the health care system. It was a promise to us, and so far, they have adhered to that promise — that they will put that savings back into the care of our patients with inflammatory bowel disease. They’ve done that already, and there has been some great successes and great advances in the way we can manage our IBD patients, but there is more that needs to be had.

I would suggest that what’s been put back has been a fraction of that savings.

B. D’Eith (Chair): Dr. Bressler if I could interrupt, your time is up. If you could please wrap up, I’d appreciate it.

[8:20 a.m.]

B. Bressler: Okay. I would just say that although we’ve presented multiple years, we think now there’s a real opportunity where there are savings in that budget that can be given to such an important initiative that we’re presenting today.

B. D’Eith (Chair): Thank you very much.

Next up we have Pia Schindler from the Kidney Foun­dation, B.C. and Yukon branch.

Go ahead, Pia.

KIDNEY FOUNDATION,
B.C. AND YUKON BRANCH

P. Schindler: Thank you very much. I’m Pia Schindler. I’m the executive director. I appreciate the opportunity to present to you today.

The Kidney Foundation, B.C. and Yukon branch, is a grassroots organization dedicated to supporting kidney patients in our local communities through their continuum of care. We’re part of a national organization, and we’ve been around for over 55 years. We serve vulnerable communities, including the elderly, those in low-income households and those at risk, being individuals with diabetes, high blood pressure and heart disease as well as certain ethnicities, including Asian, South Asian, African and Indigenous backgrounds.

A snapshot of kidney disease includes the fact that this is a disease that has no cure. Dialysis and kidney transplant are the only treatment options. Today we have one in ten British Columbians affected by kidney disease. There are approximately 3,500 individuals on dialysis right now.

Since the start of COVID, we’ve seen a definite impact on kidney patients. Today I’m going to talk about only two key issues.

First is the issue of the mental health and well-being of kidney patients. Depression and anxiety are common in people with chronic kidney disease. Some estimates show depression affects 50 percent of people with CKD at some point in their lives. Of course, with COVID, we now add in the additional emotional impact of physical and social isolation, and the result can be far-reaching.

Here’s how we’re helping in the kidney community. Through our information hotline, our patient services team is on the front line. They serve as navigators and advocates for kidney patients. This hotline now is more critical than ever because we provide accurate and up-to-date information on living well and staying safe with kidney disease during the pandemic.

In direct response to COVID, we’ve also developed a peer engagement initiative called kidney check-in. Our staff support multilingual volunteers who connect with kidney patients through confidential outreach phone calls. The primary purpose of these calls is to alleviate stress, and we collect relevant data so that we know that we’re, in fact, meeting kidney patient needs and ensuring that this data is then heard by our kidney partners, B.C. Renal and B.C. Transplant.

The second issue faced by kidney patients is, of course, financial. In a recent Kidney Foundation survey, nearly 50 percent of respondents indicated that their annual household income decreased once they started dialysis. One of the key ways we address financial burden is through our short-term financial assistance program, where we provide financial assistance to those who fall through the cracks.

How has Kidney Foundation been affected as an organization in the last few months? Well, historically, we’ve been funded primarily through individual donations, corporations, foundations. We receive only about 5 percent government funding. COVID, and the financial impact on the economy, has most definitely put us in a precarious situation.

Initially, our revenue was down 30 percent, and we were able to access the federal wage subsidy. However, because our revenue has slightly increased after two months of federal support, we don’t meet the 30 percent threshold. So we don’t qualify. The result is that we are now in a worse financial situation because we’re down in revenue by approximately 22 percent.

Our recommendation and our hope are that the provincial government recognizes that there is a specific gap that exists. We’re asking that you be aware that this situation exists for our organization, and likely others, and that you help to address it. The future of our organization and the ability to serve the most vulnerable in the kidney community could be in jeopardy.

Thank you very much.

[8:25 a.m.]

B. D’Eith (Chair): Thank you very much, Pia. I appreciate your comments, especially around finding the gaps. I think that’s something that is really an important point to bring up, trying to find those gaps between federal and provincial funding during the crisis and for recovery. So thank you for that.

Questions from members?

M. Dean: Thanks, everybody, for all of your work day in and day out and especially during this crisis. Thank you for presenting today.

My question is to Christine, but any of you others might have some thoughts or comments on this as well. You talked about collaborative working, which is great, work­ing with the PHSA and the health authority. I’m wondering about engagement with the First Nations Health Authority.

C. Basque: Yeah. Thanks very much for the question.

With the electronic arthritis triage tool that we’ve been developing, we held a stakeholder consultation about a year and a bit ago. We had 40 different representatives join us to finalize the framework of the tool. And we had representation from the First Nations Health Authority.

You raise a very good point. Our understanding, doing our work — and it’s been spoken about with the other presenters — is…. From a virtual care delivery perspective, there are lots of communities that are very rural and very underserved in terms of gaps in care, including particular Aboriginal communities across our province.

It was important to us to engage the First Nations Health Authority in consultation with respect to the design of this virtual tool, because we know, by doing that, we can have their input into it. Then, virtually, it can be made available right across the province to their people.

B. D’Eith (Chair): Did any other presenters have any comments on that?

Okay. Seeing none, we’ll have Rich and then Donna.

R. Coleman: I have a question for Sage. I know somebody who has one of these things that you’re talking about — the CGM one — and the difference it has made. In your presentation, you mentioned the savings of the strips — up to $15 a day, for instance, or $1 per strip.

How much are the devices, and how many different models are there?

S. Stobbe: The two main ones, if you’re up to date, are FreeStyle Libre, which is flash glucose. You wave your little device on a little site that’s on your arm, and it tells you your blood sugar. Then there’s also Dexcom, which has had many models, but the most modern one is the G6. The Freestyle Libre is about $2,000 to $3,000 a year, and the Dexcom is about $5,000 a year.

R. Coleman: Which one do you have?

S. Stobbe: I have the Dexcom, but I’ve had the Libre.

D. Barnett: Thank you, all, for your presentations.

Christine, if I could, I’d just like to ask you how prevalent arthritis is in the younger generation. We always hear about these seniors, but how about the younger generation? I know an awful lot of younger people now that are saying they have been diagnosed with different types of arthritis.

C. Basque: Thanks, actually, for the question. We do serve children as well as adults. The form of arthritis for children is known as juvenile idiopathic arthritis. It’s a collection of different arthritis diseases. I believe, Donna, that it’s one in seven children who have JIA.

We work really closely with B.C. Children’s Hospital and the JIA clinic there. That’s headed up by Dr. David Cabral and Dr. Lori Tucker.

We actually offer a camp for children each year. This year we’ll be doing it virtually for them. We work with them. They created the model. It gives them an opportunity to spend some time with the kids that come to their clinic. Also, they’re involved in research through a Stop Childhood Arthritis initiative, a research initiative that we’re funding, the arthritis society. They’re able to really gather some great information there, but importantly, from our perspective, it brings kids together so that they can just be kids and, also, connect with one another.

Thank you very much for raising that. I didn’t make a note of that in my presentation.

[8:30 a.m.]

B. D’Eith (Chair): It’s worth bringing up, too, that rheumatoid arthritis, for example…. You can’t see it. I know Spencer O’Brien, the Olympic skier, quite well. She has suffered with this condition for many years.

It’s tough, because people don’t see it, and people don’t always believe it. You know what I mean? I think that with young people, there’s a sort of stigma attached to that as well, which I think is important to work through.

I’m wondering if you could comment on that at all.

C. Basque: It’s a very misunderstood disease. Sometimes people call it the silent disease. It also has a history of people thinking that it’s an older person’s disease and that it’s inevitable. That’s osteoarthritis. There are two different types. There are inflammatory forms of arthritis, and many different arthritis diseases within that category, and then osteoarthritis. It’s very difficult for people who are living with arthritis. As you mentioned, they go through their day-to-day without real recognition of having a medical condition.

Also, looping back to children, it’s hard for them in school, for example, because kids don’t understand. If they’re having a day where they’re going into a flare of their condition, they’re not able to pick up a book or carry things that they would normally be able to carry from classroom to classroom. It’s really misunderstood for the kids. Other children don’t know that they’re dealing with a really serious medical condition. It’s very hard on them.

From a social connection perspective, it’s very easy — not just for kids, but for adults as well — to really isolate and to spend more time away from, rather than with, community. That’s a huge concern, because there are huge mental health concerns within the arthritis community as well. People struggle severely with depression because they’re so limited in their day-to-day capacity to be in the world, and so many have to step out of the workplace because of their arthritis disease. Their world can become very, very small.

We all know that health really is predicated in great part by being connected in community. I think we’ve seen that during the pandemic. We’re all reaching out virtually. It’s a very misunderstood and little-recognized disease, so people have barriers that are in front of them as they’re trying to cope with the day-to-day reality of the condition as well.

D. Clovechok (Deputy Chair): Just really quickly, I’m very interested in the medical cannabis side of this, because I’m an advocate for it. Has your organization or anyone else started any clinical trials in relationship to medical cannabis and the treatment of arthritis?

C. Basque: Actually, as a national organization, we were out of the gate quite early in funding research into the efficacy of medical cannabis. We continue to do that. We just currently created a partnership with CIHR to get…. We said that we’ll put $1.5 million into continued research into medical cannabis. Our contribution to that is $750,000.

We know there aren’t guidelines at the moment. It’s very difficult for health care professionals. Their guidelines are important to them to understand how to best care for their patients. We’ve put a lot of money to date, over $1 million, into research into medical cannabis. We’ll be putting more. One of the goals is, on the back end of the research, to be able to create some critical clinical guidelines for health care professionals. It’s a big commitment for us.

B. D’Eith (Chair): I have a quick question for Brian just in regards to the cost. I appreciate the fact that there’s been a fair amount of money saved by moving to biosimilars and whatnot. But I’m just wondering what the actual cost is of you creating and maintaining a centre.

