The committee met at 8:01 a.m.

[M. Bernier in the chair.]

M. Bernier (Chair): Good morning, everybody. This is the Standing Committee on Public Accounts. It’s really exciting to actually be here in person. Let me start off by acknowledging and saying that and thanking everybody for following all the rules about being safe. More importantly, it’s been 18 months for some of us to be able to be face to face. I know there are some new faces, probably the first time in this chamber in this format.

I also want to welcome Carl, Michael and our presenters today. We’ll get to that in a moment. Again, being in person for our first meeting…. As Andrew said to me, “Yes, I am not as tall as I look on Zoom,” but it’s great to see everybody here in person.

Today we’re discussing the Community Living B.C.’s Framework for Monitoring Home Sharing Providers report that was done by the Auditor General.

As we normally do, we'll just kick things off right away and turn things over to our Auditor General, Michael Pickup.

Thank you so much, Michael, for you and your staff and everything, for all the work you’re doing.

Consideration of
Auditor General Reports

Community Living B.C.’s Framework
for Monitoring Home Sharing Providers

M. Pickup: Good morning.

I would like to start by acknowledging with respect that today I am working on the traditional lands of the Lə­k̓ʷəŋin̓əŋ-speaking people of the Esquimalt and Songhees Nations. I’m grateful for being a visitor on these lands and strive to be mindful of the connection it holds to Indigenous people of these territories. I did want to mention that.

I would like to respectfully thank the Public Accounts Committee for your ongoing interest in our work and for the really timely consideration of our reports. It does matter to us, and it does help, both as the Auditor General and for the folks who are doing the audits and across the office, to have this kind of engagement. It does really help us and encourage us to do the work that we’re doing. I do want to thank you for that.

To our audit team who did this work, I very much ap­preciate all the work you put into this audit report as well. I would like to specifically thank Malcolm Gaston, assistant Auditor General; Laura Pierce, director, who I believe is on the call with us today; Alexander Gunn, who is to my left and your right and who will be walking through the presentation today as well; and to Peter Nagati, who retired from the office earlier this year.

I would also like to thank the ministry and staff at CLBC for cooperating with us throughout this audit, especially under the challenging and difficult times and circumstan­ces surrounding a pandemic as well. We very much appreciate that, and it was nice to be able to share some niceties this morning before we got started.

I also want to thank the Clerk of Committees and the office of the comptroller general. Getting to a day like this today takes a fair bit of work, so I appreciate the professionalism. As you all know, we have a wonderful, respectful, professional and independent relationship. That’s a lot of adjectives in there to define that relationship, but it’s working very well. Certainly, we very much appreciate that as well.

Before moving on to Alex, I do want to mention that for us, as an office, October is an important month, as it is Women’s History Month in Canada.

[8:05 a.m.]

At the OAG British Columbia, appreciating our history, you may find this interesting. Erma Morrison was the first woman appointed as Auditor General in British Columbia under the Auditor General Act. She held the role from 1977 to an impressive 1986, which is impressive. Today I’m happy to report that over 50 percent of our executive and the senior people in the office, running the organization, are indeed women as well. I did just want to mention that, given the month that it is.

Now I’m going to turn it over to Alex, who will walk you through a very brief — it is very brief — presentation. It might even be briefer than my opening.

A. Gunn: Thank you, Michael.

Good morning, Chair and committee members. Thank you for your interest in our report, Community Living B.C.’s Framework for Monitoring Home Sharing Providers, which was tabled June 15, 2021. I will be walking you through the information in the Audit at a Glance, which provides a summary of the report, including the key findings. If you have the document in front of you, please feel free to follow along.

Home-sharing is the main form of residential support for adults with developmental and intellectual disabilities that is funded by Community Living B.C., also known as CLBC. In 2018-19, roughly 4,200 people lived in a home-sharing provider’s home and received support based on their needs and goals. During our audit, we had the opportunity to connect with a few people who lived in a home-sharing arrangement and heard about the supportive relationships they had developed with their providers and the opportunities offered by living in home-sharing.

But these arrangements can come with some inherent risks. People receiving home-sharing services may be vulnerable, isolated and unable to advocate for themselves. It is important that CLBC ensure that individuals are cared for in a safe environment and that they receive the services they need to lead fulfilled lives.

Our audit assessed whether CLBC had implemented a monitoring framework to ensure that home-sharing providers complied with the outcomes, standards and service requirements in their contracts. Our audit focused on CLBC’s monitoring of home-sharing providers from 2018 to 2019.

Overall, we concluded that CLBC had not implemented a monitoring framework to ensure that home-sharing providers (1) had aligned their service delivery to further quality-of-life outcomes for people in care and (2) had complied with all contracted standards and service requirements.

Next I will provide a brief overview of the four main findings from our audit. For those following along with the Audit at a Glance, you can find the beginning of this section at the bottom of the first page.

First, we started off by looking at how CLBC had de­fined the outcomes, standards and service requirements that providers were expected to comply with. We found some shortcomings with the outcomes — in particular, that CLBC had not clearly defined these in its contracts with home-sharing providers and that it was unclear how providers should align their services to further outcomes for people in their care. We did find, however, that CLBC had clearly defined the expectations for home-sharing providers to meet the standards and service requirements.

Second, we looked at the policies and procedures CLBC had developed to monitor providers against the contracts and found that these did not allow staff to examine all the contract requirements. Almost 90 percent of people living in home-sharing received support through a service provider that was monitored indirectly by CLBC via an agency. The other 10 percent received support through a service provider that was directly contracted and monitored by CLBC.

We found that CLBC had developed two processes to monitor home-sharing providers based on contract type. Its process for direct contract providers examined the standards outlined in the contracts but not the outcomes or service requirements. Its process for monitoring agencies, meanwhile, did not examine whether those agencies were monitoring their home-sharing providers.

Third, we looked at the extent of CLBC’s monitoring and critical incident response and found that it was un­clear from the data. The tools CLBC uses for tracking its monitoring activities were incomplete or inconsistent with other monitoring reports, and CLBC’s system for tracking critical incident response did not track the timeliness of staff follow-up on critical incidents.

