The committee met at 8:35 a.m.

[J. Routledge in the chair.]

J. Routledge (Chair): Good morning, everyone. My name is Janet Routledge. I’m the MLA for Burnaby North and the Chair of the Select Standing Committee on Finance and Government Services, a committee of the Legislative Assembly that includes MLAs from the government and opposition parties.

I would like to acknowledge that we are meeting today on the legislative precinct here in Victoria, which is located on the territory of the Lək̓ʷəŋin̓əŋ-speaking peoples, now known as the Songhees and Esquimalt Nations.

Welcome to everyone who is listening to and participating in today’s meeting on the Budget 2023 consultation. Our committee is currently seeking input on the next provincial budget. British Columbians can share their views by making written comments or by filling out the online survey. Details are available on our website at bcleg.ca/fgsbudget.

The deadline for input is 3 p.m. on Friday, June 24, 2022. We will carefully consider all input to make recommendations to the Legislative Assembly on what should be included in Budget 2023. The committee intends to release its report in August.

The public hearings today are being held virtually, with most presenters organized into small panels based on theme. We will be starting things off today with a general panel, with general presentations on a variety of topics, followed by presentations related to health, including mental health, long-term care and autism. We will also be hearing about housing, fisheries and agriculture.

Each presenter has five minutes for their presentation. To assist presenters, there is a timer available when in gallery view. Following presentations from the panel, there will be time for questions from committee members. I also ask that everyone please put themselves on mute and wait until you are recognized before speaking. All audio from our meetings is broadcast live on our website, and a complete transcript will also be posted.

I will now ask members of the committee to introduce themselves, starting with the Deputy Chair.

K. Kirkpatrick (Deputy Chair): I’m Karin Kirkpatrick, and I’m the MLA for West Vancouver–Capilano.

R. Merrifield: Renee Merrifield, MLA, Kelowna-Mission.

H. Yao: Henry Yao, MLA for Richmond South Centre.

B. Bailey: I’m Brenda Bailey. I’m the MLA for Vancouver–False Creek and the Parliamentary Secretary for Technology and Innovation.

H. Sandhu: Good morning, everyone. I’m Harwinder Sandhu, MLA for Vernon-Monashee.

Welcome, presenters.

It’s good to see you, Robin.

J. Routledge (Chair): Also with us is Mike Starchuk, MLA for Surrey-Cloverdale. He is having intermittent connectivity issues, but he will be with us.

That’s the committee that’s present at this moment. There’ll be others joining us as well.

Assisting the committee today are Jennifer Arril and Emma Curtis from the Parliamentary Committees Office and Dwight Schmidt from Hansard Services.

With that, I would like to introduce our first panel, for which the theme is chambers of commerce.

Our first panellist is Robin Cardew, Greater Vernon Chamber of Commerce.

Budget Consultation Presentations
Panel 1 – General
(Chambers of Commerce)

GREATER VERNON CHAMBER OF COMMERCE

R. Cardew: Good morning. Thank you very much.

I’m here today on the unceded territory of the Syilx Okanagan peoples.

This opportunity to be heard is very much appreciated. Two topics for the 2023 B.C. Select Standing Committee on Finance and Government Services are as follows. We have a recommendation to begin again the PST rebates for capital, technology and other purchases program, which had expired on March 31 of 2022, and support for families with increased non-refundable or refundable tax credits for sports, culture and art expenditures.

The PST rebates for capital purchases for small businesses announced in September of 2020 as part of Stronger­BC, which was B.C.’s economic recovery plan, allowed incorporated businesses to recover 100 percent of the provincial sales tax on most machinery and equipment purchased. Continuing this initiative, which has expired, will allow businesses to receive some relief from the inflationary pressures all British Columbians are experiencing and will allow them to continue to grow and be competi­tive in the Canadian and global marketplaces.

[8:40 a.m.]

The continuance of this program, which was already in place, will be cost-effective for the province to initiate. The result and long-term benefits are organizations growing and improving their operations and offerings, with support from the province.

The second topic was beginning again the support previously in place for families through non-refundable or refundable tax credits. Sports, culture and art expenditures are important for families. Some relief for them, or to them, through those families making those investments in their children’s future, is the recommendation. To bring this credit back provides incentives for families to enroll their children in mind-expanding activities and also provides some relief to those that already do.

The Greater Vernon Chamber of Commerce thanks you for this opportunity to be heard and appreciates your efforts very much.

J. Routledge (Chair): Thank you, Robin.

Now we’ll turn to Bruce Williams, Greater Victoria Chamber of Commerce.

GREATER VICTORIA
CHAMBER OF COMMERCE

B. Williams: Thank you very much, and good morning. It’s nice to be here with you all.

I’m speaking to you from the traditional, unceded territory of the Lək̓ʷəŋin̓əŋ-speaking Nations, the Songhees and the Esquimalt. It’s our privilege and pleasure to live and work alongside them every day.

I apologize for my appearance. I lost an argument with a staircase about a week ago and fell down, and the stairs won. But I’m back in the office today.

I will join all of my colleagues across the province, with all chambers of commerce, highlighting a number of issues, but the ones I’d like to focus on today are specific to Vancouver Island in particular.

After the climate issues of November, when the atmospheric river came along, everyone’s supply chain was interrupted, no matter where you were in the province and, in fact, across Canada. One of the elements in that, with us, of course, is all of the goods coming into this country through the Port of Vancouver have to go through the Port of Vancouver before they come back to Vancouver Island. For us, that creates an issue of time. It’s a large carbon footprint and cost, as well, especially goods that then leave that region, go to other points east of here to be brought back again, not only in British Columbia but to Vancouver Island.

There’s been a long-standing proposal to upgrade one of the facilities on Vancouver Island to allow it to be a point of entry for goods that are coming in, especially on supply ships and container ships. That plan has been underway for quite some time in the Port of Port Alberni. On closer examination, you would find that that would create an opportunity for goods to arrive directly on Vancouver Island, be off-loaded on the Island and distributed across the Island.

In a bigger picture, there’s an opportunity for that to also create less of a workload going into the Port of Vancouver. If things were to be sorted on the Island and sent across again to Annacis Island on smaller ships, that, again, reduces the carbon footprint, the time and the cost of doing all of those things.

Although I don’t represent Port Alberni, we have created something across the Island called the Island Chamber Policy Alliance, where we take a look at things that are specific to Vancouver Island, because we are kind of a unique piece in B.C., of course. We are separated by water. We are much more reliant on ferries and on other means of getting our goods to and from the Island all the time.

Supply issue, in general, also impacts our food supply. Vancouver Island only creates about 10 percent of what we consume. We import 90 percent, which again, is a large carbon footprint. That’s a matter of food security. It means that we’re creating jobs in other jurisdictions. We need to take a look at increasing our capacity to produce, grow food and create employment surrounding that, much of which would be based on a containment farming model.

That, of course, means that despite having the best climate in Canada, we can only have one harvest here. Containment farming means multiple harvests over the course of a year. Much of that requires land, of course, which is a bit of shortage, again, on Vancouver Island, especially on the south Island. But working in partnership with nations, I think, is an opportunity for them to have tenancy on their land that would create not only food security but job opportunities for them too. So supply chain touches a whole bunch of different points.

I’ll probably emphasize the measures that my other colleague just spoke about, and that is housing supply. Workforce housing is a huge issue here. We are inarguably the second-most expensive market in Canada — in southern Vancouver Island. Workforce housing is a huge challenge.

We also have to work very hard to differentiate between affordable housing and housing for those who identify as homeless. Very often, the public tends to sort of group them together as the same thing — housing for those who need…. It’s completely separate.

The province has undertaken an initiative — and thank you for that — to create complex care facilities for those who are most vulnerable. We appreciate very much what the province has done to support that. We need to move forward with more of that as well as affordable workforce housing, which includes daycare and multipurpose facilities that we are now promoting through advocacy with our municipalities here.

Developers are creating communities that are rental, sale — all levels of affordability. They include daycare. They include some agriculture, some wastewater management — all of those things that are a sustainable form of housing. We would love to see the province step up to make that easier and whatever influence you may be able to have on the provincial level, as Minister Kahlon has spoken about, with his ministry working with municipalities in approval of housing projects.

[8:45 a.m.]

Another connection with that, of course, is moving peo­ple around the region. We have transportation issues here — moving people around in a jurisdiction that has a lot of water in place and a lot of peaks of land. There’s been a proposal pending for quite some time for a feasibility study for a West Shore ferry, a commuter ferry into downtown from the West Shore. We know very much, from Minister Fleming, that that is not in the plans for the current fiscal. We would love to see that considered for the next fiscal — to look at the feasibility of making that happen.

Housing supply also relates to the workforce. We have the same workforce shortages as everyone else. One of the things we would also encourage government to do is invest in making government workplaces, especially in the core of the city, in the downtown area, more acceptable for people to return to their offices. That addresses the vitality and the sustainability of the downtown area.

That’s a lot of stuff. Thank you for your time. I’m available and open to any questions or comments.

J. Routledge (Chair): Thank you, Bruce.

Now, it looks like Bev is not going to be able to join us this morning. So that concludes panel 1.

I’ll now invite members of the committee to ask questions.

K. Kirkpatrick (Deputy Chair): Thank you to both of the presenters.

Bruce, you were able to sneak a lot of recommendations into those three recommendations. Well done.

I did want to ask you about the Port Alberni facility. That’s a very interesting idea. I had not been alive to that as it being an option. Do you know…? I’m just thinking of the logistics of that. Do all goods from one container or one ship go to one location? Or is there a logistical issue if one ship has containers that are…? Some will come to Vancouver Island. Some will be on the Lower Mainland.

That’s a specific question. It might be a bit too tactical, but it does impact the recommendation.

B. Williams: Right. It’s an opportunity, I think, at the other end, at the Asian end of it. It’s going to bring some, probably, efficiencies and effectiveness to what they do as well if, at the other end, things are determined to be going into a container specifically for Vancouver Island. That means that it could be loaded there, off-loaded here, done. “Thanks for coming out.”

That, again, is something that’s being done, at a higher level of diligence, by our friends in Port Alberni — at the Port of Port Alberni, in particular. We, as a chamber alliance on the Island, got together to support that for all the reasons that I mentioned.

The other two factors that are in that project…. By the way, it’s a three-pronged thing. One would be the container ship importing and off-loading facility. Another part is a floating dry dock that could serve a ship. So instead of the ships going to the dock, the dock would go to them. It basically floats to the ship, comes underneath them and lifts them up.

The third part is a facility for approach, which touches on another point of view here on supply chain — a wood-processing facility. That would mean that we could create supply, in particular, for building supply on Vancouver Island and not have to be reliant on moving goods from the north part of the province or offshore to come here to create the all-important housing that we need right now. That’s another part of the supply chain.

They’re all in that facility in Port Alberni. A secondary facility could be in Nanaimo, for off-loading. Both are deep-water ports.

Another piece to that, if I may, pursuant to it, is the transporting of those goods after the fact, which could go back to transportation. That might be one of the reasons to take a look, again, at upgrading the rail facility to move goods around before they are loaded on to trucks for further distribution.

K. Kirkpatrick (Deputy Chair): I’ll wait, if there’s time at the end, for another.

J. Routledge (Chair): That’s great. Thank you.

H. Yao: I will follow Karin’s questions, actually. She actually asked a similar question that I was about to ask.

First of all, thank you so much, Bruce, for sharing a lot of interesting insights.

I guess my question right now is…. When we’re talking about, obviously, cargo ships going to the Port of Vancouver, instead of having an alternative to go straight to Victoria, is there some kind of international requirement because of products coming in from various countries? Is this some kind of project you see — that we actually need to work with our federal counterpart in order for us to deliver? You’re actually creating some kind of separate international port in Port Alberni.

B. Williams: Yeah. I think that would all be a part of the diligence that’s needed to go into this project, to take a look at it. The feasibility has to be finalized. The plan is in place, but all the parts of it — as I said, those three parts — work together.

Yes, there would have to be the feds involved because we’re importing from other countries. Again, anything like that, to me, anyway, is an opportunity as much as a challenge. I think it’s a way for us to be a bit progressive. We don’t need to keep doing things the way that we’ve been doing them.

[8:50 a.m.]

There is that issue of what the upset might mean for the Port of Vancouver, which involves a whole lot of moving parts. I understand that. I believe the opportunity is there to do something that’s more sustainable, that’s more environmentally friendly and more supply chain–secure for all of us, but yes, the feds would have to be involved in that.

H. Yao: Perfect. Thank you. I’ll reserve my spot for the next question when we go around the room then as well.

R. Merrifield: Thank you, Robin and Bruce, for your presentations — really appreciated. Robin, thank you for continuing to sound the alarm bell for our small businesses and the PST exemption. I love that being brought forward. Unfortunately, I don’t have a question surrounding it, and I am going to go to Bruce. I’m not going to repeat any questions that have been asked, but I will just reinforce that point.

I think what the climate change disasters of this last year really showed us was the need for redundancy and the need for distributed supply chain channels. I absolutely love the ideas that you’re bringing forward. I also am quite aware that the extension on the port for a new terminal in Vancouver took almost ten years. I think that we need to start now if we want to see it happen in this decade.

I do want to ask a question, though, on the housing that you brought forward, Bruce. That’s specifically on your comment about separating the affordable and the homeless initiatives, specifically to complex care and your understanding of complex care and the facility approach — just what you were thinking along those lines and what the needs are of the communities that you represent.

B. Williams: We know that for people who have been housed by the province — in particular, in the activity that was done to create housing in hotels and temporary shelters — most of the people housed in those facilities have been, at some point, in the care of an agency. That agency has assessed those people, and most of them have said: “Please help me. Please help me get my life back. Please help me beat my addiction. Please help me manage my mental health.”

Complex care facilities are not ones where people are dealt with as a whole. Each person is dealt with as an individual, with their individual needs. That sort of care is something that will help these people get their lives back faster to get them back to where they would like to be, to live a healthy lifestyle and perhaps even stream them back into the workforce again. That sort of housing differs from people who are simply low-wage earners, who maybe have a lack of skills to help them achieve at a higher level.

My background is in media, so I’m very happy to blame the media for all of this stuff. Very often the message is blurred, and it’s not clear enough that the needs of people who can’t afford living right now — the old term is the working poor — are a separate need from those who are identifying as homeless because of mental health and addiction problems. Too often, they’re seen as the same thing.

We try very hard to make sure the messaging is separate so people can identify the need and prioritize it according to their own beliefs. We think the province has a particular opportunity right now to clearly define where investment can be made in both of those for the best possible outcome. The moves that have been made so far to commit to complex care housing are very much appreciated and are being noticed, for sure.

R. Merrifield: Madam Chair, just for clarification, I think we missed on the question. Could I ask again in a different way?

Bruce, are you understanding this as a separate facility for these individuals that are requiring and are willing to engage in this help? Or is this a scattered model, where the care comes around these individuals who are in various housing models all throughout the communities?

B. Williams: Yeah, to bring them together for complex care. The commitment has been made by the province for five of them on Vancouver Island, to date, which has already been enacted, and the plans are underway to build those.

I guess my messaging on it is, yes, that is a separate thing from creating affordable housing, which could be integrated into current development projects for people that need affordable housing. Complex care is completely separate from that. There needs to be a more safe environment for those individuals to be, if you will, isolated and their health care better managed.

R. Merrifield: Thank you so much, and I appreciate the opportunity to clarify.

B. Bailey: Good morning. Thank you for the presentations. I’m also going to ask a little bit more about the idea of the port. I wonder: first, has there been any discussion with Robin Silvester and the folks at the Port of Vancouver? Second, my understanding was that ports were a federal jurisdiction entirely. I’m curious about that, if you can comment on that as well, please.

B. Williams: The conversations with the Port of Vancouver would have been through the Port of Port Alberni. Again, I don’t wade into that. We, from the chamber, are doing this on an advocacy point of view. Any conversations they have had, yes, are on a federal level. We’re doing this from a regional level for the idea of addressing supply chains.

[8:55 a.m.]

As an organization, we do advocacy, as we’re doing with you here today. We have done some through the feds, but again…. My chamber, I think, is the third- or fourth-largest in B.C., but we’re certainly the largest on the Island. We’re here to support our other chamber partners, to put advocacy forward so that every possible step can be taken to improve our supply chain and make it more sustainable and more secure for all of us.

I’m not here to speak on behalf of the Port of Port Alberni. They can do that themselves. I’m just here on behalf of the Island chamber alliance. We’re here to support them in the work that they do, and support from the province would be very important in the feds’ making their decision to prioritize what they’re going to do in this region. I hope that answers your question.

J. Routledge (Chair): Harwinder has a question. That’ll probably be all the time we have.

H. Sandhu: About your presentation and asks, I want to say: thank you for all you do and for your advocacy. Just a question: have you submitted or will you be submitting the written submission for this? I was trying to look into my files, and I haven’t been able to find it.

R. Cardew: I’ve not submitted it yet, but it shall be submitted.

J. Routledge (Chair): Well, there are more questions, but sadly, I think we’re out of time.

B. Williams: Well, let’s do this again soon.

J. Routledge (Chair): Yes. Thank you for taking the time to come and for sharing your vision with us, about how we can make our local economies more responsive and reflect the lived reality of what we need at the community level for us all to thrive. I think people are quite engaged. I think we will like to have more conversations about this.

We’ll call a recess.

The committee recessed from 8:58 a.m. to 9:19 a.m.

[J. Routledge in the chair.]

J. Routledge (Chair): Hello, everybody. This is the Select Standing Committee on Finance and Government Services. Our next panel that we’re going to hear from is representing boards of trade. We have Bridgitte Anderson representing the Greater Vancouver Board of Trade and Anita Huberman representing the Surrey Board of Trade.

What we’ll do is we’ll hear from each panellist, in turn. They each have five minutes. There is a timer that can help you see when your time is almost up. After each panellist, we’ll open it up for questions from the committee.

Even though you’re making separate presentations, feel free…. Some of the questions may be directed towards a specific panellist. The other panellist should feel free in jumping in, elaborating. Some of the questions may be general. It’s kind of like a discussion.

With that, I’ll ask Bridgitte to start off.

[9:20 a.m.]

Budget Consultation Presentations
Panel 2 – General

GREATER VANCOUVER BOARD OF TRADE

B. Anderson: Good morning, everybody. I hope everybody is well. My name is Bridgitte Anderson, and I’m the president and the CEO of the Greater Vancouver Board of Trade.

I’m speaking to you today from the traditional territories of the Musqueam, Squamish and the Tsleil-Waututh.

On behalf of our directors and our board and our over 5,000 members, we thank the standing committee for the opportunity to speak with you today.

Our province continues to face challenges due to the pandemic, climate-related events and geopolitical issues, which is why we’re going to focus on three priorities for Budget 2023 — the cost of doing business, competitiveness, and workforce skills and shortages — and make three primary recommendations.

B.C. businesses are continuing to struggle with rising costs, in part due to external factors such as supply chain disruptions, rising fuel prices and record inflation. But there has also been an onslaught of new government pol­icies that have increased costs for employers. Some examples: sick leave, EHT, minimum wage, regulatory changes to different regulations.

An example of that is the employer health tax. It has cost businesses over $1.9 billion annually, and depending on the uptake, the new mandatory employer-paid sick leave entitlement could cost businesses more than an additional $1 billion. So to provide some relief while simultaneously improving B.C.’s competitiveness, we recommend that the government provide a rebate for the PST paid on computers, software and telecommunication services, at a total cost of approximately $200 million annually. Now, this would incentivize investment in technology, which we’ve all learned is integral for enhancing productivity and remaining competitive.

On the other factor around competitiveness and the cost of doing business, a safe workplace is a top priority for our members, and our members have made record investments to keep their workplaces safe since the start of the pandemic, while also investing at WorkSafeBC to support workers who are injured. As of December 2021, WorkSafeBC has a funded ratio of 155 percent to 166 percent, depending on the accounting standard used, meaning employers’ contributions and the return on those contributions have been substantially more than what is required to fund the system.

Our second recommendation. We recommend WorkSafeBC’s board set a new funding ratio target and return the surplus to those that fund the system. Just to put that in perspective, if the target funding ratio was set at 130 percent, there would be a surplus of approximately $3½ billion to redistribute to employers. This approach is similar to what is done in nearly every other province.

Moving on to labour and workforce challenges. Prior to the pandemic, B.C. had struggled with long-standing skills-related labour shortages in various sectors, particularly in construction and other skilled trades but also the highly skilled professionals’ roles. B.C.’s job vacancy rate is 7.3 percent, the highest in the country. So simply put, we need workers now. We need to face reality when it comes to the economic implications of our aging population.

Universities, colleges and businesses are undertaking work to solve these challenges. For example, here at the Board of Trade, we recently partnered with BCIT to launch the ESG micro-credential, the first of its kind in North America. So our third recommendation: we urge the government to work to ensure the prompt recognition of foreign credentials; encourage new, innovative skills programs, such as micro-credentials; and set the goal of being the highest-skilled province in Canada.

B.C.’s shortage of available and affordable housing has made it even more difficult for employers to retain talent. We did a recent survey, and 83 percent of our members report this is a challenge for them. So we encourage bold action at the provincial level in regard to municipalities on zoning and permitting to increase housing supply.

A second important challenge for your government is the role land prices are playing across the economy beyond the housing sector. Metro Vancouver industrial land va­cancy rates are the lowest in North America, and lease rates are climbing at rates similar to the growth in housing prices. We encourage an increased role for the province in working with municipalities and Metro Vancouver, as well as the Agricultural Land Commission, to understand and act on this challenge to avoid losing investment to other provinces or even the United States.

As we know, the last few years have been remarkably challenging for all of us — fires, floods, the global pandemic, a war in Europe and more. I’m really proud of the work that our businesses at the Board of Trade have done over the past few years to build an inclusive and clean economy for all British Columbians, and we look forward to working collaboratively on these issues with all of you in the months ahead.

Thank you very much for the opportunity to speak with you.

[9:25 a.m.]

J. Routledge (Chair): Thank you, Bridgitte.

Now we’ll turn to Anita.

SURREY BOARD OF TRADE

A. Huberman: Thank you. I’m Anita Huberman. I’m president and CEO of the Surrey Board of Trade.

I acknowledge that we’re on the land of our Coast Salish peoples and also the Inuit and Métis.

We are a Surrey city-building business organization, representing over 6,000 member contacts, where we support business and attract business through a very diversified service portfolio. Surrey will be the largest city in B.C. very soon.

Our three areas for Budget 2023 are (1) taxation, (2) im­proving infrastructure and greater investments, and (3) business and economic enhancements.

Under the area of taxation, we are asking the B.C. government for a comprehensive tax review. The B.C. government has implemented many programs that have served to alleviate some cost pressures that were felt by businesses during the pandemic. Now we find ourselves buried in provincial debt, rising inflation and an even higher cost of living.

What we need is to create a commission to review all of the taxes that are eroding a business’s bottom line. Determine debt levels, ensuring we’re finding revenue opportunities and ensuring you’re conducting consultations with the business community. In this area, to the budget committee, I would also like to ask that you review the cost impacts to B.C.’s taxpayers as a result of Surrey’s public safety transition from the RCMP to a municipal police force. Over $2 million has already been spent and has impacted the B.C. budget.

Recommendation 2: improving infrastructure and greater investments. There’s an opportunity to really look at transportation investments. Surrey and south of the Fraser have been starved in terms of transportation investments. There’s more that can be done in addition to SkyTrain.

Investment into digital technology and digital hubs, centres of excellence in Surrey — with our health and technology district, the quantum computing centre at SFU and many universities investing in this region, we have the opportunity to look at centres of excellence around digital technology, education investments, and the medical school at Simon Fraser University, in addition to the one that will be at UBC with their expansion into Surrey.

We have also presented to government an Indigenous centre of innovation and entrepreneurship to be based here in Surrey, fashioning ourselves after the city of Toronto’s Indigenous centre of entrepreneurship. These are true, actionable results on a pathway towards Indigenous reconciliation, focused on economic opportunities for all.

Our recommendation 3, under business and economic enhancement, is to ask the B.C. government for reallocation of dollars towards workforce investments. In the past two years, we have created, here at the Surrey Board of Trade, a trifecta economic partnership between private colleges, immigrant-serving organizations and then us as businesses, where they get trained — newcomers — for six to eight weeks. We place them in businesses — 90 percent employment sustainability.

In the area of housing, our development and construction sector is thriving in Surrey. We need more housing supply, but our development approvals get held up at the B.C. government office in the department of forestry, especially with those lands that have water-bearing features, of which there are many in Surrey. So we’re asking for more staffing in that department to ensure that we’re creating actionable results towards housing supply.

With that, I look forward to your questions.

[9:30 a.m.]

J. Routledge (Chair): Thank you, Anita.

I note that we do have more time on the agenda than we thought we did, so probably we’ll be able to have more of a discussion and more questions than we would have otherwise thought we would.

I’ll open it up now to questions, and the first hand I see is Brenda.

B. Bailey: Good morning, presenters. Thank you very much for your words. I have potentially lots of questions, but I’ll just focus in on one, Anita. I’m the Parliamentary Secretary for Technology and Innovation in the province, and I’m interested in your suggestions in regards to a digital centre of excellence in Surrey.

I wonder if you can flesh out for me a little bit more about the hubs that you’ve talked about and what the vision there is.

A. Huberman: Well, the vision — through our health and technology district — is to look at pilot centres of excellence, where we start it off, and then it is taken over by other entities.

One is the blockchain centre of excellence. The second one is a cybersecurity centre of excellence. We’re working with a San Diego cybercrime centre of excellence in order to implement that. As I mentioned, the Indigenous centre of entrepreneurship and innovation would also look at different startups and support mechanism for Indigenous tech entrepreneurs.

We’re just in the infancy of all of that, but we are progressing with the B.C. government — specifically, as a first step — with the Indigenous centre, so we are hopeful for some form of funding on that journey towards partnership with our Indigenous partners.

K. Kirkpatrick (Deputy Chair): Hello, Bridgitte. Nice to see you again. Hello, Anita. Thank you for that. Really interesting. I’m just going to limit to one question, and then I’ll come back, if there’s time.

Bridgitte, has there been a costing out of the impact of the five-day sick leave to businesses? It’s interesting to hear the EHT number, and I am curious about the sick leave number.

B. Anderson: Yes, we did provide information to the Ministry of Finance and a number of other folks in government in regards to…. And really, we were looking at significant amounts. We did do the figures around five days — and also ten days and three days.

I can pull up the figures for you. I don’t have them at my fingertips, but we did cost it out, and we’ve spoken about that a fair bit. I just can’t remember exactly, off the top of my head, what the costing was.

K. Kirkpatrick (Deputy Chair): That’s fine. I know that you’ve done that, so if you don’t have it at the…. I don’t get the Ministry of Finance notes, but I know you did do this publicly as well.

I’m going to pass to my colleagues, and I’ll come back for some other more specific questions.

A. Huberman: If I could just also add to the EHT question, we have members that get impacted. If they own five businesses, they get impacted by the employers health tax five times. That is significant bottom-line erosion.

Bridgitte is so right that the EHT, in addition to other taxes, absolutely needs to be re-evaluated.

B. Anderson: Thanks, Anita. If I could just…. I have the costs right here. If we’re talking about the five days, if there was a 45 percent uptake, it would be, it looks like, between $506 million and $1.1 billion. We’re talking about five days. That’s with a 45 percent uptake or a 100 percent uptake.

R. Merrifield: Thank you both for being here this morn­ing and for your thoughtful presentations.

Bridgitte, I really appreciate the numbers that you’ve put to these different initiatives and the alarm bell for how we are eroding affordability for and competitive nature of our businesses.

I actually have a question for Anita, and that is on the superclusters. Has there been any business case or analysis done on creating those superclusters for the digital hub, etc.?

