The committee met at 7 p.m.

[M. Bernier in the chair.]

M. Bernier (Deputy Chair): Okay. Good evening, everybody. It’s Monday, May 1. Welcome to the Select Standing Committee on Children and Youth.

We have a couple of different reports that we’re going to be discussing tonight, but first, we’ll welcome the representative and staff.

I really appreciate your time, again, on a late evening, on these important topics for us to be able to address them.

The first one we have on the agenda here is the consideration from the representative for the report Missing: Why Are Children Disappearing from B.C.’s Child Welfare System? That was just presented here, actually, not too long ago — just a week ago, if I remember — in the House. I appreciate the committee as well as the representative and the office. It’s only been about a week, but we’re able to get into it while it’s fresh, which I think is really important.

We have Dr. Jennifer Charlesworth with us today as the Representative for Children and Youth.

Maybe, Jennifer, what I’ll do is I will start by turning it over to you and allow you to introduce the folks that you have with you. They’ll be part of this report presentation. Thank you again for coming in.

Consideration of Representative
for Children and Youth Reports

Missing: Why Are Children
Disappearing from
B.C.’s Child Welfare System?

J. Charlesworth: Thank you very much.

Good evening. It’s nice to be here with you again. I appreciate the investment of time that you’re making into the work that we’re doing and committing to your evenings with us. I’m happy to be here to present two more reports.

I’d just like to begin in a good way, too, by taking a deep breath and acknowledging the beautiful lands that we’re on — the lək̓ʷəŋən peoples, a “place to smoke herring,” and the Esquimalt and Songhees Nations.

I’d also like to acknowledge the staff that are here with me this evening — the deputy, Samantha Cocker; Pippa Rowcliffe; and executive director of systemic advocacy, First Nations, Métis, Inuit research, Jennifer Dreyer, whom you met last week.

I also want to speak into the room other leaders that have contributed tremendously to the Missing report and to the work that you’re going to be hearing with respect to children and youth with special needs: Blair Mitchell, the executive director for individual advocacy; John Yakielashek, who’s our executive director for reviews and investigations; and Jeff Rud, who’s knowledge mobilization and communications. This was definitely a collective lift. Shortly, I will introduce you to Dr. Pat Mirenda from the University of British Columbia, who will be speaking with us on the second report.

First of all, I’m going to bring you up to date on the latest release. It’s literally hot off the press as of Thursday. Missing: Why Are Children Disappearing from B.C.’s Child Welfare System? This was really motivated because of the work that we do. Stories of children and youth who are lost or missing from the child welfare system continue to come to us and, indeed, are coming across the country. Unfortunately, many of the young people who are lost or missing or fleeing care experience tragic and preventable injuries and deaths.

We’ve been closely monitoring this issue for a long, long time. But in the fall of 2022, we decided to initiate a major project on the young people who are lost or missing from government care. Before we get into the details, I’ll just give you a little bit of a thumbnail sketch on the terms that we’re using.

“Lost” or “missing” — our definition is a young person who is lost or missing from care is a child whose whereabouts are unknown to the Ministry of Children and Family Development or the Indigenous child and family service agencies and where information about their circumstances that contributes to or arises from their disappearance is often unknown or incomplete. If you put this into your own personal context with your own children or the young ones you’re close to, imagine that experience of their whereabouts being unknown, and we actually don’t fully understand what has happened or what is going on that’s contributing to their experience of being lost of missing, or we don’t know enough to really be able to fulsomely come around that child.

[7:05 p.m.]

Over the course of this report, it became evident that many children were also being characterized as AWOL — the old military term, absent without leave — or running away, or runners. When we started to take a look at those stories, we also realized that there was another term we needed to bring in, which was “fleeing from care.” For these young people, these are children and youth who run away from the system due to an experience of a lack of belonging or a lack of meaningful care and support. In essence, they’re simply not getting their needs met. We’ll talk some more about that in a bit.

When we first began the work, we had a very robust project plan, and we had a vision of lots of engagement and convening in a longer period of work that we would be doing. We wanted to include the data and the stories and examine policies and practices in B.C. and elsewhere, and engage young people, family members and those who are providing services to them.

As each week progressed…. As you know, we receive reports of critical injuries and deaths, and our advocates are out there working alongside young people. The more we received notices of children who were lost or missing and who had experienced life-altering critical injuries and deaths, the more that we thought: “We have to do something soon, quickly.”

We decided that this problem called for more urgent action, so we opted to release our preliminary findings, if you will, in the form of an issues brief. This was new for us as a new format, but it meant that we were able to get some things out that we felt were really important for the system to understand so some immediate actions could be taken.

We recognize…. The caveat is that this is not an exhaustive report in the sense that we don’t have the voices of children and youth or their families and caregivers in here, and we also don’t have the voices of the social workers, the child and youth care workers, the police and all of the people that are involved trying to meet the needs of these children. But we’ll come back to that in a moment. We still plan on doing that, but not for this, because we just felt that the timeliness was very important.

Why did we consider it such an urgent issue that it would mean that we changed the course of the project and the methodology? Really, it was about the numbers of kids that were lost or missing in care. We think it’s an extremely troubling situation and, I think, being exacerbated by some of the dynamics that we’re seeing in our communities and with service providers, etc., right now.

To go into the details, over a nine month period that ended at the end of 2022, we received more than 500 reports regarding children and youth in provincial government care who were lost, missing or away from their placement and who experienced a critical injury or were considered at risk of harm during that period. This relates to 198, so just shy of 200 children. Four of them died.

During the same period, the Ministry of Children and Family Development received 12,000 calls about other children and youth who were also missing or absent, but for whom there were not immediate safety concerns. So that’s a significant sort of dividing line there, but that’s a lot of calls. That’s a lot of activity, and it’s a lot of children who are missing.

We felt that was unacceptable. The provincial government is the de facto parent of these children. Like any prudent parent, government should know where the children that they are responsible for are.

Now, there’s a wide spectrum of missingness, as we were calling it, from the system of care. In some cases, the young people are gone for short periods of time. They’re gone, they come back, and life carries on. For others, it’s all the way to the spectrum where a child never makes it home or they’re gone for extremely long periods of time and they never return. We host that spectrum, but we of course are very concerned about the young people that are experiencing significant harm.

It’s also telling to us…. I know Sam and I were talking about this a couple of years ago. When a child flees or is missing or lost, they’re also telling us something. So even though something isn’t happening, it is a bit of a telltale sign that we need to pay attention to.

[7:10 p.m.]

Those 12,000 are also important for us to be paying attention to. I am extremely concerned with the number of young people who are missing from a system that is supposed to protect and nurture them.

I also wanted to stop here, saying this issues brief is not about casting blame on the individuals who are trying to provide care. I’m very clear about that.

We have lots and lots of stories of people going out of their way as social workers, child and youth care workers, community workers, foster care givers or service providers that are out there in the middle of the night trying to find the children. In fact, we had a person that was talking about the kinds of work that they were doing to try and find a young person that we were very concerned about. We know that that is going on. This is not to cast any blame or suggest that it’s the fault of the individuals working in the system.

What we want to point to is what the system is doing to create the conditions in which young people feel like they’re getting nurturance and protection. Then the staff feel like they are getting the support to do the work that they need to do, rather than experiencing some of the systemic restraints that limit their ability to respond to young people.

We also know that the personal characteristics of young people alone don’t cause them to become lost or missing. There are always lots of variables, so it’s complex. There isn’t a simple solution. Various systemic factors and individual factors for the child, the child’s family and the context within which they are living create the situations in which we find ourselves.

What this issues brief does is that it summarizes what we know about who is missing from care, why they are running from or hiding from the care system and how the child welfare system and other child-serving systems have created the conditions that actually contribute to kids being lost in care.

