Third Session, 41st Parliament (2018)
OFFICIAL REPORT
OF DEBATES
(HANSARD)
Wednesday, May 9, 2018
Afternoon Sitting
Issue No. 132
ISSN 1499-2175
The HTML transcript is provided for informational purposes only.
The PDF transcript remains the official digital version.
WEDNESDAY, MAY 9, 2018
The House met at 1:38 p.m.
[Mr. Speaker in the chair.]
Routine Business
Prayers.
Mr. Speaker: Members, we’ll have introductions by members, but before we do, if I could call upon the Parliamentary Secretary for Emergency Preparedness to make a short announcement about something which is going to happen at 1:55 today.
Statements
EMERGENCY WIRELESS ALERT SYSTEM
J. Rice: Today at 1:55 p.m. — hopefully, if all goes well — B.C. will be testing its new wireless alerting system, at the same time as our regular testing of TV and radio public alerting systems. This is an opportunity to make sure that the system is working correctly, allow people to ensure their device is compatible and also raise awareness about the importance of emergency preparedness.
Now, understanding the standing orders of how we conduct ourselves with electronic devices during question period, today members may want to keep their phones on, but on silent or on vibrate, so that they will actually experience and receive the first text message of the public alerting system. This is to broaden our reach to make sure more people have access to critical and possibly life-saving information in the event of emergency or disaster.
Given the number of British Columbians who have wireless devices, this evolution in alerting is the next logical step in emergency management to save lives and promote greater resilience in the face of disaster. So I appreciate everyone’s participation today, with your permission, hon. Speaker.
Mr. Speaker: We might extend that invitation to people in the gallery, if you have your phones on mute.
Interjections.
Mr. Speaker: They don’t have phones? Okay. Apparently, I’ve been overruled on that.
Tributes
JAMES PAXTON
I. Paton: Roughly three weeks ago today I got asked, and it was an honour, to throw out the first pitch for Ladner Minor Baseball. Does anybody know where I’m going with this?
I was so honoured that a graduate of Ladner Minor Baseball, James Paxton, yesterday, last night in Toronto, threw the first no-hitter since 1945 by a Canadian. James Paxton grew up in Ladner. He went to Delta Secondary School, which is my alma mater. Even my son and his buddies are friends with James. They holidayed together this past winter.
We’re just so proud of James in Ladner and Tsawwassen and Delta, in general. What a game last night. He went the full nine innings, and even on his last three pitches, he hit 98, 99 and 100 miles an hour in his pitches — the first no-hitter since 1945 by a Canadian.
Congratulations to James Paxton.
Introductions by Members
R. Chouhan: I have the pleasure of welcoming new staff to the parliamentary education office today. This summer 15 post-secondary students have been hired to work in the parliamentary tour program. Over the next four months, these nine summer tour guides and six Parliamentary Players will provide free guided tours to about 100,000 school children and tourists from around the world seven days a week, starting on the May long weekend.
We will be offering tours in six different languages: English, French, Spanish, German, Mandarin and Hebrew. You will certainly notice the Parliamentary Players, as they will be in period costume, to bring history to life as Queen Victoria, Francis Rattenbury, Thomas Uphill, Nellie Cashman, Hamish the stonemason and Amor De Cosmos.
I would like you to please welcome Madeleine Humeny, as team lead; Stephan Bagan, Aidan Guerreiro, Teanna Lackner, Kaylyn Olynyk, Gabrielle Parent, Joy Peters, Naomi Reuveny, Maria Wallis, Alec Xu, Sheldon Graham, Nicholas Guerriero, Ellen Law, Avry Payne, Douglas Peerless and Daniel Saretsky. Would the House make them very welcome.
T. Redies: I’d like to welcome two constituents from South Surrey to the gallery today — Paul Hague, a local realtor, and Shelley Coburn, who is with the B.C. and Yukon legion and also a Langley school trustee.
The reason why they’re visiting us here today is that Paul bid on a lunch with the member for Surrey South and myself for a very worthy cause, our Peace Arch Hospital Foundation. I know there are some members on the other side of the House that might wonder about a prize with myself for lunch — if that’s really a prize — but not Stephanie. Stephanie is okay.
Anyway, I’ve broken multiple rules here with this introduction, but I just want to make sure I welcome Paul and Shelley and thank Paul for all his support for the Peace Arch Hospital Foundation.
Hon. J. Sims: It is my privilege today to introduce MLA Pargat Singh Powar, who is joining us on the House floor today. MLA Powar has been a member of the Punjab Legislative Assembly since 2012. He is a dear friend. I first met him at hockey tournaments, of all things, because he is also a very well-known and renowned hockey player. That’s grass hockey, not ice hockey. He is considered one of the world’s best defenders. That’s when he used to play a lot. We have a member from North Delta who’s had the privilege of playing hockey with MLA Powar.
I would also like to recognize that we have other guests who’ve come with MLA Powar, and that is his son Harnoor Kaur Powar, his son Hartaj Pargat, his daughter Harnur Pargat and his friends Harpreet Singh Atwal and Paramveer Sohi. Please may I ask all of those in the House today to make them very, very welcome to our warm Canada.
P. Milobar: We have several people here today representing the cement industry in British Columbia. From the Cement Association of Canada, we have Michael McSweeney, Adam Auer and Shane Mulligan. We have Kent Stuehmer from Lehigh and Jonathan Moser from Lafarge. Will the House please make them welcome.