A. Huberman: For the cybersecurity centre of excellence, yes, and the Indigenous entrepreneurship centre, yes. We’re just finalizing those proposals for government right now. We are speaking with the Ministry of Economic Development, with Minister Kahlon’s staff, on both pieces. But I can’t speak to the specifics just yet, because it’s not final yet, Renee.

[9:35 a.m.]

R. Merrifield: Thank you so much. I will reserve my space for another question, if time.

M. Starchuk: The question I have is for Bridgitte, re­garding the comment about an increased role with government with regard to employment lands. What do you see that as?

B. Anderson: Thanks for the question, Mike. We have been working with a number of our members on an industrial land strategy. We’re going to have more to say in the coming weeks about that, including some research that has not yet been done. But when we’re talking about the employment lands or industrial lands, we know there’s a shortage, and we are losing businesses every day because of this. There’s a great example of a brewery that has bought a $15-million building in Calgary because they simply could not be able to set up their business here.

There is a role for the government to play around em­ployment lands, and there’s also a role that could be looked at in regard to the Agricultural Land Commission. We’re going to have a numbers of recommendations that we’re making to government over the coming weeks and months, but we are in the middle of doing some further research on economic impacts. That’s a study that has not been done to date.

There is definitely a role that government can play in being able to free up some of these lands and the way that it is also zoned. I’m happy to speak about that and provide more information as we have the details available.

M. Starchuk: If I may, when you talk [audio interrupted] land, are you talking about exclusions?

B. Anderson: We’re talking about a whole strategy to deal with employment lands or industrial lands in British Columbia. As we know, there are a number of zonings that are in place that really prohibit any kind of growth on that land. Some of it is for good reason, because it’s agricultural land. We’re not suggesting that those sorts of zones should be touched. There are a number of other zones, 1 through 8, that should be looked at.

There should be a strategy about freeing up some of these lands. Also part of that strategy, though, would be understanding where those lands are and what they could be used for, whether it’s light industrial or heavy industrial. But given the shortage that we have — we’ve got the biggest crucial shortage in North America around employment lands — it is inhibiting businesses’ ability to grow and to scale. So we know that there’s work that needs to be done.

H. Yao: Thank you so much, Anita and Bridgitte.

This is a question for Anita, if you don’t mind. Bear with me, as I don’t fully understand the geography of Surrey as well as I should. You mentioned that the south of Surrey has often, unfortunately, been falling behind in regards to infrastructure. Do you have any insight? Maybe it’s due to population density, or it’s due to a lack of commercial activity in that area.

Is there something you can maybe recommend? What kind of infrastructure would you love to see to be incorporated into South Surrey to ensure that we can actually increase the prosperity of the South Surrey area?

A. Huberman: Thank you for the question. We’re not only talking about South Surrey. You can fit the cities of Vancouver, Richmond and Burnaby into the geography of Surrey. Our population is close to 600,000. We’re growing, even during the pandemic, by 1,200 to 1,400 people a month. But our ability to move people efficiently and effectively is compromised because we don’t have accessible transit.

Our workforce is a car culture. SkyTrain is only one transportation mode, a regional mode that will move peo­ple between Langley to Vancouver. But we do need transportation technology to move people within Surrey to really ensure that connectivity. Buses are not the only answer. We’ve also been, of course, communicating and working with TransLink.

It has to do with the politics over the past two decades and, certainly, investment dollars and courage to really be leadership-oriented in terms of transit and transportation investments in Surrey and south of the Fraser.

[9:40 a.m.]

H. Yao: Thank you. I’ll reserve my spot for the next question.

M. Dykeman: I have a question for Anita related to recommendation 1. You talked about a full review of taxes in the province and looking for the ability to eliminate redundances and see where some proliferation can occur. I’m wondering: can you provide some examples of the efficiencies you’re looking for and if you’ve seen this done in other jurisdictions?

A. Huberman: Next month we’ll be presenting a report to the Premier and to the Finance Minister on the specifics of what we’re looking for in terms of a comprehensive tax review. It has been done in the province of Nova Scotia, as well as in New Zealand, for example.

We’re trying to ensure a B.C. focus, where those taxes that have been identified by our finance and tax team — such as EHT, PST and other red-tape administration that is really eroding a business’s bottom line — are looked at, in consultation with organizations like ours but also speaking directly to the business community.

It includes creating a commission; doing an analysis of revenue sources, tax revenue sources — the gas tax is another one, to ensure affordability for businesses and residents; determining the fiscal challenges of today, what may come tomorrow; categorizing spending; determining debt levels; and ensuring that we’re looking together at the economic future, in terms of revenue opportunities for government.

R. Merrifield: My question is based on what, Anita, you had brought forward, with respect to the housing ap­provals and the approval process by the Ministry of For­ests. I’m also curious as to whether or not you’re finding the same delay in approvals from the Ministry of Transportation or, possibly, the Ministry of Environment and whether or not there are delays occurring in other ministries that the province has oversight over.

I would love if Bridgitte could weigh in on that question as well. Thank you so much.

A. Huberman: Well, when the B.C. government came and presented to British Columbia the CleanBC program, therein lay the problem for a development community to be compliant with what that CleanBC program entailed.

Really, it’s the department of Forests that we’re challenged with, Renee. That’s where our development community is experiencing the holdup. We have so many approvals. I mean, yes, there are delays here in the city of Surrey, as well, as there is in every municipality, but because we have so much water-bearing land, some of our developers are waiting two or three years for approvals — because of that lack of staff.

B. Anderson: Renee, I’m not sure what I could add to that. I think Anita has really said it very well. Of course, our members also have noted — in survey after survey, pre-pandemic through the pandemic, and even in our recent survey that we did a couple of weeks ago — that permitting delays are costing them time and money in their businesses. That is across the board.

To be really candid, businesses would place the blame at all three levels of government and redundancies that exist between regulatory processes. This is not a new message from the business community, but I also have to echo what Anita said around taxation. It’s taxation and the regulatory system that really hold businesses back in their ability to grow and scale.

So anything that can be done to simplify the proces­ses…. Whether we’re talking about housing or transportation or we’re talking in regards to municipal, provincial or federal, more needs to be done to make it simpler and easier for businesses to operate. That really is a broad statement, but it could apply to any single ministry that we could talk about.

[9:45 a.m.]

R. Merrifield: Excellent. Thank you.

K. Kirkpatrick (Deputy Chair): Anita, you have spo­ken about the need for workforce investment. I’ve heard you speak previously about the challenge around child care provision and child care and the number of child care spaces in Surrey because of the young and growing population. Is that something, when you’re thinking about workforce investment, that’s important to you?

A. Huberman: Child care is very important to us. We have been advocating for it since 2008 as the first business organization to really ensure that child care was consid­ered as an infrastructure investment from an economic lens. We need 20,000 child care spaces in Surrey just to meet our current demand. We sit on Surrey’s child care task force, which is co-chaired with the city of Surrey.

Certainly, from a workforce perspective, that is one ingredient in the overall workforce investments that government should be considering.

K. Kirkpatrick (Deputy Chair): Thank you. Renee asked my other questions.

H. Yao: Hi. Thank you so much. I would like to ask a question to Bridgitte.

I do want to emphasize that my question doesn’t undermine your suggestion at all, because I think you talking about rebate on PST for computer technologies is such a great idea. But I just have a question. That is: do you have any other suggestions of rebates where the money stays within British Columbia, instead of going back to different jurisdictions?

As we know, computer technology tends to be the composition of multiple foreign jurisdictions. We’d just love to find a way to not just focus on supporting local businesses but also keep the economy strong for British Columbians. I would love to hear your feedback or maybe suggestions.

B. Anderson: Thinking about rebates, we’re also thinking about how to incentivize and grow businesses, which is one of the reasons why we made the recommendation on the PST bid on computers, software, telecommunications. But now I think back to the previous budget. There used to be a rebate on machinery and equipment, which was phased out in the last budget. That particular rebate also incentivized businesses to invest in their own businesses and grow.

I would say overall that any kind of rebate that businesses can take advantage of to invest in their own growth is really a wise use of dollars. We decided to focus, for this particular budget, in regards to digital technology. But I think that if we look back at manufacturing, we would also be in favour of bringing back the machinery rebate that was phased out in the previous budget.

M. Starchuk: Just a comment to Anita. Just so that we’re clear when we talk about the backlogs that could be there because of the amount of water streams that Surrey has, I just wanted to make sure it was known that the city of Surrey is one of the few cities that doesn’t have staff to deal with that directly. I understand that the government has their backlog, but there’s no intermixing within those two areas that are there. That’s part of the complication.

But I wanted to know, from Anita, if you wouldn’t mind: what kinds of talks have you had with TransLink? What areas are you looking at for improving transit?

A. Huberman: Well, we’ve talked, of course, with Trans­Link about rapid bus transit as a short-term solution on the 104 corridor as well as to Newton, to South Surrey, to Cloverdale and to Campbell Heights. I mean, it’s that whole connectivity, Mike, that we’re looking for. But I do bring into play light rail transit as a possible technology mechanism.

We can’t wait until Transport 2050 for things to take place. We’re all going to be old and gone by 2050, maybe. But we need to start looking at implementing those transportation modes now.

We have been speaking, though, to the Premier’s office as well as to the Ministry of Transportation on re-energizing the railway line between Surrey all the way to Abbotsford. That is in partnership with CN and CP. That is an existing rail infrastructure network which was used long ago but can be revitalized as a passenger line.

[9:50 a.m.]

We know 1.3 million people are moving to Metro by 2030, I believe, 2040, and many of them will be living and working in Surrey and south of the Fraser. So we need to look at existing rail infrastructure that we have but also transportation modes. We’ve been speaking to TransLink about it, but they just don’t have the money to really ensure that leadership and technology investment.

B. Stewart: I just wanted to touch on your recommendation No. 3, Anita.

Good to see both of you.

I do wonder about the ports. One of the things that was an issue that was raised some time ago was the draft and the access to the South Fraser in terms of expanding. You talk about industrial lands. Is there any information you have about the requirements for larger ships to go into the South Fraser?

A. Huberman: I don’t have an answer to that question. That’s why Roberts Bank terminal 2 is so important in terms of its expansion, and we’ve been huge proponents of that to the federal government. With that, in part and parcel, Ben, will come industrial lands.

We are facing a crisis around industrial lands. In ten years, we will not have the capacity to bring in businesses, to attract businesses domestically within Canada or internationally because we will have no more industrial land within Metro Vancouver. The ports are a part of that solution — of course, in partnership with our Indigenous partners — but I don’t have a specific answer to your question related to that.

B. Stewart: Thanks very much. I do think it’s important that we do know that, because I think that the growth south of the Fraser is definitely…. Port Metro Vancouver has limitations. Obviously, utilization of the existing port and infrastructure is extremely important, but to grow, we do need to make certain that the other lands that have been identified outside of that area are important.

Can I ask one last question?

I have been made aware recently that there’s another extension or discussion going on about high-speed rail down to the U.S. coming into Metro Vancouver. I guess the question I have for both of you is: where do you think the terminus or where do you think the landing should be for that?

A. Huberman: Well, it originally was proposed in Surrey, but now they’re talking about the terminus being in Vancouver, with a stop in Surrey.

I can’t speak for the Greater Vancouver Board of Trade, but we have been huge supporters of this high-speed rail as a connection of our Cascadia economic region in our work that we’re already doing with the state of Washington, the state of California, the Pacific Northwest economic regional council, to ensure….

Because we have the largest number of manufacturers in British Columbia right here in Surrey and we’re a border city, that high-speed rail and the investment in it is absolutely integral in terms of connecting, creating jobs, attracting businesses, attracting partnerships. It would actually be, for the west of Canada, a significant economic boon to our region.

B. Anderson: If I could just…. The Greater Vancouver Board of Trade has long been a proponent of this line, and we would advocate for a stop in downtown Vancouver as well as Surrey. If you think about the objective behind the rail line, it’s to connect those employees and those businesses. You look at Microsoft and Amazon and Google. They all have significant footprints in downtown Vancouver, and so we would need to ensure that there’s a connection with downtown Vancouver to those stops in Washington. That is really the prime objective — to be able to ensure business flows between those two.

But I take what Anita is saying. I think it’s also important to include Surrey in that as well, as it is a thriving and growing region, and we’re going to have tech workers there as well.

[9:55 a.m.]

J. Routledge (Chair): Well, it looks like we’re out of time. On behalf of the committee, I want to thank both of you for taking the time to make a presentation and to engage with us. We want to thank you for engaging with us about our vision of what a good economy in British Columbia would look like and emphasizing the things that we need to do more of. Thank you for highlighting the cautions, unintended consequences, that you think could get in our way. Thank you very much for that, and I’m sure we’ll have more conversations about this in the future.

Our next panel is ready. They’re here. This is a panel on public health. We’ll hear from Kelly Wilson Cull, representing the Canadian Cancer Society; Rita Koutsodimos, representing B.C. Alliance for Healthy Living; and Kane Tse, representing Health Sciences Association of B.C.

We’ll start with Kelly.

Budget Consultation Presentations
Panel 3 – Public Health

CANADIAN CANCER SOCIETY

K. Wilson Cull: Good morning, everyone. Thank you so much for having me. My name is Kelly Wilson Cull. I’m the director of advocacy with the Canadian Cancer Society. Thank you for the opportunity to speak with you here today.

Late last year the Canadian Cancer Society was very excited to open the doors to our new Centre for Cancer Prevention and Support. The centre, which is located in British Columbia, is a new national hub for research and innovation in cancer prevention and survivorship. The centre was constructed in part thanks to a $10 million grant from the B.C. government and is one example of the ongoing partnership between the province and CCS in our mutual effort to reduce the burden of cancer in B.C.

While partnerships like this and initiatives like B.C.’s ten-year cancer action plan show that B.C. is committed to being a leader in cancer care, there are many areas along the cancer care continuum where B.C. continues to lag behind. At the front of that continuum, we have cancer prevention.

Cancer prevention measures such as tobacco control remain a key component in reducing cancer prevalence in B.C. We know that tobacco use is the leading cause of preventable disease and death, both in British Columbia and, indeed, across Canada. They contribute to about 30 percent of all cancer deaths, yet B.C.’s tobacco control strategy is over 15 years old.

As one proposed measure, CCS is asking that the full cost of the B.C. government tobacco control strategy be recovered through an annual cost recovery fee on tobacco manufacturers operating or selling within the province. A cost recovery fee is based on the principle of polluter pays, which stipulates that companies who pollute should bear the cost that they impose on society.

As such, the tobacco industry should be required to reimburse the B.C. government for the cost of responding to the tobacco epidemic which they are primarily responsible for creating. If implemented today, a tobacco cost recovery fee would generate approximately $25 million in annual revenue for the B.C. government, based on the current investment in the provincial tobacco control strategy.

Early detection of certain cancers, like prostate cancer, is another important step in the cancer care continuum. Prostate cancer is the most common cancer diagnosed among Canadian men. It accounts for 12 percent of all cancer diagnoses in B.C. men. Yet it is also one of the least preventable cancers according to current known risk factors.

Due to the difficulty in prostate cancer prevention, early detection of the disease is critically important. When prostate cancer is detected early, close to 100 percent of men will survive five years or more. Prostate cancer can be detected early through a blood test, known as the prostate-specific antigen test, or PSA test, which looks for high levels of PSA, a protein made by prostate cells.

The PSA test is a critical tool in detecting early signs of prostate cancer, but it is not currently covered by the province for asymptomatic individuals who may be at risk to the disease due to family history or ethnicity and who also have a physician referral. Eight other provinces and three territories cover the cost of the test by referral, without requiring signs and symptoms.

Finally, there continue to remain gaps in the way that B.C. delivers palliative care in the province. Canadians with cancer are three times more likely to receive palliative care than those with other conditions, yet they struggle to access that care. We also know that gaps in palliative care continue to exist for Indigenous communities in B.C., who face even greater inequities in timely access and fair access.

One place where that gap is particularly evident is in the delivery of grief and bereavement supports. While the province has made mental health supports a priority as it relates to toxic drug use, there is currently no recognition of grief as a mental health issue in the province.

[10:00 a.m.]

As a result, B.C. does not publicly fund grief and be­reavement organizations, and the financial burden for pro­viding grief support falls to charities, hospices and other not-for-profit organizations. This burden is also increasing. In 2022, CCS received 216 bereavement-related inquiries to our cancer information help line. This represents a fourfold increase from the previous year. Since grief and bereavement services are provided by an array of organizations, they’re often fragmented, which can in turn lead to inefficiencies, duplication of efforts and increased inequity of access.

CCS is asking that the province make grief and bereavement a mental health priority. Doing so can pave the way for systematic funding of grief and bereavement supports and help consolidate the delivery of palliative care across the province. Investing in these actions, as well as continued support for cancer research through institutions such as CCS’s Centre for Cancer Prevention and Support, will fill the gaps in cancer care and solidify B.C.’s standing as a leader against cancer.

J. Routledge (Chair): Thank you, Kelly.

Now we’ll turn to Rita.

B.C. ALLIANCE FOR HEALTHY LIVING

R. Koutsodimos: Good morning, everyone. Thank you so much for having me today.

I am grateful to be joining you from the unceded territory of the Skwxwú7mesh, on behalf of the alliance.

The health charities and organizations that make up the alliance have been working together since 2003 to prevent avoidable chronic disease and promote the health of all British Columbians.

To start with, I’d like to ask you all to take a moment and reflect on any friends or relatives that you know who have diabetes or cancer, or heart or lung disease. I bet you that every single one of you has someone in your life who has struggled with one of those conditions, which isn’t surprising, because one in three British Columbians live with chronic disease. Now imagine that you could erase or prevent half of that. The good news is that you can make decisions in this budget that will help, because up to 80 percent of chronic disease is preventable.

We know what can be done to prevent early loss of life, as Kelly mentioned — limiting tobacco or stopping tobacco, as well as healthy eating, physical activity and limiting alcohol. Poverty is also a significant risk factor, so we’re kindly asking this committee to invest in three important areas: (1) funding to implement B.C.’s poverty reduction strategy, with an increase to income and disability assistance; (2) funding to support physical activity through B.C.’s physical activity and active transportation strategies; and (3) expanded funding for health promotion, including the B.C. health improvement fund.

Treatment of chronic disease is costly to British Columbians. It’s one of the largest line items in the Health budget. More importantly, it has a real human cost. B.C. has always been a leader in health promotion, but this pandemic has moved us backwards. We’re very concerned about this.

Poverty makes it extremely difficult to lead a healthy life. Food security, of course, is related to that, as is chronic stress, which raises cortisol levels, elevating disease risk. So we urge government to follow the advice of the Expert Panel on Basic Income and raise assistance rates to the poverty line according to market basket thresholds. With soaring inflation and costs of living going through the roof, we need to be sure that we’re protecting children, people with disabilities and those with trauma and mental illness issues who rely on income assistance.

Our second ask is to invest in physical activity. We all feel better when we move our bodies, and regular physical activity protects against numerous chronic conditions. It promotes mental health, and among seniors, it supports mobility and delays frailty.

[10:05 a.m.]

The first phase of B.C.’s physical activity strategy focused efforts at child care centres, Indigenous communities and older adults. We helped with the implementation, and the evaluation from that was inspiring. Over 52,000 hard-to-reach people got moving in more than 52 communities. But COVID-19 has shut down so many activity programs, and current data is very concerning. It shows that over half of B.C. children aren’t active enough for healthy development.

We would ask for $7 million to continue the work on the physical activity strategy, the phase 2 implementation, and $100 million towards active transportation. This supports regular daily movement in the community and also our provincial climate change targets. Last year we conducted research on active transportation in small towns, and the demand was extremely high.

Our third ask is to expand investment in health promotion. We currently administer the B.C. health improvement fund, but it only has $450,000. It prioritizes recovery from the pandemic, mitigating health impacts from climate change and reconciliation. Demand is extremely high, and our first call for proposals was overwhelming.

I would thank you for your thoughtful consideration. I’ll remind you that investments in health promotion have multiple benefits, by keeping people healthy in the community and protecting our precious health care resources.

J. Routledge (Chair): Thank you, Rita.

Now, we’ll ask Kane to make a presentation.

HEALTH SCIENCES ASSOCIATION OF B.C.

K. Tse: Good morning. The Health Sciences Association of B.C., or HSA, is the union that represents more than 20,000 health science and community social service professionals who deliver specialized services at over 250 hospitals, long-term-care homes, child development centres and community health and social service agencies. With members working at every level of health care and social service in communities all around the province, they have a unique perspective on the delivery and impact of critical services in B.C.

Our members are dedicated to better access, better outcomes and more comprehensive team-based care in an integrated public system that benefits all British Columbians. Thanks for inviting me to speak, and on behalf of our 20,000 health science and community social services professionals in B.C., thank you for taking the time to hear our views on the priorities for the coming budget.

On November 14, an unprecedented crisis hit the prov­ince of British Columbia. Over 20 rainfall records across B.C. were broken within a matter of hours, and floods washed out sections of Highway 1, Highway 99, Highway 7, Highway 3 and the Coquihalla Highway, effectively cutting off all overland transportation from the Lower Mainland to the rest of the country. The infrastructure on which the province depends had broken.

The government responded immediately with billions of public dollars, first to repair these roadways and then to make them stronger and more resilient. There was never any question that this was the right thing to do. It was the only thing to do, yet consider the public health care system, another critical piece of infrastructure on which the province depends. The crisis in our health care began many years ago and was made much worse by the pandemic.

We don’t have enough professionals to run the system. They are quitting, burning out, moving to other provinces or to the private sector, where they can earn more. Emergency rooms are closed. Clinics are shuttered. Health care is delayed or denied. Unlike the response to the highway crisis, there was no sure and urgent response to the health care crisis, but we need one. We need investment to first repair the health care system and then to make it more resilient.

Investment in new training seats to increase the supply of professionals to the system. Investment in recruitment and retention tools to keep them here in B.C., instead of losing them to other provinces and the private sector. Most of all, we need investment in fair wages, a long-overdue pay increase for the people who put themselves on the front lines in the pandemic to protect you and me — so that they can catch up with their colleagues in other provinces.

If we don’t, the health care system will collapse, as surely as a bridge that’s inundated with water. I urge you not to let that happen. I urge you to ensure that the next budget invests in a recovery plan for health care by investing in the people who deliver it.

In conclusion, our recommendations are: first, to address the severe shortage of public health science professionals by increasing wages to be competitive with other provinces and the private sector, by increasing post-secondary training spaces, and by increasing work satisfaction with higher staffing levels.

Our professions include medical laboratory technologists, physiotherapists, occupational therapists, pharma­cists, respiratory therapists, anaesthesia assistants, speech-language pathologists, medical imaging professionals, social workers, dietitians, radiation therapists and others.

[10:10 a.m.]

Second, we urge the government to expand mental health presumptive coverage to all health care and community social service professionals. In 2019, this was extended to emergency dispatchers, nurses and care aides to ensure that they had easier access to workers compensation for psychological injuries and work-related trauma. This was a very positive step by the B.C. government. However, it does not extend coverage to the whole team of health care and social service professionals, who face psychological injuries and trauma.

Three, rebuild public rehabilitative care in B.C. The Ministry of Health, the health authorities and the Ministry of Children and Family Development should begin re­building public rehabilitative services in the province, starting immediately with expanding in-patient and out-patient services at hospitals and child development centres, by filling vacancies and increasing baseline staffing.

Access to public rehabilitative care is stagnant or declining in most regions when looking at access to public therapists in relation to the growing population. The erosion and privatization of public rehabilitative care and out-patient closures is a result of inadequate funding and staffing levels as demand for services grows.

On behalf of the 20,000 professionals who are part of the health care team that keeps British Columbians healthy, we thank the committee for their time and consideration of our recommendations.

J. Routledge (Chair): Thank you, Kane.

I’ll now invite members of the committee to ask questions. We have roughly 15 minutes.

K. Kirkpatrick (Deputy Chair): This question is for Kane. First of all, thank you for everyone. That was very eye-opening and interesting.

Kane, do you know…? Has there been some research done, or something that is accessible and that we can see, so we understand what that pay gap is with those in the health sciences profession — versus, as you were speaking about, losing them to the private sector or to other prov­inces — just to get a sense of what the cost impact is and where it is? Are there specific professions within there that have got the biggest gaps?

Then, if I can sneak a second question in, is there a description of what rehabilitative care looks like and the kind of services that you are envisioning?

K. Tse: Sure. To your first question, about the studies, we have a number of studies. But one of them that we submitted, I want to say, last fall, was about privatization in physiotherapy and privatized services. There is quite a bit of data in there, as one example of where you can see the differences in the funding levels and the impact of that kind of service and care as well.

Then in terms of rehabilitative care, I can think of a few professions such as physiotherapy, occupational therapy, speech-language pathology. Those members are involved in providing care that helps, for example, when a patient completes a surgery or a service and they’re occupying an acute care bed. The rehabilitative care, as one example, provides them with the services so that they can get the treatment that they need so that they can be discharged from those acute care beds. That acute care bed can then be returned for the next patient, the next individual.

H. Yao: I have quite a few questions, but I will keep most of them for the second time around, if you guys don’t mind. I’ll go with the first question to Kelly.

Hi, Kelly. Thank you so much for your presentation. I’ve had such presentations quite a few times from the B.C. Cancer Agency in the past as well, about tobacco and how tobacco obviously is bringing a lot of pollutants, unfortunately, to our population. I guess my question right now is…. Based on my understanding, I believe alcohol is a big concern as well, and also sugar. Of course, we are hoping to make sure we create a stronger emphasis on how to keep our population healthy.

I assume the reason why you picked tobacco is because it’s right there as the most obvious one, or is it because the data supported the highest association between tobacco and cancer rates? That’s my question.

[10:15 a.m.]

K. Wilson Cull: Thank you very much for the question. Sure, the Canadian Cancer Society has been extremely focused on tobacco control for many, many years. I’m sure you’ve heard some iteration of this from our organization for decades now. We’re highly focused on the issue of tobacco for all the reasons that you talked about. The relationship between cancer and tobacco is very, very strong. We know that many, many types of cancers and cancer deaths have a direct relationship to tobacco use.

Certainly, there are many, many preventable causes of cancer, as well, that we are focused on. The CCS — I guess, a couple of things — recently funded and released a study called the ComPARe study, which really works to quantify the preventable burden of cancer in Canada. It looks at factors like tobacco but also other factors, like you mentioned — being overweight, sedentary behaviour, alcohol — and really kind of drills into how that preventable burden of cancer impacts Canadians.

In a broad stroke, we know that 40 percent of all cancers are preventable, so it’s a huge mandate of CCS to raise awareness of that preventable burden but also, from our point of view, create healthy built environments to support Canadians in making healthy choices.

The two pieces that you touched on, sugar and alcohol, are really interesting emerging bodies of work for us, really. We know the relationship between alcohol and cancer. There’s certainly a good body of evidence to support the fact that alcohol contributes to a number of different types of cancers.

We’re, I think, really seeing a shift amongst Canadians around the relationship between alcohol and cancer. We’ve seen even, over the last couple of years, a real growth in people understanding that there is that linkage and trying to really tune their consumption around that. I think throughout the pandemic that was a particularly strong public dialogue.

Our organization is looking at a number of policies and evaluating where we’re going to sit within this file. Things like alcohol warning labels are certainly raising a lot of public discussion lately. You will be seeing and hearing more from us on this topic, particularly as it relates to alcohol warning labels, which we are supportive of.

Sugar is another interesting piece. Another component of our work revolves around sugar-sweetened beverages. We have seen some jurisdictions introduce a tax on sugar-sweetened beverages or a manufacturers levy on sugar-sweetened beverages.

Newfoundland is a province that actually has introduced a levy on SSBs. It will be coming into effect in Sep­tember of this year, so we are really working to urge other provincial governments to follow their lead. B.C. lifted the PST exemption on sugar-sweetened beverages, I think, two budget cycles ago. Certainly, a step in the right direction, but we’d like to see more in the frame of a levy in terms of the Newfoundland model.