Through our reviews, investigations and advocacy mandates, obviously, we regularly review the stories of children who are missing. We also engage with young people before and after they are found. What we’ve learned is that many of these young people are fleeing systems that don’t provide adequate care, protect their rights and identity, or listen and respond to their need for belonging.

With the help of our other teams, all of the core teams were able to dig a little deeper into the children and youth who were going missing from care, and our advocates provided information that we found really helpful. They identified a number of commonalities. We’ll just go through those and talk about the implications there. For many of the young people who were missing and who were experiencing challenges in the system, there were multiple service streams involved in their lives — child welfare, mental health, addiction services, police, housing, the whole gamut.

These services don’t always work well together. Sometimes it’s not just having a big care team, but it’s what the care team can do with the resources that they have that can make a difference. There can also be quite a disconnect between policing services and MCFD practices, or the Indigenous child and family services agency practices, in responding to missing youth. That’s one thing: multiple people are in multiple service streams.

The second was that many of these young people have experienced multiple traumatic events in their lives — everything from multiple moves, being placed outside of their communities in order to get treatment or because there were no resources close by, physical and emotional harm, and losses in their lives that are quite significant.

The third thing is they’ve often had multiple social workers and service providers and may not have developed meaningful relationships with the people that are in their lives, the professionals in their lives. Even when a young person has built some relationships with somebody, the mobility in our sector and the mobility in the care system is such that a child’s relationship with somebody who is meaningful to them as a professional caregiver might get fractured because of the way in which we’ve got our systems designed.

The next thing was that of loss, grief and unbelonging. You hear me talk a lot about the experience of unbelonging that many of our children have experienced and the loss and grief that they have, often losing connection with their siblings, key family members or the death of loved ones, especially in the light of the toxic drug poisonings that we’re seeing.

[7:15 p.m.]

The next characteristic was that they’ve demonstrated a lack of trust in the people offering support in the system. Because of their negative experiences, they might not be well connected, and they might not also have a sense of their own control or agency in their lives, their sense of identity or sense of self-determination. That’s a significant characteristic.

Then the final one that the advocacy team shared with us, as a result of their analysis of their stories, is a lack of suitable placements to meet the needs of these young people and placement shortages overall that, frankly, are getting worse because of the labour and skills shortages that we’re facing and the use of shelters as placement, unapproved caregiver arrangements or kids basically in homelessness.

That’s where our advocates came. Then our reviews and investigations team also reviewed all the reportable circumstances. This is where a child has had a critical injury or death. They looked at that same time period, April 1 to December 31 of 2022, and they brought in some of the data. The highest proportion of lost or missing reports were received for cis females at just shy of 48 percent, followed by cis males at 44.1 percent and gender-diverse children and youth at a little over 8 percent. It’s interesting. That’s 3½ times higher than the population of gender-diverse children in the general population.

The other characteristics. Indigenous children and youth were represented in 54½ percent of the reportables we received, and 33 percent, a third, were reported more than once to the RCY as lost, missing or away from their placement. You can see that; do the math. We have 500 reports, and that’s 198 distinct kids. So there are a number of children who were lost or missing or fleeing more than once in that period.

Interestingly, only 24 percent of the reports for children and youth who were lost or missing were reported within the 24-hour time frame. As we know, that can be a significant consideration for finding young people. The remaining reportables were received between two and 2,187 days after the child or youth was identified as missing. That is definitely an outlier, but it just shows that sometimes we’re not getting the reports that we need in order to understand what’s going on for children.

The other thing that came up is themes of entrapment, the use of substances, the very compromised conditions in which the child lived. The system’s representation and responses to children and youth appeared to have created some of the conditions for their disappearance. We can go into that some more with your questions.

What we further identified were what some of the considerations were. We wanted to shift our discussion away from focusing on the individual and what was wrong with them and take more of a systemic look to see what was contributing to the children going missing or being lost in the system.

Some of the things that, again, came up were young people being disconnected from family members, sometimes relocated to an entirely different area of the province. They were experiencing multiple disruptions, lack of connections and that sense of unbelonging, as well, that we’ve spoken about before. One of the things that was important was that we wanted to take a look at what we call push factors and pull factors. This was also informed by the literature, and it was borne out by the children’s experiences.

Push factors are things that contribute to the child feeling that they have to leave — pushed out. The kinds of things that they were experiencing there were placements that simply weren’t meeting their needs. They weren’t feeling valued or respected or honoured, or they didn’t feel like their voice was heard — those kinds of things that just push them away from a place of nurturance or care.

Then there were the pull factors, the things that were drawing children away. I think these are really important distinctions. If you’re going to intervene, it’s important to figure out what’s going on for the child. The pull factors would be wanting to be with siblings; wanting to be in a place where they did feel some belonging; or, if they were using substances, having some access to a substance that would pull them away.

[7:20 p.m.]

Obviously, there are situations in which predators are there and are doing a darn good job, basically, convincing young people that they’re going to have a better experience away from their in-care experience. The luring and entrapment and sexual exploitation, sadly…. It’s hard for us to imagine it, but those become pull factors. If you’re not feeling your needs are met in the environment that you’re in, then you’re drawn into places where you might have the semblance of belonging.

What we felt was that this is really a systemic problem, and it’s not just an MCFD problem or an issue to fix. For many children and youth, we see the inadequate, ineffective services that just aren’t able to meet their complex needs. We also felt it was really important that we lift up their rights — their rights to have adequate care and protection and the right to be heard.

So what we did…. There are really two facets to what we felt was necessary next. One was some short-term recommendations. The minister has committed to fulfilling the recommendations that we’ve set out in the next six months. Then the other is to do a more robust convening of the parts of the system. We hope that the issues brief will frame engagement and dialogue with all the relevant voices to inspire collective action. I’ll come back to that in a moment.

We also have specific actions. What we found was that, once again — you’re going to hear me say this over and over again — the monitoring, the access to information, really knowing where the kids were…. We’ve got different lists, and they don’t necessarily reflect the same children. So we felt that there were some really important short-term actions around monitoring, the data collection and some policy and practice that would allow for the workers to address some of those push-and-pull factors. I’ll come to that in a moment.

The big recommendation or the big strategy is a special convening of the child-serving systems and children, youth and their families and communities to respond to the cracks in our system. That will include, as I say, ministry, Indigenous child and family service agencies, community agencies — the police are key in this — public health, mental health, substance use services, housing, education and public safety, as well as the young people, of course. That’s an important thing to think. There’s no easy solution.

In the meantime, we’ve got very specific recommendations: an interim plan to improve the collection of reliable information and data to enable the provincial director of child welfare to more effectively identify, monitor and respond to these children and youth who are lost and missing; and that the ministry works with the representative to identify opportunities to enhance the quality and consistency of reporting; then, that the ministry immediately remove the requirement for missing children in care to have additional safety concerns before they’re reported as lost or missing.

Essentially, what we want is that the ministry’s policies would align with the provincial policing standards — basically what a prudent parent, like you or me, would do — and not have to meet this additional threshold of known safety concerns.

The next specific one is adopting interim practice guidelines that will support the social workers and care teams to engage with the young people to better understand those push-and-pull factors, to think about ways to intervene, to disrupt the things that are pushing the child away or pulling the child away into lost or missingness.

We also suggested that the ministry immediately remove the requirement for children to be habitually missing before workers are directed to work with a young person. Right now a child has to be, essentially, chronically going missing before there’s the practice expectation that the worker would sit down and have that conversation: “What’s going on for you, and what is it that you need?” Addressing that.

We also felt that it was very important that the ministry develop resources and guidelines for staff on the use of child-centred, person-first, identity-first and destigmatizing language. One of the things I particularly love about this report is that there’s actual information and descriptions that have been found in our reports, and then how we would shift that.