Hon. A. Dix: Today is a day that we recognize and celebrate ambulance paramedics and emergency dispatchers in B.C. I had the honour this morning to meet with four members of the delegation. I’m going to do them in order of importance to me. Tim Lehman, who was extremely eloquent at the meeting, also happens to be my constituent. Secondly, of course, is Cameron Eby, who is the new president, since last fall, of the Ambulance Paramedics of B.C. Local 873 and also — interesting thought — is actually tied for first place on my list of favourite Ebys. Also there were Christian Andersen and Steven Boaly.
I’d ask the House to make all of them and all of the ambulance paramedics with us today welcome.
A. Weaver: I was just looking at the B.C. portraits Twitter feed. Quite remarkable, hon. Speaker.
Please let me welcome Jacob Kreiser and his son Vince, who are here today. Jacob moved into my riding in 1968 and has lived there on and off for many, many years. He’s a retired high school teacher, the majority of which was at my wife’s alma mater, the glorious and magnificent building of Victoria High School, as well as Spectrum Community School here in the greater Victoria district. Would the House please make them feel very welcome.
Hon. B. Ralston: It’s a pleasure to welcome some distinguished parliamentarians to the Legislature today. A delegation from the European Union Parliament, led by Chair Bernd Kölmel, is on a five-day visit to Canada. The group, representing various member states, held interparliamentary discussions in Ottawa and is now, obviously, here on the west coast, spending the day in Victoria before heading to Vancouver.
Thank you, Mr. Speaker, for receiving and welcoming our guests today. I know that they have meetings, as well, with my colleagues the Minister of Education and the Minister of Environment and Climate Change Strategy, and that will strengthen our interparliamentary relations.
Would the House please congratulate those representatives of the European Union as we celebrate Europe Day today, and make them all feel very welcome.
G. Begg: I’m delighted to welcome to the House today the Rotary Club of Surrey essay contest winners. They’re all from Kwantlen Park Secondary, in my riding. I don’t see them here yet, but I’m sure they’ll join us momentarily. They are Jagjyot Parmer, Mike Ghost, Emily Best and Hanibal Reda. Accompanying the students are Rich Greczi, teacher of social studies at Kwantlen Park Secondary; Dick Wareham, member and secretary of the Rotary Club of Surrey and a longtime personal friend; a member and past president of Surrey Rotary Club and former MLA for Surrey-Tynehead from 2001 to 2013, Dave Hayer. Would the House please join me in making them all feel very welcome.
Hon. J. Darcy: Today with so many paramedics here, it is an opportunity to give a shout-out to all the ambulance paramedics and all the first responders of British Columbia and to just say there’s an untold story in this overdose crisis. That untold story is the thousands of lives that are being saved by our ambulance paramedics and our other first responders.
The province of British Columbia owes you a great debt of gratitude. Thank you to all of your members.
D. Ashton: It’s my great pleasure today to introduce a gentleman. He’s a longtime employee of the provincial government and a gentleman that had the unenviable and almost impossible task of balancing the freshet flows into the Okanagan system and trying to keep the pooling heights at a reasonable height for all those that are affected by flooding — Brian Symonds from Penticton.
Brian, welcome.
Hon. C. Trevena: From the government side of the House, I’d like to also welcome the members of the cement industry who are here and from the cement association who are here. I know we’ll be having many meetings with them in the coming days. I look forward, also, to their event this evening. I hope the House will once again make those people from Lehigh, Lafarge and the Cement Association of Canada very welcome.
N. Letnick: I would also like to offer my thanks to the paramedics from British Columbia. One of my first jobs in this House was to travel the province and look for a way to help paramedics and firefighters and all first responders to avoid contracting contagious diseases, like hep C and HIV.
We in this House introduced the Emergency Intervention Disclosure Act thanks in large part to the paramedics in British Columbia. On behalf of the official opposition and people all over B.C. that rely on the paramedics, please make them feel very welcome.
R. Singh: In the House today, we have members from Diabetes Canada. We have Joanne King, Sheila Kern, Russell Williams, Keith Godfrey, Colin Mallet, Mario Miceli, Karnjit Sarai, Ellen Stensholt, Brian Symonds, and also from Better PharmaCare Coalition, Dr. Ganive Bhinder. Would the House please make them make them feel welcome.
B. Ma: I don’t get a lot of opportunity to exercise, so I appreciate the opportunity to stand up and sit down.
I am very pleased today to be able to introduce to the House someone I know as a constituent, a volunteer, a supporter but, most importantly, a friend. You may all know him as the former executive director of the B.C. Council of Film Unions, for 20 years. Mr. Tom Adair is now enjoying a relaxing retirement by serving as the chair of the health benefits trust for IATSE 891, the largest film union in Canada; as the chair of the mental health and addictions task force of Calltime: Mental Health, which is a joint initiative by B.C.’s motion picture industry unions; and by getting involved in several affordable housing projects.
Ladies and gentlemen, friends, this is a man who doesn’t know what the word “retirement” means. Please help me welcome him to the House today.
Tributes
JAMES PAXTON
S. Thomson: I just wanted to stand and make sure that the member for Delta South didn’t take all the credit for James Paxton’s no-hitter. I know he learned a lot in the Ladner baseball system, but James also pitched for the Kelowna Falcons. That’s where he really honed his craft.
So on behalf of all of us, again, congratulations for his great feat yesterday.
Introductions by Members
A. Kang: It is not very often that I have 42 of my friends come to Victoria to visit me on this very special day. I have seniors here who have worked on campaigns, who have helped other seniors. For many of them, it’s the first time for them to be here in Victoria.