B. Bressler: Our budget, what we’re asking for…. This is a three-pronged approach. We’re asking for a philan­thropic drive. We are now working with St. Paul’s Foundation to help us champion that.

The cost of the centre, the operational cost…. We hope it mostly will be absorbed by the health authorities, because a lot of them do relate to salaries related to health care practitioners. What we’re asking in this particular context is for some structural support.

[8:35 a.m.]

The ask was for $5 million, which we think, over five years, will give us an opportunity to have a place that these people can work at and to keep the lights on. Perhaps there’ll be some overlap, while we get our philanthropic drive up and running, to support some of the extraneous costs for some of the salary support that weren’t completely covered by the health authority.

We’re working with the health authority to have performance indicators to really show that what we’re saying we’re going to do…. We’ve already started that by reducing emergency room visits and by reducing hospitalizations with the integration of our electronic medical record and the various databases that the health authority has access to. It’s been a great project that we’d like to kick off. We’ve started in some ways, but we can’t do it without this support.

The money will go for us to be able to open the centre and allow us to do it. We’re really excited with the idea that we can prove with certainty that the care we’re delivering is changing. It is changing the way patients feel and how they’re doing, but also, it’s changing the way these costs are traditionally absorbed in our province.

B. D’Eith (Chair): Pia, you haven’t had a chance to answer any questions. I’m just wondering if there’s anything you’d like to add to any of the questions or anything that might have been asked so far?

P. Schindler: No. I guess that just a couple of things come to mind. I know there was an interest around medical cannabis, and that has started to come on the radar with the disease as well.

I guess I just want to loop back in around the notion that right now, in my view, the overarching issue for organizations in non-profit is what the short-term viability and sustainability factor is to keep the lights on to move into 2021. What we might have brought to the table last year or the year before is different than it is today, just because the economy has changed so much. I think, keeping it a little bit broad, just by virtue of the fact that within two or three months…. What we’re thinking of, in terms of short-term sustainability, is that conversation is a lot different than a longer-term outlook.

B. D’Eith (Chair): Last question from Rich — go ahead, please.

R. Coleman: It’s just a comment — thanks, back to Sage. For a young person to come on for the first time and make the presentation to something you’re passionate about, I thought you did a very good job.

S. Stobbe: Thank you.

B. D’Eith (Chair): All right. Well, that was a wonderful way to end the first session of the day. Thank you so much to all of you, the presenters, for what you’ve been doing during this crisis and what you do for our community and the people suffering from the various conditions that you work in. We thank you very much for your presentation.

We will take a short recess until 8:45. Thank you very much, everybody.

The committee recessed from 8:38 a.m. to 8:45 a.m.

[B. D’Eith in the chair.]

B. D’Eith (Chair): Next up we’re continuing with the theme of health, and first up we have Anne Babineau from Innovative Medicines Canada.

If you could please limit your comments to five minutes, we’d appreciate that. If you could go ahead, Anne. Thank you.

Budget Consultation Presentations
Panel 2 – Health

INNOVATIVE MEDICINES CANADA

A. Babineau: Fantastic. Thank you. First, I’d like to thank the committee for taking the time to hear Innovative Medicines Canada’s submission on Budget 2021, especially under such extraordinary circumstances. I also want to commend B.C.’s exemplary response to the COVID-19 pandemic. While we recognize that the threat is very far from over, it’s clear to us that B.C.’s health system remains strong and that the provincial economy is well-positioned for recovery.

Innovative Medicines Canada, or IMC for short, is the national voice of Canada’s innovative pharmaceutical industry, representing 40 research-based pharmaceutical companies. We advocate for policies that enable the discovery, development and commercialization of innovative medicines and vaccines in order to improve the lives of all Canadians.

Our reason for speaking to the committee today is to bring forth three recommendations on how collaboration between our industry and the B.C. government can improve the health of British Columbians, while also supporting post-COVID economic recovery efforts. Our first recommendation is for B.C. to co-develop a life sciences innovation strategy with us and the B.C. life sciences ecosystem.

We believe that a strategy would ensure alignment between industry and government to create a more innovative and sustainable health care system, while also supporting small and medium B.C. enterprises in the life sciences sector. It would promote B.C.’s strength in life sciences and attract investments, research and clinical trials to British Columbia, while also allowing for greater inclusion of Indigenous health, knowledge and experiences.

Our second recommendation is that B.C. use its leadership voice to influence federal regulations and policies and ensure that they do not cause B.C. to fall behind in global competitiveness for research and, indeed, in patient access to innovative treatments.

In August last year, the federal government published new regulations through amendments to its patented medicines regulations. These new regulations will limit access to innovative medicines and discourage investments in Canada for years to come. But as these regulations won’t go into effect until January 2021, IMC wants to work with British Columbia and, in fact, all provinces to build an alternative approach which will lead to the value of medicines that provinces seek, as well as an improved health system sustainability, balanced, though, with better patient access and a vibrant life sciences sector.

Our third recommendation is to ensure that British Columbians have fair access to innovative medicines and vaccines. In order to do so, we ask that B.C. ensure an appropriate drug plan budget, proportionally comparable to other large provinces so that British Columbians have timely and fair access to medicines.

In the last two years, provinces across the country have given access to 51 important new medicines that B.C. has yet to make available on its public plans. We ask that government continue to collaborate with industry on health policies that impact British Columbians’ access to medicines and industry’s ability to invest.

[8:50 a.m.]

We ask that the province consider innovative ap­proaches such as value-based agreements to provide British Columbians access to appropriate medicines, and we ask that B.C. support, in federal discussions, an approach similar to the Fair PharmaCare program that offers a mix of private and public plans so patients continue to have robust access to medicines through their employers as well as an option to have access through the government plan.

To conclude, IMC is eager to work with the government of British Columbia to improve health outcomes and ensure health system sustainability and economic recovery. We hope that all the MLAs on this committee will consider our recommendations and that we’ll be able to have a productive and successful working relationship going forward.

B. D’Eith (Chair): Thank you very much, Anne.

Next up we have Bev Holmes from the Michael Smith Foundation for Health Research.

MICHAEL SMITH FOUNDATION
FOR HEALTH RESEARCH

B. Holmes: Thanks for the opportunity to talk about the Michael Smith Foundation and our work on behalf of British Columbians. Like most people these days, I’m at home. For me, that’s East Vancouver, on the traditional territory of the Squamish, Tsleil-Waututh and Musqueam Nations.

My team and I are proud to work for B.C.’s health research funding agency, the Michael Smith Foundation for Health Research. We’re funded by government through the Ministry of Health, and we work with a cross-ministry committee to monitor a jointly developed accountability framework. Those committees are Health;, Finance; Advanced Education and Skills Training; and Jobs, Economic Development and Competitiveness.

Our mandate is fourfold. We’re primarily focused on research talent development. We help B.C. develop, attract and retain globally competitive researchers. We also support research that addresses B.C.-specific health priorities and our health system. We help ensure decision-makers have access to evidence that will improve policy. Finally, we are very committed to optimizing government investment in health research through the foundation. We deliver on this mandate through programs that support early career researchers, innovation and knowledge translation — so the use of evidence in policy.

A few quick examples of our funded researchers. We’re working with John Little in the Okanagan, who is looking at reversing type 2 diabetes using a drug-free approach. Dr. Stephanie Willerth in Victoria has created a product for neurological disease treatments, and Dr. Chelsea Pelletierin Prince George has brought together a diverse group of community members to develop a physical activity research agenda. So a very broad spectrum of research that we support.

As well as those annual programs, we also help generate evidence for emerging health issues such as COVID-19 and the provincial overdose crisis. We maximize all of those efforts through co-funding partnerships where we can.

Our foundation has been doing this work since 2001, so we’re 20 next year, and we are very grateful to have had the support of government since then to help build a strong research enterprise which, in turn, has positioned B.C. very well to respond to COVID-19. I can’t imagine a stronger example of both the link between health and the economy and the importance of research for evidence-based decision-making.

Our foundation is supporting Dr. Bonnie Henry and the Ministry of Health by helping coordinate a provincial research response to the pandemic that is the envy of other provinces, according to my colleagues across the country. We’re working with policy-makers to understand what evidence is needed in B.C. and to fund projects to deliver that evidence. We’re making sure decision-makers are talking with researchers and that voices from all across B.C. — including patients and the public, Indigenous communities — are considered.

We’re also learning through this health crisis how B.C.’s health research system can better respond in future to health issues and can better contribute to the knowledge economy and support economic recovery across the province. Our new strategic plan is very much geared towards that future, with a focus on B.C.’s changing talent needs, emerging areas of regional excellence and the need for greater equity, diversity and inclusion in research.

[8:55 a.m.]

In closing, we know important and serious decisions need to be made to ensure B.C.’s recovery from the pandemic. We are very heartened to read the emerging economy task force and the former innovation commissioner reports, and we’re encouraged to think that government is considering those reports.

For us, the Michael Smith Foundation, our contributions are reflected in the area of talent development, which, along with research and innovation, feature large in those reports and, of course, in B.C.’s recovery.

B. D’Eith (Chair): Thank you very much, Bev. Appreciate your comments.

Next up we have Larry Goldenberg from Vancouver Prostate Centre.

VANCOUVER PROSTATE CENTRE

L. Goldenberg: Thank you for the opportunity to present today. I’m Larry Goldenberg. I’m a founder of the Vancouver Prostate Centre, and we just finished celebrating our 35th year.

I was a newly graduated urologist in 1984. I was trying to better understand the disease that was debilitating and killing my prostate cancer patients, so I started working collaboratively with two researchers at the B.C. Cancer Agency to understand how they viewed the basic biology of cancer and, at the same time, to have them understand the patient and physician’s clinical perspective.

This type of collaborative teamwork was rare at the time. In fact, we were one of the first examples of what we call team science — patient-centred research and development, bench-to-bedside to commercialization space, commonly known as translational research. Thankfully, this is no longer rare, and B.C. has many, many examples.