[7:25 p.m.]

One of the things we see is language that…. Again, unintentional, I’m sure. I don’t think that workers want to shame and blame, but it has that impact. I always think: “What would the child say if they were reading that about themselves?” The way is to shift it so that it’s not blaming the victim, so to speak, but actually recognizing that the system is not meeting that child’s needs.

That’s where we’re at. As I say, the minister has indicated that she wants all children in care to receive the same response that a child with family privilege would receive. The minister has also stated that they will follow up and strengthen MCFD policy further.

Then the ministry will work collaboratively with the Indigenous child and family service agencies in our office to address these short-term recommendations. That’s heartening.

Nonetheless, it’s one of those things that we feel very strongly to bring forward, to consider what the ways are to bring a whole-of-system response and recognize that in these times, especially with the drug toxicity and the mental health crisis that we’re experiencing and the shortages, it’s something that we have to take very seriously and wrap around to figure out what’s going to happen in support of these children.

That’s it for the presentation. As I say, it was a collective lift. I’m joined by my wonderful companions here, and we will happily answer your questions.

M. Bernier (Deputy Chair): Thank you, Dr. Charlesworth, as always, for you and your staff putting the report together, a lot of information.

We’ll look, first of all, to the floor here for questions.

We’ll start with MLA D’Eith.

B. D’Eith: Thank you very much. I appreciate you distinguishing between…. The 12,000 number, if you just read it, on the face of it, it seems large and alarming and things — making that distinction between the 500 number and the ones that were phone-ins. The 12,000 could include missing curfew or somebody couch-surfing, right up to something that’s pretty serious. I appreciate you qualifying that. That was really good.

One of the things I noticed from the report is that you mentioned about 70 percent of the youth that are going missing are from — correct me if I’m wrong — contracted home care situations. I think that plays into this idea of systemic change. If they don’t, like you said, feel connected, then what’s holding that push-pull you talked about? What’s keeping the youth there?

I gather the ministry is working on specialized homes, so that there’s a more tailored support to try to build that connection more. Of course, moving to Indigenous care…. We can keep folks in their communities. You mentioned that as well. Having them leave the community is a trauma in itself. So if Indigenous families can stay together and connect with the family….

I think a lot of these systemic changes are hard to make. I know that since I’ve been elected, in 2017…. I know that before there was a real call for this fragmented system to change, and those changes are happening.

The real question is: do you feel, with the recommendations, that moving towards that connection is the critical piece? Is that the key piece here? It just seems to me that…. How can we keep young people engaged and staying where they are, where they feel a belonging? It just seems like that word keeps coming up again and again.

J. Charlesworth: Exactly. I’m going to turn to Sam as a long-term protection….

B. D’Eith: Sorry. I was a bit rambly. I apologize.

J. Charlesworth: No. I really appreciate you talking about that, because I think this is exactly the kind of curiosity that we want to bring into that whole-of-system approach. It’s like: what is going on, and what is it about the design of our system that’s actually creating these push-and-pull factors and the unbelonging or the unresolved loss and grief and the trauma that these young people are experiencing?

There are some things moving forward, and I still think we have to query some of the work. For example, with the specialized homes and support services, SHSS, there are still things built in there where a child might have multiple placements before they get settled in one place.

[7:30 p.m.]

There might be these emergency homes, if you will. I’m from an era when we used to have receiving homes, and then the same kind of thing. It’s like: where…? There are some tricks with that too, so I think we still have to query whether we’ve got the right model.

There are also things that I think are so important. I often think of this as like the hub and spoke. This is the hub, because if you start to take a look at missing, and you think, “What’s going on?” then you have to take a look at the quality of residential care, the quality of the preparation of the staff who work in there and the numbers of foster homes that are available to provide a family environment. But most importantly, backing up the bus, what do you do to support the family so that the kid doesn’t come into care in the first place?

Anyway, I’m going to turn it over to Sam.

S. Cocker: You always answer so well, Jennifer. It’s hard to know what else to say.

I’m going to go out on a little bit of a limb just because I don’t have the same…. I’m not saying that that’s what Jennifer was saying, but I worry a little bit about the specialized housing and support services. Is it being another rendition of the same system that we have? I will wait to see what happens for kids, because I feel like just with information we’ve heard, it doesn’t sound like it’s going to be a whole lot better. There are things that they say they want to put in place. But I don’t know that it’s easy enough to find that.

For us, I think Jennifer alluded at the beginning that one of the things missing from this was youth voice. Our intention is to really gather with the youth to find out from them specifically: what is it that keeps you there? What is it that pushes you out or pulls you away? For those who are staying, what is it that makes them stay?

In my experience within the ministry and within the agencies, it is really that connection. When homes, whether they’re contracted homes or foster care homes, are able to work very closely, make those connections with family and with community and walk together with that young person, that’s when I think the placements are more successful.

J. Charlesworth: Can I add just one more thing too? We’re passing notes like in school.

Why don’t you speak into this? I think it’s an important point about when we take a look at the data and we’ve got gender and sexual identity and we’ve got mental health and substance use needs, these are children who have chaotic lives, complex lives. But….

J. Dreyer: I’m trying to be respectful of time, because I know last time we ran out. So I apologize for that. I just want to note that we were intentional not to include the SHSS analysis within this work, because it is forthcoming. We’re looking forward to learning more.

One of the other things that we identified in our work here is that it’s not just residential. The link with children and youth with special needs or support needs and the link with mental health and substance use — over 60 percent in each of those areas for these young people here….

What we haven’t seen is, really, all those other systems of care wrapping around the new SHSS services. How are they integrating the services? It’s still, from what we’ve seen so far, a residential care program. Looking forward…. We offered that feedback when they came to meet with us as well.

K. Kirkpatrick: Thank you for going through the report with us and for the really good work that you do. It’s always a bit overwhelming, as I’m sure it is and you find, as well, in just so many things that need to be changed, improved and just done differently.

I’m not sure if there’s a question wrapped in here or just comments. Resources for social workers — when I look at the practice audits and I can see how many things are just simply not done in a young person’s file, is that part of the lack of follow-up? Sometimes it’s just simply because social workers have such large caseloads that you’re dealing with the child that’s there in front of you, and something urgent is happening. Maybe that’s a piece of kind of why some of these things aren’t getting done. I guess the question is: what does the caseload look like?

I’ll flag something that’s a concern for me. I mentioned it to you, Dr. Charlesworth, a few years ago. In MCFD’s service plan, one of the metrics is a reduction of the number of children in care. It’s completely quantitative. There’s nothing qualitative around that.

I think it’s just a comment. When we’re losing young people out of the system, that should not, then, make it look like MCFD has done something good because there are less children in care. I’ve always been a bit conflicted by that metric.

[7:35 p.m.]

There wasn’t really a question other than that I am curious if you know, and you may not, the caseload for social workers — how many children they’re responsible for at any one time.

J. Charlesworth: I’m going to turn it over to…. If we don’t have it — if this big, beautiful brain doesn’t have it in mind — then we can certainly get that for you, Karin.

J. Dreyer: My information is a wee bit dated from my time at MCFD. Obviously, there are discrepancies between up in the North and more rural or hard-to-recruit areas, where they could have upwards of 36 or more cases. Then in some of the more urban areas with more staff — this was pre-COVID, as well; I need to offer that context — it could be between 14 to 20. But that is definitely information that we can bring forward.

I also really appreciate the catch on the less number of children in care, because where are these children and families going? We’ve been talking about how do we better represent the information ourselves to give that full picture? While children may not be coming into care, if they’re home with their families but not receiving the support they need to be successful, they’ll eventually get here.

That’s the same with this work. When we looked back at the original stories for the young people that we reviewed in October — again, almost 60 percent of them coming into care because their families didn’t have the support they needed.