Fourth, we looked at the extent of on-site monitoring and follow-up that CLBC staff undertook and found that it was inconsistent, based on a sample of home-sharing provider files that we examined. CLBC conducted on-site visits for 63 percent of the providers we sampled. Of these, only 35 percent were conducted on time. CLBC also sent follow-up letters to 74 percent of providers who received visits. Of these, only 48 percent were sent on time.

[8:10 a.m.]

Based on this, we made five recommendations to help CLBC ensure that home-sharing providers understand what they must do to further quality-of-life outcomes, that monitoring enables CLBC staff to verify that providers meet contract requirements, that agencies oversee their home-sharing providers, that CLBC has the data it needs to oversee monitoring and that CLBC staff complete monitoring activities as expected.

We are pleased to note that CLBC has accepted all five of our recommendations.

Finally, I would like to highlight the three questions that are included in the Audit at a Glance for readers to consider as they review this report.

This concludes our presentation. I would like to thank the dedicated staff at CLBC for their support and cooperation throughout this audit.

Thank you very much, and I’ll now turn it back over to the Auditor General.

M. Pickup: Thank you, Alex. I wasn’t going to add a whole lot more, so as you can maximize your time with the witnesses who are all ready to take your questions.

M. Bernier (Chair): Thank you, Michael.

With that, as well, if PAC members don’t mind holding on to any questions, maybe hearing from the witnesses first, I think, would be prudent. Then we’ll move forward.

With that, we’ll turn things over then, probably to the deputy minister, David, first of all, to maybe introduce who you have with you and go forward on the report.

D. Galbraith: First, I would like to recognize today that I’m here on the traditional territories of the Lək̓ʷəŋin̓əŋ-​speaking people, now known as the Esquimalt and Song­hees, and I’m thankful for that opportunity, as I am every day, to live on these beautiful lands.

First, I’d like to introduce who’s with me today. I have Adam McKinnon, my executive financial officer, and he also has responsibility for CLBC. I have Ross Chilton, who is the CEO of CLBC. Glad to have Ross here with us today, and Stephen Hall, who’s the executive director of quality assurance.

I’d first like to start by thanking the OAG staff for their review. In my 29 years, I’ve learned that if you want to improve public service, having good, independent analysis is key. We all want the same thing, and that’s to provide the best services that we can to the clients that we serve. I’ve valued, over my career, the work that has been done by the OAG. I find it makes things better, so thank you.

Home-sharing — just quickly on home-sharing. I think everyone knows here that it’s where a CLBC-eligible person lives in the home of a person that has been contracted to provide a home and support to the person. It is a key part of the service delivery system that CLBC funds and oversees.

As of March 2021, well over 4,000 people were supported in the home-sharing. That is more than any other home support service that CLBC funds, and I think that’s a really important thing to keep in mind.

Data collected through the quality-of-life surveys that CLBC has conducted over the past ten years shows that home-sharing has outcomes that are as good as, or better than, those of other services across all of the domains of quality of life. Because of its importance in supporting CLBC-eligible people, public confidence in the model and CLBC’s ability to monitor its quality is fundamental.

The external review of monitoring promotes public confidence, and CLBC is eager to respond and to make im­provements, and it has.

The OAG audited records for the 2018-2019 fiscal year. CLBC has made improvements in the years since then, as work has gone underway, and plans for additional work to implement the recommendations and improve CLBC’s monitoring of home-sharing goes on. We have submitted our action plan, and we are pleased to be able to outline the plan and answer any questions that you might have.

I’d like to turn it over to Ross now, who can walk us through the action plan.

R. Chilton: Thanks, David, and good morning, everybody. It’s lovely to be on these traditional, ancestral and unceded territories today for such an important meeting and to see almost all of you in person.

I see Laura is still virtual. I’m not sure Laura is 3D. I’ve only ever seen her virtual. But Alex…. This was the first chance I got to see Alex in person. It’s great to be here with all of you today.

It is an important topic for us. I joined the organization as CEO shortly after the audit period that we’re talking about and have the advantage of being the former CEO of one of the larger providers. It did include providing home-share services, as well as now being on the CLBC side, so I do have the two perspectives. I’m happy to answer any questions in relation to that.

[8:15 a.m.]

The first recommendation on slide 3 you will see is that CLBC define what home-sharing providers must do to further the quality-of-life outcomes and how CLBC staff should verify compliance.

Now, a number of years ago CLBC adopted what we call our quality-of-life framework. Prior to that time, it was really just a sort of organic term that someone might use. They would say: “Do you think the person has a good quality of life or not?” Generally, that was kind of assessing their satisfaction with the services they were getting, rather than specifically what is meant by quality of life.

To one of you, that might have meant one thing, and to another, something different. The very good thing about this monitoring framework is that it has three areas of quality of life and eight domains, so it’s very clear in defining for individuals, for providers, for our own staff when we’re using the term “quality of life” what we in fact mean. The three areas are independence, social participation and well-being.

We conduct surveys every year, except for last year. Due to COVID, it was impossible for us to actually conduct surveys with most self-advocates. But every year we conduct surveys with individuals, and those results are posted on our website as well as provided back to the providers. The survey, however, does not provide clearly defined requirements to guide those home-sharing providers — which is sort of where we’re at with the OAG comments — or CLBC staff in supporting people to achieve those positive outcomes.

CLBC has begun the work to develop and implement requirements to make sure that home-sharing providers, service providers delivering home-sharing programs and CLBC staff understand what must be dome to further the quality-of-life outcomes. CLBC intends to engage people themselves, as we always do — “Nothing about us without us” is our mantra — family members, home-sharing providers and service providers in this process.

Once we’ve developed those requirements, we’ll be in­corporating them into the home-sharing standards, which define best practices, CLBC expectations, processes and program outcomes for individuals. CLBC will also develop methods and procedures for our staff to be able to verify the compliance with those quality-of-life requirements.

As we go to slide 4…. I’m sorry. My presentation is a little bit longer than Alex’s and even more than Michael’s. The audit’s second recommendation is that CLBC ensure its monitoring framework enables staff to verify that home-sharing providers align their services with quality-of-life outcomes and comply with standards and requirements as outlined in the contracts. Since 2018-19, CLBC has implemented improvements to its monitoring framework, including changes to the on-site monitoring policies to direct our staff, and development of standardized report templates and improved monitoring guidance for CLBC staff.