R. Merrifield: Well, first and foremost, thank you all for being here.

My first question — if I could have a second, that would be great — is to Kelly on the grief and bereavement and the mental health supports. Have you been coordinating at all with the B.C. Hospice and Palliative Care Association? I know that rather than competing for funding, looking at some collaborative efforts on that front….

K. Wilson Cull: Sure. Yes. Our space in the hospice, palliative care conversation is really an advocacy point of view. We’re working right across the country trying to raise awareness of palliative care, both with Canadians and with governments in terms of what policies are needed to support Canadians in their hospice, palliative care journey.

We work very closely with the Hospice and Palliative Care Association, and you’re actually going to see a mirroring ask from them in this budget submission as well. There is a lot of collaboration and connection on the asks. Not to speak for them, certainly, but I’m expecting that you’ll hear a similar gap in terms of grief and bereavement in their ask to this committee as well.

R. Merrifield: Okay. Thank you.

I’ll save my second question for the second round.

J. Routledge (Chair): Next we have Harwinder, followed by Brenda, and we’ll see how much time we have after that for follow-up questions.

H. Sandhu: Thank you, Kelly, Rita and Kane. Great presentations, and the work you do is commendable. I just have a comment and a question.

Kelly, thank you for raising the point. Often, we talk about opioid addictions and other addictions, which is great. We take action. I’ve always felt like we need to talk more about alcohol addiction awareness.

Sugar, also, you highlighted. The committee did have a discussion last year, as well, after hearing one presentation, and I wholeheartedly support what you’re saying. If there was a conversation, that may not deter people from using sugary drinks or whatnot, but my point was that that money can go towards the preventative measures or health care that we need, you know, the tax that we’ll implement.

[10:20 a.m.]

Kane, you mentioned about the care of people. Care is being denied to many people due to the problems you highlighted. In my understanding…. The reason I’m curiously asking this question…. Coming from a health care background for, now, two decades, I would say that we never deny care. We provide care to everyone. There have been waits, given other circumstances.

I wonder, when you alluded to that fact, as a health care professional…. Do we have any studies or stats or data representing that, when the care was denied? How big is that number, and in which circumstance has that happened? As a health care provider, it’s disturbing. That’s not the principle, and that’s not how it’s done in B.C. at least. Everybody gets the care they need, whether it’s a wait or quick.

K. Tse: What we’re hearing from our members are various reports, as staffing shortages become an issue. Often what is happening is…. In cases where there are, for example, treatments that are postponed or delayed, where the treatment is really not happening in a timely manner…. As a result, when they return for that delayed treatment, what they’re seeing is that the course of treatment will be different because of the progression of their situation.

We’re also hearing from our members about situations where they have a certain…. Again, due to the number of patients that they need to see in that time period, they’re required to triage, if you will, or determine the most urgent cases and then provide the minimum care but, perhaps, not the needed amount of care that would allow them to properly discharge the patient or to address the issue before having to move on.

These are the types of things that we’re hearing from our membership as well. It’s concerning about the potential impacts of these types of things. It is our belief that increasing the appropriate staffing levels would make sure that they’re not in these urgent situations, that they’re not having to make these decisions — where they know that there is the best care that they can provide.

H. Sandhu: A quick follow-up. Thank you for the answer. Thank you for the work you’re doing.

We have seen some incidents where people were not being properly assessed, whether due to workload and all, and they ended up going back. I was curious if there was any study or data that’s been conducted by any organizations you’re aware of or by your association. That is another factor that we need to highlight, and having stats and data really helps everybody to move in the right direction.

Once again, thank you.

K. Tse: Yeah. That’s something that we’re happy to work with the health authorities on. They really have the data on where that is. We would love to work with them, as well, to further look into these.

We’re hearing this more and more from, really, all across the province. Really, what is concerning is the widespread nature of it.

J. Routledge (Chair): Now we’ll hear from Brenda.

B. Bailey: Thank you to all of our presenters today.

My question is for Kelly, with the CCS. I’m interested in what you shared with us in regards to PSA testing — that folks who are not symptomatic don’t have coverage for that testing.

I think I heard correctly when you said eight other prov­inces cover that cost. So just confirm that for me. Also, do we have any data on what the difference makes? What is the delta between us not having provided that testing for free and other provinces that have? Do we see any differences in terms of early diagnosis? Does it move the dial, or is that something that’s been measured?

K. Wilson Cull: Thanks very much for the question.

Yes. Just confirming, eight other provinces. B.C. and Ontario are currently the only provinces that do not offer this testing at no charge for asymptomatic individuals.

In terms of outcomes, unfortunately, no, that’s not information that I have right at my fingertips. I would say, in broad strokes, that obviously where prostate cancer is…. There are not a lot of preventable components here. It is a cancer, like all cancers, really, that is most easily treated when it’s caught at a very early stage. We feel really passionate about the importance of this intervention, particularly given the genetic component that many prostate cancer patients have.

[10:25 a.m.]

I have to look back at the question that you’re specifically asking, but I could offer you some insights into some modelling that we have recently done to determine the cost of PSA testing in British Columbia. We are estimating that in 2020 there were approximately 25,000 individuals who were not covered by the province for PSA testing. This accounts for about 9 percent of all PSA tests that are done in the province.

Another interesting factor here is that for individuals who have to pay for a PSA test out of pocket, the cost is $35. That’s to that individual. Whereas if the government pays for the test — if the person, for example, is symptomatic — it only costs $11.44. That means that it would cost about $280,000, or just shy of $300,000, to cover those additional 25,000 people that are not currently covered.

Given the much lower cost to government…. You know, $300,000 is a lot, but in terms of removing barriers for people in being able to access the test when they have, for example, a family history, it could have a big difference in terms of outcomes.

The other piece I would raise here is that Black Canadians are at a higher risk for developing prostate cancer. So there’s certainly an equity lens to look through this issue as well.

J. Routledge (Chair): I think our time is up. There are additional questions, but we have run out of time.

Thank you for sparking our interest and our engagement in this important topic that you had. Thank you for framing your presentations in the context of the social determinants of health and, implicitly, the importance of prevention and putting it in the context of the fact that collectively, as a society, we have had quite a bit of experience lately about how to deal with crises. I think implicitly you’re telling us that we should transfer that awareness to the health care system and treat it like it’s a crisis. So thank you very much for that.

With that, we’ll say goodbye.

Now we’ll recess.

The committee recessed from 10:27 a.m. to 10:45 a.m.

[J. Routledge in the chair.]

J. Routledge (Chair): Our next panel is on mental health. We’ll hear from Jonathan Morris, Canadian Mental Health Association of B.C.; and Matthew Grifa, Canadian Addiction Treatment Centres.

We’ll hear a five-minute presentation from each of them in turn, and then we’ll open it up to questions from the committee for more or less an equivalent amount of time.

Jonathan, when you’re ready.

Budget Consultation Presentations
Panel 4 – Mental Health

CANADIAN MENTAL HEALTH
ASSOCIATION, B.C. DIVISION

J. Morris: Well, thank you very much, indeed, Committee Chair. It’s an honour to be here.

I’m joining you from unceded Lək̓ʷəŋin̓əŋ-speaking territories this morning.

I think many of you around this table at the committee know the Canadian Mental Health Association well, so I won’t linger here except to say we’re one of Canada’s most established national charitable organizations, and our vision is mentally healthy people in a healthy society.

Last year we had the honour and the privilege of presenting at this committee, and we shared some important statistics that I think are important to refresh for you as a committee. I think there’s a very strong awareness that at this current juncture, mental health and substance use is top of mind, given the compounding impacts of crises that we are experiencing here across the province.

Over a third of people in this province and across the country report a decline in their mental health since the start of the pandemic, which is a staggering amount of people, with 9,400 people having lost their lives due to the illicit drug toxicity crisis here in the province and 20,000 people during the year of April 2020 to March 2021 who were detained involuntarily in the province’s mental health system — a huge increase over the past decade there.

Most recently, if we look at the B.C. coroner’s report on the heat dome, 64 percent of those deaths were with people who were living with a chronic health condition, including depression, anxiety, schizophrenia and substance use problems.

Last year, when we were in front of the committee, we presented a core recommendation and then a very specific recommendation on crisis. I’m really pleased to say that in Budget 2022, we saw a $1.26 million investment in one of the recommendations we brought forward to this committee. That was related to crisis care in communities. I’m happy to share details on that at a future date.

I’m here today to make a recommendation to this committee, as you consider your planning for this next fiscal year, to look at three things. I’ll start in order here.

Lifting the base of health authority mental health spending by $200 million would make a significant difference in absolving some of the capacity and need in our existing mental health system in the province. The burden and need is being felt across the health system, including in mental health. Also, lifting the base in community mental health and substance use spending by an additional $200 million.

At the start of this administration, CMHA called for a $2 billion increase overall, and the province here, over the past number of years, has managed to achieve incremental increases in mental health spending to the tune of about $1.1 billion. So we incrementally keep getting closer to that goal in that net spend, and we encourage the committee to consider additional investments to get to that overall goal of $2 billion to improve the mental health and substance use system in this province. We’ll add some more detail to our written submission that we’ll submit during the consultation period.

Finally, as I noted, we were very, very excited to receive some pilot funds from the province in and around last year’s budget — $1.26 million attached to budget — for the piloting of peer-assisted care teams across a number of communities. That’s in addition to some incremental funding from the province from other sources.

I’m pleased to report that the North Shore implementation…. I know the Deputy Chair of this committee is attached to the constituency where one of these teams is operating.

[10:50 a.m.]

On the North Shore, it’s close to 300 calls taken since inception with very, very minimal reliance upon the police needing to respond or even the need to go to an ER. So that team is very much starting to pay for itself, improving the human experience of crisis care but also reducing reliance upon other services.

My final recommendation is to extend and expand the funding for an effective and comprehensive mental health crisis response system that provides care before, during and after a crisis, and aids recovery. There’s an opportunity this year, as we prove out the business case and the economic case and the human case, for PACT to consider extending the funding for those investments, and also expanding and scaling those teams. We’ve heard from the city of Vancouver, from Delta, from Merritt and from a number of other communities who are keen to see these teams. We’ll be launching in New Westminster and Victoria this summer, as planned.

There’s an opportunity for this committee to think about crisis receiving and stabilization facilities as part of new investments. We briefed you on this last year, but we’ve learned, as we build out these teams, that we do need alternative spaces to support people other than an emergency department. Creating new crisis receiving and stabilization facilities as part of a pilot would dovetail nicely with the Peer Assisted Care Teams that you’ve helped us launch during this fiscal year.

I’ll stop there, and thank you so much for your care and attention.

J. Routledge (Chair): Thank you, Jonathan.

Over to Matthew.

CANADIAN ADDICTION TREATMENT CENTRES

M. Grifa: Thank you very much, committee members. Hello, and how’s your day going? Thank you for the opportunity to speak with you today. My name is Matthew Grifa. I’m the CEO of Canadian Addiction Treatment Centres, or CATC.

Our organization is the largest provider of opiate addiction treatment services in Canada. Our clinics are located in British Columbia, Ontario and New Brunswick. We operate over 80 centres across the country, delivering evidence-based, integrated clinical, medical and pharmacy services to over 19,000 patients per month. We have clinics in Vancouver, Surrey, Abbotsford, Chilliwack and New Westminster. We also deliver virtual addiction treatment services to Kitimat and Terrace through a partnership with the First Nations Health Authority.

In the recent presentation to the Select Standing Committee on Health, access to opiate agonist therapies, or OAT, is a priority for the First Nations Health Authority. In addition, we know that the expansion of access to OAT and injectable OAT is a priority for the provincial health officer.

Our patients are people of all demographics. They come to our clinics, or clinics like ours, with the goal of managing their addictions and living healthier, happier and more productive lives. We utilize the comprehensive care model that meets the broader care needs of our patients. We provide medication-assisted treatment options, utilizing methadone, buprenorphine and slow-release oral morphine. In addition, we provide patients with access to basic primary care, hep C and HIV treatment wherever possible, as well as access to harm reduction alternatives, such as needle exchange programs and naloxone kits.

CATC prides itself on meeting patients where they’re at, whether that means they’re still using drugs but looking for support to use less, or whether they’ve had success with OAT and want to manage their addictions moving forward. The ability of our patients to access all of these services in one location creates familiarity and trust, which assists in a continuity of care and counselling supports.

While B.C. has taken significant steps forward in the last several years, there are consistent challenges which prevent many people from accessing opiate addiction treatment services in the province. It is important for me to tell you that there’s a missing middle in addiction treatment in B.C. I know that physicians in British Columbia are currently negotiating a new contract with the government, and the current fee-for-service funding model is an important issue in those discussions.

In our case, the current fee-for-service funding model covers some clinical care, but CATC and other clinics like ours are limited in our ability to offer wraparound services such as counselling support. There’s no stable and dedicated funding model available for all British Columbians to access the addiction treatment and ancillary services we provide. Not everyone is covered through government support or employer-paid health plans.

CATC sees many low- and middle-income patients whose only option to access addiction treatment is to pay, at least partially, out of pocket with their already-stretched resources. I think I can articulate this point quite clearly by telling you a quick but very real story.

Recently a couple came to one of our clinics in the Fraser Valley to seek treatment. They apologized for being late and mentioned they’d recently found stable housing after being homeless. They also described how the husband had recently found employment, so they were no longer eligible for any social assistance. After meeting with one of our physicians and receiving treatment plans, our support team prepared to book their next appointments and discuss the fee that they would have to pay to support their ongoing treatment.

That conversation was difficult, as they described the impact those fees would have on their monthly income. Our team assured them that we would do everything we could to continue the services while we worked on a solution together and suggested that they applied for government funding to cover the costs.

[10:55 a.m.]

The couple left the clinic with the required forms and never returned. The government of B.C. should bridge this funding gap, so prospective patients don’t have to. What could be more important than equitable access to addiction treatment while we’re in the throes of an opiate overdose crisis? We desperately need to increase access to treatment services for low- and middle-income British Columbians.

So what is our ask? Our ask is that the government of British Columbia remove an ongoing financial barrier to seeking opioid addiction treatment for all British Columbians.

How can that happen? The monthly alcohol and drug fee paid by the Ministry of Social Development and Pov­erty Reduction should be paid for all patients seeking opioid addiction treatment services. That means across the province and not just in clinics operated by CATC.

Currently about 40 percent of our patients qualify for financial assistance, based on existing income-based thresholds. The other 60 percent are forced to pay out of pocket for the ancillary services, like counselling, that we offer. This payment interaction with the health care system brings with it additional stigma and shame.

Our overworked clinicians are forced to become collection agents, which brings mistrust of the therapeutic relationship that they’re trying to build with their patients. Everyone who works in the system hates this payment interaction. The clinician-turned-cashier situation happens in every opioid addiction treatment clinic in B.C.

How much will what we propose cost? Extending the alcohol and drug fee to patients seeking care with CATC would cost the B.C. government approximately $1.3 million a year. Extending that same fee to all patients seeking care at all locations across the province — excluding centres funded by regional health authorities — would cost the B.C. government approximately $10 million a year. That’s based on our estimates of publicly available information.

The return on this relatively modest investment would be exponential when considering the full impact of in­creased productivity, lower health care spending and reduced criminal justice costs.

Thank you so much for your time.

J. Routledge (Chair): Thank you, Matthew.

Now I will invite the committee members to ask some questions.

B. Bailey: Thank you, both, for your presentations.

Matthew, I specifically want to ask you…. I’m going to try to sneak two quick questions in, if I may, but they’re very short. My first one is…. I’m aware that at UBC there is a peer support program for supporting students who are struggling with addictions. I’m wondering if that’s part of your service. That’s my quick question that I’m sneaking in on the side.

The real question that I’d like to kind of dig at a little bit is your very interesting suggestion that there could be a solution to the gap that you’ve described for merely $10 million. That’s exciting to think about.

I wonder if you could just expand a little bit for me how you came to that number. I heard you say that there were a couple of things that were excluded in terms of if you’re not counting the regional health centres, I think you said.

If you could just help me understand that a little bit more, because that’s intriguing.

M. Grifa: On the first question, we don’t necessarily partner with UBC on anything in particular; although, we do have volunteer peer support workers that from time to time provide support and work with some of our existing patients. We do that wherever we can.

On the second point around how we arrived at the $10 million, in our clinics, the fee I described is a $100-per-month, per-patient fee. Multiplying our number of pa­tients by 60 percent…. Those that don’t already qualify, because some do qualify for that rate, and we’re being paid for that — to provide counselling, etc.

If you take the estimated portion of $100 per month, per patient, by the number of patients that we roughly estimate, based on our numbers across the province, who would otherwise not be already covered for a similar fee…. Again, extending…. So this would be any “private” clinic operator, of which there are numerous across the province, the non–regional health authority locations where patients may attend.

I was just trying to extrapolate our experience across the entire province.

B. Bailey: Thanks.

K. Kirkpatrick (Deputy Chair): A quick comment, and then a question.

Jonny, have you changed your name to Jonathan? That’s not my question, but it confused me when I looked at the list here.

I wanted to give a shout-out for the PACT program on the North Shore that’s being funded. It’s different than the Car 67, which I hadn’t realized, in that it provides that ongoing support in recognizing people in the community that can have follow-up. Thank you. It’s a beautiful program.

My question is for Matthew. I’m going to limit it to one question to start with here. It’s one big question. Are you non-profit or private, and do you have contracts, at this point, with government — providing services on their behalf?

[11:00 a.m.]

M. Grifa: We are a private organization. We don’t contract with the government directly. We contract with physicians to deliver clinical care to patients. So we have, obviously, the clinicians and the patients attending in our facilities. And then we provide counselling and ancillary services using the fees that I’ve just mentioned.

R. Merrifield: I actually have an ask of Jonathan, and that is: in your written submission, could you provide the $2-billion-a-year breakdown that you had indicated was necessary to really tackle the mental health crisis in B.C.? I would really appreciate seeing that. And then just any annotations of what is currently being funded, what is still yet to be funded and how both of your $200 million asks come into play with that. It would just, I think, be helpful for me to see it in full context.

Then the second is actually for Matthew. I’m going to echo what Brenda had mentioned, and that is that $10 million seems like a drop in the bucket for equitable access to treatment services. Definitely, you don’t want to see people being turned away. My question is this: how are you networked with other facilities across B.C.? Would they echo this same sort of ask? I know that might be unfair, in terms of putting words into their mouths. But that $10 million — how would that necessarily impact them as well?

M. Grifa: Yeah, absolutely. I appreciate…. Just to be clear, I guess — I’m sure it is clear — this is one small barrier that we are talking about, in this case, for a specific set of funding options. Jonathan’s point is that the need for funding is much, much bigger than that. But we’re trying to take away one very specific barrier to care.

Although there is no formal network of cooperation, if you will, amongst clinic operators in B.C., I do know, on an informal basis…. I am chatting all the time and understanding people’s experiences with different types of medication, different patients, etc., so I can fairly confidently say, without putting words in their mouths, that they would absolutely echo the request and the experiences that I’ve related to you today.

People will attend, not being able to pay $100 a month, rack up large balances and then feel that they have to switch providers because they don’t want to keep coming back, having the same conversation about a relatively modest sum of money time and again. I know that this is an ongoing challenge across the province.

R. Merrifield: Perfect. Just one other question, and this would be to Matthew.

Are you aware of the wait-list right now for treatment across B.C.? Do you know what that number would be?

M. Grifa: I don’t. I don’t know that. We don’t have any wait-lists at our centres. I can tell you that. But I’m aware that some exist.

B. Stewart: Of course, this is a really important topic. I want to just ask both of you…. The treatment that, Matthew, you’re providing…. I don’t know if that’s consistent, best practices or whatever. What’s the success rate? I guess, considering that we’ve got six people a day dying from opioid overdoses, we’re obviously interested in the solution. I’m asking about the success rate in getting people from being addicted off opioids.

M. Grifa: Sure. I can speak very specifically to opioid agonist therapy.

Jonathan, please chime in beyond that.

Opioid agonist therapy is a therapy that has existed for decades in British Columbia and across the world, frankly. Different therapies have evolved over time, but in our experience….

As a way to try to approximate success on program, we do measure retention on program as a proxy for some other life improvement outcomes that we don’t necessarily measure and don’t track particularly well with all of our clients, because they’re just not willing to disclose some of the information. So our retention rates after 90 days would be in the 40 percent range. And if people do….

The longer you stay with the program, the higher the chances that you’re going to have stability and ongoing success, not only within the program but beyond that. Our one-year retention rates are more like 60 percent for those that make it through one year — after one year on a program.

[11:05 a.m.]

Now of course, to be fair, that is becoming more difficult as fentanyl has crept into the system. It’s more potent. The supply is more toxic than ever, so retention rates and just getting people stabilized and on the program has become more of a challenge for our clinicians than ever before.

J. Morris: MLA Stewart, thanks for your question. I’m in front of the health committee later this week.

This committee may not be aware, but a number of years ago we were given a one-time grant to both convert a number of private paid beds into publicly accessible beds and also resource a number of operators around the province. I’ll be presenting some data, because we actually have been able to collect occupancy rate data.

We’re seeing, currently, an 83 percent occupancy rate of those publicly funded beds. Almost 40 percent of referrals we saw last quarter were from Indigenous communities, and 256 clients over the course of this pilot were admitted on OAT. We’ve been really wanting recovery operators to support people coming in on OAT, make sure that they’re not being tapered off. Then we’re also to track how many people have maintained OAT on their way out. It should be data I share with Matt here, as well.

I’ll be bringing forward a comprehensive review of that investment later this week. There’s some good data that I think would be quite compelling for members of this committee as well, so we can send that around too.

J. Routledge (Chair): I think we have time for one more quick question, and that’s from Henry.

H. Yao: Unfortunately, I don’t have a quick one. I have a long question to ask. I can email them afterwards, I guess.

I’m going to talk to Johnathan. You mentioned talking about maybe around an alternative emergency facility where you can help people dealing with mental health crises. I think that’s such a great idea to introduce. But one thing that sort of troubles me a bit is that I’m always worried about stigmatization with people going to certain facilities, especially if it’s been labelled something similar.

I would love to hear feedback. What kind of suggestions do you have to help us to ensure that, if we do introduce something similar to that…? How can we combat stigmatization or avoid the unnecessary general categorizations of the people who will be sent there to receive treatments so they can walk out without the fear of being judged?

J. Morris: Yes. We could spend all day on this, but I’ll be brief for the committee, Chair.

Currently, I would say that people who are brought into the emergency room experience profound stigma, because many of them are sitting next to an armed police officer for many hours pending an admission. We saw 20,000 involuntary admissions. If you just even attach a $1,000 cost to each of those admissions for one year, we’re talking about millions of dollars of cost for actually simply waiting in an ER waiting room. Those folks are competing with motor vehicle accidents and heart attacks.

Some hospitals have done a good job, here in B.C., of creating spaces for people coming in for mental health reasons so that they don’t experience stigma. But what’s been contemplated in a number of other jurisdictions is crisis care stabilization, where you have health responders, including peers, in facilities that sit outside of hospitals, where people can experience drop-in care without the need to sit in the bright lights of an emergency room. Many report better experiences of care, a reduction in the use of emergency room resources and also better outcomes, including the prevention of suicide.

I’ll add some detail to our written submission there, because all that I’ve described is really about stigma reduction. I really appreciate your question. We do have to find a better way forward when it comes to the use of the ER around mental health emergency care.

J. Routledge (Chair): Well, sadly, we are out of time. I think this is the beginning of what could be a much bigger, deeper conversation.

I want to thank you for taking the time to meet with us and engage with us. I’ve got to say, the thought that I’m left with is that perhaps before our recent massive health care crisis, the pandemic, maybe a lot of us thought that mental health was a marginal issue. I think we’ve now discovered that it actually could be a defining issue of our society and that we need to treat it as such. Thank you for framing it for us that way. It has certainly focused my views and, I’m sure, those of the committee as well. Thank you again.

[11:10 a.m.]

We’ll go right to our next panel, which is on long-term care. We have Penny MacCourt, representing Action for Reform of Residential Care; Kim Slater, Family Councils of B.C.; and Ayendri Riddell, B.C. Health Coalition.

If you’re ready, we’re ready.

We can start with Penny.

Budget Consultation Presentations
Panel 5 – Long-term Care

ACTION FOR REFORM
OF RESIDENTIAL CARE

P. MacCourt: [Audio interrupted.]

Thank you for the opportunity to advocate today on behalf of seniors living in B.C. long-term-care facilities, their families and their staff. ARRC B.C. is a residential care advocacy group with close to 900 individual members, who are dedicated to promoting quality of life in long-term-care facilities in B.C. The association is made up of clinicians, researchers, family members and other citizens concerned with the care provided in long-term care. Our goal is a long-term-care system where residents are supported to live their lives as fully and joyfully as possible.

The 80-page ARRC report published in 2021 enjoys support from 50 diverse organizations representing seniors, health-care providers, professionals, unions, academics and institutions from every region of our province. It introduces the ARRC proposal for a COVID/LTC advisory forum, which we believe is needed to guide residential care through the remainder of the pandemic and lead reform of the current system. In preparation for today’s presentation, we submitted the report and our proposal for an advisory forum.

I’ll focus the rest of my time today on why we believe the Ministry of Health should fund and lead an advisory forum. Why is such a comprehensive strategy needed? It’s because COVID-19 shone a spotlight on the broken long-term-care system. Too many buildings are old, crowded and institutional. Food is institutional in nature too. There’s often no safe access to outdoor spaces. Only 6 percent of people living in care can access quality care services at the end of their life.

The front-line workforce crucial to resident well-being remains precarious. Staff are burning out from workload and stress and developing mental health issues which will have long-lasting effects. Too many are leaving the field, causing even greater staff shortages. The number of RNs leading care has been steadily eroded over time. In most facilities, there is minimal coverage, if any, by recreational therapists, occupational therapists, physiotherapists and social workers to care for the steadily increasing acuity of resident care needs.

Facilities lack oversight that is effective. The criteria and processes for monitoring quality of life and quality of care are inadequate. Families have become the backbone of care, silent partners performing feeding, bathing and social, emotional and psychological care. Many of them feel like their voices are not valued or appreciated and that they’re not recognized as partners in care. Too many residents died during the pandemic, alone, as angry and grief-stricken family members stood outside the building looking in, their hands on the window.

These inadequacies, which are the result of decades of systemic neglect, were revealed to the public because of the devastating effects of COVID-19. They’re not actually new. In March of last year, the Canadian Institute for Health Information reported that the proportion of COVID-19 deaths in Canadian long-term-care and retirement-home residents, at 69 percent, has remained significantly higher than the international average of 41 percent, which is pretty sad.

For too long, the long-term-care system has failed its elder population. Good intentions and a piecemeal, reactive approach to change is no longer enough. We need a strategy. ARRC has submitted our proposal for a COVID and long-term-care advisory forum to the Ministry of Health. The mandate for this leadership group would be to support care facilities through the remainder of the pandemic and then to begin planning and implementing sustainable reform of the system.

A diverse, multisectoral, collaborative, goal-focused advisory forum tasked to create change for the common good is the most cost-effective and humane strategy to move B.C.’s long-term care forward. The proposal recommends that the advisory forum be structured to harness the expertise and energy of government, health care providers, residents, gerontologists, [audio interrupted] and citizens.

[11:15 a.m.]

The terms of reference for this working group would be specific and goal-focused. Such a group would mobilize evidence-based practice to move research into practice. The first phase would direct ongoing support to residential care facilities through the remaining months or years of the COVID-19 pandemic. Phase 2 would develop a comprehensive provincial action plan to reform long-term care by addressing long-standing systemic issues and also taking into context the larger seniors continuum. We don’t want to rob Peter to pay Paul.

The advisory forum would transform the design and operation that speaks to facility care to create environments that look and feel like home, where staff are supported to provide relational and person-centred care, where quality of care and life are facilitated and effectively monitored.