K. Kirkpatrick: Thank you very much.

S. Cocker: Can I add one thing? With the CHRT funding for agencies that have on-reserve caseloads…. Because their funding is based on need for their organization, they’ve been able to advocate…. I know, in one agency, especially for high-risk young people or young people who are really struggling, their caseloads are eight. They’ve said we’re not going to have caseloads of more than eight, and they’ve been able to get funding for social workers for that many.

I think that’s a huge discrepancy for our off-reserve kiddos, both within the ministry and within delegated agencies or Indigenous child family service agencies.

M. Bernier (Deputy Chair): Excellent. Thanks for that addition there.

M. Babchuk: Thank you for the clarification on that, because I also believe that those caseload numbers play a significant role.

I do have a question. One of the pieces that’s in this report talks about the majority of people that go missing that are mostly between the ages of 14 and 18. One of the things that automatically sparked in my head — primarily in dealing with friends of my own children, actually, where our house had a lot of children that gravitated to it — was that the kids that had been in care from a younger age seemed more settled than the ones that were pushed into that sort of circumstance as a 14- or 15-year-old.

I’m wondering if there’s been thought put into different strategies around…. I’m not even going to say “belonging” because I don’t know that I spoke to any of them that actually had a feeling of belonging. They know they belong somewhere else. I don’t know that we’re ever going to be able to instill that in somebody, especially in their teenage years. But it seems to me that there would be a different strategy for a youngster as opposed to a teenager, especially if they’re entering that system for the first time.

I just didn’t see that reflected in this at all, in regards to the strategies or anything that’s being put forward to MCFD. So I’m wondering if you could comment on that.

J. Charlesworth: I love the curiosity that you’re bringing into it, and I’m going to pass it over to Jennifer after, actually, just to see it from a methodological point of view.

A couple of things that I think are really interesting about those questions. One is, again, curiosity around the children who have been in care for a while, and whether they’ve experienced some stability in their placements. I would say that’s probably one of the significant things, because if you’ve experienced that stability and you haven’t experienced multiple placements, then you have more opportunity of creating that sense of: “Oh, well, this is where I am and this is where my home is.”

We still have to unpack whether a child should be growing up in care, or whether they should be supported to go back to their families. That’s a whole other consideration.

[7:40 p.m.]

I think you also raised a really important point that really reflects something that is brought in here — recognizing that every child is different, and their journey has been different. Their story has been different.

Two 14-year-olds might look the same in terms of their behaviour, but the reasons could be very different. One could be in a push place; one could be in a pull place. Their sense of belonging and where they want to be could be very different. One would be desperate to be with their siblings. Another would be desperate to be with their best friend that they grew up with and in their community. It’s a very interesting thing. That’s why we think it’s so important for the practitioners to be meeting with the children to really understand where they’re at.

I’m going to pass it over to you, to see if you want to unpack the age differences.

J. Dreyer: Yeah. When we reviewed the literature and looked to other jurisdictions for work that had been done, we didn’t see anything that analyzed the experience of lost and missingness from an age or an ages-and-stages developmental approach.

Interesting, though, when our advocates sat down with the stories of the young people that they walk with, there was, as Jennifer pointed out, that consistent theme of placement breakdown. Many of these young people, their stories are very complex. As complexities grow or their needs are unmet with those complexities, placements break down, and they get moved and moved and moved.

In this work, we each very intentionally came each day with a young person in our hearts, whom these pins were beaded for, who experienced lost and missingness. The ones that are in my heart all grew up in care, experiencing multiple placements from an early age, because we weren’t able to meet their needs and, in the end, experienced lost, missingness, and in one case, lost their lives.

K. Kirkpatrick: I wanted to say that I really like the language piece of this, where you demonstrated what it was and what it could have been. I thought that was very good.

A question I have, though, not related to that, is…. I was just thinking about a child being in care. At what point are they not considered to be in care anymore? If a child goes missing, is there a period of time…? Until that child is found or if that child is never found again, are they considered to be in care? At what point are they no longer in the statistics that MCFD tracks?

J. Charlesworth: It’s an interesting question. Well, if the child is in care, then there’s a statutory authority. There’s a court decision that has brought them in, so regardless of how long they’re away, they’re still in care. The state is still the parent.

S. Cocker: If I could just add, unless it’s voluntary care. Then, if they were missing from their placement for an extended period of time, the ministry and/or the family can stop that voluntary arrangement. It could be that the ministry would say: “Kiddo is not happy in this arrangement either. We need to come back to the table and think of something different.”

K. Kirkpatrick: My previous question was about the statistics that MCFD tracks in terms of children in care and the goal to have a reduction of children in care. Are those young people who are missing — they are deemed to be in care — in those numbers? I don’t know if I’m articulating the question clearly enough.

J. Charlesworth: In terms of the number of children?

K. Kirkpatrick: Yeah, like when does MCFD…? Those children, are they just in those numbers until they’re 19 because they don’t know where they are?

S. Cocker: Yeah, unless they tragically died or something happened, they would be in those numbers as part of the ongoing in-care number.

N. Letnick: Thank you for the report and the presentation. A couple of things. One is that you said the minister had agreed to the recommendations and to following up on that. The other part is you also said that you’re planning, I believe, some kind of consultation round table to bring this to. Okay.

Can we break those two out? Is one happening before the other? Are they happening at the same time? If you’re doing your own thing and the minister is doing their thing, are they waiting for your work until they do their thing, if you follow what I’m saying?

J. Charlesworth: Yeah, I follow that.

N. Letnick: Then, also, what are you going to do, as the rep, to follow up with the ministry to make sure they’re actually doing what you said they should do and they’ve committed to do? As opposed to the report we got last time, which shows five years of not doing what you told them to do.

[7:45 p.m.]

J. Charlesworth: Yes. Well, this gets to the sidebar conversation we were having.

I’ve had a very fulsome conversation with the minister. She has committed to these recommendations over the next six months. We’re going to be proceeding with the convening no later than the fall. So, in fact, the convening will happen while the ministry is working, because they’re not mutually exclusive.

One is dealing with the bigger systemic issues and bringing the whole system together. One is dealing with the internal operational changes that can be made right now that are within the authority. They don’t need any legislative authority. They don’t need regulatory authority. This is policy practice and data collection.

The one addresses the immediate needs that we felt were important. The second is addressing the systemic issues that were revealed through this. So they’re not mutually exclusive, and they’ll be going on simultaneously. No later than the fall, we’ll be doing the convening to bring the system in the room to try and figure out how to address the bigger issues.

Does that answer your question?

N. Letnick: It answers part of it. Thank you.

The other part was: how are you going to make sure the ministry is actually fulfilling the recommendations that they’ve agreed to do?

J. Charlesworth: That’s why we have our monitoring function. We, again, have been very clear that we need to see some very significant movement by September, because in the fall, we’ll be working, bringing forward to this committee another report that does a deep dive on a population of young people where missing is a factor, but there are other things. The ministry’s progress in the areas that we’ve identified here will be important to factor into that work, coming into the fall.

We use our monitoring function, basically, to see if any change is going to be happening, if sufficient change is happening. Of course, then we report out in a public-facing way as to the progress that’s being made.

J. Dreyer: Can I add something as well?

We have a lot of conversation around our different strategic tools for change, and our public reports are one way that we can influence change. While we were doing this report, as the numbers kept coming in, we immediately brought it forward to our meetings with the provincial director for child welfare, because we saw early on the glitch in the monitoring where we were counting more children than they were counting. We immediately brought that to them in that spirit of when you know, you need to act — regardless of the fact that our paper, at that point, was still possibly years to come.