Over 35 years, the Vancouver Prostate Centre has grown to a team of over 300. We are an economic engine — publishing widely, hundreds of patents, spinning off biotech firms and creating impact provincially, nationally and internationally. Yet typically, as humble Canadians, the value of our research enterprise is probably better known outside of Canada than inside.

There are many components to the Vancouver Prostate Centre, a large patient clinic at VGH with a busy clinical trials facility, an internationally recognized and pan-provincial patient supportive care program, a basic science research powerhouse in 60,000 square feet of expansive space. All of our doctors, surgeons, scientists, nurses, researchers and staff are dedicated to changing people’s lives by personalized caring and by addressing complex questions.

The impact of our research stretches far beyond prostate cancer. Discoveries by our team have made a difference in other cancers, including breast, ovarian, bladder and kidney, as well as biologically related non-cancer diseases such as Alzheimer’s.

Over the 35 years, we have developed a platform-based laboratory that allows for shared research and collaboration. It was because of this infrastructure that we were able to pivot this past March and switch our focus from cancer to COVID-19. Our computer-aided accelerated drug design platform utilizes a homegrown artificial intelligence system called Deep Docking to screen billions of commercially available chemical compounds in a fraction of the time of other systems.

We are currently searching through 40 billion compounds to figure out which ones could potentially knock out one of five identified SARS-2 targets, including the main COVID-19 protease. Our expertise has led to collaboration with institutes around the world as part of a global team looking for an effective treatment for COVID-19. Our work continues, and if any of you would like more in-depth understanding, let me know.

All of our exciting successes have a downside: they cost money. The Vancouver Prostate Centre is one of B.C.’s remarkable success stories, but like others in the province, we are a non-profit organization. For 35 years, we have had to regularly seek philanthropic and targeted government dollars to support basic operations.

Historically, we’ve leveraged those dollars and an exceptional ROI of 5 to 1 by obtaining highly competitive research grants, but as you know, these grants are limited to paying for research. They cannot be used for scientists’ salaries or to employ the support staff who keep the centre running. And with the pandemic, all sources of funding, particularly philanthropic, are being strained to the maximum.

[9:00 a.m.]

In this upcoming budget, I strongly urge you to set aside significant funds to support the operations of B.C.’s core and well-established not-for-profit health research groups. In such challenging times, strong, focused financial support of the most successful centres, as determined by any number of parameters, will keep B.C.’s health and biosciences industry thriving while allowing us to reap the health system benefits.

Thank you for this opportunity to speak to you.

B. D’Eith (Chair): Thank you very much, Larry.

Next up we have Bill Barrable from Praxis Spinal Cord Institute.

Please go ahead, Bill.

PRAXIS SPINAL CORD INSTITUTE

B. Barrable: Good morning. I’m Bill Barrable, CEO of Praxis Spinal Cord Institute. Until last fall, we were known as the Rick Hansen Institute. Praxis is a Greek word which means moving knowledge into action.

The new name, Praxis Spinal Cord Institute, reflects the work we do as a B.C.-based global leader driving collaboration in spinal cord injury, or SCI, research, innovation and care.

There are an estimated 12,000 British Columbians living with SCI. SCI has a devastating impact on the health and well-being of individuals. Many would categorize it as one of the greatest survivable catastrophes experienced by a human being. Health care services for people who sustain an SCI are specialized and complex.

In B.C., the annual economic burden of new traumatic SCIs exceeds $372 million annually. Chronic SCI-related health complications incur $70 million annually in B.C. health care costs. Then there is the human cost to those living with SCI, many of whom have reduced capacity to contribute to the economy because of the complications.

Our vision, a world without paralysis after SCI, is unwavering. Our mission is to identify, develop and accelerate the translation of evidence of best practices into action. Through this, we reduce the incidence and severity of paralysis after SCI, improve health care outcomes, reduce long-term costs and improve the quality of life for those living with SCI.

Praxis Spinal Cord Institute does this in three ways. First, we collaborate locally and internationally. The strength of the Praxis Spinal Cord Institute is our ability to connect local and international consumers, patients, researchers, health care professionals and industry to create solutions. The Praxis Spinal Cord Institute is truly a global organization, with an SCI registry at 30 hospital sites across Canada and a network spanning more than 30 countries internationally. This degree of international multidisciplinary collaboration is unprecedented and has transformed SCI research and care around the world.

Secondly, we develop real solutions for pressing problems. The process to get from research to implementation is difficult. Obstacles include lack of funding and incentives to change. We focus on four interrelated areas: consumer engagement, care, cure and commercialization. We take current problems of those living with SCI and work to find solutions and then ensure those solutions actually benefit patients’ health care systems and, as an added benefit, the economy.

Driven by the real-world challenges of those living with SCI and their health care providers, we focus on innovations coming from B.C. as well as top universities and accelerate their development into real-world solutions.

Like the Michael Smith Foundation and the Vancouver Prostate Centre, we’re not unaffected by COVID-19. We re-prioritized funding towards national grants for projects to develop SCI-specific COVID-19 resources. We are part of national global efforts to track the effect of the disease on those living with SCI.

People with SCI are highly compromised. Many have respiratory deficits and are dependent on a rotating team of caregivers. This places them among the most vulnerable COVID populations. Our global network allowed us to work on informing best care practices for those living with SCI here in B.C.

Finally, we develop and feature B.C. talent and expertise. Among Praxis’ 50 staff are specialists in IT, research, en­gagement, data modelling, knowledge translation and commercialization. Given international political realities, many of the collaborations led by Praxis would be im­pos­sible otherwise and showcase B.C.’s position as a gate­way to the world. The impact of these human resources is magnified through the partnerships with other agencies such as the Michael Smith Foundation.

[9:05 a.m.]

We are very appreciative of the funds we have received in the past from the B.C. government. We provide a direct return of investment of 3 to 1 on those funds. As Dr. Goldenberg highlighted, the Praxis Spinal Cord Institute uses these funds in part to support basic administrative infrastructure, enabling Praxis to remain headquartered in B.C., which ensures B.C. benefits first from these advances in SCI treatment.

We urge you to consider continued investment in those of us who are international calibre health research organizations to help us keep our lights on and core staff employed. This will allow us to continue to contribute to B.C.’s twin challenges: the resilience of our health care system and the resilience of our economy.

B. D’Eith (Chair): Thank you very much, Bill.

I just wanted to say thank you to all of you for the work you’ve done, especially during the pandemic, and pivoting to be able to help the research globally. So important. We’re very, very lucky, particularly in cancer research. While you may think that we don’t recognize that, Larry, I promise you, many of us know very well how lucky we are to have the cancer research and treatment in this province. So thank you so much.

Rich, please go ahead.

R. Coleman: You guys all do such great work, and I’m familiar with all of you.

My question to Bev, though, is…. In your presentation, you passed very quickly over that you were doing research and moving along to finding a non-medicated solution to type 2 diabetes. Can you expand on that?

B. Holmes: Thank you for the question. I would be happy to send further information on each of the research projects. What our programs do is they…. We are funding about 300 projects at any one time in the system. They come in through all the universities in the province, and then they’re ranked by peer review committees.

What Johnathan Little is doing is really advancing knowledge in one of the ways that we can actually reverse, not just manage, diabetes through diet and exercise. The peer reviewers around the world thought that this was groundbreaking work and so chose to fund his salary. Then he gets funding from other organizations to continue his work. I don’t have specific details about the results and where he’s at, but I’m happy to get them.

R. Coleman: I would appreciate that. Thank you.

M. Dean: Thank you for all your work, especially in times like these. I know it’s really difficult. Thank you for your presentations.

I’m interested in hearing from each of you, if you’re able — if that’s okay, Chair — how you’re engaging Indigenous people and immigrant people and other marginalized people. We know that we actually need to have a diverse group of people who are designing and prioritizing research, because we need to make sure that we don’t end up with, you know, not a representative population that is actually being researched.

Previously, the way that the health system has responded to heart and stroke, for example, wasn’t actually fully informed by research about the whole of the population. I just want to hear from you about how you are making sure that all of the diversity of our population in British Columbia is incorporated into all your planning and prioritization.

Especially at the moment, as well, because COVID isn’t a fair virus. It’s actually hitting different communities unequally. That is making it much harder for parts of our population — marginalized groups, racialized groups, Indigenous communities — to even think about doing anything other than survival at the moment.

Just as time allows, Chair.

B. D’Eith (Chair): Of course. Thanks, Mitzi.

I can’t see you, Bev. Did you want to comment on that first, and then we can go around?

B. Holmes: Yes, thank you. Thank you for the question, MLA Dean.

There are two ways that equity, diversity and inclusion are being considered by us at the foundation and our partners. First of all, it’s in doing the research itself, because we know that there are some groups that are able to do and participate in research, as researchers, and then others that are less able to do that. And then, of course, as beneficiaries of the research, people of great diversity need input into the questions.

When it comes to COVID-19, we are working with the province on a strategic research advisory committee which is establishing a patient and citizen council that can provide input into a diversity of questions about COVID-19. We know that there is a danger that it could all be about vaccines and drugs, and, of course, there is so much else to be addressed when it comes to COVID-19.

[9:10 a.m.]

In our own work, as we look at the researchers that are being funded, the peer reviewers all look to make sure that patients, that various groups, are involved in the proposals that they’re putting forward.

Finally, the foundation has a memorandum of understanding with the First Nations Health Authority. In our new strategic plan, we are supporting an Indigenous health research capacity–building initiative.

L. Goldenberg: Prostate cancer, obviously, is gender-specific, but it’s not race-specific. We’ve made sure, through our prostate cancer supportive care program, that we have distributed it across the province. For example, one of our sites is in Prince George, which addresses a lot of the Northern Health area. We also have a telehealth program now, where our programs are webcast to rural areas where patients, men who have prostate cancer, can’t access the larger centres. That has focused a lot on the Indigenous communities.