They are from the CCSA, the Canadian Community Service Association, with the senior branch. They have a junior branch, a senior branch and a general branch. I belong to the general branch, age-wise.
I would like to introduce their presidents. The past president for Burnaby is Jen Ching Wang. The current president for Vancouver is Linda Pang. The Surrey president is Annie Mue. A very dear friend of mine is regional president of seven branches in Metro Vancouver and Fraser Valley, Wendy Hu.
As well, we have here the Northern Star Lions Club and their members. I want to thank Harry Hsu for bringing your members over as well.
A very special thanks goes to Tian-Jin Temple and TJ Living for their seniors program, for enabling these seniors to come over. And ferry fares were free today, because Monday to Thursday.…
As well, I would like to make a special mention that my executives are here. Vice-President Trevor Morgan is here, as well as three youth volunteers: Ella Dee, Jamie Hahn and Latina Pankova. And a very, very special thank you to my CA, who’s here today making sure no one got lost, Apollo Chung.
Everyone, please make them feel welcome.
A. Wilkinson: I’d just like to welcome the Cement Association of Canada. They are, of course, the foundation of our society. I do hope that the Minister of Environment and the Minister of Transportation will hear them, because they bring a wealth of data and information from their worldwide industry to British Columbia. It’s been a long-standing relationship between the association and government, no matter who’s in office. We’ll look for a strong, structural response from those two ministers.
Introduction and
First Reading of Bills
BILL M215 — LEGISLATIVE ASSEMBLY
MANAGEMENT COMMITTEE
AMENDMENT ACT, 2018
P. Milobar presented a bill intituled Legislative Assembly Management Committee Amendment Act, 2018.
P. Milobar: I move that a bill intituled the Legislative Assembly Management Committee Amendment Act, 2018, of which notice has been given in my name on the order paper, be introduced and now read for a first time.
With this bill, as the current rules stand, MLAs who are exempt from the capital city living allowance are able to claim per-diem allowances for meals and vehicle mileage while they are in Victoria, while the Legislature is sitting. This bill will align the rules around per diems with the rules around the capital city living allowance to make sure they are synchronized, and that will no longer occur.
Mr. Speaker: The question is first reading of the bill.
Motion approved.
P. Milobar: I move that the bill be placed on the orders of the day for second reading at the next sitting of the House after today.
Bill M215, Legislative Assembly Management Committee Amendment Act, 2018, introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.
Statements
(Standing Order 25B)
EMERGENCY PREPAREDNESS
J. Rice: I’ve just returned from visiting flood-affected regions in the South Okanagan and Similkameen communities.
As government, we’re doing everything in our power to help these folks and communities. We recognize it’s a trying time, and in many places, the water is still rising. On top of this, we still have to prepare for and contend with the upcoming wildfire season. Furthermore, in British Columbia, we have some of the highest seismic risk in North America.
Monday was the start of Emergency Preparedness Week, and hopefully, if it was turned on, you received B.C.’s first wireless test of the Alert Ready system on your LTE phone.
I’d like to talk to you about the critical importance of getting good and ready for what Mother Nature may send your way, and to reinforce three simple steps that we need to keep ourselves, our loved ones and our families safe: learn the risks, develop a plan and prepare a kit.
When disaster strikes, it could take days for help to reach you. That’s why it’s so important that everyone takes the time to collect a minimum of three days of supplies — and, ideally, as much as seven. According to a recent PreparedBC survey, many British Columbians aren’t prepared for a disaster and don’t have the supplies necessary to take care of their families. Why? We’re lazy, and we don’t know what to put in our kits.
Our government and our partners, though, are committed to changing this. This week we’re launching the new Partners in Preparedness program to help British Columbians get prepared. Under the program, B.C. retailers will champion emergency readiness by promoting and selling disaster supplies in their stores. The goal is to make it easier for people to find and purchase supplies that they need and to help them learn about their risks.
I’m thrilled to announce the first two B.C. retailers to come on board: London Drugs and Save-On-Foods. British Columbians will be able to visit London Drugs or Save-On-Foods, grab a premade emergency supply list and build their kits in one easy shopping trip.
But emergency preparedness goes beyond the consumer and the retailer. Emergency preparedness is a shared responsibility. We all have a role to play. I call on British Columbians to get your emergency kit stocked and get good and ready, and I encourage all B.C. retailers to get on board with Partners in Preparedness and help British Columbians be prepared.
GEOFFREY COWBURN
S. Bond: On March 27, the Robson Valley lost a health care legend. Dr. Geoffrey Cowburn passed away at the age of 90. His life is celebrated in a recent article in the Valley Sentinel newspaper, beautifully written by Birgit Stutz.
Dr. Cowburn served McBride and the Robson Valley region for decades. Born in England, Dr. Cowburn and his family emigrated to Canada in 1967. While originally destined for Quesnel, a practice was for sale in McBride, and that became their new home. Quesnel’s loss was the Robson Valley’s gain, and Dr. Cowburn served not only McBride but the entire region.
He did just about everything. As the article notes, that included suturing wounds, delivering babies, saving lives — basically, anything from prescribing prescriptions to doing emergency surgery in both McBride and Valemount.
Dr. Cowburn loved to read and garden, and he loved horses. He also loved to fly. You couldn’t miss him in his bright yellow Tiger Moth biplane. While flying may have been part of his hobby, it was an important part of his practice, as he would use his plane to fly to Valemount and Blue River to care for his patients. Dr. Cowburn’s daughter, Lisa, recalls: “If he was needed at the McBride Hospital when he was out flying his plane, Mom would put a white sheet on the front lawn of their residence to signal that he was needed at the hospital.”