From that, we have been, through executive correspondence and briefing notes, sharing the information and pointing out the gaps and the concerns as we go. I have to say that the folks over there, they’ve been asking for more information. They’ve been showing up to the table in terms of the work that they’re doing as well. Those conversations were: “We’re working on this too. We know that there’s a problem.”

I think that’s another mechanism where we are monitoring and, each and every month now, asking, “Where’s the update? How is this going?” and then also just meeting with them as part of our recommendations process. We meet with them to share all of the research that we do and connect them to the subject matter experts that we’re working with. We’ll be doing that same process to meet with them and share everything that we found in more detail.

M. Bernier (Deputy Chair): I don’t see any more, so I’m going to ask one. It’s really around some of the recommendations. I do thank you, again, for all of this. I’m just, from the policy side of things….

Reading through the report, you said the average time is about 13 days that a child is missing. Of course, when you have an average, that means you’ve got one day, and then you could have months, to get to a 13-day average. But a couple of different policies that I just want to unpack a little bit….

No. 3, if you could for me…. When we talked about the 13 days, I’ll just quickly say…. You know, No. 5 talks about them having to be — whether they’ve been chronically missing or what have you. Your recommendation on No. 6 is actually one from 2017 that you have suggested gets done. So just flagging those as some of the ones that have to be highlighted.

Again, back to No. 3. Can you explain this one a little bit further for me? When we talk about the reportables, I guess, of when somebody goes missing, 13 days…. Well, 24 hours is a long time for someone to be missing. A lot can happen in that time. So 13 days, to me, is scary, but I understand how this works.

[7:50 p.m.]

When I looked at No. 3…. I’m trying to understand it better, about that policy recommendation, to try to get to the root of how we actually solve this so it gives the teeth and the tools for the caregivers, the ministry and everybody involved so we’re not all just staring at each other wondering when do we report, when don’t we, how do we…?

This is all about our children here. If there’s a way to allow more opportunities, so they can report sooner…. You know what? If it’s a false alarm, so be it. I’d far rather have a false alarm than wait for somebody to have a bunch of boxes checked off to meet the criteria.

Can you maybe explain a little bit more about what you’re trying to accomplish with that?

J. Charlesworth: I think you just described it, which is not to wait until you have to tick all the boxes. If it’s a false alarm, or the child shows up the hour after you’ve submitted, I think we were basically saying: what would a prudent parent do? How quickly would you call?

I’m going to turn to Jennifer to talk about why we chose the BC policing standards, because we think that that’s a good framework to align with, and then I’ll come back to the other reference for No. 6.

J. Dreyer: For that one, what spurred that recommendation on was the research that happened over in the U.K. that identified that there was a risk of a less robust police response for children and youth who were in care because children would be deemed as absent rather than as lost or missing.

Currently, right now, that assessment of whether or not they’re…. There are two categories: whereabouts unknown, with risk to safety; whereabouts unknown, no known risk to safety. Who is doing that assessment of risk is the caregiver.

We did hear from the ministry, and you saw in the report that they’re going to add some language to the contract so that caregivers are compelled to go out and look for children or go through that process.

As it is right now, a caregiver is to make that decision on their own. Then, if they think, “Okay, there’s no risk,” they pick up a phone, and they call provincial centralized screening. They man a non-priority line where they have to call to report. The wait time can be, as we have in here, anywhere between 20 to an hour and a half before they get somebody on the phone to say: “Yeah, I think they’ve just missed curfew” or “Here’s how I went through that safety assessment.”

Our purpose for adding that was that those risk assessments are done like you and I would do for our children when we pick up the phone and get to do that with a social worker or with a police officer that has that background to help us with the risk assessment.

M. Bernier (Deputy Chair): With that, the system right now sounds very subjective. That would be a concern of mine. Definitely, a caregiver might know the child, and might at first instinct say: “Well, this is not normal behaviour, but they don’t normally hang out with or live with a high-risk group.” So maybe there’s not a concern, but ten minutes out the door, you don’t know who they’ve hooked up with or what’s going on.

I appreciate the commentary there and understanding that, yes, as a parent, you can be subjective as well. But I would find that a parent, for the most part, if their child’s missing for even a short period of time, will worry and be very concerned and want to report that and get everybody out looking.

J. Dreyer: The police principles are clear. There should be no interruption for reporting, and then they’ll take that on. They’ll do that risk assessment with you to determine: “Okay, let’s wait a few hours” or “No, let’s go out and start looking right away.” That’s keeping it within their purview as to who is responsible for going out looking for them.

J. Charlesworth: The other thing I think is important to add is that having these kinds of less subjective standards and having that additional help to discern what we should be doing here, what some of the options are and whatnot is really important. Frankly, and this is one of the reasons we put language in there, one of the things we see, sadly, is that sometimes young people are being framed in quite a negative light in terms of missing curfews or not being where they’re supposed to be at the time that they’re supposed to be at.

I think that changes. We know about implicit bias. We know that the language kind of says: “That’s just what they do.” We’ve had some pretty high-profile situations. An inquest that…. Really, there was an assumption that the kid would show up in a day or two or four or six, when people should have been out looking.

That’s why all of these things are kind of interconnected, to recognize that we shouldn’t be so subjective. We need the professional help to discern and to have more eyes out for these kids.

[7:55 p.m.]

M. Bernier (Chair): You were going to quickly mention something about No. 6.

J. Charlesworth: Yes. Just to let you know that in 6, the reference to In Harm’s Way? serious occurrences report isn’t one of our B.C. reports. That’s an Ontario report. We thought it was really good. We thought: “Why reinvent the wheel?”

So that’s the reference there. Not that it’s another report that we haven’t had some action on.

J. Dreyer: We know there needs to be a B.C.-grown solution for this important work, but in the interim, there has been good, in-depth work that has been done elsewhere that can inform that. So that’s why we lifted that up too.

M. Bernier (Deputy Chair): Thanks for that clarity.

Seeing no further questions, thank you very much for that one. We’re going to move on to the next item on the agenda, then. I believe we have Pat online. We’re going to get that set up.

I’m actually going to read this out. This is a very lengthy one. It’s from February. We’re going to be moving on for the consideration now of Key Components of Effective Service Delivery for Children and Youth with Support Needs and Their Families: A Research Review and Analysis. There’s no, even, acronym that I could have put into that one.

J. Dreyer: Oh, come on. We’re government.

M. Bernier (Deputy Chair): Thanks, Jennifer. Good point.

J. Charlesworth: It’s a little bit hard to distil.

M. Bernier (Deputy Chair): I’ll turn it back over to you.

Key Components of Effective Service
Delivery for Children and Youth with
Support Needs and Their Families:
A Research Review and Analysis

J. Charlesworth: So I think we’ve got Pat Mirenda. Yes, we do.

I’d like to introduce you to Dr. Pat Mirenda, who is joining us via Zoom from her home on Musqueam territories.

Hello, Pat.

Just a little bit about Pat. She is professor emeritus at the department of educational and counseling psychology and special education — talk about long names — at the University of British Columbia, my old alma mater, for one of the degrees and past director of UBC’s Centre for Interdisciplinary Research and Collaboration in Autism.

At UBC, she taught courses on applied behaviour analysis, autism, augmentative and alternative communication and positive behaviour support. She has also published over 150 research articles, books and chapters and presents frequently at international, national and regional conferences.

She kindly came out of retirement to support us in this work, and we have many fond memories of Friday afternoon discussions and debates. It was a beautiful way to end our weeks, often, in conversations with Pat.

Pat will be doing most of the talking this evening, but I just want to set the stage for you on this work. As you know, we’ve been advocating very strongly for children and youth with special needs for a couple of reasons. One is that there are thousands of kids with special needs who get little to no support in the current system that we have. Our system right now is diagnosis driven. Certain diagnoses gain access to services, and others don’t. While diagnoses are valuable in many situations, they obscure the functional and developmental needs of the child, and kids with the same diagnosis will present very differently.