The other area is through our Men’s Health Foundation. This is a separate organization, but one that I’m involved in as well; I’ll just comment on it.

One of the spokes in our wheel, if you will, is the DUDES Club from the Downtown Eastside. That has now spread through the province. I believe it’s close to 50 communities. It provides a social environment for men, pri­marily Indigenous, to re-engage with their communities, with their families and to try to get them, if you will, out of the hole that they’ve dug over a number of years. It’s a highly successful program. We’re very aware of all that.

As far as COVID goes, if we can get a therapy, it’ll apply to everybody. We’re very hopeful.

B. D’Eith (Chair): Bill or Anne, did you want to comment on that at all?

B. Barrable: Yes, I’d be happy to. Thank you for that excellent question.

Insofar as the institute is concerned, the Praxis Spinal Cord Institute, we’re working nationally, internationally and provincially with Indigenous communities, provincially with Neil Belanger and the B.C. Aboriginal Network on Disability. Recently we convened them with the India-Canada IMPACTS program, which is an NCE out of UBC and which does work in India. They have the capability of producing housing in 3D printing. This is of particular interest for our rural and remote communities.

We’ve also brought them together with two researchers that we support and fund that are affiliated with Waakebiness-Bryce Institute for Indigenous Health, which is part of Dalla Lana at the University of Toronto. It has a national mandate. We are supporting someone who is building a national network of Indigenous researchers in spinal cord injury.

We know, anecdotally, that there is a higher burden of injury in the Aboriginal Indigenous communities. We just don’t know all of the detail, and we need partners to do that so that we can understand the true scope and scale of the problem, so that we can, with those communities, develop strategies that make some sense to them, where there’s a strong ownership and a high level of success. We’re working very closely with those communities.

The former chair of Waakebiness-Bryce is a researcher at University of Northern British Columbia, and there are a surprising number of people across the country who are working in these areas. However, they need to be introduced to each other. Part of our role — we’re called an institute, but really, we operate like a network — is to bring smart people together to solve practical, real-world problems.

B. D’Eith (Chair): Thanks, Bill.

Anne, did you want to comment on this?

A. Babineau: Thank you. I appreciate that.

As for the treatments and vaccines, we’re working really hard on this as an industry. We’re working around the world. Particularly, one of our members, Lilly, has a partnership in B.C. with AbCellera working on a treatment for COVID-19. We’re quite enthusiastic about that.

When we’re talking about the diverse populations in British Columbia, that is one of the reasons our members are so attracted to the province for their clinical trials — not only because of the great science that’s in British Columbia and the high ethical standards of British Columbian researchers and academic partners, but also because of the diverse population. It helps our clinical trials and our clinical studies when we do have the studies with diverse populations. It is extremely important to us and is one of the priorities we look at when we’re conducting studies.

[9:15 a.m.]

B. D’Eith (Chair): Thank you. Larry, you brought up telehealth. I know that during COVID-19 there has been quite an uptake, obviously, in telehealth because of the physical distancing. It seems that people are starting to buy in to it. I gather there wasn’t a huge uptake initially, even though it might have been available. I’m just wondering. Do you see telehealth as something that should grow or stay in a big way? I mean, particularly for rural and remote British Columbia, it could be very important.

Then, I guess, the corollary of that is….

L. Goldenberg: A crisis can energize and catalyze a process. We’ve been talking telehealth for quite a few years. We had minor projects. Bill can probably speak to some of the projects that have involved telehealth with spinal cord injury patients. It’s something that we’ve been promoting for years. Then with this crisis — boom! — it has gone…. I was talking to my colleagues. Primarily during April and May, up to 90 percent of their contacts with patients have been by telehealth. Now it’s down to about 50. I suspect it’s going to settle in at about 50-50 or 40-60 for telehealth.

From a patient’s perspective, they don’t have to drive in or fly in to Vancouver to see me or one of my colleagues, for example, or to go to Victoria or wherever it is. They don’t have to worry about parking. It’s very, very convenient for everybody. Obviously, the exceptions are where you actually have to have physical contact with the individual, but for follow-ups or overall general consultations or discussions, I think it’s here to stay, absolutely. I think it’s been terrific.

B. D’Eith (Chair): Bill, did you want to comment on that at all?

B. Barrable: Yes, I absolutely agree with Larry. I think for people with disabilities, it’s a huge challenge getting around at times, particularly across the city of Vancouver, for example. To have telehealth is a huge opportunity. I know from personal experience. We have a son who had neurosurgery just as the COVID wind-down began at the Children’s Hospital. To have his consultations with ENT, with neuro and pediatrics, all on line was a huge advantage to us.

We know that if you have a spinal cord injury and require attendant care, there are huge challenges with COVID associated with that. To be able to be linked for specialized knowledge externally, to the specialists, is something that’s growing exponentially right now, and I don’t expect that’s going to return.

B. D’Eith (Chair): Great. This’ll probably have to be our last question.

D. Barnett: I think this is more a comment than a question.

To Larry Goldenberg: thank you for the work you do. Cancer is one of the diseases that has been around for a long time. Because of organizations like yours, and research, we are curtailing it in some form.

I have had telehealth here in my region for 15 years. The problem we have is with our health authorities. Sometimes they’re reluctant. They don’t have the proper staff, etc., and you still have to travel. But I can tell you that for patient care, it is probably one of the best things that was done years ago — to put telehealth in. I sincerely hope — not just because of COVID; we needed it before — that one outcome will be telehealth for patient care.

B. D’Eith (Chair): Great. Any other questions?

All right. Thank you so much.

One of the nice things about this new format is being able to have all of you together and being able to respond to each other. It really is wonderful to be able to have that interaction. We really appreciate that and, of course, all the work that you’re doing for the people in British Columbia, being able to pivot on the COVID-19 research. It’s just so important to everything.

Thanks, again. We will recess now until 9:30.

The committee recessed from 9:19 a.m. to 9:30 a.m.

[B. D’Eith in the chair.]

B. D’Eith (Chair): We have two of our presenters.

If you could keep your presentations to five minutes. We’ll go through each panellist, and then at the end, we’ll do questions.

Let’s start with Sandra Hanna from the Neighbourhood Pharmacy Association of Canada.

Sandra, please go ahead.

Budget Consultation Presentations
Panel 3 – Health

NEIGHBOURHOOD PHARMACY ASSOCIATION
OF CANADA

S. Hanna: Good morning. Thank you for the opportunity to participate in this consultation. My name is Sandra Hanna, and I’m the CEO of the Neighbourhood Pharmacy Association of Canada. We represent Canada’s leading pharmacy organizations, including chain, banner, long-term-care and specialty pharmacies, as well as grocery chains and mass merchandisers with pharmacies.

I believe all of you have our submission, which has some additional context about our organization and the role that pharmacy has played throughout the COVID-19 pandemic. Let me just start by saying that our members were very proud to support British Columbians and served their communities with tireless dedication. I am personally proud of the way our members quickly adapted their operations to continue to serve the public in a safe and effective manner.

Building on our role to date in B.C., we believe there is an opportunity for pharmacy to deliver critical services as we transition through the reopening stages after this pandemic. We have three recommendations for the B.C. government during this planning cycle. Our first recommendation is really to expand the role that pharmacists play in administering the seasonal flu vaccine. Pharmacies are already administering most influenza vaccines in B.C. and remain among the most convenient and accessible health care providers, given our presence in virtually every community across the province with about 1,400 pharmacies across British Columbia.

Pharmacies are also the most cost-effective providers of the influenza vaccine. Public health officials have already noted that the success of the 2020 flu vaccine campaign will be critical to the health system’s ability to manage this pandemic. Based on some analysis we performed on the 2017-2018 flu season, where pharmacies were delivering upwards of 50 percent of vaccines and this number has increased year over year, we’ve estimated that upwards of $6 million can be saved if pharmacies were to deliver all flu vaccines.

By better utilizing our most cost-effective and most accessible health care providers in this flu campaign, we can reinvest some of those savings to further support the success of this campaign. This year in particular, there will be added costs and expenses to pharmacies to continue to deliver vaccines safely and effectively, PPE and other materials, as well as continued measures to enforce and encourage social distancing.

An increase in fees paid by governments to pharmacists to administer these vaccines will be critical to expanding this capacity. By expanding the role of pharmacists in the seasonal flu campaign, this will allow public health units and physicians to ensure that vulnerable populations have access to care when and where they need it most.

Our second recommendation is to leverage the existing pharmaceutical supply chain to modernize the distribution of influenza vaccines in British Columbia. This is being done in some of the other provinces and has been shown to be quite successful. The existing distribution system for flu vaccines in British Columbia is led by BCCDC and relies on public health units distributing vaccine to pharmacists in their region. We have seen in recent years how this system has led to some gaps and shortages and how it may create cold chain capacity and workload challenges for both BCCDC as well as health authority officials.

The COVID-19 pandemic has really shown the importance of a robust and responsive distribution network. The existing pharmacy supply chain manages access to medicines on a daily basis, with systems in place to predict and react to changes in demand patterns as well as predictable shortages. We believe that this system that we’re proposing will deliver cost savings and reduce wastage, which will allow for more efficient distribution of labour throughout public health units.

[9:35 a.m.]

Based on the experience of our colleagues in the southern hemisphere, we can expect that the demand for vaccines for the influenza season will be higher than anticipated this year. Allowing pharmacy to manage the distribution of the seasonal flu vaccine will create capacity in public health systems and help to manage potential vaccine shortages while leveraging an existing distribution network, creating further savings that can be reinvested in health care.

Our third and final recommendation involves COVID-19 serology testing. Pharmacies can play an important role as serology testing sites as B.C. moves forward with its plan to widely make tests for COVID antibodies accessible, adding capacity once again, and reach, to provincial testing efforts. B.C.’s pharmacies already are able to administer point-of-care tests, and as trained health care providers, pharmacists are critical to interpreting test results and allowing for timely and accessible assessments.