CLBC has scoped, planned and launched a project to complete the transition of their 187 remaining direct-contracted home-sharing providers to agency-coordinated shared living. This will allow agencies to oversee the compliance to all standards and service requirements. In that sense, we won’t have the two systems that we currently have because we have both the agency-coordinated and direct home-sharing.

CLBC’s monitoring framework will be updated so that CLBC staff can verify compliance by agencies delivering home-sharing. The monitoring framework will include updated supporting guidance and verification tools for CLBC staff so they can verify whether home-sharing providers are aligning their services to promote quality of life and to verify all the standards and service requirements.

Slide 5 includes the third recommendation, that CLBC implement policies and procedures to enable verification that home-sharing agencies are monitoring home-sharing providers against contracted quality-of-life outcomes, standards and requirements.

CLBC is finalizing a new set of standards for agencies that coordinate home-sharing programs to ensure that there is clarity for both the agencies and CLBC staff on the expectations and accountability. The standards will be implemented into the monitoring framework so that CLBC can be confident that these coordinating agencies and their home-sharing providers are in compliance with the requirements. This will allow CLBC to verify that home-sharing providers in the agency networks are meeting all contracted expectations.

In addition, more than 90 percent of the agencies that deliver agency-coordinated home sharing are accredited by an independent, internationally recognized body and are required to meet standards that outline expectations for monitoring home-sharing providers. So if you are in the business of supporting and overseeing home-share providing, you actually have to apply to certain accreditation standards for that.

There are, I think, a total of 13 agencies right now that currently do oversee home-sharing. They’re not accredited. Of that 13, five are in the process of being accredited, and the remaining eight get additional scrutiny from our staff as we do our monitoring.

[8:20 a.m.]

On slide 6, we have recommendation 4 that CLBC en­sure it has accurate and complete data on on-site monitoring visits, follow-up activities and responses to critical incidents. In May 2020, CLBC launched a new online data system for tracking and monitoring visits, outcome of the monitoring and whether follow-up activities are required.

I think what’s important to recognize here — and we did discuss this with our auditors at the time — was that that was well in the pipeline before the audit period came to be. So it wasn’t in response to the audit. It was that we’d already identified that we needed to improve in that area. But it was just that the application of that system came during the time that they were conducting the audit.

This online monitoring system increases the integrity and reliability of the data, allows for tracking and follow-up activities and results of visits, and supports data analysis of service providers and CLBC monitoring activities.

In December 2020, CLBC updated its policy and comprehensive guidance on responding to critical incidents for both CLBC staff and service providers. Supporting training on how to follow up on incidents was released for service providers and CLBC staff in January of this year.

The quality assurance department produces quality analysis of the critical incident reporting and follow-up activities. These are used by senior management and regional operations to identify trends and improve practice. Additional improvements will be made to more effectively track the timeliness of critical incident responses in CLBC’s electronic tracking system.

On slide seven, I get to the final recommendation. It’s that CLBC ensure that staff complete on-site visits, follow-up and critical incident response. Completion of monitoring and follow-up on critical incidents are key performance indicators within CLBC, and this has been reflected in improvements to compliance.

During the fiscal 2021 year, CLBC met our requirements for monitoring in 98 percent of direct-contract home-​sharing situations and 93 percent of agency-coordinated shared living contracts to deliver home-sharing. While it’s not 100 percent, I think it’s a pretty good number, especially given the fact that that was done all during a year of pandemic.

CLBC is committed to ensuring staff complete monitoring activities and respond to critical incidents within policy. CLBC continues to improve and build upon the monitoring framework to support staff in completing those tasks.

Again, my thanks to the team at the OAG. They, like us, are interested in continuous quality improvement, and the recommendations certainly help us to continue that as we move forward. Thank you.

M. Bernier (Chair): Thank you. I really appreciate that and the run down of, as always, the recommendations — what we’re going to do for it. I know that we’ll have some questions in a few moments, but as always, I’d like to turn things over to the comptroller general — to Carl — if there are any ideas, advice or words of wisdom, as he always has, to throw in.

C. Fischer: No. Thank you, Chair. I don’t have any further comments. I think both the Auditor General and CLBC covered everything off. It’s a difficult thing to wrap our minds around, applying an objective measure like audit to a very qualitative area, but discussion and working together are probably the best ways to explore opportunities.

M. Bernier (Chair): I’m going to start looking at some of the members.

MLA Sharma, I believe, had her hand up first.

N. Sharma: Yeah, I had a couple questions.

My first one was just basically to your point, Carl. When you’ve talked about how to measure outcomes…. I read in that report the measures that you have — emotional well-being and those kinds of more subjective measures. So now that you’ve gone to this path of figuring out how to measure an outcome, what are some of the things you’re looking for to make sure that service providers are delivering on those more hard-to-measure things?

R. Chilton: Yeah. The very good news about it is that traditionally — and I think that this is true of a lot of services — the focus has been on measuring inputs and outputs. So we do that. We look at hours of service that were expected to be provided in different streams of service. Was it, in fact, delivered? So the inputs equal the outputs, and there we go.

What we move to is that we need to look at outcomes. How is this affecting a person’s quality of life? If we are spending over $1 billion in services for adults with developmental disabilities across the province, how is that money actually advancing quality of life for people?

Having been through this survey twice myself when I was with Community Living Society, I can tell you there are areas where self-advocates report, generally, that their quality of life is equal to or better than the general population. They tend to be in the well-being domain — so the emotional, material and physical well-being scores. But in the areas of self-determination, social inclusion, rights and personal development, consistently we see, across providers — it doesn’t matter who the providers are — that those do not meet with those of the general population.

So the good news about that is that we can look at, with agencies…. We’re reasonably assured that the well-being domains are being met, and the evidence certainly supports that. But it can help us to target professional development for that sector, and overall for the community living services, to attend to the more important things that are lagging.

[8:25 a.m.]