We’ve released four reports, a resource and many statements since my appointment in 2018 that specifically address the children and youth with special needs. The government took up the challenge that we were presenting to transform the CYSN system. Their primary response to the recommendations we’ve made to CYSN writ large, and specifically to some sub populations — for example, children with FASD — has been: “We’re developing a framework.”

The framework first came out in October of 2021, and it called for the development of family connection centres across the province. You will know this well from your constituency and from the debates in the House. At that time, we decided: “Oh, well, we’ll commission Pat to do some work with us on what the characteristics of successful family connections centres would be, and does this model even make sense?”

Of course, as we were doing this, the Premier and the minister paused the implementation of the framework and are undertaking further consultations and whatnot. We decided to proceed with this research because, at the very least, it is of value to the family connection centres that are going forward — the four on the pilot basis.

Regardless of what happens, the findings in this research are important to inform the new framework, however that unfolds. It really does speak to the key elements of whatever design is configured now. There are certain things that are givens that will make a difference in the life of a child.

[8:00 p.m.]

With that backdrop, Pat will introduce you to the work that she did. You’ve got some slides, and she’ll be working through those slides with you.

Over to you, Pat.

M. Bernier (Deputy Chair): Thank you.

I’ll mention, Pat, that yes, we all received the slide deck in advance. We have it in front of us, just so you’re aware.

P. Mirenda: Okay. That’s great.

Hello, everyone.

Thank you, Jennifer.

I’m thrilled to be here today. I’m happy to be able to talk to you. As Jennifer said, I was asked to look at the key components of effective service delivery. I did a deep dive into the research on this topic.

At the outset, I want to make sure that I distinguish my task of effective service delivery components from models of service delivery. Models of service delivery are…. How do you deliver services? Do you provide individualized funding? Do you set up family connections centres? Do you use child development centres? Do you do some combination of the above or a different kind of system to deliver? That was not the task that I undertook.

What I looked at was…. Regardless of how you deliver services, what are the most important elements? I looked at it in three different ways. For general service delivery across the disability and functional ability of children, what are the key components? What are additional components for children and youth with mental health needs? Then, also, are there any additional, additional components for individuals who are living in Indigenous communities or who are Indigenous themselves?

I looked at three different groups of service delivery elements. I also looked at the literature on barriers to effective service delivery. When I get to barriers and recommendations, I’ll throw this back to Jennifer, and she’ll be able to talk about that.

Let’s start with the key elements in general. This is slide 4 in your deck, which you have in front of you. You can see that there were six key elements that were quite pervasive.

The first, which appeared in literally 100 percent of the research I was able to locate, was that effective service delivery should include family-centred care. Family-centred care actually has three elements to it. The first is the understanding that parents know their children best and want the best for their children. The second is that families are different and unique, so one type of service isn’t going to be suitable for every family. The third is that optimal child functioning occurs within a supportive family and community context. So the child is seen as affected by the stress and the coping skills of other family members.

Family-centred care includes services that are available not just to the child or youth with support needs but to the family as well. That’s the first key element.

The second is cross-sector collaboration. This appeared in almost two-thirds of the research I was able to receive. What it means in the B.C. context is that MCFD, ideally, will be working together with the Ministries of Health, Education and Child Care, Mental Health and Addictions, Social Development and Poverty Reduction, Housing, Indigenous Relations and Reconciliation. All of these ministries need to be part of the solution in whatever system of care is set up. That’s the second piece.

[8:05 p.m.]

The third piece is also about collaboration and coordination but at a smaller level. Now, however therapies or other kinds of supports are delivered, there needs to be coordination across those therapies and supports so that families aren’t given the burden of having to do that coordination themselves.

The way that appears in the research literature is through people who are called key workers sometimes, care coordinators. The idea is that families will be hooked up with someone who will help them coordinate speech-language, occupational therapy, physiotherapy, mental health supports. All of the things that they and their child need will be coordinated through some kind of facilitator assigned to each of the families.

The fourth element, which in some sense goes without saying, is sufficient, equitable and accountable funding. All of this is very nice, but if there isn’t enough funding available for the services that children and families need, then they’re obviously not going to get them.

Sufficient, equitable and accountable funding goes together with the fifth element, which is services customized to meet individual needs. Here the customization has to include at least three elements: that services be delivered with sufficient intensity over a sufficient duration of time and be of sufficient quality.

Intensity basically means: how many hours per week or how many hours per month of a particular service or therapy does a child and family receive? There’s no point delivering low-intensity service or low-intensity therapy to a child who needs more of it. Low intensity isn’t going to result in any kind of progress, any kind of a desired outcome.

Duration means: over what period of time? If I deliver the right amount of service per week or per month but I only give it to the child for a month or two at a time…. He actually needs six months, eight months, ten months, 12 months of service. Again, I’m not going to achieve the desired outcomes for that child.

Then quality means: is the service geared to the functional disabilities of the child? Forget diagnosis here for a minute. Are the people delivering the service familiar with, for example, Down syndrome and the particular needs of children with Down syndrome or FASD and the particular needs of children with FASD? If the quality isn’t there, then intensity and duration will be for naught. So funding and customization of services really go together.

Then the sixth element is staff training related to the service model, whatever that is. Staff need to be trained in the technologies that are going to be used, how to do information-sharing, how to do efficient case management, how to use the assessment tools that are going to be involved in whatever service delivery model is selected. Of course, staff training is related to cultural competence. Safety is also necessary.

These are the six elements that emerge across the literature, regardless of the focus of a diagnosis for children and youth with support needs.

In the mental health literature, in particular, for this population, two additional elements emerge. One is the importance of what are called wraparound supports. Wraparound is a team-based planning process that’s child and family centred, that builds on child and family strengths, that’s culturally relevant, that’s flexible and that is developed and implemented based on an interagency, community-based, collaborative process.

It’s exactly what it says. It’s a wraparound of supports. The supports could come from Health, MCFD, education, social housing and poverty reduction, mental health. Whatever that child and family need is wrapped around that child and family.

[8:10 p.m.]

Then the other really important element, which is even more important for children and youth whose support needs are in the mental health domain, is ease of access and referral. In the research literature, this is referred to as a No Wrong Door policy.

Wherever the child shows up — in school, at a social worker’s office, in a doctor’s office — the child can access the services that he or she needs, which is, again, congruent with the idea of wraparound. Of course, that’s more important for mental health, perhaps even for other neurodevelopmental disorders, because mental health services are often acutely needed, more so than services for other kinds of support needs.

Finally, there were additional elements that showed up as key for Indigenous children and families. The first is the importance of embedding Indigenous culture, values and practices in however it is that service is delivered. The research literature, at least some of it, refers to this as Two-Eyed Seeing.

Two-Eyed Seeing is a term created by honoured Mi’kmaq Elders Albert and Murdena Marshall. It’s based on the idea that one can learn to take the perspective of seeing, from one eye, the strength of Indigenous ways of knowing and, from the other eye, the strengths of Western ways of knowing and then use both of these perspectives for the benefit of those being served. That appeared in more than 85 percent of the Indigenous literature I looked at.

Then the second piece, which, again, is part of family-centred care but emerged as especially important for Indigenous children and youth and their families, is the importance of supporting the whole family around the social determinants of health beyond those that directly affect the child or youth, so supporting the whole family around issues of housing, access to clean water and healthy food, access to employment, and so forth and so on. Often for Indigenous families, it’s those needs that bring them in the door to a service delivery system. Making that part of the overall system of care becomes even more important for these families.

Those are the key elements regardless of how services are delivered. Those are the key elements that ought to be present in the system as a whole.