We also have existing networks in place to communicate information to public health through our drug claims system and through PharmaNet, which can also, then, enable communication with the Canadian Institute for Health Information on the federal level.

In conclusion, to ensure that our health system can operate efficiently throughout the pandemic and into the recovery, we must make sure that all health care providers can contribute to the full extent of their training, knowledge and expertise. Community pharmacies can play an important role by assisting patients closer to home, ensuring continuity of care, facilitating integration of information and allowing government and public health to focus on priorities such as addressing the needs of our most vulnerable populations.

Thank you for your time.

B. D’Eith (Chair): Thank you very much.

Next up we have Kim Davidson from B.C. Epilepsy Society.

B.C. EPILEPSY SOCIETY

K. Davidson: My name is Kim Davidson. I’m the CEO and executive director of the B.C. Epilepsy Society. I’m going to speak very quickly because there’s lots to say. Thank you very much for having me.

In terms of prevalence, there are over 65 million people living with epilepsy in the world, over 380,000 people living with epilepsy in Canada and over 50,000 living with epilepsy in B.C. The WHO found that the risk of premature death is up to three times higher in people living with epilepsy than in the general population. Additionally, according to the Epilepsy Foundation of America in the U.S., more people will die from epilepsy than from breast cancer and traffic accidents annually.

I’d like to tell the unbelievable story of the orphan disease of epilepsy in B.C. Imagine that you’re a person living with epilepsy and that you’ve just been told that the government here believes that you’re only worth $1.10 per year for programming and services. That is what the government of B.C. has awarded the B.C. Epilepsy Society in 2020. For the life-saving epilepsy programs and services for 50,000 people, we received $55,000.

Now I’d like to tell you the story of Jared Ricks, which will be featured in our What If…Documentary Series coming in fall 2020. Jared was a 23-year-old young man living with epilepsy, a musician that just recorded his second album. He died in December of 2018 from sudden unexpected death in epilepsy after experiencing a seizure in his sleep. At the time of his passing, Jared was on a three-year wait-list for epilepsy brain surgery in B.C. and three other provinces. He had finally gotten his date for surgery. It was set to take place in March 2019. But unfortunately, he passed away three months before that surgery date.

There are many stories just like Jared’s taking place in B.C. Amanda Ricks, Jared’s mother, spoke on Shaw TV’s Citizen Forum about the epilepsy therapies that could have saved his life but were not available in B.C.

Now, 35 percent of the 50,000 people living with epilepsy in B.C. have drug-resistant epilepsy. This means that pharmaceuticals do not work on them to control their seizures. Of these, less than half — about 8,500 people — should be considered for brain surgery. The remaining 9,000 people should have access to alternative therapies, such as a ketogenic diet and VNS neural brain stimulators. However, we do not have a ketogenic diet program in the adult epilepsy program in this province, and the number of neural brain stimulator procedures done in the province was capped at 16 in 2019, when there should have been hundreds offered.

B.C. has only four epilepsy beds in the seizure investigation unit at VGH, when other provinces with similar and even less epilepsy populations have twice as many beds and twice as many epileptologists. B.C. does not have a neuropsychologist or a neuropsychiatrist funded or attached to an adult epilepsy clinic in this province, nor does it have system navigators to support people living with epilepsy, which all other provinces in this country have.

[9:40 a.m.]

Furthermore, epilepsy brain surgeries in the adult epilepsy population are often being sent out of province, to Alberta and Ontario, with extremely long wait-lists for surgeries occurring both in and out of province.

Finally, B.C. is the only province in Canada that does not cover Belvara, a medication used in the treatment of drug-resistant focal epilepsy, meaning they have to pay out of pocket, creating immense financial burdens and causing some who need Belvara, as well as other therapies, to move to Alberta, where those things are covered.

Here are our recommendations. Fund B.C. Epilepsy Society $500,000 to hire six system navigators to serve and support people living with epilepsy in communities around the province. Fund B.C. Epilepsy another $500,000 for the expansion of existing programs and services. Create and fund an epilepsy ketogenic diet program in the adult epilepsy system. Increase the current cap of 16 brain neural stimulators, which should be in the thousands, at least up to double or to 40. Each one of those surgeries costs approximately $30,000.

Allocate $750,000 to create three new neuropsychologist positions in this province for epilepsy clinics. The fact that B.C. doesn’t have a single one, with these extensive wait-lists, is costing our people significant challenges and also costing significant challenges in terms of emergency room visits, increased seizure activity, and so on.

We also want a recommendation to be heard, and that is to provide PharmaCare coverage for Belvara, like it’s done in all other provinces except for B.C.

The other recommendation — we have seven — is for the province, the Ministry of Health, to partner with B.C. Epilepsy Society and create public service announcements around what to do in the event that somebody sees a seizure — is seizure-ready and knows what seizure first aid is, just like what is being televised right now for strokes. That knowledge exchange, that piece of information, is critically important with 50,000 people walking around having seizures.

In closing, I’d like it thank the Standing Committee on Finance and Government Services for hearing our recommendations. Although this is our first time presenting, we consider it a legacy builder. We hope that you’ll help us rewrite the story of epilepsy, this orphan disease in B.C. I’ll be sending my executive summary next week.

Thank you for having us today.

B. D’Eith (Chair): Thank you very much, Kim.

Before I open it up to the other members, just in regards to Neighbourhood Pharmacy. I had a couple of comments and questions in regards to vaccines and the flu vaccine. I’m just wondering if your thoughts there in expanding pharmacies providing vaccines would actually help in terms of when and if a COVID-19 vaccine is developed and whether or not that could be potentially a good reason to also expand the services. Could you comment on that?

S. Hanna: Certainly. We believe very, very strongly that pharmacies have developed a really important role in the provision of vaccines in general. British Columbians, just like Canadians across the country, have voted with their feet, so to speak. They are appreciative of the convenience and the accessibility of pharmacies as an avenue to receive vaccinations, and we certainly believe pharmacies are already trained and already equipped with the infrastructure to be able to very effectively deliver, in a very accessible and convenient manner, the COVID vaccine once it becomes available.

B. D’Eith (Chair): Thanks. The second question I had is just for people who are listening or for the record. Could you explain what a serology test is? Also, my understanding on serology tests at this point is that there isn’t one that’s very effective. Fair enough, if there is an effective serology test, pharmacies should maybe be involved in a big way with that. But I’m just wondering if you could comment on the state of serology testing, what it is and how pharmacies can help with that.

S. Hanna: Certainly. Serology testing is really antibody testing. It’s critical in the later stages of understanding immunity and herd immunity in the development of future research for vaccines. It’s an important step in terms of data-gathering.

[9:45 a.m.]

Pharmacies are already equipped with PharmaNet, which is a centralized system, as you know, where a lot of those tests and test results can be recorded and easily transmitted to the Ministry of Health in British Columbia.

B. D’Eith (Chair): Thank you, Sandra.

Sorry. I don’t mean to hog it, Members. I’ve just got a few questions.

Kim, in regards to the asks that you’re making…. I appreciate that this is the first time in front of the Finance Committee. I’m just wondering. Have these asks been made to the ministry? What stage are you at with the type of program and development with the ministry? If you could just comment on that, please.

K. Davidson: I’m not sure if you’ve seen, but there has been quite a bit of press around my request to meet with the Minister of Health. In fact, it has been over 18 months, and that’s what has brought on our very desperate measures of trying to get his attention by creating documentaries and then by going into the media.

There was a promise of a meeting that took place after my Global interview, and that has not happened. So here we are, making our request to the standing committee and trying to really highlight what the crisis is here in our province.

The answer to your question is…. There has been no movement because Adrian Dix has not met with us.

N. Simons: I’m just curious. Have you gone to your MLA to ask for that meeting as well?

K. Davidson: We’re dealing directly with Adrian Dix. That’s who we’ve been trying to connect with for almost 22 months.

N. Simons: Well, that’s my point. Perhaps try another tactic.

K. Davidson: We did. I went to Darryl Plecas, who is my MLA, and spoke to him. There was conversation at that level, and I was redirected to deal with Dix on our own.

N. Simons: Thank you.

B. D’Eith (Chair): Have you had any opportunity to meet with any of the staff or the deputy minister at all or talk to them?

K. Davidson: No. What I will say, though, is that the B.C. Epilepsy Society has a robust professional advisory committee. Of course, we have professors from UBC that sit on that advisory committee. We have epileptologists and neurologists that also sit on that committee.

The crisis that I’m speaking of is…. We are very well informed in terms of what’s happening within health care and the system. We also know what’s happening on the ground in terms of the social needs of our people.

I will just add that. I am one voice, but I am the voice that is coming out of the health care system in addition to our constituents.

B. D’Eith (Chair): Thanks, Kim.

Any questions from members?

All right. Seeing none, thank you very much to our presenters. We really appreciate everything that you’re doing for your constituents and the people you work with, particularly during the COVID-19 crisis. We really appreciate everything that you’ve done for that as well.

With that, if we could recess until ten o’clock.

K. Davidson: Thank you for having us and for the opportunity.

The committee recessed from 9:48 a.m. to 10 a.m.

[B. D’Eith in the chair.]

B. D’Eith (Chair): Welcome, presenters.

First up we have Betsy Alkenbrack from Downtown Eastside Literacy Roundtable.

Budget Consultation Presentations
Panel 4 – Literacy

DOWNTOWN EASTSIDE
LITERACY ROUNDTABLE

B. Alkenbrack: Good morning. My name, as you’ve heard, is Betsy Alkenbrack.

I’m speaking to you from the shared unceded traditional territories of the Musqueam, Squamish and Tsleil-Waututh Nations. I’m grateful to be able to work and learn on their lands.