B.C. has the opportunity to become a leader in this field, the first in the country to reform long-term care in a meaningful way. The cost of funding of our proposal for an advisory forum will be feasible because we know we can count on the expertise and energy of countless volunteers with diverse expertise and lived experience — individuals and organizations. The commitment is there, and the NDP government is well positioned to lead the way. B.C. would be the first province in Canada to create an action plan that would actually improve quality of life for people in long-term care.

Documentation and publication of viable and cost-effective solutions to existing COVID challenges would also reflect well on us. We’ve got gerontological researchers all over the place. We mustn’t lose the momentum for change generated by the pandemic. We don’t need any more studies or research; we need a strategy. We know what the challenges are.

J. Routledge (Chair): Thank you, Penny.

Now we’ll turn to Kim.

FAMILY COUNCILS OF B.C.

K. Slater: Thank you very much for this opportunity. I’m going to talk to you about residents in long-term care and two of the most important things that we can do to improve the quality of their care and their quality of life. I’ll begin with family councils. They are residents’ loved ones who want to exercise an independent collective voice in the policy decisions that impact on long-term care. Their recommendations come from direct lived experiences in the middle of the system.

Regional associations of family councils are made of these individual councils, and they share common experiences between communities — concerns and ideas about long-term care — and they bring their common experiences and ideas to our provincial association, which is now composed of regional associations from every health authority in the province. We aspire to take our common important recommendations, which are now identified as systemic needs, directly to the Ministry of Health. Our recommendations are important.

We’ve tried hard to build and sustain these important organizations, but the truth is we really struggle to do it alone, and here’s why. I’ll use an example to make my point. People who get involved in parent advisory councils in B.C. schools are usually there for 12 years, sometimes more. Their membership tends to be full of informed advocates, because they’ve had years to get informed. They have structured communication networks, information centres and funding to help make those things happen, and they have a direct link to the Ministry of Education.

Well, in long-term care, just about the time that family members even figure out how long-term care works and they understand all the rules that surround it, their loved ones die. At just about the time that they hear of innovations or better practices, their loved ones die. This situation is repeated with every new entry into long-term care, and people who lose residents tend to move on themselves.

The truth is our system currently heavily relies on peo­ple like me, who are willing to stay involved well after. In my case, my mother passed away. I also had the advantage of being involved for quite a while because of the length of my mother’s stay, but people like me are exhausted. I’ve done this for 20 years. Remember that unlike PAC members, most advocates that we’re talking about today are in fact elderly spouses.

[11:20 a.m.]

We’re seeking funding so that we can hire just two very qualified people to help us build things like association websites and community networks and systems, provide support and timely information for family members and individual councils and their larger associations, and help all councils to network. They would also help manage other special projects that would come our way. Our ask is in the neighbourhood of $300,000 per year — which, by the way, is a fraction of what’s spent in Ontario for a similar system in long-term care.

Our second ask is for something that’s long overdue — certainly in B.C. but, in fact, all across Canada. Penny’s right that there was shock and despair, especially among family members here, in the dark days of COVID, because it, in fact, exposed many weaknesses that have existed for a long time.

Our seniors are living longer. Within that reality come more chronic diseases such as dementia and other complex challenges, but we have not had a comprehensive plan to meet the needs of these changing residents. We haven’t dared to imagine a better way to deliver services to them. We haven’t imagined ways to make, as an example, care delivery universally person-centred and delivered by respected, skilled workers where quality of care and quality of life is a lens through which we make our policy decisions.

Well, it’s time to do that. That’s, in fact, what Penny is proposing in the advisory forum: reimagining long-term care. The proposal has received the support of literally thousands of people across B.C. — experts, advocates, family members. Our own organization has very enthusiastically supported the idea.

We ask that the Ministry of Health support and fund this very, very important initiative. Today’s long-term-care residents and future residents need us to act on their behalf. When we consider that the seniors demographic is the fastest-growing demographic in Canada, it’s really important that we make this happen. We’ve got to get it right.

J. Routledge (Chair): Can you wrap it up, Kim, please?

K. Slater: Yeah, I’m wrapped up. That’s it.

J. Routledge (Chair): Okay. Thank you very much. You will have another opportunity to elaborate during our time of questions from the committee.

I’ll now turn it over to Ayendri Riddell with B.C. Health Coalition.

B.C. HEALTH COALITION

A. Riddell: Thank you for the opportunity to make a submission regarding Budget 2023. I’m here representing the B.C. Health Coalition. We are a not-for-profit, non-partisan coalition of individuals and organizations dedi­cated to the preservation and improvement of public health care in British Columbia. Our membership is comprised of over 800,000 people, including community service providers, health policy researchers, NGOs, health care workers, trade unions and concerned individuals. I’d also like to support the recommendations put forward by Penny and Kim.

The province currently faces a crisis in seniors care, in primary health care access and in recruitment and retention of health care staff. These crises were exacerbated by the COVID-19 pandemic but were created by years upon years of short-term thinking that not only avoided making necessary investments in our health care system but drained it of its resources through privatization.

The evidence tells us that public health care is not only equitable; it also offers better quality, more efficient and cost-effective care. Now more than ever, we need an investment in our universal public health care system so that it can effectively address the needs of all B.C. residents.

With that context in mind, the B.C. Health Coalition submits the three following recommendations.

We need to ensure public money is not kept as profits by holding private operators of long-term-care homes accountable for the funding they receive and ensuring all new capital investments are publicly or not-for-profit-operated; to improve access to publicly funded home care by eliminating current, regulated daily rate co-payments and by addressing the staffing crisis with higher wages and guaranteed hours of work; and to address the primary health care access crisis by investing in community health centres that offer comprehensive, longitudinal team-based primary health care.

[11:25 a.m.]

I will start with the first recommendation. We need to ensure that public money is not kept for profit by holding private operators of long-term-care homes accountable for the funding they receive and ensuring that all new capital investments are public- or not-for-profit-operated.

In the 2020 report A Billion Reasons to Care, the B.C. seniors advocate found that despite receiving the same level of public funding, for-profit long-term-care operators were spending about $10,000 less, each year, per resident than non-profit operators. Those public funds, which were designated to be used for the care of seniors, were and continue to be pocketed as profits.

We need to ensure public money intended for the care of seniors is spent on the care of seniors by requiring that all contracted long-term-care facilities that receive public money, both not-for-profit and for-profit, clearly and publicly report revenues and expenditures and that all surplus funds be spent on the care of seniors or be returned; by embedding a standard for direct-care hours in provincial regulation that includes a clear guideline for monitoring and reporting so that staffing ratios and actual delivered hours can be verified and enforced with penalties; and by requiring that all publicly funded long-term-care operators be of the same public sector master collective agreement and banning exploitative subcontracting practices.

Finally, we need to ensure that the funding for new builds cannot be used to pay for infrastructure that will be owned as assets by for-profit operators.

Our second recommendation is to improve publicly funded home care. Older adults, nearly unanimously, wish to live independently at home for as long as possible. However, without adequate home care access, many seniors experience health decline more rapidly, and family caregivers become overextended, pushing seniors to move into long-term care earlier than necessary.

Our two recommendations are to remove the co-payments, which represent a significant financial barrier to this essential service, and to urgently address the staffing crisis by increasing the wages of community health care workers, so that they are paid the same no matter where they work, and creating stable conditions by guaranteeing hours. I include data about this in our written submissions.

Our third recommendation is to address the primary health care access crisis by investing in community health centres that offer comprehensive and longitudinal team-based primary health care. Currently B.C. is experiencing a primary health care access crisis. This has been attributed to a family physician shortage. However, B.C. currently has more family physicians per capita than at any other time. The actual crisis is that our current primary health care model is unsustainable to work in.

Community health centres offer family doctors and other health care practitioners the opportunity to work in a team-based primary health care model, where they can be paid a predictable salary while also giving patients a higher quality of care. CHCs are community-governed, not-for-profit, primary care organizations that provide integrated health care and social services, with a focus on addressing the social determinants of health.

There’s a growing body of evidence that CHCs do better than other models at providing preventative care, supporting people’s chronic conditions, reducing reliance on hospital emergency services and improving care and support for a broad range of vulnerable populations.

I’ll include more data about that in our written submissions, as well, as I see that I’ve run out of time.

J. Routledge (Chair): Thank you so much.

I’ll now invite members of the committee to engage you all further with some questions.

H. Yao: A question for all three, actually. I keep on hearing about how long-term health care needs a system overhaul and how so much change needs to be done. I guess my question….

Obviously, we have a specific Parliamentary Secretary for Seniors Services. Was there any discussion with the parliamentary secretary in regard to having more of a systematic re-evaluation of what we can do about our long-term care?

A. Riddell: I can speak to that quickly. Yes, we have been in conversation with Parliamentary Secretary Mable Elmore. There has been an announcement around standardizing funding for long-term care, which has the potential to really shift things, especially with some of the recommendations I made.

However, right now that’s being undertaken by a private firm. We really believe that we need community input and front-line workers to organizations like ARRC and Family Councils to be a part of that process. This can’t just be a political negotiation; we need to really rely on evidence and experiences of seniors and families.

[11:30 a.m.]

K. Slater: Could I add a thought to that?

Currently we’ve got a system in B.C. where the stakeholders, and I’ll speak specifically about long-term care, are made up of the Ministry of Health; health authorities; care providers themselves — you know, the B.C. Care Providers Association; and health care unions. What’s missing in that kind of system, and this is why we’re pushing for a greater voice for communities, are the voices coming from the very people who are sending loved ones into care and experiencing that care.

Now, I am aware that the Ministry of Health is working to strengthen that community voice by revisiting regulations and policies around family councils to prevent facilities from just ignoring them, etc., but more needs to be done. We still have those situations that I described. People have to relearn things over and over again as they’re cycling through, say, long-term care — hence the need for this two-body oversight, source of information that we’re asking for.

I also think there needs to be a voice coming from the community members that says: “Look, we need more person-centred, relational kinds of care.” One of the biggest issues is that our success seems to be measured in terms of tasks completed in long-term care, instead of the quality of life and good quality of care that come from more person-focused attention.

Does that make sense to you, what I’m saying? Okay.

P. MacCourt: May I add something to that?

J. Routledge (Chair): Yes, please do.

P. MacCourt: Okay. I think what Kim was saying there about the measures…. When we wrote the ARRC report, we reviewed the licensing criteria. We also looked at the accreditation criteria, and [audio interrupted] look at quality of care — measure quality of care, look at quality of care beyond paper or quality of life.

I might point out that the for-profit organizations that were put under administration just prior to COVID had all been renewed by licensing over and over. All of them had had accreditation granted to them two months before they were put under administration. So the measurement isn’t right. They’re not asking the right questions. We need a different system for that.

J. Routledge (Chair): Thank you.

Our next question is from Karin.

K. Kirkpatrick (Deputy Chair): Thank you very much, Chair.

It’s for Ayendri. I apologize if I’ve butchered your name. Everyone butchers mine.

I want to clarify one of the points you said. You said B.C. has more physicians than other jurisdictions. You were talking about the primary care team-based model. Just so I understand it, are you suggesting or recommending that a team-based primary care model is something that replaces individuals being attached to one family physician? Are those two things different?

A. Riddell: That’s a very good question. Just to clarify the fact around the family physicians, I’m articulating right now that there is a primary care access crisis. People think it’s a shortage of family physicians, but the reality is that we actually have more family physicians per capita than ever before. They’re simply not working in primary care right now.

The solution we’re putting forward is…. One of the reasons is that our current primary care model is just not sustainable. Community health centres are a team-based model. To clarify, attachment to a family physician would still occur. Family physicians work best when they are working within a team and are able to connect with other specialists — not just specialists but other needs and social services needs that a community might need addressed. That is the position that we’re talking about.

[11:35 a.m.]

Attachment sometimes means quite a large burden on family physicians. One of our key recommendations is implementing a global funding model that ensures that funding for overhead is separated from funding for positions. So you are able to build those teams in a more equitable way than actually just through a hierarchical model through the family physicians.

K. Kirkpatrick (Deputy Chair): That’s great. Thank you.

H. Yao: Thank you so much. I would love to have a little bit of conversation around additional funding for home care. I think one of the things…. Before, in my past life, as an MLA, I worked on a few cases regarding home care. We talked about the number of baths they get, the number of people cleaning, the number of meals they prepare, and we talked about additional funds.

I would love to learn from you. When we’re talking about additional funding, what kind of increases of quality of life are you suggesting? Which areas can we actually increase funding in to ensure that our seniors, as you mentioned earlier, can spend more time in their space of comfort instead of being rushed into long-term care before they are ready to go?

A. Riddell: To be specific, home care…. Again, according to the B.C. office of the seniors advocate’s report from 2019, home care actually makes a lot of economic sense to invest in. While subsidizing a long-term-care bed costs the taxpayer about $57,500 per year, two hours of daily home support saves an average of $29,860 per year. That’s because people will maybe be able to stay at home for longer with home support.

For the increased funding, there are two very specific ways that I outline. One, right now we have something called co-payment. These co-payments really just act as a hindrance to deter seniors from actually accessing home care. We’re one of the last provinces that still have this barrier in place.

There would be a sharp increase in demand if we removed this co-payment, but investing in home care all together would reduce the burden on long-term care and then, in the long term, actually save us money — and just improving quality of life.

The second and very important way, I think, is to ad­dress the staffing crisis in home care. Most home care workers also…. It’s a lot of the same work that is happening in long-term care, or in other spaces, but in facilities, actually, you are paid more for that work, and there are more sustainable hours.

Community health workers who provide home support services are paid less than care aides with equivalent training who are offering comparable care in other sectors. More than 75 percent of them are employed in part-time or casual positions. Increasing community health workers to be levelled with those of other care aides — just levelled — in LTC and guaranteeing hours will stabilize that workforce.

It’s not a coincidence that this workforce is overwhelmingly female, deeply undercompensated and also working in precarious positions. The work that’s done at home and in community is very gendered and, honestly, very undervalued. So we really just need to invest in it.

J. Routledge (Chair): Renee has a question, followed by Brenda.

If we have time, we can go back to another question from Henry.

R. Merrifield: Thank you, each, for your presentations and for your advocacy work on behalf of seniors. Having four aging parents currently, it’s definitely a topic near and dear to my heart.

My question is actually to Ayendri. I wanted to clarify something that you said — that right now a long-term-care bed is about $57,000 in cost, and you said that home care saves $29,000.

Did I get that correct? Or it costs $29,000? It’s really not that big of a difference. It’s $28,000.

A. Riddell: Oh, no. It saves. That’s out of the seniors advocate report. I can follow up with that data to give you a link to it, but it saves.

R. Merrifield: Great. I can get that out of that report.

I love that each of your presentations were really centred around the quality of life and patient-centric.

My question is to Ayendri again. That is on the home care improvements. Has there been work done to quantify what dollar figure we would need to allocate in order to supply to the seniors currently wanting home care or needing home care? Has that work been done, and is that available to us?

A. Riddell: I think that work is being done. Currently the seniors advocate’s office has told us that they are issuing another report. I’m hoping something like that is included.

[11:40 a.m.]

I can actually look up that data and see if it is available and include it in our written submissions as a follow-up. I don’t have it offhand. I’m sorry.

R. Merrifield: That would be excellent if it could be included. Thank you so much.

B. Bailey: Thank you to all three presenters. That was very interesting and helpful.

Kim, my question is for you. I’m thinking about your model that you described and the distinction between the council that you work with and what happens with a PAC, with the 12 years that they have. I found myself wondering how do you deal with the challenge that…?

If you do get folks who stay on after they’ve lost a parent, for example, how do you ensure that they can still represent the voice of seniors, when, perhaps, it would be five or ten years since they’ve been very closely attached to a long-term-care facility? Does that come up as an issue for you, and how have you grappled with that?

K. Slater: Oh, for sure. Typically what Family Councils will do is they’ll write in their own terms of reference, very specific kinds of expectations of themselves in terms of under what situations a person like myself can stay involved. The vast majority of the time it will be as non-voting members who are more a source of information than anything else.

Believe me, there’s such a tremendous learning curve that accompanies entry into long-term care. People are, first of all, wrestling with the sense of guilt that I felt — that my mother was in care and that I couldn’t look after her, etc. You become overwhelmed with these things, and something like a family councillor, somebody like me, can say, “Well, look. Here’s what I did to help my mother with Alzheimer’s on a daily basis, some tricks of the trade,” and so on. They bring a value to it that can’t be measured, necessarily, by any other means than just providing comfort and ideas for people to work with.

The other thing is that if you’re going to develop regional associations and provincial associations — which is why I try to stay involved — it does take a background in the system. Remember that all of these things are intended to provide the community with a voice on the quality of care that happens in long-term care. I can share with you honestly that there are, unhappily, corporations or individual facilities where, as soon as somebody’s loved one dies, it’s: “Well, you’re out of here.” My question would be: how does that help residents? It doesn’t. In fact, it does the opposite.

Worse than that, they’ll occasionally marginalize councils. They won’t meet with them. I know that’s something that the Ministry of Health is working to correct right now. That’s very good news. Does that help to answer your question?

B. Bailey: It does. Thank you.

J. Routledge (Chair): I think, sadly, we’re out of time. We’re going to have to wrap it up. On behalf of the committee, I want to thank all three of you for taking the time to meet with us, engage with us and share your commitment to improving long-term care.

Speaking for myself, you’ve reminded me of the pain of supporting a member of my family who resisted going into long-term care because she thought it was really a warehouse where she was being sent to die. You have shared with us that it doesn’t have to be that way — that long-term care can be something where people maintain their dignity, their safety and their sense of joy in life. It does require a systemic change, and you’ve given us some really concrete ideas about what a new system could look like and how to get there. Thank you so much.

[11:45 a.m.]

Our final panel of the morning is on hospices. We are joined by Pablita Thomas, representing the B.C. Hospice Palliative Care Association; Gretchen Hartley, representing Vancouver Island Federation of Hospices; and Michele Neider, representing Hospice Society of the Columbia Valley.

Each presenter has five minutes. We’d ask that you look at the timer on your screen to pace yourselves. After we’ve heard from all three of you, I’ll invite the committee to ask you some questions and engage you further.

We’ll invite Pablita to make the first presentation.

Budget Consultation Presentations
Panel 6 – Hospice

B.C. HOSPICE
PALLIATIVE CARE ASSOCIATION

P. Thomas: Good morning, everybody. Thank you for having us today to talk about hospice and palliative care services in our province. My name is Pablita Thomas. I am the executive director at the B.C. Hospice Palliative Care Association. The association is a non-profit public membership organization which has been representing individuals and organizations committed to promoting and delivering hospice care to British Columbians for over 36 years. With 72 hospice societies in the province, all of them are members, and we strive on promoting and educating those of hospice services in our province.

I’d like to just, firstly, talk a little bit about hospice services. Our societies in B.C. provide a broad range of hospice palliative care programs. That includes grief and bereavement support, palliative support, home support, education and caregiver support for those that are either seriously ill or dying in the province. The services and supports that hospices provide are integral in the full spectrum of person-centred care.

I’d really like to talk about some of those care services where we have seen an increase due to COVID. The pandemic environment and environmental disasters, toxic drug use and the residential school crisis have brought to the forefront an urgent need to respond and to support grieving British Columbians. This increased need for grief support has promoted the need to provide additional support to our hospice societies and other community grief and bereavement services groups to build the capacity around serving those that need it most.

While the government of B.C. has announced significant pandemic- and opioid-related investments in regard to mental health, grief remains outside the mandate of the Mental Health Commission of Canada and of mental health associations. To date, there has been no acknowledgment, by the government of B.C., of unresolved and complicated grief as an additional mental health crisis, no planning to address the severe shortage in grief services, nor a recognition of the long-range impact that failing to act will have on our communities and economy.

Currently in B.C. there are no fully publicly funded grief and bereavement organizations which support psychosocial support, unresolved and complex grief. Free grief services are offered by hospices. In other not-for-profit community provincial organizations there has been a significant decline in volunteers, charitable donations and financial security through the pandemic.

This lack of systematic funding has created a significant barrier to accessing grief counselling due to a lack of organizational capacity and/or expertise at the community level, which is overburdening the private sector and health authorities. Hospices are finding themselves supporting the shortfall with no additional supports.

I would like to talk about the level of the stress and complexities of grief related to the pandemic. Our hospices have seen, over the past year, over 110 percent of referrals from health authorities and the private sector. Those seeking psychosocial services have been passed on to the hospices. This includes counselling services for one-on-one, group grief supports and even complicated support services.

Hospices in 2020 and 2021 responded to this need with an average hospice budget of $32,000 per year, with some hospices serving their communities with a budget of $1,000 a year in the rural and northern communities. They were able to serve nearly 1,584 patients a month, and that is three times more than the Community Action Initiative program that the Ministry of Health and Ministry of Mental Health have supported for 29 mental health organizations in that same year with an investment of $7 million.

[11:50 a.m.]

It is time that we really look at our grief and bereavement services and really make it a mandate and a priority in our health system.

I am asking that the Finance Committee consider the following in supporting British Columbians to navigate the crisis: a provincial leadership to look at grief and be­reavement as a mental health navigator in supporting those that need it most, investing in hospices to provide grief and bereavement supports of $2.3 million in the next three years. That includes workforce support, training, education and providing grief support services.

With this investment, hospices will be able to support close to 10,000 patients and their families a month — over 120,000 people a year, the highest return on investment of any mental health community program or health services organization in the province to date.

Lastly, looking at a grief and bereavement capacity in building hospices referral in terms of a grief awareness day, evidence in research and really looking at our health system and how grief and bereavement is captured.

With that, I would like to thank the Finance Committee for the opportunity to present on the grief and bereavement services that our hospice societies provide, and how we can further support British Columbians during their time of need.

J. Routledge (Chair): Thank you, Pablita.

Now we’ll turn it over to Gretchen.

VANCOUVER ISLAND
FEDERATION OF HOSPICES

G. Hartley: I’m the executive director of Cowichan Hospice, and past president of Vancouver Island Federation of Hospices, here today to speak in favour of the BCHPCA proposal that the province invest in the mental health of British Columbians through bereavement support.

I endorse the three following proposals, which relate to a $3.4 million investment in bereavement care for the next few years.

Establish a provincial task force to focus on the mental health impacts of difficult grief to identify resources and gaps.

The second is to invest in grief and bereavement capacity building for community hospices across the province, including funding specialized training for counsellors and specialized volunteers to support people experiencing prolonged and complicated grief.

Invest in the standardization and collection of bereavement care metrics, referral tools and processes with referring agencies.

The bereavement care provided by community hospices is an overlooked resource, frankly. It’s available in communities all across the province and supports tens of thousands of people annually with specialized grief support services. Hospices are responsible to local needs, re­sourced, for the most part, by their communities. With a modest investment of funds to build capacity, enhanced grief support can be available in every small community across the province, to support mental health at a time when British Columbians face many mental health challenges.

Pablita spoke to the challenges of separation and grieving during COVID, when we couldn’t be with family members who were dying, or afterwards, in grief, leaving really difficult grief for many families. Of course, many Indigenous people across the province already impacted by intergenerational trauma relating to the deaths, disappearances and experiences of children at residential schools, found their grief re-activated in the past year. Several community hospices have been invited to step up — not to lead, but to partner — with Indigenous organizations to provide grief support.

Many hospices are also facing the impacts of grief relating to the parallel pandemic of toxic drug deaths, and finding innovative ways to provide connection and support to grieving parents and family members, and to reach out to people who are doubly challenged by their circumstances to reach out for support.

Vancouver Island Hospice Federation represents ten community hospices and two hospice programs in isolated communities. I’m going to skim a bit of background here. It’s interesting, though, to note that 100 percent of the hospices on the Island receive referrals from provincial mental health programs. In 2019, seven of the hospices reported that they provided grief support for 3,005 adults and 313 children and youth.

I have a brief story to go beyond the statistics. I’d like to tell you about a mother who recently sought bereavement support at Cowichan Hospice. Her two-year-old son had been murdered 40 years ago by someone she was dating. Although she was referred to a psychiatrist, she felt that he did not understand her grief and trauma.

Encouraged by those around her to carry on, she eventually went on to marry and raise her children. She never spoke of the death to anyone outside her family, but of course, the impacts of the death didn’t just go away. As she approached the 40th anniversary of her son’s death, during the isolation of the pandemic, another son came close to dying due to toxic drugs.

[11:55 a.m.]

Her panic and fear led her to reach out for the first time in 40 years, and she was referred to Cowichan Hospice. We helped her find some other community resources, and she joined a traumatic loss support group. For the first time, she met other parents whose child had died traumatically. It had a huge impact on her wellness. When the group was over, she said: “I didn’t think I could do this.” She said — this the healing that she experienced — “If it wasn’t for you and Dee, I don’t think I could have done it.”

A contribution of $3 million — or $3.4 million, Pablita? — over the next three years to support capacity-building and specialized training for community hospices is an effective and worthy investment in the mental health of British Columbians.

J. Routledge (Chair): Thank you so much.

We’ll now invite Michele to make a presentation.

HOSPICE SOCIETY
OF THE COLUMBIA VALLEY

M. Neider: Good afternoon. My name is Michele Nei­der. I’m from the Hospice Society of the Columbia Valley. We are a rural area, with our office being in Invermere and a population of a little bit more than 3,300 permanent people. The whole valley has less than 10,000 people. We collaborate with many other rural hospices, and I’m here to support Pablita and also Gretchen for representing the regional components of hospice and also to speak on behalf of rural hospices.

The B.C. Medical Journal, July and August 2021 issues, mentions that there are inequities in the delivery of care between rural and urban populations. Yet in the past few years, we also have seen a huge migration of people leaving large cities, seeking a better lifestyle in rural areas. Statis­tics Canada supports this statement in their 2021 population and dwelling town census.

For instance, here in Invermere, we have seen an in­crease of 15.5 percent in the population. Radium Hot Springs, which many of you may have visited in the past and is just ten minutes down the road, has seen an increase of 72 percent in its permanent population. The village of Canal Flats, south of us, has seen 20.1 percent in population increase.

People moving into rural areas have been accustomed to receiving medical and hospice support as needed, when needed. Unfortunately, once they move here, they face a very different reality. The intensity of care for a dying family member is magnified in rural hospice and rural settings, due to geography — we cover over a 200-kilometre geographical area here — and due to sometimes close-knit community relationships, limited palliative and hospice services and lack of coordination of system services. Many rural communities have few palliative care beds. Therefore, we go where people are, which is in their homes.

In the case of rural community hospices, where people are most often being supported in their homes, the overall operating expenses must be raised year after year to make up for shortfalls. Thank God for our volunteers and committed community members.

That said, we often think of hospice as only caring for people who are dying. But, like Pablita and Gretchen have mentioned, we cover a wide variety of services, such as anticipatory grief support and bereavement support. There is a tendency to believe only older people grieve, which is not the truth. Grief can be experienced at any age.

[12:00 p.m.]

A 2018 school district 6 survey on adolescent health indicated that 53 percent of youth reported having experienced a loss in their lives, either through natural death, illness, accident, suicide, overdose or even through divorce of their parents. Yet only 28 percent of them felt that they could receive support from adults.

Studies of adults and various mental disorders, especially depression, frequently revealed childhood bereavement issues. Many rural hospices do not have access to grief counsellors. There are no grief counsellors, for in­stance, in the Columbia Valley that can understand what an “unembarked grief” is, what “carried grief” is, what “complicated grief symptoms” are.

Many mental health clinics focus on mental health issues, which is right, but not necessarily on grief. Even if a person does not have, let’s say, a mental illness, they are often referred to a mental health clinic, because it is free, there is a long waiting list. Most people cannot afford $180 an hour — and that’s conservative — for a psychologist.

So many are referred to hospices in the hope that they will receive adequate support for their losses. Yet these rural hospices do not have the means to provide proper grief counselling.

I thank you for your time and hope that you will take into consideration what Pablita, Gretchen and I have mentioned about the need for our hospice services beyond the palliative.