I’m going to turn it back over to Jennifer now, who can then talk about what the research said about barriers in the original framework that was proposed by MCFD and also recommendations going forward.

J. Charlesworth: Thank you, Pat.

As I said, this was undertaken while the framework was still top of mind. Some of the things that we identified during this were: if this framework were to continue, how would it stack up on these key elements?

We offer this here because, even though there’s a reset and a pause on the original framework, it’s still important. It’s still part of the history. It’s still part of the deliberations. So we wanted to provide the feedback on what the barriers would be if that original framework had gone forward, in light of what Pat has learned through the research.

First and foremost is the inadequate funding, and that is funding for staff, for the resources and for the training that’s necessary. This is in order to bring about a system that’s equitable, that’s accessible, that meets the criteria of quality, intensity, duration that Pat is talking about. Funding is required.

The other thing that is a challenge, and it’s going to remain a challenge regardless of how the framework evolves, is that right now we have an inadequate number of staff that are available to do the work, the specialty work. We’ve already got significant and growing wait-lists and lack of availability across this province. If you are in a hard-to-serve area in the North or in Dawson Creek or whatever, in Campbell River, and you’re looking for a speech-language pathologist — those positions are sometimes vacant for years.

[8:15 p.m.]

We really have to be paying attention as we go forward to what are the kinds of skills that needed to be — and the resourcing that needs to be — built up in order to be able to deliver whatever the model becomes.

The other thing that’s really interesting is that we’ve had some significant concerns about eligibility criteria with the previous model. One of the things that Pat and I felt particularly strongly about was there was a very high threshold for families to get respite care. At least from what we see, sometimes that makes all the difference in the world for a family.

We actually think that for families who are trying to do the best they can for their kids, having a lower threshold and more access to respite and respite supports could actually be something that would make a huge difference in them being able to support the child within their family, and also, not having a high threshold for other kinds of family supports and counselling.

Not all families are equal in the sense of having the same kinds of needs. So really, evaluating those eligibility criteria to be very mindful of it’s not just supports for the child, it’s also supports for the family, and ensuring that those criteria are not set so that there’s really very little access for families unless they meet the highest threshold of disability for their child.

The other thing that we felt was really important, too, as a critique and something to build in, is evaluate. Make sure that there’s a very robust evaluation plan. And with the family connection centres, going forward, that’s something that we’ve been asking for too — to make sure that there are clear outcome measures, there’s a clear evaluation plan and there’s ongoing developmental evaluation so you’re learning as you’re doing, not just waiting for three or four years from now.

Then the other thing that was important that we saw that is critical going forward — and Pat spoke to this beautifully — is that importance of cross-sector collaboration in the care coordination. This is, again — we say this over and over again — not just a one-ministry deal. These are kids…. If we take a whole child approach, then that needs to have that cross-sector collaboration and coordination across care teams.

We basically put forward…. We don’t have formal recommendations in this report, but we did say: “Here are some things, Ministry, that we strongly encourage you to do during this reset.” That’s towards the end there: “Guidance to MCFD.”

We basically said that meaningful consultation…. Make sure it’s really meaningful consultation with the families, with the service providers, and then people like Pat, who have been in this field for a long time and have some really important perspectives to contribute. So really making sure that consultation is robust. The whole child approach that really speaks to the care coordination and the multisectoral approach, bringing that together.

Also, we think it’s important that there be some very good financial modelling, and there are economists out there that do this kind of thing, and to really project out and get a very good funding modelling sort of projection so that we know what we’re in for in terms of getting that equity, accessibility and quality.

Then we are nothing if we don’t have the people to deliver the services — so, really, calling in the Ministry of Post-Secondary Education and Future Skills to build that professional capacity. We have to start now, because it takes years to train up a speech-language pathologist and OT and behavioural interventionists, etc. And we can’t poach from other provinces, either. They’re coming and poaching from us, so that doesn’t serve anybody if we kind of just try and attract people from other jurisdictions. We actually have to build that up.

Those were some of the things that we saw as the barriers or the challenges with the first model, and then it just leads us nicely into what we think is important for the ministry to consider.

Just to give you a sense of what we’re doing with this…. We are so grateful to Pat for working with us, and we were also joined on our dedicated team by Randy Mjolsness, who is a former ADM in the ministry — 40 years’ experience in this field. Between Pat and Randy, we had a wealth of knowledge to draw upon, and we also have a dedicated internal team that continues to follow up on children and youth with special needs.

We’re now sharing this research with the family connections centres, with the Disability Collaborative, with anybody with government, etc. We are going to carry on with our work in terms of recommendations monitoring.

[8:20 p.m.]

We’re doing some work right now with families who participated in both our Left Out report and our Excluded report. We’ve gone back to visit with the families in their community to find out what has changed and what hasn’t changed. Their stories are important: to see what is working and what is not working. Then, of course, as government continues with the reimagining of the CYSN framework, we’ll be right alongside monitoring and providing feedback, etc. This is another one of those areas that is complex.

You know, from your experience over this last year, that there are lots of strongly held views and perspectives. It’s not for the faint of heart to get into this work, for sure, but we still have to keep trying to get in the same room and see where we can go to bring this forward in a good way for our children. They shouldn’t have to wait for years before they start to see some change in their lived reality.

This was an offering to the ministry and to our colleagues. You can appreciate that it also accompanies the report that we just shared with you last week, around improving access to mental health services for children and youth with neurodevelopmental conditions as well. These are all sort of weaving together to try and create a more robust sense of direction going forward.

With that, Pat and I are happy to take your questions.

M. Bernier (Deputy Chair): Thank you, Pat, as well, for joining us tonight.

Please take this as the compliment it’s meant to be: I really appreciate a slide deck that’s explained and not read to me. I really appreciate the style with which this was presented. Thank you very much.

M. Babchuk: I just want to talk a little bit about the barriers. In a previous life, I was a school trustee and the chair of a school board. I really love the idea of family-centred care and love the idea of the wraparound supports.

One of the things I didn’t hear you talk about in the barriers is something that I’ve seen and experienced of quite a few times. That is not necessarily a collaboration or discussion around the family, but the inability, through privacy laws and whatnot, to be able to actually access the information.

I’m just going to give an example of a couple of youngsters in the school district who had wraparound supports. They had self-harming issues or suicidal ideations. While they were at school, they were fine. They weren’t ever left. They had those supports wrapped around them. But as soon as they left the school district, they were with their parents. If they weren’t with their parents, they never knew after the weekend if that child had access to the crisis nurse at the hospital because they had tried to attempt something.

That information is never shared back and forth so that you are able to continue to wrap those services, either to intensify that service or find another service. I’m just wondering if you could speak to how we would access and break down those barriers so that we could collaborate, at a bit of a higher level, for the needs of the individual child.

J. Charlesworth: I think there may be two parts to this. One, I’ll turn to Pat to see whether anything like that came up in the research. Then I’m going to cue my colleagues here, because this is something that we do see. I really appreciate you raising that, because there are significant concerns around information-sharing. We’ve got some ideas.

Pat, did anything come up that would be helpful for this conversation?

P. Mirenda: Yeah. The most successful wraparound systems involve someone who is assigned to be at the centre of the wraparound circle with the child. All information gets channelled through that person. So the school, health authority, family, whoever is serving that person for that child can talk to that person and has access to information. The agreement is that person can share that information with other identified people — not outside of the circle but within the wraparound circle.

[8:25 p.m.]

There is a sort of mechanism for maintaining privacy within the wraparound circle, while at the same time being able to channel information through the care coordinator, who’s at the centre of the circle. That seems to be the way that that kind of thing works the best. Otherwise, exactly what you describe is what happens.

Some people know some things, some people know other things, and there really is no wraparound, because there’s not a sharing of sufficient information. It takes some planning. It’s part of the whole system that’s set up.