You know, it’s not much of a deal if you know that you’re in a home, you have access to a doctor, you’re treated by kind people, and you have a roof over your head. But you don’t have a lot of rights. Things are decided for you. It’s not much of a life for that.

It’s enabled us to look at the areas that are lagging generally and make sure that, as we’re doing the monitoring, the agencies that are monitoring are delving into those areas in particular to make sure the person’s rights are being respected, they’re being included in decisions, they’re having opportunities to grow as such. Those areas have pop­ped out across the province, and then help us focus going forward.

N. Sharma: I guess I had a couple more questions. One is: do you see a difference in outcomes between the indirect and the direct? In most of the areas that you work in, it sounds like most people are served through indirect agencies. I was curious about that.

R. Chilton: It was a decision made about ten years ago, after the Hughes report, to look at having agencies in the community do that direct monitoring. It was a decision I agreed with at the time when I was with a service provider, and it’s a decision I agree with now as the CEO of CLBC.

What I see with agencies is that they’re better positioned in the communities to be able to do effective monitoring and home-sharing, but they also provide other ranges of services. For example, you may have somebody that’s in a home-share environment, but they’re kind of outgrowing that. They don’t really feel the need to live there. The agency is in a position to understand that and to appreciate that and to look for opportunities within their organization to move into a more independent model.

The outcomes are as good in the agency-coordinated home-sharing as they are in the direct home-sharing. The number looks a little bit deceiving, because our sort of monitoring ourselves is higher than the monitoring of the monitors. But that’s a bit of comparing apples to oranges, because really, what we’re looking at is…. The agencies do the direct monitoring in agency-coordinated home-sharing, and then we monitor the agencies’ monitoring of the home-share arrangements. Whereas in direct, it’s the actual monitoring of the arrangement.

The advantage to the system we have now, that we’re moving towards completing in the next 18 months, is you have the direct oversight by the agency, and then you have our oversight of the agency in the home-share arrangement.

I’d certainly say that though it could appear that there’s a better outcome for the sample — I think it was of ten, Alex — that they did of the direct home-sharing, but in fact it is equal or even better quality.

N. Sharma: I just have one more question. It’s interesting that you have an online tracking system now. It’s been a few years since the audit and that sample size.

I was curious: with some of the findings of this audit, with the response times to the request that came through, is the online tracking system getting those stats higher in terms of responding? Would you have an update on some of those numbers now?

R. Chilton: We do have the numbers, and it has im­proved significantly. So if you look at the 2021 year overall, we’re looking at 92 percent done in the fiscal year. I think that is a combination of the tracking system and a culture around that as well.

What I emphasize with Stephen, as the executive director of quality assurance emphasized, is that this is not a discretionary activity on behalf of our staff. We fund services, and it’s also critical that we are also monitoring the quality of service. It has improved his results of the tracking.

It is also much easier for me. Stephen can meet with me on an as-needed basis, and also with the VP of regional operations, to look at where we’re at today. We can do that and look at any different quarter — how we are doing — so we can course-correct before the end of the year to make sure that the visits have in fact taken place. Because there can be events in the region that affect our ability to do that.

I think the Interior and the North would certainly say over the summer — the fire months, where they were spending a lot of their activity and energy responding to the threat that the fire represented to people in those communities — that they may have lagged a bit on their monitoring activities during that time. But there’s still time within the contract year to course-correct and make sure that they’re done before the end of the year so we can apply the resources that are required to get them done.

A. Mercier: First I want to commend you for the work you are doing, because at the end of the day, what matters are the clients of CLBC and their experiences.

I’d echo what Niki’s raised, you’ve raised and Carl raised, pretty eloquently, about the balance and tension between clearly-defined contractual requirements and very intangible, aspirational goals like quality of life.

[8:30 a.m.]

It seems that any time you move from more qualitative, aspirational goals or that kind of level — which arguably allows for flexibility and application across a variety of circumstances — and you move to something more clearly-defined and more tangible, you risk reducing it to a checklist for providers to…. That drives human behaviour as they try to kind of meet their contractual requirements.

I’m really interested in where the rubber hits the road in examples of what ideas you have in terms of those clearly defined contractual requirements, as opposed to where they are now, at the kind of aspirational…. I’m thinking social determination and social inclusion. How do you boil that down to a tangible contractual requirement that’s flexible enough for a variety of circumstances? Could you give us some examples of that and the process that would be involved in that?

R. Chilton: Yes. I’d be happy to. You look at self-determination as an example. One of the things that is evaluated on the questionnaire is: does this person have a key to their home? If you think about that, none of you wonder whether or not you have a key to your home. But people with developmental disabilities, unfortunately, have been subjected to custodial care over the years, first in institutions and then post-institutionalization in group homes and such. It’s a very important thing that a person has a key to their own home and can let themselves in and can lock their home. That’s the sort of thing that you would look for.

In terms of social connections, it’s very important. Even though they are in receipt of support from a home-share provider, that doesn’t mean that everybody else in the person’s life doesn’t need to be actively involved. So we look to the extent to which the home-share provider makes sure that if there’s family, the family continues to be involved, and also that there are friendships involved.

I learned this lesson from the Woodlands Parents Group, which was the group that transformed disability services in this province back in the ’80s, when they got the government at the time to close the institutions and return people to the community. They said the most pow­erful safeguards are not the staff or those that are evaluating the staff; it’s the other people in the person’s life. It’s the family, and it’s the friends. They are the ones that are going to notice first if things are getting better or if things are getting worse. So we look to make sure that those people continue to be involved in the person’s life, because it would be a concern if they’re not. We look specifically for those sorts of things.

Now, having said that, home-share providers don’t have 100 percent control over what a person’s quality of life is. For instance, the actions of our ministry, in terms of raising the income assistance levels over the last number of years, have more effect on the material well-being of the individuals than any action the home-share provider would take, unless they’re able to help the person secure a job. So there’s kind of that balance of recognizing that the quality of life is affected by a whole set of circumstances but that we do need to drill down into some other ones.