J. Routledge (Chair): Thank you so much to all three of you.

We’ll now invite members of the committee to engage you further — ask some questions. The first hand I see is Brenda’s.

B. Bailey: First, I just want to begin by really thanking you for the work that you do. It’s just so integral to be there for people at often what is the toughest time in their lives — losing a loved one.

I will share with you that I had an extremely positive experience with hospice support when we were having that experience with my father. The support provided to my mother has been literally life-saving for her, after being married for 50 years and being alone for the first time.

I’ve seen firsthand the incredible power of your work and the work of the people that you support — the volunteers that give their time to care for others that are going through what they’ve experienced.

Just lots of appreciation for the model and the work that you do. Thank you.

I want to ask the question about the model of work, because I’m familiar with the grief volunteers and the training they go through and the incredible work that they do. When we look at a $2.2 million ask over three years, I just want to check my assumption. I think that money is to support ongoing training but to stay within a volunteer delivery model. I don’t think that you’re asking to transition to a professional delivery model.

I just want to check that assumption with you.

P. Thomas: Thank you, MLA Bailey, for that question. I love the fact that you have experienced hospice care, as well, with your family. That’s fantastic.

The ask for the $2.3 million is really around building on the current model that hospices are delivering their services. So that is inclusive of volunteers. That is inclusive of some of the hospices that do have counsellors or do have a professional registered support person in place, but also, it is to really fill some of the gap that we have seen.

Even like Michele had talked about, there are some hospices in the rural and remote communities that cannot support their communities further, because they don’t have the funding capacity to do so.

So really, this is to stay within the standards of care in how services are delivered but really to build on that so that we have more of a reach.

R. Merrifield: Thank you, each, to your presentation and to all the work that you do. It’s never been…. Well, I shouldn’t say never been, but it’s been incredibly important over the course of the last couple of years, especially as people were journeying much more alone than they have been in the past. So thank you so much for that.

I have firsthand experience with my own organization within my local riding. Natasha Girard is absolutely a phenomenal advocate. I was really honoured to attend their volunteer appreciation luncheon just recently, as COVID restrictions released.

[12:05 p.m.]

My question is actually going to piggyback a little bit on Brenda’s, and that is the $2.3 million. Has there been any sort of quantification or total analysis done of what the business case looks like to provide that hospice and palliative support for all British Columbians as they go through that grieving process? Have we done an analysis of what it looks like across B.C. to provide that mental health support, and what number is associated with that? And then, obviously, the $2.3 million would fall into that number.

P. Thomas: Thank you for that question. Right now our association is supporting regional federations or collective groups, and that is because we have seen that there is a variance in service gaps and helping capacity. So in saying that, on a provincial level, we haven’t done a business case, but we’re helping regions to really quantify what that looks like and really speaking to their needs.

At this time, this $2.3 million is really looking at the grief and bereavement survey that we did last year. We quantified that by the current gap, current referral and the current budget that hospices have in line with their grief and bereavement services compared to other organizations in other provincial jurisdictions that provide this same quantity of care or type of care.

We haven’t really done one in B.C., but this is really highlighting the gaps and putting a number together on where we’re falling short. So that $2.3 million, in all honesty, is how we fall short in comparison to, say, Alberta or in comparison to Montreal or Quebec and how they provide the care with the same model of services that we provide.

M. Dykeman: Renee actually asked the question I was going to ask, but I do have a second question, which is just a bit more of a dig in from that one.

I do want to thank you for your presentations. My mom passed away at a hospice a few years ago, and I have to say that the care that you provide is so important, not just for the patient but for the families. My father and mother had been married for 50 years, and without the support of the hospice, I fear that my father wouldn’t have fared as well, having been together that long. The work you do is so important, and I think all of us have a story of how hospice care has touched us. Seeing them open is always such a wonderful event, knowing how much they’ll service the community for a long time.

My question is related to looking at the challenge of getting capital spaces in the hospices rurally that you talk about in your recommendations in your report. When you talk about where there is a hospice building, in the case of community hospices, and where people are, more often, needing support in their home, have you seen any unique models either here or elsewhere in the world where there’s been an opportunity to repurpose other spaces or something very innovative?

I look at the gap you’re talking about. It’s significant. One of the things is that even if you start building today, there’s always going to be a gap. I’m wondering if you’ve seen anything that has expedited the ability to get this in there that might be slightly unique, a different model.

G. Hartley: Our community fundraised to build a beautiful hospice facility here. But we’re very aware that people stay there for, maybe, 17 days, so most of their end-of-life journey is at home, and that is really the area of growing need. We’re here today focusing on bereavement care, and that investment that we’re talking about is not a capital investment; it’s an investment in training and supports and being able to provide a continuum of care.

A lot of the work hospices are doing is around supporting people at home with the psychosocial piece of care, supporting quality of life. Also, many of them provide practical supports, like equipment loans or very short-term respite — speaking now about Vancouver Island.

Do you want to add to that?

P. Thomas: Yeah. I would agree with that, Gretchen, 100 percent. I think when we look at the upstream model of care of what hospices provide, it really is to support those upon diagnosis, and a lot of the time, those individuals are at home.

[12:10 p.m.]

Yes, building more bricks-and-mortar hospices is always good. As a provincial organization that supports hospices, we want to see that. But really, what we’ve seen is that there is a shift. People are wanting to be supported in their choosing.

For example, when we look at the rural remote and even Indigenous and First Nations community, for them to travel to any sort of brick-and-mortar hospice house, we’re removing them from their community. That really is not a continuum of care or support that they see fit.

Really, where hospices are filling the need is in going and serving people where they want to be served, in their community, but also ensuring that their continuum of care, their family supports, are integrated within the health model. I think this is where hospice palliative care is quite specialized in the form of end-of-life and health care services. You will definitely see us, even nationally — and in other countries, as well, like New Zealand and Australia — really pushing for hospice home support services, because that is where people would like to be supported.

M. Neider: If I may, in the case of rural areas, we have no choice but to go to homes, because the population, although we are growing, does not justify big buildings. Right? So we must be where people are. Like Pablita has mentioned, people mostly want to be in their own home.

When we focus on bereavement, yes, there’s the end of life, that component that we do. We will support the person who has been diagnosed with a terminal illness from the very beginning to the end. Then after that, the people who are left behind continually need support from us. That’s the bereavement part that often is too ignored.

There are a lot of taboos out there in communities. Peo­ple will hear, and people well-intended: “Move on. It’s been three months. Oh well, he’s had a long life. You’re lucky.” Well, maybe he’s had a long life, but the pain doesn’t help. It still hurts to have lost a loved one.

So there are a lot of taboos that…. Hospices, especially volunteers who are being trained in understanding the grief process and the bereavement process, can continue to journey with those who are left behind and help them heal through the process, heal their loss. They can never be the same, but they can move on with a life that is now different but can be happy.

Brick and mortar in rural areas will probably never happen, because the capacity is not there. But there are so many other ways of supporting rural hospices that can be included and supported.

M. Dykeman: Thank you for that clarification. From one of the written recommendations you had, it looked as though you were also looking for capital support too, so thank you for the clarification. That’s good to know.

P. Thomas: Can I just answer Megan’s point there? I think when we talked about capital, we talked about having a metric system that will help in quantifying, in a qualitative sense, what the grief and bereavement services look like, because provincially, we don’t have one. So that was really more of the capital towards that. Apologies if that wasn’t clear there.

H. Yao: Sounds great. Thank you so much for your presentation. I really appreciate it.

During the process of the presentation, you shared something that triggered, because everyone is talking about utilizing the service for hospice. Unfortunately, in my life, I’ve had quite a few family members who have passed away, obviously. I never had the privilege to receive the service of hospice because of cultural barriers, cultural superstition or taboo, which was mentioned earlier. I would really love to know if there’s any kind of data to support, to showcase the importance of hospice and, of course, of grieving support to allow people to be a productive member as they live through the rest of their life, when they can learn to let go of a family member.

I think one of the challenges that often most of us would like to look at, too, is volunteers. You were talking about volunteers right now. But when volunteers are working with individuals in the field, they also carry the emotional burden back with them, as well, and they become stressed, of course, through that process.

[12:15 p.m.]

I would just love to hear if there’s any kind of data on human costs and human benefits of early intervention, early support or proper intervention to show we can have a healthy recovery from unavoidable tragedies in some of our lives.

P. Thomas: I love that question. It’s interesting that you ask that, because this is really what we’re asking for the capital for. In B.C., when it comes to hospice palliative care, we do not have a provincial metric system to really quantify on what grief and bereavement client supports, caregiver support and volunteer retention, when it comes to the grief and bereavement component, really look like.

In Alberta and in Ontario, they have an extensive, qualitative metric system. I know that on the Island, there are some hospices that are starting to really look at that program. Gretchen can speak on that.

This is really why we’re asking for the capital, because when we did the grief and bereavement survey last year for our hospices and we reached out to all of the crisis lines and all of the mental health organizations, because we’re partnered with the B.C. Mental Health Association, we really noticed that even within the regions, grief and bereavement are captured completely differently. The only organization that really captured grief and bereavement referrals cohesively was the First Nations Health Authority. But all of the other health regions….

That really got us to think about: well, how do we quantify that? We know that we have stories. We know that we have people that say that hospice services have saved their life. But how do we quantify that? So we’re asking for capital so that we can put a standard and a metric system so that we can start really measuring those, because we’ve seen how that has been impactful in Ontario in asking for not only expansion of beds but expansion of services as well.

G. Hartley: I think it’s also important to add that, yes, there is research that shows that good bereavement support does promote mental health. Maybe we can send some of those resources to you afterwards.

As far as supporting volunteers, we have careful screening. We have in-depth training. We have clinical supervision, right now by Zoom, so that people can debrief what they’re going through and ask for advice and ask for support. We have, following our training period, kind of an apprenticeship program, where they have a mentor, an experienced volunteer.

Although sometimes it presents as a nice cup of tea in the hospice, there’s a lot of training and support that makes that care sustainable. When we talk about adding counsellors, it’s really part of a continuum of care. I think that the heart and the core of the care will continue to be volunteer care for many years.

P. Thomas: Just one last thing. When we look at our volunteers, our hospice volunteers are quite unique. We’re the only sector that has competencies for volunteers. So just keep that in mind. In B.C., we’ve just finished with the B.C. Centre for Palliative Care on doing volunteer competencies. That is very much similar to the pan-Canadian and the other clinicians that provide palliative care. That is just to really quantify how our volunteers have expertise in the services that they provide. But yes, there’s a lot of research out there, for sure.

J. Routledge (Chair): Well, thank you to all of you. We’re going to have to wrap it up at this point. Thank you so much not only for taking the time to engage with us but also for the leadership that you provide in our communities and for our loved ones.

As one of my colleagues said earlier, as she framed her question, it’s assumed that grief is a journey we take alone. I think, as Michele said, there’s a certain implicit assumption that we grieve for a while, we give each other sympathy and then we’re supposed to get over it. Your stories and your perspective underline that it is an issue of mental health. Grief is an issue of mental health, and it requires some serious shifting in our thinking.

Thank you for what you’ve presented with us today. You’ve certainly helped me think about approaching grief in a different way, and you’ve made some really good, concrete suggestions about how we can do it and support each other long term in society. So thank you again.

The committee recessed from 12:19 p.m. to 1:15 p.m.

[J. Routledge in the chair.]

J. Routledge (Chair): Hello, everybody. We’ll call on our next panel, which is on health human resources. On my agenda, the first one up is Marina.

You’ll see the timer on your screen. Each of you has five minutes. If you could, look at the timer, just to give you a sense of when you should be wrapping it up.

After we’ve heard from all three of you, then I’ll open it up to questions from the committee. Because you’re a panel, what has been happening is that sometimes the questions may be directed to one of you. If others of you want to elaborate or add, feel free. Some of the questions might be to the whole panel. It can kind of be like a bit of a discussion, to sort of build on each other’s ideas.

With that, I’ll invite Marina Banister, on behalf of the Canadian Association of Physician Assistants, to kick us off for the afternoon.

Budget Consultation Presentations a
Panel 7 – Health Human Resources

CANADIAN ASSOCIATION
OF PHYSICIAN ASSISTANTS

M. Banister: Good afternoon, everyone. Thank you, Chair and hon. members, for the opportunity to speak with you today about our recommendations on introducing physician assistants, more commonly known as PAs, into British Columbia.

My name is Marina Banister, and I’m the manager of advocacy and stakeholder relations for the Canadian Association of Physician Assistants. We are the professional voice of more than 800 PAs who work in public health systems all around Canada, in the Armed Forces and all around the world.

What is a PA? PAs, like nurse practitioners, are ad­vanced practice professionals. PAs are educated in the medical model, which means that their training is similar to that of Canadian doctors. They work autonomously, under the supervision of licensed doctors, to deliver primary, acute and specialty care in all types of clinical settings.

Every day we hear about the hardships that British Columbians, especially in rural and remote regions, face in accessing health care. At CAPA, we understand the enor­mous task of improving health care with the budgetary resources that are available. PAs represent an untapped resource that can help the government provide high levels of care to patients while reducing overall costs.

Let me dive into some examples. Around Canada, in emergency rooms, PAs are widely considered essential to improving patient flow, lowering wait times and boosting physician morale and productivity. The addition of PAs can help lower initial practitioner assessment time and reduce the percentage of walk-ins leaving, unseen by a doctor.

For example, in rural Gimli, Manitoba, there’s a population of about 2,000. A PA makes it possible to keep the ER doors open even when physicians are not on site. Doctors are always available to consult electronically, but PAs are trained to perform procedures like wound care and casting and to begin stabilizing more urgent cases. This model could be seen in rural emergency departments in places like Ashcroft, where they could stay open all weekend, instead of the closures that we see now.

PAs also help with surgical wait times. Demands on an already stretched surgical workforce are growing. One successful model has been the use of PAs within the Winnipeg Regional Health Authority. In this study, PAs increased the surgical throughput of primary hip and knee replacement by 42 percent, and wait times decreased from 44 weeks to 30 weeks, compared to the previous year. With more PAs providing support to surgical teams, tasks like postoperative evaluations, follow-up visits and even prescription refills would be more efficient.

[1:20 p.m.]

Last but certainly not least, I want to put special em­phasis on how PAs can help access in rural and remote communities. Health care needs in rural remote and many First Nations communities are complex. Patients often lack timely access to services despite high rates of chronic disease and other illnesses. The addition of PAs in these communities could improve the continuity of care and offer patients more practitioner time. It can also make the physician workload more manageable and bring much-needed flexibility to local health care teams.

In December 2021, CAPA submitted a pilot project to the government of B.C. to help alleviate health care professional shortages in northern British Columbia. We never heard back. However, it is not too late to implement this pilot project. We hope that this pilot project can become a reality and, in turn, help British Columbians during these challenging times.

So given all these arguments, CAPA would like to make the following three recommendations. First, CAPA recommends to the committee that the provincial government introduce and regulate PAs under the College of Physicians and Surgeons of British Columbia.

Second, we recommend that the government create PA training programs in B.C. to train PAs locally.

Thirdly, we recommend that the government earmark $6.5 million in funding to hire 50 PAs over the course of the next three years and work with health stakeholders to identify where the PA model could have the greatest impact.

The PA model can help British Columbians deliver better care at a lower cost, and there’s no better time to regulate PAs than now.

J. Routledge (Chair): Thank you, Marina.

Now we will hear from Dave Deines, Ambulance Paramedics of B.C.

AMBULANCE PARAMEDICS OF B.C.

D. Deines: Thank you very much, Chair and distinguished members. As I said, my name is Dave Deines. I am the provincial vice-president of the ambulance paramedics and emergency dispatchers of British Columbia. I’m also the national president of the Paramedic Association of Canada.

It’s my honour to join you here today from the traditional unceded territories of the Squamish, Musqueam and Tsleil-Waututh First Nations.

As you’re aware, the ambulance paramedics and emergency dispatchers of British Columbia not only represent over 4,700 paramedics and emergency dispatchers em­ployed by the single provider of service in British Columbia — the British Columbia emergency health services — but we’re also the professional voice and the British Columbia chapter of the Paramedic Association of Canada. Thank you very much for the opportunity to present today.

As you know, paramedics have played an integral role in front-line care for the last 47 years that APBC has been around, most recently with the pandemic as well as the environmental calamities that have plagued our province. During these disasters, we’ve seen the opportunity that paramedics play, firsthand, in bridging the gap in health care in British Columbia. There are many communities within British Columbia where paramedics are the only health care resource within that community and play an integral role in navigating the health care system for patients that start their journey in those communities.

Paramedics also are unique in British Columbia in that of all the health professions, we are the only profession that spans both the health and public safety domains, which is very unique in British Columbia but also akin to paramedics across — coast to coast to coast. While recently we’ve seen the challenges again with the climate calamities and the pandemic, paramedics have risen to the challenge. We have done so through some innovative programs developed through government over the last five years.

One of them, of course, that members may be familiar with is the community paramedic model, which sees paramedics placed into communities in what we determine as non-traditional roles. What I mean by that is that typically, when you mention the word “paramedic,” people automatically associate that with two people in the front of an ambulance, lights and sirens, going to somebody’s emergency through the 911 system.

Community paramedics, on the other hand, play a vital role in chronic disease management and primary health. Again, in some communities in British Columbia, they are the only access to health care, where we can see them integrate the quadruple aim along these disease processes, helping patients navigate that through a peer care team. We have over 140 community paramedics spread across the province in different communities in a highly successful model that has reduced the burden both on the acute care and the chronic side of public health within British Columbia.

[1:25 p.m.]

One of our asks you’ll see in our submission today is that government consider the expansion of these programs into metropolitan British Columbia. What I mean by that is…. We’re also sitting in on the conjoint Health Committee. Tomorrow we’re presenting on the opioid crisis. As well, we have just had a meeting with stakeholders on the Peer Assisted Care Teams to deal with mental health and people in crisis, which, as you know, has become a major issue within British Columbia that affects not only the public safety but the health care system in its entirety.

We feel community paramedics can play an integral role in all of these initiatives, from opioid response to Peer Assisted Care Teams. We’ve made presentations to the Police Act reform standing committee on integrating paramedics into these teams with law enforcement and other health professions to address some of these demands on health care.

In order to do this, of course — and this goes hand in hand with the other two recommendations — would be increased funding for operations for the British Columbia emergency health services. This is everything from increasing the amount of physical ambulances and community paramedics, paramedics that are available, also working with other ministries like Advanced Education to increase subsidies to the public school, the Justice Institute of British Columbia, that subsidizes primary care and advanced care paramedic seats.

Finally, of course, the need to address retention and recruitment within the paramedic ranks. It’s nothing unique to British Columbia. It’s happening across the country right now. Some recommendations you’ll see in there address retention through advanced training opportunities that paramedics used to enjoy pre-2004, as well as addressing some of the retention and wage gaps we see within the public safety sphere.

With that, I respectfully submit our submission, and thank you very much for your time.

J. Routledge (Chair): Thank you, Dave.

To wrap up this panel, we will now hear from Bernice Budz, Midwives Association of B.C.

MIDWIVES ASSOCIATION OF B.C.

B. Budz: Thank you very much, Chair, and distinguished members of the Finance Committee, as well as my fellow panel members. It’s a great privilege to be able to present to you this afternoon.

The Midwives Association of British Columbia is the professional association for midwives in B.C. The MABC promotes the profession of midwifery while advocating for the ongoing development and enhancement of its service. The MABC provides continuing education opportunities and professional services to over 350 midwives across the province, while supporting midwifery education programs.

The MABC works with its members to ensure they provide skilled trauma-informed, culturally sensitive, patient-centred, evidence-based care and has been regulated under the Health Professions Act since 1998. There are three recommendations for your consideration today.

The first, increase access to midwifery education programming. There are over 350 registered midwives across B.C., and that’s not enough to meet the growing demand for midwifery services in the province. We need to attract, retain and provide security for this skilled workforce to continue to provide access to care for newborns and families.

In recent years, B.C. has experienced one of the highest rates of midwifery-involved maternity care in Canada, at 26 percent. Indeed, the demand for midwifery services is only expected to grow, as the number of births in the province is expected to reach over 50,000 by 2025.

Midwives in B.C. play an integral role in closing the gap for families seeking health care services and are critical in delivering accessible, culturally safe and effective health care. B.C. midwives provide primary maternity care to over 10,000 families a year across the province.

Bursary funding or government loan forgiveness to qualified midwifery students would increase access to education programs and ensure that there are trained midwives in our province to meet this demand. Additionally, we encourage the B.C. government to explore the potential for a more regionally distributed model for midwifery edu­cation programming available to improve the access for all these programs.

The second recommendation is focused on expanding Indigenous midwifery and rural maternity. Registered midwives are highly trained primary care leaders, accredited through the province by the B.C. College of Nurses and Midwives, who specialize in healthy low- and medium-risk pregnancies. For many B.C. families in rural, Indigenous and northern communities, access to midwifery care can be the only way to avoid having to travel long distances to give birth.

[1:30 p.m.]

We recommend the creation of a secure stream of funding to enhance programs for Indigenous midwives that meet truth and reconciliation targeted action items and promote Indigenous people to gain access to Indigenous midwives. This funding support could focus on increasing pathways to education or working to address barriers to practising Indigenous midwives in the province.

In addition, we recommend the expansion of programs aimed at retaining and attracting midwives to rural and remote communities to increase access to reproductive and sexual health care, minimize travel for families and stabilize maternity services. This could include financial incentives for new midwifery graduates to set up their practices in B.C. communities in need of maternal health supports.

The third recommendation focuses on addressing the gender pay gap. Perhaps unsurprisingly, the demand for home birth has increased significantly as a result of COVID-19. Access to midwifery care can reduce pressure on hospital resources and has helped support COVID-19 containment measures by facilitating early discharge from hospital and by enabling families to receive essential services in the safety of their own homes. Including B.C. midwives in equal pay legislation and any related work to close the gender pay gap, as the primary care providers for over 26 percent of B.C. birthing families, would be appreciated.

In closing, working together to strengthen a system that ensures B.C. families continue to receive high-quality maternity care and the long-term availability of midwifery services for British Columbians could be the answer to your problems.

Thank you for your time. I would certainly welcome any questions.

J. Routledge (Chair): Thank you, Bernice.

Now I’ll invite members of the committee to ask questions of all three of you.

K. Kirkpatrick (Deputy Chair): Thank you to everybody for your presentations. I’m going to start with a question for Marina with respect to physician assistants. Now, when you talk about physician assistants….

To me, it just sounds like a no-brainer, in terms of an ability to do that triage or take a lot of the burden off the GP, in particular. What have been the challenges in coming into British Columbia? In what other regions in Canada are PAs being utilized?

M. Banister: Thank you very much for the question. The barrier in working in British Columbia is government regulation. We’re currently not regulated under the College of Physicians and Surgeons of British Columbia, which prohibits us from working.

There are some PAs working in British Columbia with the Canadian Armed Forces. That being said, PAs work all across Canada. Most notably, they were regulated in 2021 in Alberta. They also have been regulated for quite some time in Manitoba. There are a few pilot projects here and there. Regulation has been announced in Ontario as well.

M. Starchuk: Thank you to the presenters. My question is for Dave.

You had talked about subsidizing seats at the Justice Institute. I’m just wanting to make sure that I completely understood what was there — that it was a subsidy to the paramedics that are going through there, for an individual, or is it to the program itself?

D. Deines: Thank you very much for the question, sir.

It’s exactly that. The Ministry of Advanced Education subsidizes X amount of seats for both primary care and advanced care programs to the JI.

The issue, collectively, we’re having right now is…. All parties want to increase the throughput of students coming in the pipeline and into paramedicine in British Columbia because of our staffing shortage. But because of a limitation on that subsidy, the school doesn’t have the capacity to increase that student base. So one of the recommendations is for exactly that — for the Advanced Education Ministry to increase the subsidy to the Justice Institute of British Columbia, which in turn will allow them to train more students.

M. Starchuk: I need to better understand. Asking for that subsidy that’s there…. Have you figured out what that value is of the subsidy and what the output will be for the number of people that will come out of that institution?

[1:35 p.m.]

D. Deines: I apologize. I don’t have the number for you. I can get it. There have been discussions with both the Justice Institute and the British Columbia emergency health services on this exact issue. I’m sure we have a number of exactly what we’re looking for. But I apologize. I’m kind of a late addition to the agenda today, so I don’t have that with me.

H. Sandhu: Thank you to the presenters.

My first question was for Marina, which was asked by MLA Kirkpatrick, regarding barriers and what the biggest hurdle is here for physician assistants.

My second question is to Bernice. Bernice, you mentioned, and we all know, that the need for midwives and home births drastically increased during the pandemic, because people felt safer within their home settings. Have you seen the number of midwives increasing? I would like to think it is, but I wonder if you have the actual numbers — if we’re getting more midwives or if it’s decreasing. How about the membership in your association?

The next question is: is there a majority of nurses or RNs there receiving this training to become midwives? Or are they coming, starting from scratch?

To meet the demand, also, I want to highlight that a lot of internationally educated nurses here, from several countries — like myself, too — have nursing and midwifery. In Canada, they don’t offer both. But a lot of nurses are trained in both speciality areas. So to meet the need, I wonder if you want to suggest something, as provinces are moving ahead to support internationally educated nurses with the new funding to streamline the process. Is there anything that you can see that we can do towards the ones with this midwifery training as well that can help us meet the demands?

Sorry for the lengthy question.

B. Budz: No problem. I’ll try to remember them all and address them.

Certainly, right now UBC is the only site here in Vancouver for the training of midwives. The program is set up for any high school student to be able to enter or any other health professional. Generally, they have to start, though, right from the beginning.

In January, there was the first beginning of, I think, allowing five nurses to be able to enter the program, but they still have to do the majority of the program. There is a stream for internationally educated midwives, which I think is approximately set at ten seats currently. That, certainly, could be widened as well. I think there are definitely many nurses who have an obstetrics background. Some people are already co-trained in both professions that could become midwives.

During the pandemic, we actually did see some of the numbers decrease, mainly due to the fact of the strain on midwives of working long periods of time without a break. Midwives, generally, have no days off. They really are the only profession that works every day. You’re either on call, you’re delivering at home or you’re delivering at the hospital. There are not enough people to actually relieve people to give them a day off, a weekend off, like many of the other health professions. It’s this continual strain on people that’s leading to the burnout.

Midwives are also often responsible to help transport people out of the community. These are services where, again, there is no compensation for them, so they’re having to absorb these costs on their own. I think over the period of the pandemic, a number of midwives also de­veloped COVID. Some have been left with long COVID symptoms and now are on disability. So we have lost people during the pandemic.

We continue to lobby UBC for an increase in seats. I think anything that can be done to have a more distributed model so that people can have training in various areas of the province would be a help. It decreases the relocation expenses for people — particularly Indigenous people but all people in rural communities. I think — similar to the other programs where it is distributed — it makes it easier for people to take them. UBC does have a site in Kelowna as well as Prince George, so I think it’s something for consideration and a recommendation for maybe Advanced Ed to explore that further.

If I missed any of your questions, please just ask me again.

[1:40 p.m.]

H. Sandhu: Just a quick follow-up. I was wondering if you see there is room for support, under this new funding, to support internationally educated nurses, perhaps, when we’re streamlining and when we see that there are some that are trained in both. If there are any suggestion that comes to your mind later, feel free to send us an email. I’m just curious about your thoughts.

B. Budz: Absolutely. I think the more people that we can help support to utilize the skills they already have and to be able to enter into the profession, all the better. Again, there is a current stream for internationally trained midwives at UBC, but I think that could be expanded.

I think a partnership between the School of Nursing and the midwifery program would also be a good idea. There are many similarities. I think this is the time to look at some creative options for people, really to help those who are interested in being in the profession, and all the patients who can benefit in the province as well.

H. Sandhu: Thank you. I really appreciate the answer.

B. Stewart: Thank you to all of you coming forward with your own area and talking about the fact that there appears to be an education gap in all three professions. I appreciate that.