M. Babchuk: Where does the consent come from, then? From the parent? From the child? From the health authority? At some point we start running into some legal definitions of privacy and freedom of information. I mean, I love that. I’m just trying to figure out how we get there without….

P. Mirenda: The fact is that most of the wraparound research is from the United States or Australia. They’ve figured out within their restrictions, in those countries or in those states, how to finesse this so that it’s legal yet wraparound at the same time. Very little of the research that does what I just talked about actually has come from Canada, and none of it, that I know of, came from British Columbia. It’s a sort of jurisdictional finessing that seems to have to happen.

Of course, the parent would give consent, and of course, the child, if the child is of age, would also give consent. It’s tricky, but it’s obviously possible, because it has happened in other places, and it would need to be sorted out if wraparound were truly available.

J. Charlesworth: Yeah, it’s such a great question. I’ve been in similar situations as we’ve been building other resources. Here are a couple of things that I’ve learned from that.

One is that there is a sense of, “Oh well, we can’t possibly share,” but if you actually query it, there’s nothing to say you can’t. Really, if you’ve got the consent of the parent and the child, you’ve got a very different landscape, and others would know. I mean, there are lawyers here. Consent is the key thing, for sure — the child of capacity and the parents and caregivers, or, if the child is in care, then the guardian. So there are possibilities.

The other thing that’s very interesting…. I think there’s almost a mindset, “Oh, we can’t possibly share,” but it is important for us to query that. As I say, when we’ve got into it, it has been particularly challenging around mental health, but actually when we take a look at the professional code of conduct, the code of ethics, the regulatory bodies or the legislation and whatnot, with consent, it can be shared.

It is a matter of challenging some of those conventions that seem to have been established and not queried. I think it’s possible. I’ve seen it happen for the benefit of the kids and their best interests. That’s where the criterion becomes really important: what’s in the best interests of the child? Great question.

K. Kirkpatrick: Thank you again for all of this work. I’m so glad that Pat has been involved in this, and that there’s a set of eyes outside kind of looking back into what’s happening right now. I think that’s very important.

I just want to ask for some clarification. Dr. Charlesworth, you had said that something is paused, and I just want to test my understanding of this. I didn’t believe anything had paused. I thought everything was moving ahead, as had originally been planned with the four pilot sites.

The only difference had been a change in the families who are currently receiving the individualized funding for their children with autism — that that piece of it has been kind of rethought or is continuing on. The actual family connections centre — the structure of that and the services — is still the original framework. It’s just that it’s in a piloting sense now. Is that correct?

[8:30 p.m.]

J. Charlesworth: Language matters, doesn’t it? We heard “pause,” and then we heard “reset.” I can’t speak for the ministry — it’s best to query them — but this is what I understand. Pat and I were curious at one meeting, and we got the confirmation that it’s actually a reset, so really going back to the consultations and figuring out what is the right way forward.

Having said that, those four pilot sites are carrying on. They used to be early implementation sites. They’re now pilot sites and we know with pilots, you can stop pilots if they’re not working. That’s why we say it’s so important to do an evaluative plan. Our understanding is that they are going forward, and that’s for a number of contractual reasons, frankly. That was well underway by the time the November decision was made.

I actually think it’s a good thing. I think that sometimes we need to try things in order to figure out what’s the best way forward. I think there will be a tremendous amount of learning from those sites. Each one is going to be quite different. We’ve basically got more than four models because some have two different locations. That’s my understanding: those pilots, but the whole rest of it is a reset, and it could look very, very different, going forward.

That’s what I understand to be the case — and that the Premier has made the commitment to the continuation of the autism funding, which was actually one of the fundamental challenges that people were raising in the first go-round.

K. Kirkpatrick: Yes, I’m aware.

J. Charlesworth: Yes. I know you’re very aware, as we all are.

M. Bernier (Deputy Chair): Any other questions? Okay.

Well, I want to thank you again. That was very thorough.

Thank you, Pat, again for all your work and for joining us tonight to help run through this again. It was very well done, very informative.

I really appreciate everybody’s time this evening, going through all of this. Seeing no further questions, though, I will just….

Sorry, Jennifer, did you want to add…?

J. Charlesworth: Can we just do one thing before we close, if that’s all right?

M. Bernier (Deputy Chair): You know what? Absolutely.

J. Charlesworth: I’m going to ask Jennifer to speak.

J. Dreyer: Thank you so much for the opportunity. We just wanted to end our night bringing us back to the cover image of the Missing report and share a little bit about how we came to choose the symbol of the forget-me-not, and end our night with a moment acknowledging those young people who are still missing today.

In the month of April, in the first three weeks — we just have the first three weeks of reporting — six young people have been reported missing for seven days or more. Four of those young people are the same young people that we saw back in October.

When we look to their stories, we see all these common themes. Our hope, in choosing the forget-me-not and aligning ourselves with the work of the International Missing Children’s Day, is that our young people in care who are missing get the same recognition as children who have family privilege.

The forget-me-not flower represents a promise that you’ll always remember them and keep them in your thoughts. We just wanted to end our night…. We mentioned earlier we’ve kept young people we knew, and went out searching for, in our hearts as we did this work. We reached out to a beautiful beader, Sarah Underdown — she’s out there with these kiddos; she does this work with us — and asked her to put her love and prayer into these beaded forget-me-nots, and into the symbol that we’ve used. We just wanted to close tonight to acknowledge those six young people that are out there tonight. And the many more.

M. Bernier (Deputy Chair): Thanks Jennifer.

Other Business

M. Bernier (Deputy Chair): The last thing on the agenda here, I believe, is other business, if there’s anything.

N. Letnick: I’m not too sure if I mentioned it before, but members here are pretty familiar with the work of the Public Accounts Committee. The Public Accounts Committee, when a representative provides — in this case, the Auditor General — a report to the standing committee, the subject of the report also has an opportunity to be at the same meeting and provide an explanation to the standing committee as to how they’re proceeding with the recommendations from the Auditor General.

I’ve been on many committees in my 15 years. I find that process leads very well to a non-partisan approach. As we saw in question period last week, there were eight questions of the minister based on the representative’s report of the five years. I’m not going to get into a partisan thing here.

[8:35 p.m.]

What I’d like the committee to consider is, going forward…. We don’t want to do it now, at 8:30 at night…. Maybe we can put it on a future agenda so people have a chance to think about it: that when the Representative for Children and Youth has a report to make, with recommendations for a ministry or ministries, those ministries actually appear to us at the same time and indicate to us how they’re going to enable those recommendations to actually occur — not five years later, when we get a report saying that only 15 percent of the recommendations were acted upon and a whole bunch of kids died because of that.

Again, I don’t want to make this a political football. It was when we were in government. Stephanie Cadieux got slammed all the time by the former representative. Our current representative is taking a different approach. She’s working collaboratively with government. Let’s encourage that. Let’s not make it partisan. Let’s not open it up to question period if we don’t have to. Let’s bring it here as MLAs on all sides of the House and listen to what the ministry has to say as to how they’re going to actually fulfil those recommendations or, maybe, not fulfil the recommendations that the office is proposing.

Anyway, it’s late. I’m not asking you to do that. But I’d like to put that on an agenda for next time, so we can actually have an intelligent discussion around that.

M. Bernier (Deputy Chair): No. thank you, Norm. I know we have done that in the past. I know that’s at the discretion of the committee here and that we can invite people as well.

We’ll take that up. I’ll look to Karan, here, and everyone else too. I’ll talk to the Chair of the committee when she’s back. I appreciate that recommendation.

Anything else under other business? Okay. So a motion to adjourn, then, please.

MLA Kirkpatrick.

Motion approved.

The committee adjourned at 8:36 p.m.