Dr. Cowburn was compassionate, caring and hard-working. He cared deeply for his patients, and he loved living in McBride. He retired from his medical career at the age of 85. After the death of his beloved wife, Jane, he spent the last few years of his life in Qualicum Beach with his daughter, Lisa. The Robson Valley region was blessed to be served by this incredible physician. He will be missed but never forgotten.
PARAMEDICS AND EMERGENCY DISPATCHERS
R. Kahlon: Members of the Ambulance Paramedics and Emergency Dispatchers of B.C. are in Victoria today for a day of advocacy, to offer us a view into the extraordinary work they do every day. We welcome them. Many MLAs are planning to meet with these caring and heroic professionals to discuss issues of concern.
These are jobs that come with unique stresses and challenges. Both historically and today CUPE 873 and its sublocal, representing 4,000 ambulance paramedics and 500 emergency dispatchers in B.C., has a long history of advocating for its members. They’ve come a long way.
There was a time not long ago when ambulance services were provided by a mix of private and public organizations, including funeral homes and community groups. Consider this. In 1963, metropolitan ambulance attendants worked 86.5 hours a week and got paid $90.
In 1974, the B.C. government, under the leadership of Premier Dave Barrett, formed the B.C. Ambulance Service. Hours for members were reduced, pay was increased, and outcomes for patients improved vastly. Today BCEHS is in the midst of making more improvements, hiring more full-time and part-time paramedics, adding more ambulances and hiring more dispatch staff.
As a first step towards providing more support for first responders, the Minister of Labour announced legislation that will add post-traumatic stress disorder and other mental injuries to a list of presumptive conditions. This means workers will no longer be required to prove their disease or disorder is work-related.
Our emergency health care workers are there for us during some of the most difficult and frightening times of our lives. On behalf of my colleagues, I wish to thank them.
MARTY BOOTSMA
G. Kyllo: I rise in the House today to pay tribute to the life of my friend Marty Bootsma, who passed, April 20, at the age of 69 after a brief bout with cancer. Marty’s memorial was attended by well over 500 family, friends, dignitaries and members of the community. The large attendance was telling of Salmon Arm’s admiration and respect for Marty. Heartfelt stories were shared by Marty’s son Roger and daughter Grace and other family members and friends, providing personal insight into Marty’s ambitious, adventurous and family-centred life.
Tributes were also extolled by former Salmon Arm mayor and MP Colin Mayes and Coun. Alan Harrison, who shared that along with a strong work ethic and a great sense of humour, regardless of the politics involved, Marty always voted with Salmon Arm’s best interests at heart.
Marty was born in the Netherlands and immigrated to Vancouver with his parents at a very young age. He met Margaret in Vancouver, and they were married in 1971 and had three children. In 1980, they moved to Salmon Arm, where Marty pursued careers as a carpenter, a real estate agent and the owner of Bootsma’s Bakery.
Marty lost his wife Margaret to cancer in the spring of 1999. These were difficult years, but Marty remained an involved member of the community. Marty was a volunteer firefighter, a Rotarian, a city council member and mayor of Salmon Arm from 2005 to 2011.
Marty found love again and married Wendy, adding to his growing family. Marty enjoyed his time as a member of the Salmon Arm barbershop project and having morning coffee with his closest friends. Marty enjoyed people, was quick-witted and had the ability to form and articulate an opinion on almost anything. But his greatest joy was spending time with his family, especially his growing number of grandchildren, who affectionately called him “Opa.”
To his wife, Wendy; children and stepchildren Roger, Kim, Grace, Gord, Jon, Christine, Curtis, Michelle, Emily, Justin; and grandchildren Harley, Jaron, Kierra, Nikki, Josie, Riley, Rachel and Joy: please accept my sincere condolences.
Marty Bootsma, cheers to a life well lived.
DOWNTOWN EASTSIDE WOMEN’S CENTRE
M. Dean: “My comfort zone and second home is the Downtown Eastside women’s drop-in centre,” says Marie.
Women in the Downtown Eastside are severely marginalized and face multiple challenges, including systemic racism and poverty, endemic violence and rampant abuse and exploitation. Indigenous women, who make up about 70 percent of DEWC members, are disproportionately affected by intergenerational trauma and the housing and fentanyl crises. Chinese senior women, who comprise another significant part of the DEWC community, face persistent racism, isolation and housing uncertainty.
DEWC provides a place where women can come as they are, find resources, support and sisterhood, and build personal capacity so as to bridge the gap from survival to self-sufficiency. Hundreds of women access DEWC daily, where they can find hot, nutritious meals, toiletries and clothing, phone and computer access, as well as a safe space and emotional support — or something as simple as, in one member’s words, “a shoulder to cry on.”
The drop-in centre is a cornerstone of the Downtown Eastside community, hosting grief and support groups, counselling, art workshops and healing circles. Starting out from serving soup from a household kitchen, the DEWC currently operates a low-barrier drop-in centre and emergency night shelter, offering a safe, women-only space, supportive surroundings, meals and basic essentials as well as a continuum of care that nurtures and empowers members towards long-term change.
This is their 40th year since incorporation. On behalf of the passionate and supportive MLA for Vancouver–Mount Pleasant, I’m honoured to recognize their members, volunteers, staff and community, which is, as they say, a fierce one that continues to survive and thrive despite all odds.