For the physical well-being, as an example, has the person been to see their doctor in the last year? Are they getting the age-related diagnostic tests done that would be done in the general population to make sure that that’s continuing? Have they seen the dentist? How’s their dental health? Those sorts of things. So we can drill down, and that’s what came out of the Auditor General report. We’ve gone from organic to being very specific, but now let’s get even more specific in terms of the actions or inactions that support or don’t support the advancement of quality of life for the individuals in home sharing.

A. Mercier: Thank you for that response. Obviously, CLBC, as an agency…. You guys have a wealth of knowledge and experience in this area. I’m curious. As you go and you look at creating those tangible contractual re­quirements, are you involving folks with developmental disabilities and their support networks in that process?

R. Chilton: Absolutely. It’s sort of built into our organization. We have two self-advocates on the board of directors, as an example. We think that it’s critical, even from a governance perspective, that the organization is led by the perspective of the people that we’re serving. We have employees of the organization in strategic advisor positions that help us to make those kinds of decisions. And, absolutely, they are involved in all those kinds of key decisions around that, as well as families.

It’s important for a family to be able to have their family member supported by somebody else, especially in an environment that is kind of personal as a home-share arrangement. They have to have confidence that the model is a good one, that their loved one will get good support. So it’s sort of built into our DNA that we don’t take any substantial direction without involving self-advocates and families.

M. Bernier (Chair): MLA Banman, please.

[8:35 a.m.]

B. Banman: Actually, I think my question was just an­swered, but I’ll ask it, perhaps, in a different way. What mechanism is there, and what efforts are made, to make friends and family aware that there is a way…? If they see a shortcoming — if they see any red flags or a lack of care, let’s say — what efforts are made to make sure that these people have someone to contact? Sort of roll that out for me so that we know there’s a safeguard in place if someone does notice there’s a problem.

R. Chilton: It’s a great question. For an agency coordinating home-sharing, the primary relationship would be with the agency that has the coordinator. We fund co­ordinators at a ratio of 1 to 25. Every coordinator in an agency has up to 25 home-share arrangements that they’re overseeing, so they would be known to the family.

As you can expect, if you had a concern, it might be a little bit challenging to confront the home-share provider themselves, because your family member’s living with them. So it might feel awkward. Obviously, if it’s minor things, that’s what we would expect, but if there was any concern, that would then be rolled up to the home-share coordinator to look into and investigate.

We also have, on our website, a very easy-to-access complaints resolution process. If somebody had a complaint, even if they didn’t feel comfortable going to the home-share coordinator, they could then go to one of our staff, one of our facilitators or analysts, to make that complaint and have that looked into.

That’s the advantage of the two systems, that there’s the one that’s really close to the person and the one that’s overseeing that, to make sure that there’s complete access to any sort of concerns being brought forward.

B. Banman: If I could just follow up on that. I guess what I’m really getting at is: are friends and families made aware of the path to be able to make a complaint ahead of…? Is it proactive versus reactive? So they’ve got contact numbers that are given out ahead of time?

R. Chilton: Yes. They would actually have met the home-share coordinator, because that is a primary relationship for them to have.

Getting to your point, with over 4,000 arrangements, there are going to be issues. What we want to make sure is that we’re aware of those issues early so they can be addressed in, as you say, a proactive or preventative way. It may not be a big thing to start with, but it’s better to be dealt with earlier on in the process. Certainly, if those concerns are significant, we deal with those differently, and we can articulate that process.

It is a big thing. I can say this as a family member myself, because I have an adult son with a developmental disability. It is a big leap of faith to trust others to support your family member. You need to know that if you notice things — as a parent, you’ll notice things really early — that there’s a way you can bring that forward and those concerns will be addressed.

B. Anderson: Thanks to my colleagues for asking such great questions. I feel like most of my questions have been answered.

Thank you for the report and the work that you do. My question might be slightly outside of what was…. It is outside a bit of what was examined in this report. How are you ensuring that the people that are providing the home care service have the supports that they need so that they’re able to provide the best care possible — looking at things like respite services?

R. Chilton: In the process of establishing these home-share arrangements, of course we’re talking about a range of disability-related needs. We use our guide to support allocation, which can go from everything from a score of one up to five — one means fairly light disability impacts, fairly light needs, to five, which are quite extensive. What’s important about that is we’re recognizing that the 25,000 individuals we are involved with are all different. We’re not looking at: everybody’s just kind of a cookie-cutter.

With that, at the very start of that, we’re looking at what their disability-related needs are. Therefore, that affects both the funding that the home-share provider gets…. If a home-share provider is supporting somebody with a GSA score of four or five, it’s a much higher dollar value, but the expectations are also much higher for their involvement. Then we look at what we call supports to shared living, which is to look at what additional supports are needed to make that home-share arrangement sustainable.

We certainly don’t want to be in a position where, over time, the demands are too high on any home-share provider such that it overwhelms them, results in a breakdown and a move for the person. We want those to be lasting relationships, where that’s possible. So we implement supports to home-sharing. That may be that the person re­ceives support out of the home during the day, employment supports. They may go to a specific program or to a community program. But to make sure that that’s manageable…. It’s in our interests and everybody’s interests if those arrangements are sustainable for the home-share provider.

[8:40 a.m.]

Having said that, and maybe to anticipate a question, COVID certainly presented a real challenge for those home-share providers, no doubt, as it did for all families. We were very mindful of the fact, especially in the early days — I mean, it’s still not great now, but it is much better than it was in March, April, May of last year — that the additional demands on home-sharing providers were quite significant.

We requested at the time and were able to apply for in the neighbourhood of about $15 million, I think it was, in additional funding to home-share providers for the five-month period that things were the most intense, because we recognized that not only were a lot of the disability programs closed, but many of the generic community programs were closed as well.

I wouldn’t say it’s returned to 100 percent, because we are still in 3, not in 4 — we’re still wearing masks — but it’s definitely gotten a lot better. That’s also the coordinator’s responsibility, to be in touch with those home-share providers and, if they’re saying that this is becoming too much, to look at what additional supports are required.

M. Starchuk: Thank you for the presentation. One of the things that you touched on was the new standards for the coordination of shared living. You touched on the accreditation and where you were in that process that was there. I’m just curious as to who’s doing the accreditation and how this puts us in comparison with other provinces.