We’re speaking about adult literacy community programs. With me today are three colleagues from the community literacy programs across B.C. With me are Michele Mobley, literacy outreach coordinator for Dawson Creek Literacy Now; Rhonda Palmer, literacy outreach coordinator for Columbia Basin Alliance for Literacy; and Sharon Crowley, literacy outreach coordinator for Literacy Matters Abbotsford. I’m an instructor with Capilano University, and I work with community programs in Vancouver’s Downtown Eastside.

We are grateful to have the opportunity to speak about the literacy needs and programs in our communities because literacy is key to good governance. That has never been so clear as during the pandemic, when many of our adult learners have not had access to the tools needed to navigate, communicate and participate in their community.

Decoda Literacy Solutions, the provincial organization that supports our literacy network, has been working with the Ministry of Education and the Ministry of Advanced Education, Skills and Training to provide community-based literacy programs and services that support people of all ages who are not served in other ways. I want to tell you about five people who have participated in these programs in Vancouver’s Downtown Eastside.

Cheryl is a student in the learning centre at WISH Drop-in, which serves women in the survival sex trade. She has been working hard to improve her academic, computer and job search skills through a CALP-funded program. During the pandemic, we’ve been distributing learning kits to keep women busy at home, but students like Cheryl do not have access to computers. In fact, only 64 percent of B.C. residents who are in the lowest income bracket have access to Internet at home. Cheryl and most of the learners I work with are in that category. She says: “Computers were my only source of news.”

Lily and Bao are two senior learners who joined the weekly drama club at the Carnegie learning centre, where adult learners and volunteers write, rehearse and perform plays in the community — in the process, improving their English, gaining confidence in public speaking and developing leadership skills.

Moussa came to Canada as an undocumented refugee and discovered Carnegie because it is close to the shelter where he lived. As is often the case with keen students who do not have work or a home to go to, he came every day and worked hard to improve his English. He now has a work permit and is close to completing his high school diploma with the Vancouver school board. We continue to support and tutor him from a distance.

[10:05 a.m.]

Elaine is a First Nations resident of the Downtown Eastside who became an ambassador in the tech café program sponsored by the Downtown Eastside Literacy Roundtable and the UBC Learning Exchange. This provides paid employment to a team of local residents who help people to access devices, use social media and solve computer problems. This vital service is on hiatus right now, but we’re currently training the team and upgrading their equipment so they can provide virtual technical support throughout the community. These are typical of the people who benefit from ministry-supported programs.

It’s important to note that when the pandemic struck, libraries, neighbourhood houses and community centres had to shut down overnight. People felt lost and abandoned. But with the help of CALP funding, we’ve been able to reach out to them and help them to stay connected by phone, by door-to-door delivery and, in some cases, on line. We look forward to the day when we’re once again able to help them face to face, and we invite you to help us answer this question: how can digital access and adult basic education be part of the recovery plan?

Thanks for letting me speak about our programs.

Now over to you, Michele.

B. D’Eith (Chair): Thank you very much, Betsy. Obviously, we wish we could all meet with you personally and be able to travel around the province, but one of the advantages, of course, of having this type of format is that we can get everyone together like this, which is wonderful. Thank you so much for that.

Next up we have Michele Mobley from Dawson Creek Literacy Now and Dawson Creek Literacy Society.

DAWSON CREEK LITERACY NOW,
DAWSON CREEK LITERACY SOCIETY

M. Mobley: Thank you so much, Betsy, for your introduction. As you know, I’m Michele Mobley.

Before I begin, I want to acknowledge that I work and live in the traditional unceded and shared territories of the Saulteau and West Moberly First Nations.

I’m an English language instructor with the Dawson Creek Literacy Society and literacy outreach coordinator for Dawson Creek Literacy Now.

Thank you for the opportunity to share our stories. We’re grateful to the Ministry of Education for funding literacy outreach coordination in B.C. communities. This funding helps to plan for, develop and maintain literacy and learning programs in over 400 communities across the province.

In Dawson Creek, those funds have supported multiple book-share locations across our city that provide free books, games and other literacy materials to families; resources and materials to support English language learners and their children; seniors’ game days at our local library; summer fun in the park for preschoolers and their families; and a monthly community newsletter, just to name a few.

B.C.’s literacy organizations and practitioners are being asked to do more with less. While costs and needs have increased, funding has stayed the same. Literacy matters more now than ever. With the onset of COVID-19, it has really highlighted the need for technology in both its physical form as well as in skills training.

With so many face-to-face programs being transferred on line, we find that some learners are indeed being left behind. Some lack the computer knowledge or confidence to participate on line, while others, particularly families with school-aged children, simply don’t have the resources everyone in the household requires to keep learning on line. Closing that digital divide is more important now than ever.

Just like many other organizations, we’ve lost the ability to provide face-to-face programming, and that’s why our current focus is on keeping our community engaged and active. Maintaining community connections is critical to prevent isolation, especially for our vulnerable populations. We have to be more creative and innovative than ever before.

One way we have helped to keep people in our community connected and keep them learning is by developing family literacy packages. Packages are safely delivered directly to the homes of existing clients or participants, while other family literacy packages are being distributed by the Nawican, our local friendship centre. It allows us to keep in touch with families we can’t reach on line. Through this contact, we’ve been able to help families with other literacy issues as they arise.

A mother with low English skills was having trouble connecting with her son’s teachers after they began online learning. Because we maintain that connection with our families, we were able to help her with the tech setup she needed. Another program participant, a recently widowed immigrant, required assistance setting up and organizing her children’s learning. After a couple of weeks, she was managing her children’s schoolwork on her own.

[10:10 a.m.]

We need our families to succeed. Community networks and partnerships are integral to our successes. We’re very excited about working with school district 59 to offer book walks this summer, a chance for families to get outside and connect with one another at a safe distance.

We ask the province to increase funding for community-based literacy work to a minimum of $3 million for literacy outreach coordination and $4 million for community adult literacy programs. This funding enables us to reach all parts of the community — adults, youth, children, families, seniors, Indigenous people and immigrants. It allows us to deliver services people count on and plays an important role in B.C.’s recovery program.

Thank you so much for the opportunity to speak with you today.

B. D’Eith (Chair): Thank you very much, Michele.

Next up we have Rhonda Palmer from Columbia Basin Alliance for Literacy.

Please go ahead, Rhonda.

COLUMBIA BASIN ALLIANCE
FOR LITERACY

R. Palmer: Thank you for letting us speak today. Like you said, my name is Rhonda Palmer, and I’m talking to you on behalf of the Columbia Basin Alliance for Literacy and all other LOCs in the province.

I would like to acknowledge that I work and learn on the traditional, ancestral, unceded and shared territories of the Sinixt, the Ktunaxa, the Okanagan and the Shuswap peoples.

The Columbia Basin Alliance for Literacy is the Columbia Basin and Boundary regions’ not-for-profit literacy organization. We’ve been offering literacy programs and services since 2001 for families, children and youth, adults and seniors and immigrants. I am one of CBAL’s 16 literacy outreach coordinators, who serve 77 communities in our region.

It’s my honour to speak to you about the importance of literacy in our community and bring you the stories from the people whose lives have been impacted by our work. Thank you, Betsy and Michele, for the introductions and the lead-in to what is happening in the province and the significance of all the work that we do.

In addition to the Ministry of Education and Decoda Literacy Solutions, I’d like to acknowledge how grateful we are to the Ministry of Advanced Education, Skills and Training for its long-term commitment to adult literacy through the community adult literacy program. We all kind of know this as CALP.

CALP specifically helps us to develop, deliver and maintain literacy programs for hard-to-reach and vulnerable adults across the province. Although this year has been somewhat unusual due to the pandemic, our commitment to learners’ needs has never wavered.

Where possible, programming was moved on line. Staff focused on reaching out to our learners, and we tried to keep things going. We helped all the vulnerable adults stay in touch with everything that we were doing.

I’d like to share a story with you from one of our CALP programs, the Together to Learn program. It’s a family literacy program designed to support parents with young children, an opportunity to upgrade their education to either earn their GED or complete prerequisites to satisfy other program requirements. Parents that access this program face multiple obstacles, such as transportation, child care, family support, poverty and other invisible barriers.

It’s a unique program, and we have multiple partners. Selkirk College provides an adult basic education instructor to directly support learners with course material. Kootenay Family Place, which is a hub in our community, provides a safe and welcoming environment that includes adult learning space and a separate area where CBAL facilitators offer childminding and the family literacy component of the program. While the education component is integral, the opportunity to connect the parents to community resources and build a network of support is fundamental.

To demonstrate the impact of the community program, I’d like to share a story about Gabi. Gabi has been a Together to Learn participant for the past four years. She’s the mother of four boys and came to our program in hopes of earning her GED. With the support of this program, Gabi not only earned her GED, but she is also completing her care aid program at Selkirk College. She’s currently doing her practicum.

In Gabi’s words:

“Being a stay-at-home mom has its obstacles, such as isolation and the fear of being vulnerable. When I first heard about the family literacy programs in Castlegar for me and my family, I had my doubts. The fear of unknowing what I was getting myself into or just the fear of being rejected made me not want to go.

“As I stepped through, it has clearly changed my life. I now know what I want to do with my life. I’m more openly involved with my children, and life is giving me meaning and has given me opportunities. I say you just have to open up your mind and involve yourself. If you let fear take over and hold you back, you’ll never succeed.

“I owe a huge thank-you to the family literacy programs for showing me kindness, love and support to succeed for myself and my family.”

She’s just one of many that have come through our program and have kind of been able to move on to other things and move on to education.

[10:15 a.m.]

Decoda Literacy Solutions and the provincial literacy network continue to seek stable, multi-year funding for literacy in B.C. so many of our programs can meet the increasing needs of their community. We understand that with the increase in the number of CALP-funded programs, it means less funding in other existing programs.

At this time, I’d really like to thank and acknowledge Minister Mark and Louis Chen for being instrumental in giving us a top-up on our CALP programs this year — our funding. It was greatly appreciated, and it definitely didn’t go unnoticed.