BIG GREEN EGG BBQ FESTIVAL
IN
CHILLIWACK
J. Martin: Let’s save the date, May 27, as Grandpappy’s Home Furniture and Appliances in Chilliwack hosts the second annual B.C. Eggfest.
Now, this has absolutely nothing to do with our thriving poultry sector in the eastern Fraser Valley. What are we talking about? We’re talking about a barbecue food festival, absolutely — B.C. EggFest. It’s a gathering of Big Green Egg fans and experienced cooks from all over the province. Among these will be Brian Misko from the House of Q. He’s one of the most decorated pitmasters in the country, if not North America.
Fifteen different cook teams will be showcasing their skills and talents while preparing, demonstrating and sampling their special recipes all day long for the hungry tasters to enjoy.
Big Green Egg aficionados — or eggheads, as we like to refer to ourselves — are devotees of an ancient outdoor cooking method that originated 3,000 years ago in China. Over time, the Japanese embraced this clay cooking vessel, and this eventually became known as the kamado cooker.
But enough with the history lesson. It’s going to be a great day for the entire family at the B.C. EggFest. Anyone with an appetite and a love for great barbecue is invited to come out and taste what all the teams have in store.
There’ll be live music, courtesy of Mr. Entertainment himself, Trevor McDonald; and for the first time ever, the Axewood axe-throwing crew is going to be at the B.C. EggFest. Everyone is invited to join the battle for a little bit of friendly axe-throwing competition.
Food, axe-throwing — I mean, what more do you want? It’s all happening May 27 from 11 to four at Grand Pappy’s Home Furniture and Appliances, just a couple of minutes off Highway 1 in Chilliwack. [Laughter.]
I don’t know what’s so funny here. Will the House join me in wishing the organizers and everyone involved a successful EggFest 2018.
Oral Questions
IMPACT OF EMPLOYER HEALTH TAX
ON SCHOOL
DISTRICTS
M. Hunt: Further evidence has come to light that the employer health tax was announced without any regard for its impact on school districts. I have an email written by the Minister of Education on February 22, after he downloaded an additional $7 million on Surrey schools through the employer health tax. In this email, the minister forwards a news article about the budget challenge faced by the Surrey school district with the question: “What is the shortfall this article refers to?”
Will the minister explain his disconnect from the budget challenge he imposed on the Surrey school district with the NDP’s new higher tax on schools?
Hon. C. James: Thank you to the member for the opportunity to be able to talk about all the good things we’ve done in education in this government over this last year, particularly the investments we’ve made in the Surrey school district.
When it comes to building schools, when it comes to seismic upgrading, when it comes to getting rid of portables, we have invested in the Surrey school district. We are supporting education in a way the other side never did as they picked a fight with teachers.
The normal implementation process for the tax continues. Further information will be available in the coming weeks, as I said yesterday, as I said the day before. And as I’ll continue to remind people, this will eliminate medical service premiums, a savings of $900 for individuals and $1,800 for families. I’m not sure why the other side is against the affordability for families.
Mr. Speaker: The member for Surrey-Cloverdale on a supplemental.
M. Hunt: Well, when asked on March 12 if he was aware, going into the budget, that the tax would be applied to school districts, the minister said: “I wasn’t aware of the contours of the tax.”
Now we find out that he was unaware of a significant school budget shortfall in Surrey when he imposed the new health employer tax. How can the minister justify his ignorance of Surrey’s budget when he imposed an additional $7 million tax on the Surrey schools?
Hon. R. Fleming: First of all, it’s great to hear from that member there. I know he missed the opportunity to show up and see 2,500 new spaces in Surrey be announced the other week in his own riding — and $100 million of capital investment since Labour Day that will benefit students in his riding and every constituency in Surrey.
The member is absolutely wrong about the 50 percent cut that we’ve introduced to MSP. In fact, the Surrey school district gets to keep $1.8 million of additional savings this year.
Here are the discussions that I’ve had with Surrey parents and Surrey trustees about the difference between this school year, the next school year and the ones previous under the last government: $59 million of new operating funds, 600 new teachers in the classrooms and the smallest class sizes in Surrey’s history in generations.
We just disclosed those numbers, so I’m sure the member is thrilled to hear that there’s more one-on-one time with teachers and support staff in the schools that he represents in his riding under our new government than there ever was under his.
We said to the Surrey school board: “Keep the savings from the broadband Internet cut that we’ve made this year. Invest it in kids.” They’re doing that.
The pension fund savings they’ve achieved — we didn’t claw it back like the previous government did. We said, “Invest it in classrooms and kids,” because Surrey parents have waited long enough for a government that cares about education and stands up for the kids.
Mr. Speaker: The member for Surrey-Cloverdale on a supplemental.
M. Hunt: Well, I would be more than happy to attend the announcements that this government makes for Surrey schools if I got more than one business day announcement of it so that I could have changed my schedule to attend.
Let’s recap what we know.
Interjections.
Mr. Speaker: Members, if we may hear the question.
M. Hunt: Let’s recap what we know. The minister imposed a $7 million tax grab on Surrey schools. He writes a bewildered email when he reads in the media that they’re having a budget shortfall in Surrey. Then to add insult to injury, he can’t even tell Surrey parents if he has money to exempt the schools from this tax grab. This, in my opinion, is incompetence.
To the minister, will the Surrey school board have to find another $7 million or not?