I wanted to ask Marina a question that I have. The College of Physicians has to recognize the PAs. You’ve obviously accomplished that in eight other jurisdictions. I guess if you were starting somewhere — knowing that was not insurmountable, but a challenge — obviously, you’d need to bring the college along. Where is the PA team on that particular part of your request?

M. Banister: Thank you very much for the question. The college has let us know that if the government were to regulate, they would be fully prepared to support PAs and introduce them into the province. We do not see the College of Physicians and Surgeons as a barrier to our implementation. They’re a good partner of us, and they would love to see us working in British Columbia.

B. Stewart: Just to follow on the question, that’s great — that’s really important — the training that you talk about. Well, of course, we’ve got nurse practitioners. I’m just trying to understand the difference in training and, maybe, the cost. You mentioned $6½ million. I don’t think of that going very far. Where is that going? Is it to the training? For 50 PAs, it would seem to me that at least the annual cost would be a lot more than the $6½ million.

Help me understand the difference in training and what the province would have to do to add this to the existing programs that they have.

M. Banister: In regard to training, the only school in western Canada is in Winnipeg, so there is a huge opportunity for another school in western Canada to be developed. In all of Canada, there are three programs, and there’s a total of 69 seats. For those 69 seats, there are over 2,500 applicants every year. It’s a very in-demand program, and there’d be a lot of opportunity to train more students, if there were such training spots available.

CAPA would like to see a PA program attached to every medical school in the country. That’s how the model currently works. The PA program works hand in hand with the medical program at a particular university. We would like to see that happen in British Columbia: a PA training program where people can be trained here and then stay here to work.

In regard to the money and the difference between how nurses and physician assistants are trained, PAs complete a two-year training program, and it’s generalist training. They are trained kind of like a family physician would be, in the general practice of medicine, not within the nursing scope of medicine. That allows them to have a very broad scope of practice under a supervising physician.

We would like to see some money earmarked, in Advanced Education, towards funding those spots — and then, once those physician assistants are trained, funding to employ them in the province. We do know that B.C. is a very desirable place for folks to work. According to our 2021 member survey, about 15 percent of our membership, all across Canada, would work in B.C. as their first choice if they were able to work here.

[1:45 p.m.]

H. Yao: Thank you so much for the presentation. This question is really for Bernice.

You mentioned something about a gender pay gap. I had a hard time fully comprehending it. Would you mind helping me appreciate better what kind of challenge you are facing, for a midwife, when it comes to a gender pay gap?

B. Budz: Certainly. The midwifery profession is allowed to bill directly, like physicians, to government. At this point, there are a limited number of fee codes that midwives are able to submit for billings. That’s different than what physicians are. They may be doing the same type of work in caring for a pregnant person during the course of their pregnancy, but they are only allowed to bill for a limited part of that care. It would be approximately a quarter to a third of the care provided that would be equal to a physician. The midwife would be paid a quarter of the pay that a physician would be paid.

Much of the work that midwives do is actually considered in a volunteer capacity, as there is currently no compensation for the work that they are performing. That’s caring for people, again, pre-pregnancy, throughout the pregnancy, and for six to 12 weeks after. This is part of the concern that we have — that there should be equal pay for equal work.

J. Routledge (Chair): I think we’re out of time now. I know there are other questions. Sorry about that.

I do want to thank the panel for taking the time to en­gage with us. Thank you for your advocacy for your professions and for spotlighting how the work of the people that you represent could help a long way to address the health care crisis — and also for helping to point out to us the barriers to you being able to play that role.

With that, we’ll say goodbye. We’ll just take a very quick recess.

The committee recessed from 1:47 p.m. to 1:48 p.m.

[J. Routledge in the chair.]

J. Routledge (Chair): We are now moving to the panel on autism. That panel will be represented by Julia Boyle, representing AutismBC, Vivian Ly, representing Autistics United Canada, B.C. chapter, and Elena Lawson, B.C. Autism Advocacy.

We’ll invite each member of the panel to present in turn. You’ll each have five minutes. Once you’ve all presented, I’ll invite the committee to ask you questions. They may ask questions to specific panel members, which doesn’t mean that other panel members can’t jump in and elaborate. Or they may ask questions to all of you, and it can be more of a discussion.

With that, I’ll invite Julia to open things up.

Budget Consultation Presentations
Panel 8 – Autism

AUTISMBC

J. Boyle: Good afternoon, everyone. My name is Julia Boyle. I’m the executive director with AutismBC. Our mission is to empower, support and connect the autism community across the province.

[1:50 p.m.]

My first recommendation is an investment in the training and recruitment of service providers for kids with disabilities to eliminate the one- to two-year wait-lists for services. This includes speech and language pathologists, occupational therapists, behaviour analysts and physical therapists. Two years in the life of a toddler is a very long time, and what happens when you’re on a wait-list is that your brain and your body continue to develop without the supports that you need.

In 2025, the Ministry of Children and Family Development will be opening up services to over 8,000 additional kids with support needs, but they will not be providing additional service providers. Our concern is the quality of care will be compromised and kids will be left behind. Service providers are the disability community’s greatest resource, and B.C. has a very limited number of academic opportunities for speech and language pathologists, occupational therapists, behaviour analysts and physical therapists. We should not be turning people away from these essential and rewarding careers. We need to open up the academic seats for those interested and qualified.

I am asking for us to double the academic seats in each of these professions, preferably by offering cohorts available across the province, in the North of B.C., in the Interior, and on Vancouver Island. This will help ensure that we have a distribution of service providers across the province and that they aren’t just mostly here and available in the Lower Mainland. This might include adding four permanent faculty positions to each of these programs to ensure that there are instructors available to provide these academic opportunities.

I’d also like to advocate for student bursaries for students from remote and rural communities to be able to access these professional opportunities and, again, ensure that there’s a distribution of service providers across the province.

My second recommendation is eliminating the two-year wait-list for children’s autism assessments through the B.C. Autism Assessment Network, also known as BCAAN, by investing in the program and the human resources needed to provide these specialized assessments. This investment involves paying the assessors at a market wage and matching program funds to the number of children on the wait-lists yearly. Currently, the number of children on the wait-list is over 4,000.

We commend the Ministry of Children and Family Development for ensuring that kids receive services based on need, but this shouldn’t mean de-emphasizing the role of diagnosis. Diagnoses are essential in validating a person’s identity as autistic and in informing clinicians and service providers so they can develop effective approaches. Not all disabilities are the same. Additionally, diagnosis is still required to receive school-based supports and em­ployment and tax benefits as an adult.

The wait-list at BCAAN is steadily growing and now at over two years. We need to be able to retain qualified and experienced assessors, which requires providing favourable salaries, benefits and workforce conditions. Additionally, we request that the BCAAN budget be indexed to the wait-list for autism assessments. As I mentioned, it is currently at 4,000. This will ensure that BCAAN has the budget and the staff to eliminate the wait-list.

My third recommendation is developing an adult autism assessment program. Over the past year, we’ve had over 600 adults reach out to AutismBC, trying to access an autism assessment. With the only option being the ability to access a private assessment, which costs $3,500 or more, and few clinicians available to provide these assessments, many adults are struggling, lost. Some are in crisis. There is a deep existential and practical need for autistic adults to receive a diagnosis, many of whom fell through the cracks when they were a child and were never assessed or supported as children.

We recommend a one-time investment of $500,000 for a pilot project, awarded to AutismBC, to provide 100 assessments to low-income adults seeking an autism assessment. We will partner with well-known and respected clinicians with experience in providing autism assessments to adults.

[1:55 p.m.]

J. Routledge (Chair): Thank you, Julia.

Now we’ll turn to Vivian with Autistics United Canada.

AUTISTICS UNITED CANADA,
B.C. CHAPTER

V. Ly: Good afternoon. Thank you for the opportunity to speak before you today. My name is Vivian Ly. I am a cofounder and organizing member of Autistics United Canada. We’re an autistic-led collective representing hundreds of diverse autistic youth and adults across what is colonially known as Canada.

Our three recommendations for you today are to fund individualized supports for neurodivergent people, to fund livable conditions for all disabled people and to fund measures to protect disabled people against violence.

Our first recommendation is to increase funding for accessible, individualized, neurodiversity-affirming, strength-​based, trauma-informed autism services. This includes continuing and expanding the direct funding model for autism services; increasing funding for neurodivergent-led programs and initiatives; supporting equitable education, housing, employment, health care and peer support; and providing supportive services for people with conditions affecting adaptive functioning, regardless of diagnosis.

Autistics United, B.C. chapter, conducted a survey for autistic people, parents, caregivers, clinicians and educators to provide feedback on how autism services should be funded in B.C. Eighty-nine percent of respondents indicated that they would like the direct funding model to continue, either alone or in conjunction with the new hub model that’s being proposed, while only 6 percent wanted to switch solely to the family connection centres.

Caregivers expressed a desire for choice to build their own service provider teams, customized to their children’s needs, and had grave concerns about losing the existing care teams that they rely on. Many autistics and non-autistics alike oppose the reliance of the family connection centres on controversial ABA services, which emerging research and large anecdotal evidence show leads to long-term trauma and non-adaptive skills in many. Others noted that centralized hubs have led to the brain drain of a diversity of autism service providers, including those that are autistic themselves.

While a needs-based model will lead to access for families of children with other developmental disabilities, it should not be at the cost of flexibility and stability that individualized direct funding provides.

Our second recommendation is to invest in deinstitutionalization and universal supports for independent living, in line with the United Nations convention on the rights of persons with disabilities. Since the passage of Bill C-7, expanding medical assistance in dying to include disabled people without terminal illness, there have been several high-profile cases of disabled people in B.C. seeking MAiD not through choice, but because of poverty and lack of access to housing and health care.

Disabled advocates and organizations have long called for an increase in financial assistance to livable rates. CERB was $2,000 a month and a recognized amount for livable income for those employed, yet disabled people on PWD are routinely expected to survive at hundreds of dollars below that while bearing additional costs for medical needs. The combination of one of the most permissible medical-assisted-dying laws in the world alongside inadequate financial, health care and housing supports to live constitutes state-sanctioned poverty and death of disabled people in B.C. This is eugenics in practice.

We call for immediate action to increase financial assistance rates; expand respite services, home care services and community-based supports for independent living; investment in universal basic income, universal PharmaCare and housing-first strategies to address poverty and homelessness; and to provide funding for disabled-led organizations to empower disabled people to engage in government consultation, education and community-building.

Our final recommendation is to end violence against autistic and otherwise disabled and neurodivergent people by defunding the police departments across B.C.; investing in non-police, community-based violence prevention and crisis response services; funding for educator training and accountability measures to support a full ban on restraint and seclusion in schools; and creating an independent disability protection advocacy office to safeguard the rights of disabled persons in B.C.

I notice I’m running out of time, so I will focus solely on the statewide protection and advocacy systems that are occurring in the United States, where independent agencies are providing information, assistance and advocacy for disabled people experiencing abuse, neglect and discrimination. We call for a similar independent office for disabled persons in B.C.

[2:00 p.m.]

Instead of violence, police violence, restraint and seclusion, Autistics United calls for investment in non-violent, community-based violence prevention and crisis response services, non-violent crisis responses in schools and an independent disability and protection advocacy office to safeguard our rights.

J. Routledge (Chair): Thank you, Vivian.

Now we’ll turn to Elena Lawson, B.C. Autism Advocacy.

B.C. AUTISM ADVOCACY

E. Lawson: Good afternoon. Thank you for inviting me today. My name is Elena Lawson, and I’m the co-founder of B.C. Autism Advocacy.

I’m speaking with you today from the traditional territory of the Lək̓ʷəŋin̓əŋ people, including the Songhees and Esquimalt First Nations communities and their descendants.

B.C. Autism Advocacy is a parent-led, grassroots advo­cacy group representing families, parents, caregivers and service providers of children on the autism spectrum. The primary focus of our advocacy has been to show the impacts the family connection centres will have on our children and to ensure that our children’s needs are not only being heard but also understood.

Our first recommendation is to retain individual autism funding. Individual autism funding is a lifeline to thousands of families and gives them the ability and choice to use this funding in a way that best suits their child’s unique needs.

The autism spectrum is vast, and children on the spectrum have different levels of need. The saying that if you’ve met one autistic child, you’ve met one is a very accurate portrayal of just how that spectrum can vary.

It can take years for a child with autism to build trust and relationships with their service providers, which currently takes place in a calm, quiet, private, one-on-one environment that is neither triggering nor overloading for that child. A lot of the time this takes place in the child’s home. Removing this piece has many consequences of its own. To eliminate individual autism funding and force children into a family connection centre will lead to unnecessary stress and triggering trauma. The transition period alone can cause regression, self-harming behaviours, sensory overload and more.

Retaining individual autism funding will maintain this lifeline for families and give them the opportunity to not only keep their existing teams in which their child has grown to trust but also ensure that families with children that are very high need are not being forced into a centre, nor virtual therapy, which can and will be traumatic for many of our families.

B.C. Autism Advocacy recommends that individual funding stays in place and that government builds off of the existing system.

Our second recommendation is parent-directed funding within the family connection centres. Parent-directed funding within the family connection centres is a hybrid approach, giving families choice. The hybrid model would give families the ability to access funding from the family connection centre in a delivery that keeps their children’s needs met.

For example, families would be able to keep their existing teams, keep their in-home services and the ability to use a service provider that does not currently work in a hub. This would function like individual funding.

This recommendation gives parents the choice to decide what is best for their child’s unique needs. It would also ensure that there would be no transition or gaps in services so children could continue to thrive. Autistic children thrive on routine and consistency. If there is any sort of gaps in services, you would see immediate regression in that child, which could impact many aspects of their life.

Our third and final recommendation is move the autism file out of the Ministry of Children and Family Development. Autism is a medically diagnosed, lifelong disability — one that cannot be treated where services are time-limited and goal-focused, which is how the family connection centres are structured. Because autism is a medically diagnosed, permanent disability, B.C. Autism Advocacy recommends that the autism file be removed from MCFD and placed under the Ministry of Health, or alternatively, a creation of a new disability ministry where we would be willing to be part of a steering committee to ensure that the needs of children in the autism community are met.

Shifting services to the Ministry of Health or a disability ministry would ensure a culturally safe environment, where parents and guardians would have less fear requesting help for their children.

In closing, the needs of autistic children are unique, and their supports need to reflect that. We believe that any of our recommendations, or a combination, would be a better solution than the upcoming changes announced in October. We have concluded that the family connection centres presented the way they are now will be detrimental to children on the autism spectrum.

I thank you for your time and the opportunity to speak today.

[2:05 p.m.]

J. Routledge (Chair): Thank you, Elena.

Now I will invite members of the committee to ask their questions.

H. Yao: The question I have is for Julia.

Hi, Julia. My name is Henry. I’m MLA for Richmond South Centre. Sorry, I forgot. I apologize for that.

My question is about your adult autism program evaluation assessment pilot you were talking about earlier. I just want to make sure I heard your number correctly. You mentioned…. You talked about $500,000. That’s what you’re requesting. It’s for 100 assessments?

J. Boyle: Yes. We’d like to do a pilot project to really learn more about autistic adults or people seeking an assessment. There really isn’t very much research or information available on that.

Typically, an assessment costs about $3,500. So for 100 assessments, that would be $350,000. But we’re also forecasting that there will be a lot of travel involved, because the assessors are located here in the Lower Mainland, and we may need to provide travel bursaries for people to come and get the assessments. It may involve staying overnight as well. So I’ve requested a half a million dollars.

K. Kirkpatrick (Deputy Chair): Hi, everybody. Thank you so much for being here today. This is Karin Kirkpatrick.

I’m going to ask my first question to Vivian. Thank you for your presentation. I’m curious about — I’m probably using the wrong term here; I didn’t quite get the full reference — disabled advocacy office. I know there’s a better term for that. I’m curious. Is this related to in-custody constraints, detaining disabled persons in schools? Is that what the advocacy is? Is this something, I believe you said, modelled on something in the United States, perhaps? What is that called?

V. Ly: Yes. The United States…. In every single state, there’s something called a protection and advocacy agency, so P and A. They’re independent statewide agencies that provide information, assistance and advocacy for disabled people who experience abuse, neglect and discrimination. So literally any time that their rights have been violated — if they’ve been discriminated against or they’ve had violence enacted on them — those are the protection and advocacy agencies that are providing information and direct advocacy.

B.C. has something a little bit similar. We have the Representative for Children and Youth. And ideally, we’d have something that is an independent office for disabled persons in B.C., not just for youth, that helps support in both information and direct advocacy support.

Currently, the Human Rights Tribunal is one of the only ways for recourse if you have been discriminated against as a disabled person. It is not an accessible option for many, and there’s little support at all to go through the complaints process. So having a very similar model in B.C. and ideally across Canada would be fantastic.

H. Yao: Hi. My name is Henry. I’m MLA for Richmond South Centre, again. I have another question for Julia.

I’ve had a few conversations, obviously, with my constituents, talking about service providers for individuals who are on the autism spectrum. They talk about behavioural intervention specialists, and they talk about how it is an unregulated body, and there might be a considerable interest…. Maybe they should….

Because you’re talking a lot about increasing seats for service providers, like specialists, would you recommend something like behaviour intervention specialists becoming a recognized and regulated field? Or is there something else I should be considering in regard to that recommendation?

J. Boyle: Yeah, I think regulating the profession of behaviour analyst has been something people have been advocating for, for a number of years. They’ve pursued different means and measures to try to regulate that profession. I think, at one point, there was some advocacy to try to get them regulated under the College of Psychologists, but I don’t know much more about that advocacy issue at this time.

I would say that regulating that profession would be a good thing. I can’t speak much more to that as this time.

[2:10 p.m.]

J. Routledge (Chair): Do I see Vivian’s hand?

V. Ly: Yes, I would like to add on. While regulation may be a first step, I do like to note that there is emerging research and large anecdotal evidence from autistic people ourselves which shows that ABA can, and often does, lead to long-term trauma and maladaptive skills in many. While regulation may mitigate some of that harm, there is also a need for a diversity of services — a diversity of truly neurodiversity-affirming, strengths-based and trauma-informed services.

There has also been discussion that occupational therapists and speech-language pathologists — already regulated professions — are better suited to be in the family connections centres if the model does go forward, because they do not just specialize in autism. They specialize in all types of developmental disabilities as well, and they have the skills to provide neurodiversity-affirming services.

R. Merrifield: Thank you for being here today and for sharing for us. My name is Renee Merrifield. I’m the MLA for Kelowna-Mission. I loved the comments that were made by Julia in terms of increasing the number of service providers, really tackling the wait-list and using that as a great benefit to those families struggling with autism.

I want to go, though, to Elena Lawson’s proposal on the hybrid model. Could you clarify a little bit how that would work? I saw, in the written submission, that it looks like it’s basically how the funding is distributed, but it would still remain parent-directed and individualized care. Is that correct in terms of my understanding?

E. Lawson: Hi, Renee. Yes, you are correct. Also, it would give the parents choice if they want to keep an individual funding framework that would work best for their child. Or, if it worked better for them, they could go in and have access, through the family connections centres, for the services that they need, if they don’t feel that they can use the individual funding to the full potential.

J. Boyle: I just want to say I’m also in support of Vivian’s and Elena’s recommendation to maintain individualized funding and build off that system if they are to add needs-based services.

J. Routledge (Chair): And Vivian, you wanted to jump in on this too?

V. Ly: Yeah. We did do a survey, with a couple of hundred respondents across B.C., about what they would like to see in terms of autism service funding. I can give a few more numbers from that: 51 percent of respondents wanted to have individualized funding continued alone, but a good portion, 38 percent, wanted individualized funding to continue in conjunction with the hub model, so the hybrid model that Elena was referring to.

B. Stewart: Ben Stewart, MLA for Kelowna West. I want to thank you all for sharing what has been a very topical topic.

In your presentation, Julia, you mentioned a doubling of seats. I’m just trying to understand: what is the rate that we turn out speech and language therapists and the others — OTs, PTs, the spectrum? What are turning out currently, and where do we have to get to, to catch up with this 4,000-individual wait-list?

J. Boyle: I think right now the worst wait-list is for speech-language pathologists. Right now the University of British Columbia has the only training program in B.C., and they turn out 36 speech-language pathologists per year. I believe that at a recommended caseload of 40 clients per full-time professional, we would need double the current number of speech and language pathologists in B.C., so it is a long-term solution.

[2:15 p.m.]

Obviously, adding academic seats…. It takes several years for those people to graduate and get experience and be actually serving the community. That’s why I’m advocating that we really take a sense of urgency with this request, because the new family connection centres are opening up in three years, in 2025. If we don’t have the service providers to serve these family connection centres, it’s very likely that we will have what you see in Ontario, which is a 50,000-plus kid wait-list for their recent transition that they’ve also incurred there. So I’m really seeking urgent action to open academic seats to get more service providers in B.C.

V. Ly: Just to add on to the discussion of having more trained professionals, it would also be of great benefit to include funding towards having autistic and otherwise neurodivergent people be part of the training for new professionals. This is, again, in line with “Nothing about us without us.”

There’s a lot that even the speech language pathology field is behind on, especially in supporting augmentative and alternative communication users. These are people who either full-time or part-time, like myself, use things like text-to-speech apps or picture boards and other non-speech ways of communicating. Many autistic people and otherwise neurodivergent people are AC users, but speech language pathology as a field has been quite focused on oralism.

Having any kind of service or training that is for us should be also led by us to be in collaboration with us. We need to have dedicated budget lines for that type of consultation and engagement — and leadership, too.

J. Routledge (Chair): I’m going to go to Mike to ask a question. If we have time, we’ll come back to Karin.

M. Starchuk: Thank you to the presenters. It is a topic that hits my office on a regular basis. At times, everybody’s really concerned about their children, but there’s a little bit of concern as to what may or may not be happening. And I heard it loud, Julia, from you — about opening academic seats. I think we heard it last week as well, from one of the speech pathologists that was out there.

My question is that…. I believe you made a comment. You said it was okay to build off the hub model as long as there was a needs-based assessment that was there. I just want you to kind of explain how that part of your statement is there.

J. Boyle: Is that question for me?

M. Starchuk: Yes.

J. Boyle: Okay. I’m not exactly sure what you’re referring to. I’m in support of moving to a needs-based system, but I don’t think that that should eliminate individualized funding, and it shouldn’t eliminate the need for a diagnosis. These are also…. Individualized funding has proven benefits to families. I’m sure many of you listening today have heard from many parents and autistic advocates as well about the benefits of individualized funding, so I won’t speak to that too much.

But we agree that there are problems with the current system. No one is saying that the current system is perfect, and we do want to see change to the current system. We want to see kids not having to wait two years to be able to get a diagnosis and to be able to access services. When there’s a need, you should be able to get services quickly. But that doesn’t eliminate the need for a diagnosis, and it doesn’t mean we need to eliminate individualized funding.

What you often see for families is that when they receive a diagnosis or when their kid is first kind of presenting with needs, they need a lot of support. They might need the support of a hub. But over time, as they get their footing and they learn more about their child’s diagnosis and needs, they will want to have more control. They will want to have more choice, and they should have that choice, because at times, parents do know what is best for their children. They might have to advocate against what a hub is trying to propose.

I do think that’s it’s a very complex system. There are a lot of different needs. And a one-stop-shop hub…. There’s no way that that can meet the diversity of needs across the province.

[2:20 p.m.]

J. Routledge (Chair): Vivian, you wanted to say a few words on this? That will probably then bring this part of our afternoon to a close.

V. Ly: Yes, I can add on that diagnosis particularly is useful for throughout your life, because that’s how we get the documentation for employment support. That’s how we get academic accommodations. As others have noted already, autism and other developmental disabilities are lifelong. They’re a part of us. Having diagnostic papers is still needed, because we have current health care, employment and education systems that require it.

J. Routledge (Chair): Well, thank you to all of you for joining us today and sharing your perspective with us.

I do note that a strong theme in what you’ve been talking about is that you’re not proposing an either-or. You’re proposing an expansion of what we’re doing now, and I think we really appreciate that. That gives us some elbow room in terms of making the system better and making sure that it meets the needs of people who are in the system — the families who are in the system already. Thank you for framing it in terms of human rights and reminding us that there’s a lot of discrimination that can follow someone for life and that we need to be sure that one’s human rights are protected and defended.

Thank you for your input to the committee.

With that, we’ll bid you goodbye.

The committee recessed from 2:22 p.m. to 2:25 p.m.

[J. Routledge in the chair.]

J. Routledge (Chair): Our next panel, panel 9, is on affordable and supportive housing.

With us are Jill Atkey, B.C. Non-Profit Housing Association; Thom Armstrong, co-operative housing association of B.C.; Jeff Krafta, Habitat for Humanity Mid-Vancouver Island; and Nizar Laarif, Aboriginal Housing Management Association.

We’ll invite each of the presenters to make a five-minute presentation, in turn. We’d ask you to keep an eye on the timer on your screen so that you can wrap up at five minutes. After we’ve heard from all four of you, I’ll open it up to the committee to ask questions. They may ask questions of an individual, or they may ask a general question. Either way, feel free to build on each other’s ideas.

I’ll turn to Jill to make the first presentation.

Budget Consultation Presentations
Panel 9 – Affordable
and Supportive Housing

B.C. NON-PROFIT HOUSING ASSOCIATION

J. Atkey: Great. Thank you. Good afternoon, Chair and members of the committee. I’d like to thank you for the opportunity to be here with you today speaking about the importance of investment into affordable housing in communities right throughout British Columbia.

I’m Jill Atkey, the CEO of the B.C. Non-Profit Housing Association, which is the umbrella association of non-profit housing providers throughout B.C. Under the Housing Central banner, which is comprised of the Aboriginal Housing Management Association, the Co-operative Housing Federation of B.C. and ourselves, we have three primary recommendations for Budget 2023.

The first is to support B.C.’s first urban rural and northern Indigenous housing strategy by reinstating the Indigenous housing fund, establishing a new Indigenous co-op housing program and prioritizing investment into supportive housing directed at for-Indigenous, by-Indigenous organizations right across the province. My colleague Nizar Laarif is going to speak to this recommendation in more detail.

Our second ask is to commit $500 million to develop a rental housing acquisition strategy, which was a campaign commitment of the current government. My colleague Thom Armstrong will speak to this in more detail.

Then finally, our third ask is to accelerate planned spending on non-profit and co-op homes. I’ll speak to this one in more detail here.

In Budget 2018, the provincial government committed to investing nearly $6.2 billion to build 33,700 homes over ten years in British Columbia. Since that time, just over $1.6 billion has been invested through Building B.C. programs, which has led to project commitments, not actual dollars in all cases, on about 17,000 affordable homes across all of the various programs that fall under that umbrella.

Since 2018, I think it’s fair to say that the affordability situation in British Columbia has become far more critical. In part, this is because it takes time to move from a commitment to funding to constructed homes that people can move into. It’s also, in part, because the cost of rent is increasingly out of reach for many, and the availability of rental homes — even for working professionals, let alone those with lower incomes — can now be classified as a crisis by, I think, virtually any definition.

The data bears this out. Vancouver and Victoria have the fastest-growing rent increases in the country, hovering around a 24 percent increase in the last year. Availability of supply is contributing to these rapid increases.

Under the last call for proposals under the community housing fund, which is the biggest program in the Building B.C. program…. In 2021, applications for some 14,000 permanently affordable homes were submitted. With available funding, about 2,400 of these were approved. So essentially, for every six homes proposed, one home gets funded.

In Budget 2022, an additional $100 million was ad­vanced. However, that is still leaving us with 10,000 desperately needed homes that are unfunded at this time, when the need is really critical and grows more critical by the day.

[2:30 p.m.]