COVID-19 has brought new challenges and opportunities in planning for the fall. We hope that programming…. We know it will look different, including smaller cap sizes for programs and implementation of blended learning options for learners. With these changes, there will no doubt be budgetary pressure in order to reach those most vulnerable. In looking at the future landscape of literacy and learning, and the learning needs, it is more important than ever to look for stable and consistent funding.

B. D’Eith (Chair): Thank you very much.

Next up we have Sharon Crowley from Literacy Matters Abbotsford.

Please go ahead, Sharon.

LITERACY MATTERS ABBOTSFORD

S. Crowley: Thank you. Good morning.

I would like to acknowledge that I work and learn on the traditional, ancestral, unceded and shared territories of the Stó:lō people, people of the river, which includes Sumas and Matsqui First Nations.

Thank you, Betsy, Michele and Rhonda. My name is Sharon Crowley, and I’m the literacy outreach coordinator for Abbotsford. I would like to share a story of some of the work I do in the Abbotsford community. This story comes from one of our Learn About sessions, where adults gather to learn about a range of topics, free of charge, at the Clearbrook Library.

The target audience is adults new to the Abbotsford community and perhaps also new to Canada. This session was entitled “Truth and Reconciliation.” Perry Smith, a member of the Bonaparte First Nation and director of curriculum with Abbotsford school district, gave freely of his time to provide a shared understanding of a brief history of truth and reconciliation.

One of the attendees was moved to tears by the presentation, acknowledging that she was a settler and apologized for the action of her past generations and the role they played in the mistreatment of Indigenous people. This brief example of embedding Indigenous literacy in the Abbotsford community is one example of a broad range of the work being done.

Let me repeat. As literacy practitioners, we are grateful to the Ministry of Education for funding literacy outreach coordination in B.C. communities. The funding flows through Decoda Literacy Solutions, B.C.’s provincial literacy organization. This funding helps to plan for, develop and maintain literacy and learning programs in over 400 communities across the province. Please refer to the document “Goals, Objectives and Actions” for an understanding of some of the work that will be done in Abbotsford next year.

Communities in B.C. are asking for literacy coordination for more programs and services. The need for these programs and services is even more acute as communities work their way through the COVID-19 recovery plans. As stated by Craig Alexander in the “Literacy Matters” fact sheet sent to you, “it is hard to identify any other single issue that can have such a large payoff to individuals, the economy and society.” Literacy helps reduce poverty and affects everything from health care to employment.

As stated by ABC Life Literacy, increased literacy rates, specifically health literacy, improve a community’s ability to recover from COVID-19 while building a strong, innovative economy that works for everyone. Stable, consistent funding for literacy provides people with opportunities, making life better for British Columbians. The digital divide, even more apparent now, has grown, due to lack of technology available — for example, devices and access to stable Internet — and also low literacy skills, both in reading and writing as well as digital literacy. This has created more isolation for those experiencing the digital divide.

In closing the presentation from provincial literacy practitioners, let me reiterate: we are grateful to the Ministry of Education for funding our literacy outreach coordination in B.C. communities. Decoda Literacy Solutions and the provincial literacy network continue to seek stable, multi-year funding for literacy in B.C. so programs can meet the increasing needs of their community.

[10:20 a.m.]

Finally, we ask the province to increase funding for community-based literacy work to a minimum of $3 million for literacy outreach coordination and $4 million for community adult literacy programming. This funding enables us to reach all parts of the community — adults, youth, children and families, seniors, Indigenous people and immigrants. It allows us to deliver services people can count on and plays an important role in B.C.’s recovery program.

As members of the provincial literacy network supported by Decoda Literacy Solutions, we implore you to consider and respond to our requests. Thank you. We now welcome your questions.

B. D’Eith (Chair): Thank you very much, Sharon, and everyone for your participation today and your advocacy for literacy throughout the province. We really appreciate it. Certainly, during the crisis, it shines a light on how important it is to have connections, especially through places like libraries and others and your program. So thank you for that.

If I could open the questions to members.

M. Dean: Thank you for all your work and support for our communities. I’m just wondering…. We invested $50 million in Indigenous languages. Preservation and revival are so important. Just wondering whether there are any partnerships that have emerged between community literacy coordination and networking and any Indigenous-language programming?

B. Alkenbrack: I’m not sure if the programs we work with are funded by that, but we have two partnerships at Carnegie Community Centre. There is a very thriving First Nations culture and language group. Indigenous language is part of that, and we work really closely with them.

In fact, our tutors…. We’ve had them come in and do tutor training, sensitivity training and, also, a little bit of culture and language training with our tutors. The other place…. This is not Downtown Eastside, but I think a lot of the post-secondary institutions are working with First Nations education centres. For instance, we have a literacy program going on with the Squamish Nation, and they, themselves, are very active with bringing back the Squamish language and teaching the students in the Squamish language.

I can’t speak to the funding that they receive for that. But certainly there are partnerships happening.

B. D’Eith (Chair): Would anyone else like to comment on that?

R. Palmer: Yeah, just on the heels of that. We also don’t get direct funding for that, but we have a very close relationship with COINS, which is the Circle of Indigenous Nations Society, here. We do programs with them.

Again, I’m not sure about the funding. I’m sure that they have applied for that funding, and we do a lot of programming with them.

S. Crowley: I have been working on a partnership with Sema:th First Nations and introducing an APALS program. Part of the APALS, Aboriginal Parents as Literacy Supporters, is to introduce some of that language, the Halq’eméylem language.

Again, I will speak to the person I’m meeting with and connecting with at Sema:th, as well, regarding the opportunities for the language.

B. D’Eith (Chair): Thanks, Sharon.

Any other questions from members?

R. Leonard: Thank you for your presentations. One of the questions I have is around…. All of your focus through the years has been around paper and reading and books. Now we’re in this whole new world where there’s this brick wall of online…. It’s like “It’s Greek to me” kind of stuff.

I’m looking at your objectives and the kinds of activities that you do. What kinds of supports are you looking for in terms of being able to start to develop that online education access, online literacy?

[10:25 a.m.]

R. Palmer: One of the things that we’ve been working on is…. We’ve been working in conjunction with Kootenay Family Place, which got a grant from the Columbia Basin Trust in Castlegar. They have been offering loans on iPads. They purchased, I think, 50 iPads. They were doing a loan process, so we could apply, or our clients could apply for them.

Now that we’re opening up slightly, we can support one or two people to come to our office, so we can kind of work with them and train them on how to use the iPad and how to set things up on it for some of our literacy programs. At the onset of COVID, we actually switched really quickly to online learning because we had our immigrant clients that we needed to work with right away. So we got into a role of using the Internet quite quickly. We have adapted, also, some programs, the school-based programs, that we’ve been doing and working with families in the schools.

I think that it’s just a matter of using some of the resources in our community and some of our partnerships to allow some of these things to happen, as I said — these loans of different equipment. The library is also going to begin opening, kind of a slow opening, in early summer. They have eight stations currently, but they’re going to separate them slightly and have four stations open. Then we may be able to offer our clients that as well, going in with them or having someone go in with them, with the social distancing, and helping them learn to access some of these things online. It has been very tricky, though.

S. Crowley: Yes, before this COVID all started, we were launching on to an ABC life literacy program — youth teaching adults. The adults could work one on one with the youth teaching them how to use specific apps on their phones or on their specific devices.

What we’re looking at coming up would be to figure out a way to do that social distancing. We’re actually looking at one of the temples in Abbotsford and had just started a partnership with them before this all came about. I will look and see if there’s a way that we can do that and meet distantly, keeping everything safe for everyone. But that is one of the ways that we’re looking at increasing the digital skills of the community as well.

B. D’Eith (Chair): Betsy, do you want to follow up?

B. Alkenbrack: Yes, just a follow-up. Both of those programs sound great. We have something similar in North Vancouver. The North Vancouver library made iPads available — I think it was through a partnership with TELUS — to families and to individuals.

For us, I think the big stumbling block is access to affordable Internet. Families at home, in the community…. People were hovering around the library to try to get their Internet — all of that kind of thing. It’s like an overall strategy that needs to be looked at.

The Internet is becoming like a land-line telephone now. People need to have access to it. That, to me, is the biggest stumbling block and a really important thing to work on.

Thanks for that question.

B. D’Eith (Chair): I appreciate that, Betsy. Definitely our committee is hearing quite a bit, whether it’s health care or literacy or others, education generally, around access and the ability to get access to, especially, broadband Internet in rural and remote British Columbia. I would imagine that, obviously, this is a similar challenge.

M. Mobley: That’s just what I was going to mention here in Dawson Creek, because we are fairly rural. Some consider us semi-isolated. So Internet is one of our biggest issues. We’ve lost a few clients at the literacy society. I say “lost.” We know where they are. They’re not reachable via Zoom anymore. They can’t participate in classes because of that Internet strength. It just can’t sustain it. That would be our No. 1 barrier.

No. 2 is the actual physical devices. We’ve got families who share one laptop, and they have three elementary-aged students who need to use it for school. Tmotionheir education comes last, and their children come first. We’ve lost a lot of people that way too.

That would be our second-greatest gap that we’ve seen — just the actual physical hardware.

B. D’Eith (Chair): Yeah. Fantastic.

Any more questions?

All right, seeing none, I wanted to thank you for all the work that you’re doing, especially during the crisis, being able to pivot and go to virtual teaching and continuing to fight for literacy in this province. Thank you so much for everything you do.

With that, if we could please take a recess until 10:40. Thank you.

The committee recessed from 10:30 a.m. to 10:40 a.m.

[B. D’Eith in the chair.]

B. D’Eith (Chair): I just wanted to welcome our two presenters.

If you could please keep your comments to five minutes.

We’ll have both panellists go through their presentations and then have questions after. Thank you very much.

First up we have Yvonne Jeffreys from the Prosthetics and Orthotics Association of B.C.