Hon. R. Fleming: I apologize for the late notice to the member, but I suppose he prefers the days when there were no school announcements in Surrey.
We have worked very closely with the school board chair, with trustees, with the superintendent in that district. We have worked with parents very closely on the finances of that school district. They have never been higher. There have never been more teacher or instructional staff in the district. We have worked hard with them to get rid of portables, which their kids have studied in for way too long in terms of their school careers.
The investments that we are making in Surrey schools are at record levels. We’ve just announced a new playground fund. Just yesterday I had the pleasure to be with the Premier.
I know that for the member opposite, when you have 550 million new dollars in the school system this year than in the last full year of his government, when they were in power, that the sky is somehow falling. But that’s not what I’m hearing from Surrey parents and families, and the school district has thanked our government for all the initiatives that we’ve made to finally fund an investment that will pay dividends for this province.
T. Redies: School districts across this province were blindsided by the surprise employer health tax. So too, apparently, was the minister. Unfortunately, over 2½ months later, school boards are still being left in the dark by this minister.
The Surrey board of education is meeting later today to approve their 2018-2019 budget submission. To the Minister of Education: will the Surrey board receive an exemption or be forced to pay an additional $7 million for the NDP’s new higher tax on schools, yes or no?
Hon. R. Fleming: The reception that I’ve had from the B.C. School Trustees Association and other organizations was to thank this government for finally listening to their concerns about a whole range of issues. They are glad that finally, a government that fought for 12 years against the teaching profession in this province — literally ripped out hundreds of millions of dollars of annual funding, took it away in terms of learning supports for kids…. They have seen record levels of investment in the education system. It’s long overdue.
The Minister of Finance has been very clear that she’s working with school leaders around the province. She’s working with others in different sectors around the health tax. Those discussions are ongoing.
I’ve told the members opposite about the $1.8 million savings from getting rid of 50 percent of the MSP this year. The tax will be completely eliminated, and that’s wonderful news for Surrey families.
The member opposite knows that this government is dedicated to pursuing measures that will make life more affordable for B.C. families. We’ve eliminated a regressive tax. We’re the last province to even have it. That will save working families in Surrey $1,800 a year. We’re proud of that.
Mr. Speaker: The member for Surrey–White Rock on a supplemental.
T. Redies: If I may, I just would like to point out to the Minister of Education that $7 million is higher than $1.8 million. The minister’s email reveals he is completely disconnected from school board budgets, even as he imposes significant additional costs. He doesn’t seem to care about the impacts of downloading $7 million on Surrey schools. He doesn’t even care enough to tell the school boards if they will be exempt or not. He can’t answer a yes-or-no question.
To the minister, how is the Surrey school board supposed to approve a budget tonight with a $7 million unanswered question?
Hon. R. Fleming: The member’s numbers are completely inaccurate and wrong. We have worked with the school districts through the B.C. association of school board officials to look at what this transition to the elimination of the MSP will look like for school districts, and we are managing that transition right now.
The Finance Minister has met with school leaders and is continuing discussions with them. For the time being, there’s a $1.8 million savings by the 50 percent cut in MSP.
There are record levels of funding in the Surrey school district. We’ve hired hundreds of new teachers there. That’s good news for Surrey families. We’ve made record investments in school capital in Surrey.
I think the member should celebrate all of the great news, with this side of the House, that’s going on in her constituency and all over Surrey, because it’s long overdue.
BUS SERVICE ON VANCOUVER ISLAND
S. Furstenau: This February Greyhound announced that it was discontinuing its only bus routes on Vancouver Island, one of which ran from Victoria to Nanaimo. This was a blow for students in Cowichan who attend Vancouver Island University in Nanaimo. These campuses are 39 minutes apart by car but essentially impossible to reach by transit as there are no routes that link Duncan and Nanaimo.
Transit is a critical need for youth in communities across B.C. This government continues to emphasize the importance of education, and I applaud them for that — for giving our youth the tools they need to thrive. Yet these efforts are overlooking areas where our youth are most in need — even when, as in this case, there is a simple fix available.
To the Minister of Transportation and Infrastructure, there are ongoing plans to improve transportation infrastructure and access in major cities, but less populous communities are in dire need. What is your ministry doing to prioritize transit infrastructure in underserved rural and semi-rural regions?
Hon. C. Trevena: I thank the member for her question. It’s important to recognize that people, wherever they live in the province, need to be able to travel safely and affordably to get to work, to visit family, to visit friends, to go to school. Our government is absolutely committed to that — investing in transit through the province.
B.C. Transit is in collaboration with local governments and is working on future plans for transit in the area the member talked about over the next couple of years. Part of this looks at new connections between Nanaimo and the Cowichan Valley.
Once partners have reached an agreement on the service levels and funding, the work will go ahead. In the Cowichan Valley itself, the regional transit system is in fact getting this summer, July 2, 1,500 hours of new service.
We are absolutely committed to ensuring that people can travel, not necessarily by car: have access to bus service, have access to transit. We’ll continue to invest in transit around the province to make sure people can travel affordably and safely.
Mr. Speaker: The House Leader, Third Party, on a supplemental.
E&N RAIL LINE AND
TRANSPORTATION
CORRIDOR
S. Furstenau: I appreciate that we’re looking at plans over the next few years; however, there are students who are actually leaving school right now because they can’t get between Duncan and Nanaimo. So we are in a bit of a crisis.
We also have a transportation corridor on Vancouver Island that links Victoria to Courtenay, but it has sat unused for years. This corridor could provide much-needed relief for communities, for commuters, for youth, and it presents an untapped economic opportunity for the tourism industry on Vancouver Island.