Many of these homes have been fast-tracked through the municipal approvals process and are now sitting and waiting for funding to achieve deeper levels of affordability. As an example, the city of Burnaby has contributed five parcels of land, in good locations, with appropriate zoning in place. When I spoke to the mayor on Friday, he said shovels could be in the ground tomorrow if the province came to the table with funding. The city of Vancouver, similarly, has fast-tracked 1,000 units of affordable housing approvals that are now awaiting funding. These stories can be repeated in many communities throughout the province.

While accelerating the investments into these 10,000 homes still doesn’t get the homes built overnight, it would significantly reduce the wait for people seeking permanently affordable homes and the life-changing peace of mind that results from housing security. These are homes that are affordable on day one and remain affordable for­ever, because in the community housing sector, we’re mission-driven to make sure of it.

I’d like to thank you for your time this afternoon and happy to answer any questions you might have.

J. Routledge (Chair): Thank you, Jill.

Now we’ll turn to Thom.

CO-OPERATIVE HOUSING
FEDERATION OF B.C.

T. Armstrong: Good afternoon, Chair and committee members. Thank you for the opportunity to speak with you today. My name is Thom Armstrong. I’m the CEO of the Co-operative Housing Federation of B.C.

I’m especially pleased to be here today with my colleagues from B.C. Non-Profit Housing Association and the Aboriginal Housing Management Association. We are partners in Housing Central, a strategic alliance of the principle stakeholders in the community housing sector in B.C.

CHF B.C. on its own is a provincewide federation of housing co-ops. We represent almost 260 co-ops, with almost 15,000 co-op homes. Of course, the real problem with housing co-ops is that there aren’t enough of them for people who are looking for a co-op home. The recommendations in the Housing Central submission are de­signed to address that challenge.

Frist of all, CHF B.C. fully endorses the recommendations in the Housing Central brief to support AHMA’s urban, rural and northern Indigenous housing strategy, not only as sound housing policy but as an important act of reconciliation and justice. We also support the call, which you just heard Jill speak to in more detail, to move up $4.2 billion in housing supply investments to tap the capacity of the community housing sector to build over 10,000 new affordable homes, not in 2028 but now, while we’re in the grip of a housing crisis.

We think it’s important also to focus on our proposal to commit $500 million in capital funding to develop a rental housing acquisition strategy. It’s important to create that fund without any further delay. It was in the government’s election campaign platform, and it’s in the minister’s mandate letter from the Premier, yet two provincial budgets have come and gone without mention of that promise.

The purpose of the proposed fund is to allow non-profit and co-op housing providers to buy rental housing stock as it comes up for sale and slow down the devastating loss of purpose-built rental homes in our very overheated market. This is just a crucial missing piece in our housing system. It’s more important than ever if new builds are going to slow down in today’s heightened–interest rate environment.

We’ve shared, with the government, data on the material loss of deeply affordable rental homes in the B.C. market. Just in the period between 2015 and 2019 alone, we lost more than 34,000 affordable rental homes. By “lost,” we mean that either the homes were demolished to make way for new developments, or tenants were evicted for renovations that resulted in rent increases that are simply unaffordable to most people. In the same period, there were just over 11,000 provincially assisted homes added to the market. So for every affordable home developed in B.C. between 2015 and 2019, we lost three.

Honestly, it reminds me of the first car I bought as a teenager. It burned oil more quickly than I could add it. I think that for a time I bought more oil than gas, with predictable results. The results here are just as predictable. Higher rents lead to higher levels of homelessness — particularly among women-, Indigenous-, Black- and senior-led households — and the already hot market for purpose-built rental properties is heating up even more.

Since the onset of the pandemic, investors have been taking equity out of their existing properties to finance new purchases, at higher levels than ever. We need to reverse this trend or, at the very least, mitigate its impact. An acquisition fund, capitalized with an initial investment of $500 million, could be deployed to provide one-time capital grants to bridge that equity gap in freehold acquisitions by community housing providers and developers.

[2:35 p.m.]

We could be doing this right now, but in most cases, current rents won’t generate the net operating income you need to support financing and operating costs. A well-timed grant from a properly administered acquisition fund simply could make all the difference. The bonus in this plan is that when the time eventually comes to re­develop the property, it will be redeveloped as non-market, permanently affordable housing. That is a win for everyone.

Thank you, again, for the opportunity to speak with you today. I appreciate your time and the work you do. I hope the measures proposed by CHF B.C. and Housing Central will find their way into your recommendations for Budget 2023.

J. Routledge (Chair): Thank you, Thom.

Now we’ll turn to Jeff.

HABITAT FOR HUMANITY
MID-VANCOUVER ISLAND

J. Krafta: Good afternoon, everyone. Thanks to the standing committee and the Chair for allowing me to be part of this today and, of course, the other presenters.

I represent Habitat for Humanity. I’m sure everybody on the panel and in attendance today knows about Habitat for Humanity, but a lot of people don’t necessarily know what Habitat for Humanity does. We have eight affiliates across British Columbia. We have a good relationship right now with B.C. Housing. We have been able to increase our capacity by over 100 percent by 2016, with the partnership of B.C. Housing.

Habitat for Humanity is a bit of an outlier in this presentation, because we are a stepping stone to home ownership for a lot of people. What happens is that we take people who are hard-working, low-income or medium-income families, put them in housing and allow them to build up equity and, therefore, wealth, where they can then go into market housing.

Roughly one-third of all of our partner families across the province come from a subsidized housing state, so that frees up capacity in the housing subsidies. We have, roughly, 50 families last year that we housed in B.C., and we did over 300 families last year in Canada. We do have tremendous impact, and those families are long-term partners, with homes, to potentially generate up to eight families in the life of the home.

My ask today is to increase our housing endowment fund contribution from B.C. Housing and from the provincial government to $125,000 per door, up to 50 homes per year by 2025, and at the same time granting access to provincially owned lands so that we can continue to build.

As we all know, the cost to build has gone up significantly, exponentially. It’s more important now than ever to have some kind of a seed money program that we have access to so that we can start builds more timely and be competitive with the current development market. Quite often, we find ourselves in a state of coming in last. We’re too slow and too late for acquisition of lands.

The third ask is a consideration of exclusion or a reduction of costs in things like property transfer tax. When we transfer ownership of our home to our partner families, there are significant costs involved there — costs that are borne by the families, which then creates a situation where they’re there longer and the unaffordability of the payment.

Overall, we stick to the affordable housing mandate of 30 percent of the income from our working families. We’re able to do that by way of having interest-free mortgages with no down payment for our partner families. There are caveats to that. They have to volunteer 500 hours, minimum, of sweat equity before they can move into the home. There are various other things — being an ambassador of the brand of Habitat for Humanity so we can better teach people in the public exactly what it is that we do.

At the end of the day, Habitat for Humanity is in a situation where, much like everybody else, we have to evolve. At this point, we’re looking at a situation where we have to redefine “family.” Certainly, British Columbia is no different than any other province, in that we have a growing number of seniors that are underhoused or unhoused. Looking at, maybe, young families potentially on their own is not the best alternative. Potentially, we’re leaving people out, creating a situation of increased homelessness.

With that, we know that we need to look at more complex builds, by way of shared walls. The single-family-dwelling days are probably over. With doing that, we present an opportunity to create communal housing.

[2:40 p.m.]

I mean, we have young families. We also have some seniors, people with disabilities and marginalized people all together, living in the same community and, therefore, helping each other. It’s about giving a hand up and not a handout for Habitat for Humanity.

That’s really what it comes down to for our families. These are families that then become part of what I would consider the tax base for the rest of the province or the rest of the country.

I can see here I’ve got about 15 seconds left. Thank you so much for your time, everyone. I appreciate it. Thanks again for allowing me to be a part of this.

J. Routledge (Chair): Thanks, Jeff.

To wrap it up, let’s turn to Nizar.

ABORIGINAL HOUSING
MANAGEMENT ASSOCIATION

N. Laarif: Thank you, everyone. Good afternoon, Chair and committee members. Thank you for the opportunity to speak today on behalf of the Aboriginal Housing Management Association.

First of all, I would like to acknowledge the unceded territory of the Musqueam, Tsleil-Waututh and Squamish people from which I’m joining the call today.

My name is Nizar Laarif. I’m the director of public affairs at the Aboriginal Housing Management Associa­tion. Again, thank you for the opportunity to speak to you today.

The Aboriginal Housing Management Association fully supports the asks submitted by Housing Central. However, we tried to pick the top three priorities for urban Indigenous, in terms of urban Indigenous housing funds, and we referred to our newly released first B.C. Urban, Rural and Northern Indigenous Housing Strategy that AHMA published earlier on this year. We encourage you all to read it.

The three asks that we’re proposing today are backed with solid data from almost a year’s worth of work that we put into the Indigenous housing strategy.

Our first ask is to bring back the Indigenous housing fund. As you all know, with the Homes for B.C. plan, the government has pledged to build 1,750 units under the Indigenous housing fund. So far, as a result of the 2018 and the 2019 call, 1,100 units have been approved. They are in different stages of development. I believe, as we speak today, there are over 200 units that became operational.

However, our urban strategy shows that over the next decade, we need 12,000 subsidized units similar to the ones produced by the Indigenous housing fund. So our ask is to double the original commitment of 1,750 units with 800 units to be included in the upcoming budget.

Our second ask is with regard to co-op Indigenous housing. Our strategy calls for over 1,200 Indigenous home ownership units over the next ten years, co-op being one of the proposed models. Knowing that B.C. doesn’t have any Indigenous co-op housing projects and not a single government-subsidized program for home ownership, we recommend establishing a new Indigenous co-op housing program with four projects across our province to be funded in the upcoming provincial budget.

We estimate a cost of $10 million per project for a total of $40 million. Also, we would recommend that this project would be designed and developed in partnership between AHMA and CIHF.

Our third ask is with regard to supportive housing. As you all know, the toxic drug crisis has created an unprecedented demand for a permanent supportive housing solution that can provide shelter and support for those that need it the most. The province has responded with a targeted investment to support the development of 2,500 units of supportive housing through the supportive housing fund, representing approximately a $1.2 billion investment over the next ten years.

However, as we speak today, only 154 units funded through this investment will be operated by Indigenous-led organizations or housing providers, representing only 6 percent of the total investment, or the total number of units.

Indigenous people, as is well documented, make up­wards of 39 percent of the chronically homeless population across the province. To improve outcomes and best principles identified under DRIPA, the province must prioritize investment in supportive housing directed for Indigenous, by Indigenous organizations and models across the province.

[2:45 p.m.]

Our strategy estimates the need of over 5,000 units of supportive housing. Our ask is either to accommodate or make it proportional to the number of people facing chronic homelessness. So either a carve-out from the supportive housing fund — 40 percent of that would go towards Indigenous supportive housing programs — or to set a separate supportive housing program for Indigenous by Indigenous.

Again, thank you all for the opportunity to speak today.

I’m happy to answer any questions.

J. Routledge (Chair): Thank you, Nizar.

I’ll now open it up to questions from the committee.

R. Merrifield: Thank you all for the presentations today here. My question is to Nizar.

That is: how do you propose that B.C. coordinate with Canada, in terms of just some of the housing funds, etc.? Are there coordinating efforts that would be undertaken, or how does that actually work?

Forgive the presumption. I’m assuming that this is off-reserve Indigenous housing, both for home ownership as well as for rental.

N. Laarif: Thank you for the question. Exactly. All the asks in our strategy are for off-reserve. The terms that we commonly use are urban, rural and northern Indigenous housing.

Excellent question. When we developed our strategy, our main target was the federal government. It was a re­sponse to a lack of a fourth stream in the national housing strategy that totally excluded urban Indigenous housing needs. So while we’re calling for and we’re actively pursuing funding through the government, we want our provincial and municipal governments, as well, to join, either by matching any funds that we get from the federal government, but also in case….

To be quite honest, our federal government has been dragging their feet. They renewed their commitment to urban Indigenous housing through the 2019 election and the 2021 election. We’re yet, still, to see any concrete movement. While we’re pursing and waiting for the federal government to pitch in, we also call on our provincial government to step up, as they usually did before, and at least bridge some of the gap and the discrepancy in the numbers.

R. Merrifield: I have another question, so I’ll just reserve it for after everyone’s had their opportunity.

J. Routledge (Chair): Great. Thank you.

M. Starchuk: Thank you to the presenters for their insightfulness. My question is to Jeff.

There were a couple of things that you had said. I was just wondering the whys and hows, where you said that since 2016, you’ve increased capacity by 100 percent.

The other one was access to provincially owned lands. I’m wondering if you’ve taken an inventory of those provincially owned lands and determined what may or may not be suitable.

J. Krafta: Yeah. I can speak for, I would say, the majority.

Maybe let me answer the first piece first, the 100 percent improvement. We, since 2016, have had a relationship with B.C. Housing wherein we get essentially $50,000 per door. It’s very welcome, but it comes at the end of the build, and it’s a stretch sometimes to make builds stay on budget, as everyone knows. So that $50,000 a door does very much help, but it comes at the end. My ask was that increase and potentially be at the beginning, by way of seed money.

In terms of the provincial lands, I can only really speak, myself, for the area that I’m in. I’m based out of Nanaimo. There’s a significant shortage of available land in the city proper and outside of the city. That’s basically because, at this point, anything that’s reasonable, that is accessible by a developer and/or a corporation, has been snapped up. If it hasn’t been snapped up, there’s an issue with it, by way of a steep slope or things of that nature.

[2:50 p.m.]

Now, there are outliers. There are places in the province where there is plenty of land. That’s just not right here. Unfortunately, we don’t have the penetration to go up to, say, a place like Dawson Creek, where there is a ton of land available. There’s just not the infrastructure for us up there to do that at this point.

H. Yao: I have a question for Jill, if you don’t mind. I was listening to your $500 million rental house acquisition. I assume you’re asking the provincial government to provide $500 million to actually start purchasing units so they can be converted into affordable units so we can have more of an immediate relief to the current affordability crisis for renters. I’m asking questions just for the purpose of learning.

My concern at this point is: would that be adding to the housing price pressure? If, in your opinion, it does, what can we do to alleviate that potential pressure so that, with the provincial government stepping in with such purchasing power, we don’t end up creating an unforeseen negative consequence?

J. Atkey: I understand your concern. The last thing we want is to make a contribution to escalating rates and prices for buildings. It’s really important to the community housing sector that when we acquire buildings, we do so in a way that allows us to keep rents where they’re at, with the goal of achieving greater affordability over time.

We had a number of non-profits execute this strategy in the early 2000s, with quite a bit of success. Buildings weren’t quite as expensive back then, so financing alone would allow them to purchase a building and maintain rents at existing levels. In fact, in the number of examples that we’ve looked at, they’ve been able to maintain those buildings not at even the existing levels, but they’ve actually turned those into rent-geared-to-income buildings over time. The rents now range from $400 a month up to about $1,300 a month for a one-bedroom versus $2,000 a month for a one-bedroom.

We’ve proven out how the initiative can work. The challenge for us now, with property costs being what they are and building acquisition costs being what they are…. We need that equity contribution from government in order to be able to maintain rents at their existing levels.

I understand the challenge that you’ve posed, which is potentially inflating the market. I think the risk of that is fairly low, given how much money is already in the market. A $500 million acquisition strategy wouldn’t be sufficient to absolutely curtail this challenge that we face in our communities. It would be a contribution to ensuring affordability over time. And we’d be looking to the province for additional measures like increased tenant protections, which also have a moderating effect on the market. I think with both of those things, we can help to address the concerns that you’ve presented.

B. Stewart: Thanks very much. It’s good to hear from you all. Good to see some of you again.

I wanted to try and better understand. We all understand, and we know, that there is this crisis out there. Affordability is probably at the tip of it.

I’m looking for…. Thom, you mentioned the fact that the cities of Burnaby as well as Vancouver had land that they’d identified that they’re ready to go on and just make things happen. I guess I’m wondering about…. Jill’s last comment was about the fact that the land acquisition cost has just become a barrier to getting more development out there. You said 10,000 new homes would need to be put under construction now. I don’t know where that is. I’m assuming it’s across the province.

[2:55 p.m.]

I’m wondering about the barriers government has in the way. One of the ones I know that the city of Kelowna has identified is Ministry of Transportation, because Highway 97 runs through the middle of the city, and 800 metres on each side requires Transportation approval. It has been very difficult for them to deal with the development, because most…. I mean, it’s not all built in that 800 metres, but a lot of new development is happening there. There’s also Ministry of Environment, as well as Forests, that is another consulting branch of government.

Is that something that any of you have….? I guess I’m just wondering. Do you have anything to add to that, or is that a fact that’s slowing down part of the development? Maybe I’ll put it to Thom, since he raised the number of 10,000.

T. Armstrong: Thanks for that question. The short answer to your question is that all of the variables that you identified have the effect of slowing down the development of not only community-based housing but private sector housing as well.

It’s such a truism that in housing development, time really is money. And in our case, it’s quite often opportunity too, because the windows for accessing either federal or provincial funding come and go. If a process that is a consequence of a municipal delay or the failure of more than one government department to climb out of their silos and cooperate with each other…. That’s adding cost to a project, which in the non-profit and co-op worlds, goes straight to rents, because we don’t have a profit margin to erode.

You’re right. The solution to it is, clearly, political will. That’s why some of the conversations that have been happening in Victoria and within the provincial government around the kinds of levers that the province might bring to bear to create incentives to climb over those hurdles and make the process quicker, cheaper and easier to navigate for community housing groups is of such interest to the sector.

R. Merrifield: The question, actually, is for Thom. Just a clarification: you indicated that there was a certain number of housing units lost, and then 11,000 added — one created for every three that were lost. Was that number, then, 33,000 or 35,000?

T. Armstrong: Between 2015 and 2019, there were 34,000 affordable rental homes lost. And by affordable, we mean rents averaging around $750 a month. Those are in older buildings that are frequently the target of investor purchasers.

By lost, we mean either demolished to make way for new developments or renovated to the extent that the tenants can’t afford the new rents. During that [audio interrupted] so affordable housing. That’s why, in our view, the acquisition fund proposal is so critical. We want net increases in affordable housing, not just the flashy new supply and the hidden loss of affordability so that at the end of the day, our net outcome is a negative.

R. Merrifield: Thank you for that clarification. My question on that, then, is on that grant for acquisitions for the rentals. If there’s kind of a natural life cycle to a building, what is to prevent those new acquisitions — because they are not new buildings, as I understand; they’re actually existing rental buildings — from needing to increase their rental rates once renovations take place as well?

T. Armstrong: That’s what the fund would be used for. As you put your offer to purchase together, you would do a calculation based on the purchase price and the net operating income you’d need from rents to be able to maintain them — to service that debt and to meet the operating costs and reserve allocations for the new project.

You would quickly realize that you can’t do it based on the existing rents. But once you’ve got those numbers, you know exactly what the equity gap is, and that’s what the fund would be used to plug.

[3:00 p.m.]

The notion would be that in the hands of the new owner, either a non-profit housing provider or a co-op or a community land trust, the transaction would be rent neutral for the tenants. As Jill pointed out, in some of the great examples that are out there in the non-profit sector, rents would actually drop relative to the market and to people’s incomes.

R. Merrifield: Thank you for the answer. I would just love to see some of that detail fleshed out in any sort of written submission, if it’s possible.

H. Yao: I have a question for Nizar. You mentioned that about 39 percent of our homeless population, unfortunately, often self-identifies as Indigenous. You’re talking about an Indigenous housing fund.

I just want to have a quick confirmation. When you’re talking about an Indigenous housing fund, are we talking about affordable homes, or are we talking about supportive housing?

N. Laarif: Our ask is for the two. So for affordable housing, which is the intent of the Indigenous housing fund, which is mostly rental, mixed or RGI…. That’s our first ask with regards to IHF: to double the original commitment of 1,750 units, with 800 units included in the upcoming budget.

For the supportive housing fund, what we’re saying is only 6 percent of that fund is going towards Indigenous supportive housing. When we see the stats that almost 40 percent of the chronically homeless population are Indigenous, we want the fund to represent those inequities in numbers — so boost the 6 percent to a level that would match the 40 percent representation in the core housing need.

J. Routledge (Chair): Are there any other questions?

Well, it looks like you’ve covered all of our questions and concerns. I’d like to thank you all of you on behalf of our committee for taking the time to meet with us.

Thank you for your advocacy for affordable and supportive housing. Thank you for sharing with us your expertise in this area and also sharing some ideas for solutions on something that I think we all agree is a huge crisis in this province. So thank you for being part of this.

We will now recess.

The committee recessed from 3:02 p.m. to 3:17 p.m.

[J. Routledge in the chair.]

J. Routledge (Chair): Hello, everybody. We’ll continue with public consultation on Budget 2023. Our next topic is housing. We have with us Edwina Nearhood, B.C. association, Appraisal Institute of Canada, and Harriet Permut, Real Estate Board of Greater Vancouver.

Each of you will get to make a five-minute presentation, in turn. The timer is on the screen. We’d ask that you watch the timer to make sure that you don’t go over five minutes. After we’ve heard from both of you, we will invite members of the committee to ask questions. They may ask questions of individuals, or they may just ask a general question. Either way, both of you can chime in, build on each other’s ideas and contributions.

With that, I’ll invite Edwina to give her presentation.

Budget Consultation Presentations
Panel 10 – Housing

APPRAISAL INSTITUTE OF CANADA,
B.C. ASSOCIATION

E. Nearhood: I just want to thank the Chair and the committee for inviting the B.C. association, Appraisal Institute of Canada, also known as AIC-BC.

As you may know, AIC-BC represents over 1,200 ap­praisers across British Columbia and the Yukon. Appraisers are an essential part of Canada’s real estate market. They continue to uphold independent, third-party valuation fundamentals and help mitigate risks by ensuring lenders, insurers and consumers make informed deci­sions. Appraisers — who work alongside homebuilders, realtors, mortgage brokers and homebuyers — form an important part of British Columbia’s real estate industry.

Appraisers are especially important during uncertain economic times such as we are experiencing right now. Strong valuation fundamentals have helped Canada’s economy remain steady in the past and are helping now.

AIC members help maintain market fundamentals by contributing their real estate expertise and knowledge to the lending industry and providing sound valuation advice to all stakeholders, including government.

[3:20 p.m.]

This is why we are first recommending that appraisers be included in all government consultations and decisions on housing, across all ministries related to housing and financial policies.

Secondly, AIC-BC members also believe that accurate market data is the foundation of quality valuations. Unbiased and independent real estate appraisals play a vital role in helping British Columbians make important decisions when buying a home. The lack of reliable information puts the financial system and British Columbians at risk for inaccurate valuations and fraud.

This is why we are asking for the government’s support in corresponding with Multiple Listing Service, also known as MLS, which provides data to realtors about properties. The data included in the MLS system is needed for appraisers to complete full and accurate valuations, helping home buyers and the real estate market remain stable.

Lastly, British Columbia continues to face major challenges when it comes to housing affordability. While the government is investing in affordable housing and looking to implement various policies, such as the cooling-off period, current inflation rates and rising interest rates are making a bad problem worse.

To ensure that the government has a full scope of the real estate market in British Columbia, we are recommending that the government create a program that funds appraisal research. This will help to ensure that the government has accurate data when making decisions on housing policies or affordable housing projects. Appraisers are unbiased participants in real estate transactions and should remain a valuable resource for the government.

In conclusion, we are asking for the government to support the work of appraisers, which, in turn, can help the housing policy development process. By including appraisers in decision-making, supporting greater data access and funding research done by appraisers, the government will be able to have a more fulsome picture of British Columbia’s real estate market. By working together, we can ensure that the affordable housing projects are built on time and on budget and that, together, we can tackle the housing affordability crisis that British Columbians are facing.

We just want to thank you once again for inviting AIC-BC, and I’d be happy to take any questions that you may have.

J. Routledge (Chair): Thank you, Edwina.

Now we’ll turn to Harriet.

REAL ESTATE BOARD
OF GREATER VANCOUVER

H. Permut: Good afternoon. I’m Harriet Permut, government relations manager for the Real Estate Board of Greater Vancouver. Since the property transfer tax, or PTT, was implemented in 1987, the real estate board has been recommending changes each year to make the tax more affordable for first-time buyers. Here I am today, 35 years later, representing the real estate board as we again ask for changes.

First, I’d like to give you some brief background on the board. The real estate board represents more than 14,800 licensed residential and commercial realtors and their clients in greater Vancouver, the Sea to Sky corridor and the Sunshine Coast. The real estate industry is a key economic driver for this province. Last year in greater Vancouver, a total of 44,000 homes sold on the Multiple Listing Service, the MLS, generating $2.9 billion in economic spinoff activity and almost 21,000 jobs.

I’m here today to talk to you about how rethinking the PTT price thresholds could make home ownership more affordable for first-time buyers.

Today first-time homebuyers who buy a resale home priced up to $500,000 or a new home priced up to $750,000 may qualify for a PTT exemption under the provincial first-time-homebuyers program or the newly built home exemption. But realtors throughout our real estate board area continue to hear the same desperate concerns. Their clients are unable to access this first-time-buyers program because there are so few resale or new homes that qualify in the price categories. Even the media has picked up on this particular trend.

In 2021, only 164 resale townhouses priced at less than $500,000 sold on the MLS in more than 20 communities within the board’s boundaries. In 2017, 765 townhomes sold for less than that amount, and 2017 was the last time that the exemption threshold was raised. Even buyers of condominiums often won’t qualify for an exemption, since the benchmark or typical price in our board area is almost $780,000 for a condominium.

[3:25 p.m.]

Today a modest resale townhouse in Maple Ridge, the most affordable community in the Lower Mainland, costs a homebuyer just over $859,000, an increase of 99.3 percent since May of 2017, when the same townhouse sold for $431,000. The PTT on this Maple Ridge townhouse will cost the homebuyer more than $15,000. The annual household income required to service the mortgage for this townhouse is just over $176,000.

First-time buyers are important to the health of the housing market because they typically buy entry-level, lower-priced, resale homes, enabling existing homeowners to trade up to larger homes if their family expands or down to smaller homes if they’re empty-nesters.

Families looking for an affordable townhouse typically move further and further, until they find a home they can afford. They may be forced to leave support networks of family and friends, schools and communities they love. This changes neighbourhoods, often dramatically. Recent census data indicates that many of our closer-in neighbourhoods have been losing children, which may be the leading edge of a change we need to be watching.

I’m here today with three recommendations. First, commit to a broad-based review of the property transfer tax. Since the PTT was introduced in 1987, there hasn’t been a major review of the tax to adjust for housing market changes. It’s time.

Secondly, raise the PTT price thresholds. The first-time-buyer PTT exemption threshold for a resale home should be raised to $750,000 from $500,000, to match the threshold for buyers of new homes. We’re also asking government to increase the 1 percent PTT threshold to $750,000 from $200,000 for all homebuyers, index the PTT thresholds to move with the assessed values of residential class 1, and make annual adjustments to the resale and newly built exemption thresholds.

Finally, increase the affordable housing market supply. Do this by mandating inclusionary zoning by amending the Local Government Act and the Vancouver Charter to require local governments to pre-zone land and infrastructure for missing middle market homes, including smaller-lot townhomes, row houses, laneway homes, du­plexes, triplexes and fourplexes and ensure local governments to change zoning bylaws to allow stratification of coach houses, laneway houses and secondary suites.

Thank you very much for the opportunity to speak to you today.

J. Routledge (Chair): Thank you, Harriet.

I’ll now invite the committee to ask questions.

H. Yao: Thank you so much, Harriet, for the lovely presentation. Definitely, I’m still learning, so please bear with me as I ask this question. You talk about the property transfer tax, which obviously is falling behind the times. It’s not keeping up with the modernized affordability crisis when it comes to housing. And you talked about increasing the threshold.

I guess my question right now is…. Obviously, housing prices are expected to either rise or fall as we move forward into the future, especially as we see, now, the current interest rate increase. Is there any kind of consideration, maybe, or suggestion for a more mobile rate, or maybe an annual review that will actually allow us to stay caught up to current demand? That way, the first-time homebuyers can continue to be fully supported when actually trying to purchase the housing price for housing and not be burdened by the property transfer tax.