R. Chilton: The two bodies we recognize for accreditation are CARF and COA, the Council on Accreditation. They come on a three-year cycle, presuming everything is good with the agency, and review all of the services they provide. That could be everything from employment to shared living, staffed homes — all that sort of stuff. They come on a three-year basis.

The size of the team depends on the size of the organization and the amount of time they spend. In the organization I was with prior to CLBC, we would have four accrediting individuals come for a five-day period to meet with people, to go to their homes, to look at all the surveys, look at our compliance with all of the standards. They’re quite extensive. There are hundreds of standards that an agency must meet in order to be accredited.

They go through all that process. If there are any kind of serious deficiencies in that process, the agency is either shut down or given a one-year accreditation. One year would be: “You’ve got a year to get things together before we'll come back in a year to attempt to accredit you again.”

Otherwise they will secure a three-year accreditation and will often have recommendations for areas that they could improve. Those recommendations are forwarded to us. They have to submit a plan to address those recommendations to the accrediting body and report on that each year in terms of their progress.

It’s a very rigorous process. We’re looking at everything from the governance of the organization right down to the lived experience of services. The question I received…. How do you include people in the decision-making around their services? How do you respect families? All those kinds of things.

Having been in the sector, I’d say the accreditation process did raise the quality of organizational response over the years that it’s been in place, so we remain committed to it.

D. Coulter: Thank you very much for all the work you do and the passion you bring to the job — it’s amazing — and also the great questions that my colleagues are asking, because you’re providing so much more context that you just can’t see in the report.

I have one question. When you undertake the project to develop, test and implement requirements, how long do you envision that taking?

S. Hall: On March 31, 2022, we plan on rolling out the standards for coordination of home-sharing. With that, we’ll provide service providers with a self-assessment tool to make sure they’re aligning their service with the new standards. Our analysts will be working closely with them.

At the same time, we’ll develop an additional tool for our CLBC staff to monitor with, and that will include en­suring that all the contractual requirements are being met at that time. Further development of our home-sharing monitoring framework will follow that, and we’ll have further guidance developed in November 2022.

[8:45 a.m.]

R. Chilton: To add, it sort of, I think, reflects the question from Mr. Mercier. We want to make sure that we’re not just doing this as a compliance exercise, where we kind of go: “We’re expected to go, so we went, we looked, we checked off the boxes, and we left.”

We want to make sure that everything’s done to a high quality, so we are taking our time to get it right. We don’t want to rush something out the door that we later go: “That kind of met the requirements technically, but it didn’t meet the spirit of the requirements.” We want to make sure that the quality of those reviews and the standards really get at the things that matter to people, so that we’re getting the qualitative but also the subtleness and importance of the qualitative factors as well.

J. Tegart: Further to the questions from MLA Mercier, I’m where the rubber hits the road. The work that you do is incredibly important, both to clients, who are very much people, and to the people who open their homes.

As we set up monitoring systems, how do we find the balance, that we not scare people away, that we lose loving homes because the paperwork is too much or because it is just too cumbersome? How do we find the balance, when we want to provide and do provide top-quality services, without overwhelming people with — I hate to say the word “bureaucracy” — paperwork?

R. Chilton: That’s an excellent question. I think it gets to what the parents taught me, early in my days, which was that they didn’t want their son or daughter to live in an institution, no matter how small it is. You can institutionalize people one at a time.

The intent is exactly as you’re describing, which is to have an environment that’s a home environment. In licen­sed homes…. In staffed homes that have three or more individuals, they’re required by this province to be licensed. For instance, in the licensing review, you have to have up on the cupboard a two-week meal plan. That’s a meal plan for the two weeks. I challenge any of you. I wonder how many of you have a two-week meal plan posted. Do you?

Interjection.

R. Chilton: You don’t have one day.

It’s not that natural, right? You understand the intent around the standard, which is to make sure that people are eating a healthy, nutritious diet. But you can turn those homes into institutions, and that’s not to anybody’s benefit.

I think that the role of the coordinators, and our role as well, is to make sure that what we need — we do have certain needs in terms of monitoring — is not a burden to the person that’s providing that information. Our role is to be supportive and to help them to do a better job. I think when they can see how that makes a difference in the person’s life….

That’s something we all have in common — that you do, we do at CLBC, staff in the organizations that oversee the home-sharing providers, and the home-share providers. All of us have the same goal. We want to see people have a good life. We need to make sure that we don’t create a bureaucracy that ends up as: “I’m spending all my time completing forms, not spending time with the person that I’m meant to be here supporting.”

Absolutely committed to that — however, balanced with the fact that we do need to know certain things. It does make a difference if people have been to their doctor or not. It does make a difference if people are connected to their family and friends or not. We will make sure, I promise you, that we will do it in a home-share-provider-friendly way.

M. Bernier (Chair): I have a question, maybe to Mich­ael, first of all, and maybe to Ross afterwards. I apologize if I missed it in the report, because I hate to ask a question if the answer’s in there. It’s around the regional aspects of the agency, but then the audit itself.

When we were looking at sample sizes and sample groups for the report, did we look at cross-sections of around the province — different sizes, different groups? The reason why I ask that is that I see firsthand that capacity level changes depending on where you’re at in the province, right or wrong, but the service delivery aspect of it should not be different depending on where you live. I’m just curious, not only through the audit but then maybe to Ross and what he sees on the ground, if there are challenges from a regional capacity level on delivering, maybe meeting the expectations and then how we solve that.

M. Pickup: Thank you for the question. Maybe I’ll make a sort of general audit response and then look to Alex and Laura if they want to add more detail on this.

One of the things we are very careful about when we do these audits, when we pick sample sizes and we select regions, if it is relevant, is that we’re just using that as a basis for the overall conclusion. We’re not providing semi-conclusions on certain regions or certain aspects of the province.

[8:50 a.m.]

We often are careful on that and often don’t get into a lot of detail for that reason, because we don’t want people to think: “Oh, this conclusion only applies to this area or that area.” It’s something where we would have a discussion, both from an audit team but also from engaging with those we are auditing, to say: “Does this sample make sense that we’re going to be looking at? Does this help us reach the overall audit conclusions that we want to make?”