Please go ahead, Yvonne.

Budget Consultation Presentations

PROSTHETICS AND ORTHOTICS
ASSOCIATION OF B.C.

Y. Jeffreys: Good morning. My name is Yvonne Jeffreys. I’m a certified orthotist representing POABC, the Prosthetic and Orthotics Association of B.C. POABC represents prosthetists and orthotists. We are health care professionals who provide assistive devices to people with amputations and physical disabilities.

Now, a prosthesis is worn by someone who is missing a limb and an orthosis or a brace, as it’s sometimes called, is not just for feet but can be worn for any part of the body that requires external support to overcome physical impairment, disability or pain.

This is our first time presenting to you, today, and we are here to identify the significant challenges that we see every day as our patients try to access appropriate prosthetic and orthotic care. Our health system is failing people because it does not fairly fund prosthetic and orthotic devices, preventing people with disabilities from leading normal and productive lives.

Walking is something that you and I take for granted, but not so for a stroke survivor or an amputee in B.C. There is an urgent need to ensure appropriate and affordable access to P and O care.

On slide 4, the first issue POABC would like to highlight is that the cost of providing prosthetic and orthotic care has gone up significantly over the past 20 years. Without increases in government assistance, there exists a gap between what is funded and the service costs, leaving the patients on the hook to cover the difference.

The Ministries of Health and Social Development and Poverty Reduction have essentially frozen funding since 2008, with restrictions to componentry despite advancing technologies that have proven to create safer and better patient outcomes. The patients must bridge this gap in funding with their own money. Many do not have the means to pay for this, and this leaves them without any choice but to beg for money from local charities.

Without the money to pay, people with disabilities wear devices that are less than ideal or postpone needed repairs, which puts them at risk for falls or their devices at risk for catastrophic failures. Some even go without any device at all, leading to increased risk of other costly medical complications at a later date.

On slide 5, POABC’s recommendation to reduce this financial burden is that the government increase current prosthetic and orthotic funding to sustainable levels, enabling people living with disabilities access to devices for fair and equitable chances for mobility, employment and human dignity.

On slide 6, we have our second issue. We’d like to highlight that B.C. is the only province in Canada that does not provide funding assistance for orthotic devices for adults. Adults may experience sudden changes in health resulting in unexpected disability. But access to an orthosis can help them regain independence and return to work without burdening family members or caregivers.

B.C. funds an orthotic program, but when a young adult turns 19, they are no longer eligible for devices that they have been wearing throughout their lifetime. We call this the funding cliff, where aging out of the child orthotic program essentially robs young adults from their continued mobility and reduces their success for educational and employment opportunities.

On slide 7, POABC’s recommendation to address this lack of orthotic coverage is to implement a health funding strategy so that all adults in B.C. will have funding throughout their lifetime for orthotic devices. This would also eliminate the funding cliff and maintain the continuity of orthotic care after a child turns 19.

[10:45 a.m.]

British Columbia has lagged behind other provinces in both eligibility and fair funding for prosthetic and orthotic devices, and POABC believes that these two recommendations to increase financial assistance and to create an orthotic funding program are the first steps forward to improving the lives of British Columbians needing ortho­tic and prosthetic care.

On slide 9, I just show a few people’s struggles. Rachel has no orthotic funding assistance and struggles in her job to put enough money aside for her orthotic care. For Joey and Charlie, despite having an orthotic program for children, their parents have to pay the entire cost of their devices. Rick, in the middle, needs components that are not considered part of PharmaCare’s basic mobility so he can be safer walking with two artificial limbs.

These are the challenges our patients face every day.

B. D’Eith (Chair): Thank you very much, Yvonne.

Next up we have Alison Hagreen from the Brain Injury Alliance.

Please go ahead, Alison.

BRAIN INJURY ALLIANCE

A. Hagreen: Thank you for agreeing to meet with me today to hear our concerns about the status of the brain injury fund. This fund was established by the B.C. government in 2015 as a first step to address significant funding disparities.

The fund is administered through the Brain Injury Alliance, a non-profit society made up of B.C.’s 13 independent charitable brain injury societies. These societies are the backbone of post-acute services for people living with brain injury in B.C. Combined, we serve more than 4,000 individuals annually.

By this time next week, the Alliance will have allocated the last of the funds provided by government since 2015. Without a renewed relationship between the province and the Alliance, the brain injury societies face a significantly diminished capacity to provide services.

What would it mean? Well, Standing Committee Chairman D’Eith, in your constituency, people with a brain injury who are incarcerated at the correctional institution in Maple Ridge would lose the service provided by the Fraser Valley Brain Injury Association. In fact, people who live in correctional institutions in Kamloops, Victoria and Penticton would also lose their services.

People incarcerated in Prince George are a bit luckier. [Audio interrupted] started providing services at PGRCC in 2015. As a result of the positive impact on inmate behaviour, the provincial health authority is now funding that service.

Deputy Chair Clovechok, if the Kootenay Brain Injury Association had to substantially cut its services, I’m sure you’d have many constituents knocking at your door. A loss of the almost $100,000 they’ve been receiving annually would leave a significant hole in their ability to serve your constituents.

Ms. Barnett, you’re the only MLA present whose constituents have nothing to lose if the brain injury fund is not replenished. Sadly, the Cariboo Brain Injury Society closed its doors as a result of funding challenges in 2014. With a renewed and enriched brain injury fund, we hope to be able to turn that around.

A couple of quick facts about brain injury. The effects of a brain injury are complex and much more debilitating than most people realize. There is no time today to discuss details, so please check out the Alliance’s website or the website of your local society.

For now, suffice it to say that acquired brain injury is the biggest killer and disabler of Canadians under the age of 40. There are more than 160,000 British Columbians living with the effects of a brain injury.

In addition to the direct effects, secondary effects can include a serious mental health issue. People with ABI are seven times more likely to develop mental illness than they were before their injury.

Run-ins with the law. More than 85 percent of people who are incarcerated have an acquired brain injury.

Homelessness. A B.C. study found that more than two out of three homeless individuals were living with a brain injury. Those are post-adult brain injuries. Those are not brain injuries that you’re born with.

[10:50 a.m.]

When there are appropriate services, especially early in the recovery period, many more of the devastating side effects can be avoided, and of course it’s much kinder and much more cost effective to provide services up front, early on in the disability period.

What are the parameters we use for our services? We accept any person with a brain injury to receive services. We do not discriminate in favour of those who are newly injured or those who are easy to manage. We serve engineers alongside the homeless and the educated alongside those who struggle to maintain appropriate social behaviour. Most people access our services intensely for up to two years; many need services intermittently for many years after that; while some need to use our services for the rest of their lives. This, too, fits within our service prior­ities.

Alliance member agencies receive more than 1,500 new referrals annually. Most referrals come from hospitals, doctors and other health professionals, but we also receive referrals from health authorities, the Ministry of Social Development, other service providers, the police and the justice system, employers, ICBC and even from MLAs.

How do we measure success? Client satisfaction surveys, number of referrals, the return of competence and the development of coping skills, return to employment, fewer crisis events.

Interim data shows that the 2019-20 funding year will be a banner year for our impact on client employment and on provincial health and justice systems.

Why should you choose to fund the brain injury services through the alliance? The alliance has a strong and secure track record of providing funding to community-based brain injury services in B.C. Alliance funding is a vital service provision for more than 4,000 British Columbians with brain injury annually, and the alliance provides government with cost-effective funds administration for less than 5 percent annually.

We respectfully request that the Select Standing Committee on Finance and Government Services support the establishment of a permanent annual allocation to the Brain Injury Alliance so that the alliance may continue to provide funds for the delivery of essential services to individuals with brain injuries.

I would imagine that you might have a question or two.

M. Dean: My question is for Alison.

S. Sourial (Clerk Assistant, Committees and Interparliamentary Relations): Sorry, Mr. Chair. Hansard wasn’t able to pick up what the question was, so I’ve just asked Mitzi. She has sent it to me, and I will forward it to Hansard.

[Can you tell us about how services are addressing the link between gender-based violence and brain injury?]

A. Hagreen: It’s gender-based violence you’re talking about — a very, very interesting question. You know what, Mitzi? That is one of the emerging…. It’s not really emerging. It’s emerging in the literature now. It’s getting to be a really big deal. I know those studies they’ve done in the Okanagan area are quite terrific.

That is one of the areas we would love to move into. Not to actually provide services — we have a lot of wonderful services for women; but we should be providing supplemental services and advisement services to those other services. Right now there is not the money for that.

I mean, right now we’re hoping, hoping that we’ll be able to get…. Well, the $1 million a year is what the government has previously given us. That $1 million a year wouldn’t allow us to actually expand services beyond the small amounts that we’re getting now. People are doubling their numbers. It’s quite amazing.

Our first goal would be to break even, to get the same as what we got before. Really, we think that it would be a good idea to have an increase. We definitely need to move into women’s services and domestic violence.

B. D’Eith (Chair): Thank you. Other questions from members?

Seeing none, thank you very much to the presenters.

Thank you to Alison.

[10:55 a.m.]

R. Leonard: I have a quick question for you.

B. D’Eith (Chair): Should we adjourn first, or is it on the record?

R. Leonard: Oh, it’s on the record. It’s a question around funding. Is there coverage right now for the braces as well as the orthotics and the prosthetics?

Y. Jeffreys: Prosthetics right now has an adult funding program that has some basic mobility, and the definition of that is quite variable.

There is no orthotic funding. An orthosis and a brace is the same, so there is no orthotic funding after you turn 19. There are some select orthotic devices covered for children, but as soon as they turn 19, it is not covered.

R. Leonard: Okay, I just wanted clarification if there was a distinction in the funding of those two.

B. D’Eith (Chair): Great. Any other questions?

Seeing none, could I have a motion to adjourn, please.

M. Dean: Motion to adjourn.

Motion approved.

The committee adjourned at 10:57 a.m.