H. Permut: Are you asking me for a variation on how the property transfer tax could be levied? Is that what you mean?

H. Yao: Yes. Well, basically, I guess, if you don’t mind me clarifying my question…. Obviously, you mentioned it has fallen behind the times. I’m worried about…. If we set a standard today, it’s going to be followed some ten years from now, when either it could be too high or too low.

To piggyback on your recommendation, I’m wondering. Based on your professional expertise, how likely…? Maybe once a year…? Is there some kind of committee? Or is there a percentage of the current average housing price we should actually consider before we set up a standard? Is it more fluid, when it comes to the need to match the first-time homebuyer, instead of setting a specific standard?

H. Permut: We’ve spoken in the past about doing annual reviews in the way that you would do a home price index, to index the tax. We’ve spoken about it before. It’s a difficult one to measure, but we did things like that with the consumer price index, for instance. You could find it. There are home price indexes, nationally and in B.C., that you could peg it against. When they go up or down, it’s possible to index the tax to that. We’ve recommended that in the past. It’s certainly possible.

[3:30 p.m.]

Governments hate that, because they can’t always know exactly how much money it’s going to raise, but it is fairer to consumers if it’s pegged to some reasonable index that’s within the industry. It’s not our index. CMHC produces that.

H. Yao: Thank you.

J. Routledge (Chair): Edwina, you wanted to jump in on this?

E. Nearhood: Yeah, I do want to jump in with that. I think that’s a great suggestion. You can just go to the municipalities, for example, who are constantly adjusting their mill rates based on the needs. If we’re not doing that, and we’ve got a 30 percent increase or, as Harriet has said, a 99 percent increase in just five years…. It can be quite a passive tax increase that’s not being captured, and it’s coming forward to the taxpayers and the housing owners.

M. Starchuk: Thank you to Edwina and Harriet for your presentations. My question is to Edwina. You were talking about how the data in MLS is inaccessible to appraisers so that they can better do their job. Can you maybe just tell me what the barrier to that access might be?

E. Nearhood: I think what we’re asking for right now — and we are just in the preliminary discussion with various real estate boards — is to work collaboratively together so we can be understood as professionals of choice that have an important ability to use that information for accurate pricing. There’s a lot of data that is available. We’re asking to have government work with us and maybe just have a letter of understanding that that would be a reasonable ask on the MLS boards.

H. Permut: Just very briefly, we have a category of membership for appraisers at our board. We’ve got lots of appraisers who deal with us every day, using our data, because they’re members of the board. We have categories and rules and such that go with that, just like we do for municipalities. We have municipal members as well.

Maybe that’s the answer. You could get full access if you’re a member of a real estate board. It’s possible to do, if there’s a category for that. We do it. I’m sure we’re not the only ones.

E. Nearhood: I think it’s a bit of a larger conversation. You’re absolutely right. We do have access. The access has been limited over the past several years.

We’re just reaching out. I find every board has a different policy and level of access, so we’d like to have some continuity across the board. I recognize that every board works on their own. It’s difficult to kind of have that standardization across the province.

M. Starchuk: A general comment would be that it’s an important part of somebody’s purchase to know what the building is appraised at for what is, in likelihood, going to be one of the most major purchases of that person’s or those persons’ lives that are out there. So to have something that reflects something that’s actually in today’s current market, as opposed to what it was three years ago, I think is really important.

E. Nearhood: I think it’s time of access, too. There are programs available that do help with that ease of access. Also, remembering that it’s not just the homebuyer that’s depending on those appraisals, sometimes. It’s risk assessment with the lenders, too, that really does help mitigate any potential for fraud or money laundering.

K. Kirkpatrick (Deputy Chair): Thank you very much, presenters. That was very interesting. Certainly understand everything that you’ve said, and it being very reasonable and make sense.

I wanted to ask Harriet more specifically about requiring municipalities to pre-zone areas. It sounds very easy to accomplish. How would that work with municipalities, and how realistic is it that you think we can have that happen?

H. Permut: Well, you and I have been around a while, Karin. I won’t say how long. It used to be….

This isn’t that radical at all, actually, because that’s the way it always used to work. Zoning was done pre-zoned. Areas were pre-zoned according to a plan. Developers knew what to expect in those areas, and they were given an understanding that that’s what was desired. If that could be done by the municipality, it would certainly be done faster than it would be one lot at a time, especially if they’re in an area that’s not controversial in any way.

[3:35 p.m.]

It could be done according to the official community plan, which is an approved document of the community that the public has input towards.

It’s not that hard. It used to be perfectly easy. Then we started talking about zoning one lot at a time, and that’s a bit of a nightmare, as you know.

K. Kirkpatrick (Deputy Chair): I remember that now, yes. Thank you.

H. Permut: It wasn’t that long ago, but long enough. Yeah.

R. Merrifield: Thank you, both, for these presentations today.

My question is to Edwina. Recently there were some changes made to a cooling-off period, etc. My question is: is there the capacity, within the number of appraisers, to pre-appraise every home that goes for sale in a timely fashion? I’ll add that last part of it. I know that at some points, the four to six weeks starts being bounced around, etc., rather than the four to six days. Is there enough capacity within the appraisers today?

E. Nearhood: Right now in B.C., there are 1,200 ap­praisers across the province. Some of them are retired.

If I can give you some statistics. This is from our insurance statistics, facts and figures. In 2021, AIC-BC completed third-party appraisals that were valued at approximately $400 billion worth of property, and $248 billion, or 62 percent, of that value was residential property.

Just to give you some context on that, I do have some more figures that would be interesting to quote. So far this year there has been $9.1 billion in total volume of sales. Properties sold are 8,594 — those are March stats — and $1.1 million is the average sale price. That kind of gives you some reflection on what the capacity is.

I would venture to say that not every property would need an appraisal — if you’ve got a high down payment or a lower risk assessment or an ability to be comfortable with the value, if you’ve got several condos in one building. It comes down to risk assessment. If there’s uncertainty in any way, then the appraisal is a very valid approach.

Also, it kind of cools things down when you’ve got a hot market where things are just overselling.

J. Routledge (Chair): Well, we are out of time. In concluding this panel, these presentations, I want to thank you, on behalf of the committee, for taking the time to meet with us, engage with us and share your perspective on how to make housing more affordable. I think it’s top of mind for most British Columbians, the lack of affordability of housing.

There are many other presenters who have come to us either to tell us it’s a problem or to share their ideas about what the solutions are. I do want to say that what you have proposed to us today is quite unique and quite specific and concrete, and we thank you for that. So with that, we’ll say goodbye.

We can move right to our next panel, which is fisheries. We have two presenters. I’ll welcome two presenters. One is Emily Orr with the United Fishermen and Allied Workers Union, and Christina Burridge, B.C. Seafood Alliance.

You each have five minutes to make your presentation. We’d ask that you keep an eye on the timer on the screen so you know when your time is wrapping up. Once we’ve heard from both of you, the committee will ask questions for roughly an equivalent amount of time.

With that, I’ll ask Emily to take it away.

Budget Consultation Presentations
Panel 11 – Fisheries

UNITED FISHERMEN
AND ALLIED WORKERS UNION

E. Orr: Thank you very much for this opportunity to speak to you this afternoon.

We have, from the United Fishermen and Allied Workers Union, some strong themes that we were hoping to address, in terms of the 2023 budget. To get started, the theme that I wanted to speak to in general is the transition and rebuilding of commercial fisheries.

[3:40 p.m.]

The first piece that I’d like to talk about…. As many of you are aware, last summer we were struck quite unawares by an announcement that shut down roughly 60 percent of commercial salmon fisheries in B.C. Harvesters were left without any notice this was coming. They were left, some of them, on the grounds, freshly geared up, fueled up, ready to go fishing and truly not knowing what to do or where to turn. There were no emergency supports in place. There’s no transitional support in place for these harvesters. It’s something that we’ve been really focused on trying to pull together for them.

For some of these workers, the only work they know is in commercial fishing. They do not have the means to transition comfortably out of fishing, so they’re quite stuck. Some of these folks are on in their years. Retraining may not be a viable option. It may not be a pragmatic solution. Some of these folks are looking very desperately at an unplanned early retirement.

There’s a piece here…. The DFO is looking at a licence buyback. Licence buybacks really serve the licence owner. Lots of times, that’s a company. It’s not even the active harvester. Many active harvesters who’ve fished their whole lives don’t own licences. It doesn’t help them. It doesn’t help crew. It doesn’t help shoreworkers. There’s a raft of workers here that are really being left in the lurch, and we’ve been really begging, since the onset of these closures, for supports — transitional supports for retraining and, potentially, for a bridge to early retirement.

In B.C., there is currently, as you’re probably aware, a very robust program of supports for forestry workers displaced by old growth deferrals. That program really mirrors exactly what we’d love to see for fish harvesters. It offers retraining opportunities. There’s a rapid response team to go into the communities to assess what the economic development and community support services are that are needed. There’s bridging to early retirement, offering up to $75,000 per worker over 55 years old. There are all kinds of exactly perfect programs that we would really love to see for B.C. fish harvesters.

We also want to see a way for fisheries to survive. We need ways to support the folks that can stay in or that wish to stay in. That maybe looks a little bit different. I’ll move on into the next thing, mindful of the time. That’s certainly a big one that we’d really like to focus on.

The next piece is around fish hatcheries. As we look at the closures in salmon, looking in the future and hoping to rebuild and keep a fishery alive, it’s really important that we support these workers so that they can continue on and survive this restructuring. The knowledge succession, otherwise, is lost. The ability to operate these fisheries, the infrastructure that’s involved in fisheries, will suffer and degrade and be completely collapsed if we don’t do something to support these harvesters.

Small coastal rural communities that really rely — often really into 60, 70, 80 percent of their micro-economies — on fisheries are struggling. It’s imperative that we do something to help those communities move forward. So hatchery production is a big one. We’d really like to see an increase in commercial fish at hatchery production level, an increase in the number of hatcheries.

DFO is looking at reducing hatchery production because of the reduction of fisheries, and to our thinking, that’s backwards. We want to see a plan that involves an improvement and a durable way to look toward the future and have better fishing opportunities for commercial harvesters.

The last thing I was going to mention is around owner-​operator policy and supports for that. We’d really like to see a provincial loan board set up to help new entrants cross those barriers that currently prevent them from getting involved and owning their own licence, getting out of foreign ownership and reducing corporate concentration. That owner-operator policy piece and the loan board are quite tied. We’d really like to see more of what is offered on the east coast become a reality for the west coast harvesters.

I see I’m very close to being out of time. I welcome your questions.

J. Routledge (Chair): Thank you, Emily.

Now we’ll turn to Christina.

B.C. SEAFOOD ALLIANCE

C. Burridge: Hello, everyone. The B.C. Seafood Alliance is an umbrella organization whose members represent fisheries accounting for about 90 percent of the value of wild seafood from Canada’s Pacific coast.

[3:45 p.m.]

Our members are associations that represent commercial fishermen — the licence holders and vessel owners and operators — in all major fisheries in B.C., with vessels ranging from less than 30 feet to more than 150 feet. We also represent most of the major seafood processers, which account for at least 70 percent of salmon, herring and groundfish production, as well as some specialty products.

Thank you for the opportunity to appear today. The new format for specific recommendations is very helpful.

Fisheries issues are sometimes difficult, I think, for the province, because while you have interest, you don’t have jurisdiction, in most cases. Today I have only one recommendation, and it is one that falls squarely within provincial responsibility.

Our recommendation is that B.C., in its next budget, addresses the inequity faced by B.C. commercial seafood harvesters and provide an exemption to the motor fuel tax and carbon tax equivalent to farmers and consistent with every other province in Canada. Every Canadian province except B.C. provides commercial seafood harvesters with a tax concession from the motor fuel and carbon tax used in commercial fishing vessels.

Historically, commercial harvesters in B.C. were eligible for these concessions. Changes to the law in 1985, ostensibly to simplify government policies, eliminated this concession, despite the government of the day saying that there were no policy changes in the legislation.

The reason for this exemption or concession in other provinces is that food production, including commercial fish harvesters, is essential to Canada’s food security and its reputation as a reliable net exporter of food to the world. While the exact concessions vary province by province, all other provinces provide exemptions or refunds. We’ve detailed these in a letter to Ministers Bains and Robinson.

Scientific evidence, such as recent studies by the Ecological Society of America, demonstrates that the environmental costs of animal-sourced foods created in the land-based farming industry far exceed the environmental costs of food produced from the sea. B.C. farmers enjoy an exemption from the motor fuel tax and the carbon tax, while B.C. seafood harvesters do not. We should note here that in our view, relevant aquaculture operation vessels, such as aquaculture support vessels, should also be included if you decide to fix this historic inequity.

Fuel costs have risen dramatically this year. On February 28, a litre of diesel fuel in Ucluelet cost $1.28. Today it was $2.18 and rising. The imposition of the motor fuel tax and carbon tax on commercial vessels supporting food security in B.C. and for the world is an unfair and unusual hardship compared to the rest of Canada.

The past two years, as Emily has said, have taken an unprecedented toll on many industries in B.C., including ours. We respectfully ask the committee to re-evaluate the current tax practices faced by B.C. producers of seafood to the domestic and export markets and to assist in our post-pandemic recovery.

Thank you very much. I see I’ve got a minute to go, but I think I’ll leave it there and say only that we would support Emily’s concept of a provincial loan board, as well.

J. Routledge (Chair): Thank you, Christina.

I’ll now ask the committee for their questions.

The first one is Megan.

M. Dykeman: Thank you for the presentation. I have one question that’s two parts; it’s related. The first one is…. I’m gathering from your presentation today that those that farm fish, or commercial fishermen, are not able to use marked gas.

Then the second thing is: when the changes were brought in, in the mid-’80s, was there any conversation beyond…? I see you’re saying, “simplifying government policies.” Were there any specific reasons, even though I know you alluded to it being simplification, that these were changed, and was marked gas ever allowed for commercial fishing boats?

C. Burridge: Yes, it was allowed before 1985. The government of the day wanted to simplify the regulations for fuel sellers, because there were at least three or four different ones, so it consolidated everything into a single regime.

[3:50 p.m.]

At that point, for some reason…. There’s nothing that we could find in the legislation or the debate at the time. Commercial fish harvesters were simply forgotten, and nothing has changed since then.

We don’t think it was deliberate. We think it was an oversight. And 1985 was actually before my time in fisheries, so I don’t really remember whether there was a big fuss about it at the time or not. But I know that from time to time, some of my members have felt that this was profoundly unfair — as it is, I think. Of course, the situation has become so much more acute this year and looking to get worse before it gets better.

M. Dykeman: Thank you. It’s very interesting.

B. Stewart: Thanks very much. I really enjoyed the succinctness of both your presentations. It’s good to see you again, Christina.

C. Burridge: Hello, Ben.

B. Stewart: Emily, I am disturbed by what is happening with the workers that work in fisheries. Everything you’ve outlined there makes complete sense in the sense that we need to find a way. I do think it is the province’s responsibility.

I was the unfortunate minister that had to sign over the fisheries responsibility to the feds, and I didn’t agree with it. But anyways, it did happen. I can only tell you that this is one of the things that I fear. I don’t know what it is about DFO; they seem to forget about the other coast a lot. But I do think that we need to really invest.

So the question I have is…. You know, what I hear from even First Nations is that predatory species…. There needs to be some…. I don’t know the science behind this. Is that not part of the salmon issue? Or maybe it’s a seafood issue, Christina. I don’t know.

E. Orr: Certainly. If you’re referring to pinnipeds, we’re currently in the midst of an explosive, unprecedented pinniped population. We have UBC marine biologists chomping at the bit to get the message out that unless we do something to manage pinniped populations back to a historical balance, salmon don’t have a chance.

Unfortunately, commercial fish harvesters are on the unfair end of poor optics. Often they’re regarded as plunderers of the resource — that they’ve sort of earned their own demise. As a semi-retired commercial fish harvester, I can vouch and say that after over 20 years of representing and advocating for harvesters, the opposite is true. These folks have everything to gain from well-managed fisheries. So when we look at the reasons for the cause in salmon, for example, climate change and habitat degradation and pinnipeds are really at the centre of what’s gone wrong here.

So we could get into all of that, and that’s a much larger conversation. But when it comes down to who’s bearing the cost and the brunt of these decisions out of Ottawa, it’s these individual harvesters and their families who are struggling and looking at bankruptcy and defaulting on mortgages. The union has since added mental health coverage to its benefit plan.

There’s no way to overstate the damage and destruction these policy decisions are having on individual workers. If I can do anything to help ease that or to help coordinate something or to promote that, then my purpose is fulfilled, because it’s just heartbreaking to see these lifelong fish harvesters be pushed out of their work, especially with no notice and no support in place.

R. Merrifield: Thank you both for the presentations. They were very informative. I’m going to try and put, I guess, a couple of questions together, and hopefully you guys will be able to tear them apart and answer them.

Emily, just in order of magnitude, how many of these fishing families are we talking about? What would be the order of magnitude in terms of support? Also, I’m very curious as to what impact the Alaskan fisheries have on our fisheries and our number of salmon, etc. If that’s a question for another time, that’s fine as well.

Then, to Christina: what’s the total value that’s required for the exemption? Have we quantified how much fuel is actually utilized? Just a number, if that’s possible.

Thank you so much, both of you.

E. Orr: Christina, did you want to go first?

[3:55 p.m.]

C. Burridge: Sure.

It’s a little tricky to quantify the number, but we are proposing to do that over the next few weeks. I can tell you that for most commercial seafood harvesters, fuel is probably their biggest single expense. When we look, say, at Grand Fish, which harvests the majority, by volume, of species in this province, a single trip might use anything from 8,000 to 140,000 litres of diesel fuel per trip. Now, obviously, that depends on the size of the vessel and the length of the trip, but you can see that there is something real here.

Most other provinces give back to commercial seafood harvesters somewhere between 15 and 22 cents, so I think we could give you a number in the next fairly short while as to, roughly, what it would cost. I’ll just add it would be a lot less than in 1985, for many of the reasons that Emily has mentioned.

E. Orr: To your question, doing some quick math, if the fishing fleet in salmon is reduced by half, we would lose 50 seiners, multiplied by an average of five people; 500 gillnetters, by 1.5 people, which I understand is DFO’s multiplier; trollers would be 50 times 2.5. The math works out to 1,125 at first estimate — individuals and their families.

Shoreworkers are more difficult to assess. Fish plants sometimes are able to stay operational on other species of catch and sometimes not. We’ve also seen a drastic reduction in herring, for example, and as that infrastructure is fractured and dismantled, those shoreworkers are losing their jobs too. If there aren’t the fish coming into the plants, they don’t need the fish workers there to process them. So those jobs are being lost. And those jobs are more difficult….

I understand, when one of the canneries shut down — the Canadian fish cannery shut down — that 700 people used to be employed there. Currently, it went down to 20. It’s a staggering loss, but it’s a finite number, I suppose, if you want to look at it in that type of context.

In terms of the value of that, of what a program would look like, I know that the forestry old-growth deferral program to help those workers…. They just recently were awarded another $19 million on top of…. I believe it was $120 million to initially get it going. Between what has been offered in supports to agriculture workers post-flood and to the forestry workers, those two support programs combined, I think, were just shy of $360 million.

I don’t know what the program operational costs would look like to run this for fish harvesters, but the UFAWU and the Native Fishing Association were part of administering the program in the Mifflin era to do the retraining. That part is something that we’d be really willing to work alongside with and to help garner those details and to have that connectivity with the fish harvesters and shoreworkers and try to put something into place and evaluate what would work really well.

I don’t know if I can speak to the exact number myself. I tried to speak with folks in forestry, but they’re a bit tight-lipped about their budget and how they arrived at it. But I’d be really happy to flesh out some of those numbers and look at ways that we can put something together.

J. Routledge (Chair): Well, thank you so much to both of you. You have certainly painted a dire picture of the future of the fishing industry in British Columbia, an in­dustry…. Whether or not any British Columbian, any of us, have worked in the fishing industry, we certainly know that it’s a big part of our identity as British Columbians.

Thank you for sharing your warnings with us and for reminding us we have some models in place that could be useful to people in this industry.

C. Burridge: Thank you. Appreciate being invited.

E. Orr: Likewise. Thank you very much.

J. Routledge (Chair): I guess our next person isn’t here yet. We’ll take a brief recess.

The committee recessed from 3:59 p.m. to 4:01 p.m.

[J. Routledge in the chair.]

J. Routledge (Chair): Welcome back, everyone. Our final topic for the day is agriculture, and we have one presenter today. It’s David Zehnder, Farmland Advantage.

David, you have five minutes to make your presentation, and then the committee will ask you some questions.

Budget Consultation Presentations
Panel 12 – Agriculture

FARMLAND ADVANTAGE

D. Zehnder: Great. Thank you so much. Thanks for the opportunity to present today. I appreciate that very much.

My name is Dave Zehnder. I’m a rancher from the East Kootenays and the Invermere area. It’s a very wet day out here today. There was a tremendous downpour. A lot of our flood warnings and watches are being all upgraded, which kind of underscores the need for our request today.

I grew up in this beautiful area, and like many areas across the province, farmers and farmland have been a very important part of the community. But over my lifetime, there has been a lot of recreational development that has been squeezing a lot of that out. I saw a lot of the things that I really value that go along with that, like the wildlife populations and clean water, also being impacted.

That was kind of the impetus for starting this program, which is called Farmland Advantage. Farmland Advantage is a program that contracts farmers to take on special projects to improve habitat on their farms so that they can produce cleaner water, fire protection, carbon sequestration and more abundant wildlife populations.

A good example of how it works is that we would target farms — a farm that has been identified as having high potential for flood mitigation, for example. Then once we’ve identified that farm through some GIS analysis, we would then proceed to contract the farmer to take on some of these extraordinary actions, such as planting trees with deep roots along creeks and rivers, which would allow the stream bank to be more resilient to floodwaters and avoid excessive erosion during flooding events.

Last year we benefited from the healthy watersheds initiative, which helped many of our farmers take on these projects. We worked alongside many of our partners to implement some of these amazing solutions.

[4:05 p.m.]

The private agricultural land reserve area of the prov­ince is only about 2.5 percent of the whole provincial land base. But this area is disproportionately important because of its position in the landscape, being in the valley bottom. Valley bottom lands are known to have over ten times the biodiversity, for example, than some of the more pristine alpine areas, which are often first thought of as areas for protection.

Almost all the creeks and rivers of the province flow through a farm or ranch at some point. Of course, farms can play a really important role in mitigating fire, if there’s wildfire coming into a community, because the farms are also positioned often in areas that are close to communities.

This project has been really successful in working with farmers in this really important landscape to achieve the kinds of things that we’ve been talking about. With only five minutes, it’s hard to explain the depth and breadth of the program, but you can check out our website, of course, and we’d be happy to answer any questions about how the program functions.

Our primary request that we have for this committee is to consider a request — where we join many of the watershed groups in the province — to have the province commit to a $75-million-a-year fund that would go toward supporting watershed groups and entities like Farmland Advantage to continue their work. That would be a sustained fund over many years, ideally.

We would like to see an increase in the commitment from the wildfire protection part of the province to support Farmland Advantage in their role in contracting farmers to take on extraordinary fire mitigation practices so that they can mitigate the risk of fire to their communities, and just to help agriculture, overall, be part of the solution to many of the climate change and related challenges that we’re experiencing today in a way that we can build back better together, alongside First Nations and other stewardship groups, into the future.

Thank you for your time.

J. Routledge (Chair): Thank you, David.

I’ll now invite the committee to ask you some questions, and the first one is Megan.

M. Dykeman: Thank you, Madam Chair. I appreciate it.

Thank you for your presentation today. I really appreciate it. I’m trying to remember. I’m wracking my memory here, but I believe…. I’m from Langley East and, at one time, was part of the agricultural advisory committee there when the sustainable ag association started up.

Now, you’re doing some work, I believe, with the township of Langley, with their ag viability strategy in the Langley sustainable ag association. I can see you nodding.

D. Zehnder: That’s right.

M. Dykeman: Okay. I couldn’t quite place you, so that’s great. Very exciting.

I’m wondering, though. One of the things I was curious about, listening to your presentation, is: is there any connection with the environmental farm plans? I know now that they’ve evolved a little bit, incorporating regenerative practices, and so on. I’m wondering. With the Farmland Advantage program that you’re talking about, is there any connection to the environmental management plans, or are they looking to cover different areas?

D. Zehnder: Thank you for that question. I’m actually an agricultural environmental farm plan adviser. As we developed the program, we very much designed it to interface and be synergistic to the environmental farm plan program.

Coincidentally, the Investment Agriculture Foundation…. Our goal was to develop this program, when we’ve been working on it for the last 15 years, alongside partners like the township of Langley and multiple other local organizations and governments. The whole plan, if it had legs, was to turn it over into an actual program.

We’re really excited that…. The healthy watershed initiative helped us do that last year. Investment Agriculture Foundation took on the program. But they also, coincidentally, have taken on the management of the environmental farm plan at the same time. It’s just a perfect kind of intersection of all of these things happening at the same time — the environmental farm plan turning it over to the Investment Agriculture Foundation and, at the same time, taking on the Farmland Advantage.

[4:10 p.m.]

Those pieces that were designed to fit together can now seamlessly work actually together strategically so that we don’t duplicate efforts. We can build on the strengths of the environmental farm plan program but also take it further.

The environmental farm plan helps farmers to take on some of these actions. It just helps them to implement that. Whereas Farmland Advantage contracts the farmers to maintain these things over the long term. and we also then can go back and monitor how these things are actually working. That’s how those pieces fit together.

M. Dykeman: Thank you so much. I hope that you’ll put in a written submission, too, at some point, because there are so many moving parts to this, and it’s very interesting.

K. Kirkpatrick (Deputy Chair): Thank you very much, David, for this presentation. I looked on the website. What an interesting organization and initiative — very exciting.

The $75 million per year is directed towards the B.C. watershed security fund. Is that correct? Are you working with Watersheds B.C. and some of the other groups on advocating for that?

D. Zehnder: Yes, we are. We’re working alongside all those partners. I think there are 50 partners all together in that initiative now. We are one of those. But we have a unique role in that larger group. A lot of it is watershed groups, stewardship groups — which, by the way, we work with — and they do a lot of the specific actions that are needed. They are often the ones that take those actions or are part of the contract.

We feel like agriculture is uniquely situated to be part of the solution. There are some serious issues around flood mitigation. Obviously, that’s top of mind right now at this point in time. By the time we’re done with that, it’ll be fire season. Farms have historically been considered a victim of some of these things, but in fact they can be a serious part of the solution.

K. Kirkpatrick (Deputy Chair): Thank you very much.

J. Routledge (Chair): Are there any other questions? It looks like we have no more questions for you, David. Let me conclude by thanking you for joining us today. What a great way to end off this day of presentations. You have reminded us that not only do farmers put food on our table, that not only do farmers sustain us but that you have a critical role to play in avoiding the many disasters that have plagued us. You play a much bigger role.

Thank you so much for what you do, and thank you for sharing that with us today.

D. Zehnder: Thank you so much. Can I ask one quick question? I just am trying to clarify: on the written submission side of things, do we, in fact, have until the 23rd to do that written submission, or am I misunderstanding that process?

J. Routledge (Chair): We will have staff follow up with you, specifically, on your presentation. The committee is really interested, and you presented a lot of factual information that we want to make sure we catch — not just from our own scribbled notes that may or may not make any sense to us. Staff will follow up with you to make sure we get all that.

D. Zehnder: Thanks a lot. I can appreciate you guys have had a long day. It must be exhausting. Thank you so much for putting up with my presentation at the end of the day.

J. Routledge (Chair): It was a pleasure.

I will now entertain a motion to adjourn.

Motion approved.

The committee adjourned at 4:14 p.m.