My question is for the Minister of Transportation. What steps has the minister taken to see the E&N rail corridor restored so that Vancouver Island can benefit from this unused transportation solution?
Hon. C. Trevena: We’re very aware of the E&N corridor and the love and passion that people across Vancouver Island have for this. It is something that the previous government ignored and let fall into disrepair for many years. If that government had acted sooner, we wouldn’t be still having a debate right now on what we could be doing with that corridor.
This government is looking seriously at ways of ensuring that people can travel — as I say, travel affordably and safely — whether we’re looking at transit, looking at alternatives for the rail corridor, looking at alternatives both in the south Island and the rest of the Island. We have an absolute commitment to invest in public transit, public infrastructure, to ensure that everyone, every person in B.C., has options, has the ability to travel safely and affordably.
IMPACT OF EMPLOYER HEALTH TAX
ON SCHOOL
DISTRICTS
S. Cadieux: Well, in fact, the Minister of Education is wrong about Surrey schools. Doug Strachan, with the Surrey school district, says the net result for them from…. The replacement of the MSP with the new, higher employer health tax will mean a difference from $5.3 million to almost $12 million, or a net increase of almost $7 million that will come out of the schools’ operating budget.
To the Minister of Education, who billed taxpayers $10,000 a day on a European tour at the same time the health tax is going to cost Surrey schools a net increase of about $7 million a year, can he explain to Surrey parents why there’s enough money for his globe-trotting, but he doesn’t care enough to spare schools from the NDP’s new tax grab?
Hon. R. Fleming: I’m surprised to hear an element of that question from the member. She’ll know that hundreds of Surrey parents have been waiting and camping overnight to get spaces in French immersion programming that are in too short of a supply in Surrey because her government did nothing.
She might want to have a conversation with the Canadian Parents for French, Surrey chapter, about just that. They appreciate this government is trying to meet the aspirations of today’s parents to have bilingual education in the province of British Columbia, and we make no apologies for that.
The member’s numbers are wrong that she’s quoted again. It’s a $1.8 million savings this year. We’ve said to Surrey: “Keep that.” In addition….
Interjections.
Mr. Speaker: Members, we shall hear the response. Thank you.
Hon. R. Fleming: We’ve said for them to keep that 50 percent cut in MSP. In addition, with the reduction in broadband Internet service, we’ve said: “Keep that savings as well.” Reductions in the millions of dollars in pension overcontributions — retained by the school district.
All of that in addition to the largest investment we’ve ever seen in the public education system in British Columbia: 60 million new dollars in operating money for the Surrey school district. That’s great news, Mr. Speaker. It’s why we’ve hired specialist teachers, librarians, school counsellors…
Mr. Speaker: Thank you.
Hon. R. Fleming: …and ELL instructors in Surrey. We’ve hired them; they fired them.
Mr. Speaker: Thank you, Minister.
The member for Surrey South on a supplemental.
S. Cadieux: Maybe the minister should take a math class, because the reality of him saying that we did nothing over 16 years…. In my eight years alone, there was $400 million worth of new schools and new additions — 14, in fact, in my ridings.
While I appreciate the additional investments that are coming, and I appreciate that that’s continuing, the reality is that this new tax grab by the government will cost the Surrey school board a net increase of $7 million. Meanwhile, he’s prepared to spend taxpayer money to tour France, the Netherlands and Belgium. The four-day trip cost an estimated $40,000.
To the minister, British Columbians paid for his European tour, and they deserve some answers. How many teachers did he hire?
Hon. R. Fleming: We have a serious problem in British Columbia around the recruitment of French teachers. It’s one that the previous government ignored for years.
It’s a good problem to have in this sense: that British Columbian parents today have aspirations for their kids to learn in both languages. We have 60,000 French immersion kids all across the province, but we have thousands that can’t get into those programs.
We are developing a strategy that trains more teachers domestically in British Columbia. We’ve invested $1 million for new French-language-teacher training programs in B.C. universities starting September 1. We have recruited teachers from out of province, but we also have to look internationally if we’re to have teachers come to British Columbia. We went to Europe to explain the pathway to citizenship to teach here in British Columbia.
We went, quite frankly, to tell them that British Columbia is a dynamic bilingual province with a large francophone population, and we went to tell them that it’s a place that’s dynamic and beyond Ontario and Quebec, quite frankly, to get us on the map in Europe. I look forward to….
The teacher regulation branch is already certifying teachers today. We have dozens and dozens of applications coming forward, because this problem doesn’t exist just in her community. It exists in the 48 school districts that have French immersion programming today in British Columbia. It’s a problem they neglected. It’s a problem we attempt to work with parents to solve.
BUDGET PROVISIONS AND PLANNING
FOR SCHOOL
DISTRICTS
M. de Jong: It wasn’t meant to be a trick question. Just put your Camembert aside and tell us how many teachers were hired.
For 16 years, British Columbia worked hard and established a very positive reputation for our budgeting process. It’s one that was professional, predictable and certain. Even the Finance Minister these days, I hear, is standing up and bragging about the reputation and the legacy that she and her government have inherited.
You contrast that with the situation that existed the last time the NDP were in government, when school boards were forced to wait, sometimes months and months and months into their fiscal year, before understanding what their contributions from the provincial government would be. The Finance Minister knows that’s true because she used to be one of those trustees complaining about the behaviour of the NDP government. Today she’s creating the same uncertainty. Today she and her government are creating the same uncertainty for school boards.