I know it is something…. Even dealing with the media, in the interest in our reports, they’ll often want to get down to a particular town or region or district, and we’ll say: “Well, no. The point is that supports our work on the conclusions.”

That would be a general comment I would make, but maybe, if I could, if Alex or Laura want to add something specifically on the samples that we looked at in this case, keeping to what’s in the report and more often careful not to go further than what is in that report so that we don’t get into creating, also, this idea that “Oh, my region is bad, and your region is good” or that these problems are only regional.

I don’t know if Alex or Laura want to add to that.

A. Gunn: When we were setting up our sample, we made sure to factor in within that the regional distribution of home-sharing providers and home-sharing agencies throughout the province. CLBC was very helpful in terms of providing us a clear population of the number of home-sharing agencies and direct contracts throughout the prov­ince, broken down at their regional level.

Then based on that overall population and the distribution of those providers across the province, we similarly tried to set up our sample with a comparable distribution so that we didn’t inadvertently, for example, only look at providers in the Lower Mainland, where they tend to be more concentrated. We made sure we had a representative distribution from the north, from the Interior, from Vancouver Island as well.

R. Chilton: The only thing I would add is that when you’re operating an organization like ours, one of the im­portant things to look at is what is best done centrally and what is best done regionally. What we do is the monitoring is done regionally. The agencies that are doing the monitoring live in those communities, are aware of the unique aspects in terms of challenges and opportunities that are represented in those regions.

There are differences across the province. In some ways, it’s much easier to be included in a small community than it is in a larger community. However, in a smaller community, there are less resources. There are less options available to people.

What the audit has pointed out is it’s important that, while it continues to be done regionally, there does need to be a centralized review of that. That’s what we have with our new data system — the ability to keep track of what’s going on regionally but not take it over at a central location in the Lower Mainland, to make sure that the regional kinds of variations around the challenges are represented there.

To the Auditor General’s comments, certain things are non-negotiable. They are standardized right across the board. We need to see these things wherever people live. It’s just understanding how that ends up looking in a smaller or more remote community might differ from a larger community.

The one we’re now looking at, in terms of getting better at as well, particularly in relation to home-sharing, is Indigenous communities. Unfortunately, what has typically happened is that when a person in an Indigenous community needs home-sharing as a support or needs the support, often the capacity has not yet been developed in that community, and the person, therefore, is removed to the next nearest community, which is a huge loss. They’re taken out of their community to get support. I mean, it’s just not good.

What we’re doing with our new Indigenous relations team is having them look at home-sharing. It’s one of the projects we have over the next year — to look at what Indigenous home-sharing looks like, to make sure that if there isn’t yet capacity within a community, we’re getting in there to help develop that capacity so that people can remain with their community and get the support they need.

It requires us to look at some different things as well. Every home-share provider has to provide a criminal re­cord check. Every adult living in that home has to have had a criminal record check as part of the home study process that’s done to look at the suitability of that home-share provider.

If we tell somebody’s aunt in one of the Indigenous communities that the RCMP is going to confirm whether or not they are suitable to be a home-share provider, that may be experienced as a little bit off. So we’re going to delve into that and look at: is there another process where we can guarantee the quality of the home-share provider without bringing in trauma to the first interactions? For instance, perhaps an Elder in that community could vouch on behalf of the person that they would represent a good home-share provider.

[8:55 a.m.]

There’s still a lot of work to be done, as you get a sense that prior to, during and subsequent to the audit, continuous quality improvement is our priority, and we will continue to look at both regional and provincial standards that are required.

M. Bernier (Chair): I really appreciate that answer. Maybe if you could just explain for us, then, how that conduit between yourself and the ministry works. Obviously, as an agency, you’re going to find these shortfalls or these challenges that are outside of the CLBC’s control, really, in some aspects, and require ministry intervention or support. How does that relationship and conduit work?

R. Chilton: Well, one of the things that’s been really powerful since 2018 was the establishment of the Reimagining Community Inclusion process. That involved a large stakeholder consultation across the province, really looking at not should there be a CLBC or not be a CLBC, but what should the future look like for adults with developmental disabilities. Stakeholders from across the prov­ince got to weigh in, in quite a comprehensive way, around what they wanted to see. A report came out of that process. Now, under Minister Simons, we have our Reimagining Community Inclusion process focusing on four priorities for adults with developmental disabilities across the province.

The four priorities were employment, health and wellness, Indigenous services and housing. Those four working groups are now working across the province to look at how we improve the quality of life for people with developmental disabilities. David and I co-chair the Reimagining Community Inclusion process, along with Inclusion B.C.’s executive director, Karla Verschoor.

We have a very strong relationship with our ministry. Maybe David would describe it as too strong, gets too many kinds of communications from me, but it’s important that we’re in alignment in terms of looking at what we want going forward and what changes we’d like to make going forward to improve the quality of life. So I would describe the relationship as quite strong.

D. Galbraith: I enjoy our morning calls, Ross.

I think a couple other things. We do have a strong relationship with CLBC. To be honest, if you look around the world, I don’t know how many jurisdictions have what we have here in B.C. We’re really lucky that when CLBC was set up, we have one agency that we deal with for the people that we serve with developmental disabilities. We’re blessed with that.

But for example, I, myself, or Adam, attend CLBC board meetings on a regular basis. We’re invited. I get to go sit in-camera parts when Ross and the team aren’t there. I think the Auditor General is actually the auditor of record of CLBC and sits at those meetings also and talks about, I think, the quality of the work that CLBC does from an audit perspective.

Outside of that, we have monthly meetings that are set up between us and CLBC where we get an opportunity to work through things. Likewise, Adam attends, I think, service quality committee meetings on a regular basis, along with the ad hoc stuff that we do on a regular basis. CLBC is a large service delivery Crown. It’s effectively like an extension of the ministry, so we have a good, solid relationship between the ministry, along with the usual mandate letter and all those other service plans and all that other type of stuff done at the staff level, along with the RCI that Ross mentioned that meets quite regularly.

Then we have other…. Especially during COVID, we had set up a number of opportunities that we could connect, things like public health officials to come and talk to families and to self-advocates. I hope everyone understands the self-advocate term. We’ve used it a number of times here. I think I see heads nodding, so that’s great. So it’s a solid relationship.

M. Bernier (Chair): Thank you very much. I’m looking around to see if there are any further questions. I don’t see any.

I want to thank everybody for their very thorough, thoughtful, detailed answers. As MLA Coulter said, it helps when you read the report. But then when you have these very well-described answers, I guess, to the questions, it really helps us.

Michael, is there anything you’d like to say to wrap up before we adjourn the meeting?

M. Pickup: Yes. Thank you for that opportunity.

I made a few notes as we were going through. Firstly, a big thank you for the dialogue, for the discussion this morning.

Just a reminder, I guess…. We do these reports. We report to the Legislature. We look at the conclusion where we indicate “had not implemented a monitoring framework,” but instead of getting caught up during the audit and during the discussions around that conclusion, we get into a substantive discussion around the recommendations and the things that come out of that as well.

[9:00 a.m.]

That would be an example of what I said at the opening comment, in terms of the professionalism of the organizations we audit and that relationship. We’re not arguing or fighting over words on a conclusion. We’re into the substance of what’s coming out of it. I do thank folks for that.

While we do this work to fulfil our mandate to report to the Legislature, most of us continue to do this work because of days like this and making recommendations where we want to see things improve. If we can play a part in improving how programs and services are delivered, it’s what drives many of us to keep doing this work well past 30 years, when we could have stopped long ago. I wanted to make that comment.

A couple of other…. Being the Auditor I am, I guess, I thought I would use this as an opportunity to make a few other comments. One is in relation to follow-up that I know really interests the committee. One of the things I noted well on the action responses is that five out of the six responses all fall within 18 months of the date of the Auditor’s report. That’s wonderful to see, as an Auditor.

It’s also wonderful to think of from an accountability perspective and a follow-up perspective. The future perspective is the indication that five out of six of these things will be done within the next 18 months. Sets it up really well for a strong follow-up process. I felt like I should make that comment. There was only one of the six actions that stretched over a two-year period as well.

The other thing…. I wanted to use this as an opportunity, because I know there was some really good discussion around it, to talk a little bit about how we approach these audits, particularly when we get into areas like this that are a little bit different than the bread-and-butter type of audit things that we may think of — internal controls, the typical, more normal stuff that we think of.

When we do these audits and we plan them at the beginning, roughly — and I’m going to be rough about this — a quarter or a third of the time that goes into doing one of these audits is invested in planning. It’s not us in isolation on 4th street, working on a plan to try to come up with how we’re going to audit.

It’s working with the organizations that we audit to develop criteria, to develop the audit objective, to say, “Do we agree here that we are going to, during the audit, measure you against this bar? Against this bar? Against this bar?” across all of these audit areas. Let’s have a discussion. Is this the criteria that makes sense? Do these things make sense as to what we’re going to look at?

That’s a big investment in time, but audit standards re­quire it, and it’s part of why we end up in a position where I often say: “We’re not writing newspaper articles. We’re not doing periodicals. We’re not doing theses. We’re doing audits, with standards.”

That is a huge investment of time, but then, when we get to a report, it is very rare to get to a reporting stage of an audit, where we’re having discussions with an organization, where we go back to square one and say: “Why are you holding us against that criteria? Why are you judging us against that?” That just doesn’t really happen much, because we’ve had all that discussion up front. We’ve invested in that.

I saw this as an opportunity, and I think the comptroller general, in a comment he made, sort of reminded me of it. I thought this would be a good opportunity to talk about that audit-planning process, and the investment we make in understanding the organization, understanding the work you do, developing audit objectives that make sense, and then going back and forth on what the audit criteria are and how we work together on that as well.

Those were a few comments that I was going to make, that I thought fit naturally here, and thank everybody for the questions and interest.

M. Bernier (Chair): Thanks, Michael. I think you sparked a question from MLA Sharma.

N. Sharma: I actually was really curious about…. Ross, you brought up a point about Indigenous communities.

Michael, I know it’s really important to you to figure out how we audit and integrate our audit through the lens of UNDRIP, so I’m curious about those outcomes. How do we…?

They’re very different — what you described, Ross, in Indigenous communities, and the gaps in the well-being and having to leave your communities. When we’re looking at how well we’re doing from an audit perspective in those communities, how do we do that? How does that show up in some of the reports that we’re looking at?

[9:05 a.m.]

M. Pickup: I’m going to say that is an excellent question, and a challenging one, and not one that comes with a very historical type of answer, and saying: “We’re done that. We’re finished that.”

We’re really embarking on that discussion now. Part of what we’re doing, I think, is we’ve set up — and I’ve talked a bit about it before — this group of external thought leaders, which includes Indigenous leaders from across the province as well. We’re bringing these folks in to engage with us at the early stage of audit selection, even before we get into an audit — engaging with them to say: “What are some of the things you think we might want to consider in terms of what we audit?”

I’m hoping, then, as we select audits, that we will be looking at this group to engage even more. I think we have need — and we’re starting this now — to get out and talk, as well, and listen to more folks to say: “What makes sense?” This is why I said that it’s not an easy answer. Recognizing is complicated from an audit perspective, particularly if you’re dealing with some things that are federal jurisdiction, if you’re dealing with provincial, if you’re dealing with none of the above. It is complicated, but I don’t think the complexity should trump the need to go down this road.

So we are going down the road. I would extend it to diversity and inclusion, as well, beyond Indigenous issues, to say: “When does that make sense to try to incorporate that into an audit?” So not only an audit once we get started, but even in the selection of audits, as well.

There’s not some really nice answer that I have to wrap it all up and say, “We’ve done A, B, and C,” other than to say that I would encourage you to continue to ask us those things as we move forward, because I really think they’re good questions, and I think you should be asking us that. So I welcome the opportunity as we go forward.

M. Bernier (Chair): Excellent. Thank you very much.

I also want to thank the committee for the good questions today and then, again, the thorough and thoughtful answers.

With that, seeing no other comments from anyone, I’ll need a motion to adjourn.

Motion approved.

The committee adjourned at 9:07 a.m.