My question to the Finance Minister is: how are school boards supposed to finalize their budget — in some instances, hundreds of millions of dollars’ worth of budget…? How are they supposed to finalize their budget when she and her government refuse to state clearly to what extent, if at all, they will be reimbursed for the millions of dollars of additional costs caused by her MSP replacement tax?
Hon. C. James: I’m not really sure what the member across doesn’t understand about more money and more investment in education, record levels of investment in education made by this government on this side. We are proud of those investments: 3,700 teachers hired this year alone, starting in September.
Most importantly, what is the difference that happens for children in classrooms? The difference is that students have more support. The children are able to get better support. It’s smaller classes, so teachers have time to be able to spend with children. That’s the difference that this side is making in education. We have provided more support to school boards, more support to education.
The normal implementation process for the tax continues. There will be further information available in the coming weeks, as we move towards legislation.
I do have to take issue with the member’s comments about fiscal responsibility in this government. I am proud to say that today we had our third rating agency. Moody’s came forward with a triple-A rating once again for British Columbia.
Interjections.
Mr. Speaker: Members.
M. de Jong: What a remarkable achievement. How did you do it?
Interjections.
Mr. Speaker: Members, we shall hear the question.
M. de Jong: Yet far from building on that legacy, the Finance Minister, I regret to say, is putting it at risk. She is putting it at risk by playing precisely the kind of politics that she decried when she was a school trustee in this province.
She’s preparing a first-quarter update. I know she is. She knows what the cost of this MSP replacement tax is for school boards. She knows that. I dare say she probably knows what, if anything, the government intends to do about it. Is she providing that information in a timely way to school boards? Absolutely not. What she is doing is waiting for a politically convenient time to disclose what her intentions and those of the government are.
Why is the Finance Minister and her colleagues and her government forcing school boards to twist in the wind — and, in the process, compromising B.C.’s hard-earned positive reputation for budgeting — by refusing to be forthright today, now, while this House is in session, and telling school boards what, if anything, they can expect to offset the cost of her MSP replacement tax?
Hon. C. James: Well, I find it incredible that this member and that side of the Legislature would talk about playing politics or being forthright when they did just the opposite — which is why they’re sitting on that side, and we’re sitting on this side. ICBC, B.C. Hydro, picking a fight with teachers — I could give a long list of reasons, if the members were interested, about why they’re on that side of the Legislature.
Let’s take a look at a comment from the member’s own school district: “Abbotsford School District,” the headline says, “‘Not Panicked’ by the Added Cost of New Health Tax.” In fact, they’re saying that the district will save $650,000 this year, and the transition will mean a wash for that school district.
The member knows full well that we’re continuing on with the usual implementation process. We’re making sure that further information will be available in the coming weeks, as we build towards the legislation in the fall. And most importantly, I’m not sure why the other side is against giving more money in people’s pockets. Families in this province will be better off by $1,800 a year.
IMPACT OF EMPLOYER HEALTH TAX
ON SCHOOL
DISTRICTS
J. Isaacs: The Minister of Education can deflect and deny all he wants, but he just doesn’t care about the budget challenge he is forcing on schools.
The Coquitlam school district is going from $1 million in MSP to over $4 million for the employers health tax. Will the minister provide new money for Coquitlam schools to pay for this higher NDP tax, or has he used up all of the money on travel and meals?
Hon. R. Fleming: I know the member will be very pleased that the school district that she represents has saved $400,000 this year that they get to keep because we cut the MSP in half. I know that she will appreciate what it means for families that are struggling for affordability in Metro Vancouver to have 1,800 bucks in their family’s pockets to afford life better, when her government neglected affordability for 16 years.
The members this afternoon have put up numbers that are fictitious. They don’t account for the fact that employers, generally school district employers, have paid 100 percent of the MSP for all employee groups — support staff, teachers, administrators — and we’re getting rid of that tax. They don’t put that out there. They try and scare people.
As we’ve seen and as the Minister of Finance has demonstrated, we’re working with school districts on this. For now, what school districts have in terms of leadership from this government is a government that has tabled a budget that’s before the House today that has the largest school capital budget in B.C. history. It has the largest amount of operating funding, and we’ve hired 3,700 teachers so that students in her district can have more learning resources, which they deserve.
PREMIER’S MEETING WITH
WEST KELOWNA MAYOR ON
REAL
ESTATE SPECULATION TAX
B. Stewart: Last month the Premier agreed to a face-to-face meeting with West Kelowna mayor Doug Findlater concerning our community’s overwhelming opposition to the so-called speculation tax.
According to Mayor Findlater: “There’s been no response to what was agreed to as to have a meeting, no reply to my email, and others who have requested a meeting with the Premier have had no reply. Bad form at best.” Not even a reply.
Premier, my question to you is: why have you broken your promise to meet with Mayor Findlater?
Hon. J. Horgan: I thank the member for his question. I have spoken to the mayor of West Kelowna by telephone. I met with him in Penticton not that long ago, and I committed to meet with him. The member might not realize this, but in this parliament, the Premier likes to be in the Legislature and likes to be in Victoria.
Although it hasn’t been past practice to occupy this chair for question period day after day after day, that I believe, is a responsibility of the leader of the government. You can assure the mayor that I will be seeing him in due time.
[End of question period.]
S. Bond: I rise to present a petition.
Mr. Speaker: Proceed.
Petitions
S. Bond: This petition, signed by almost 1,300 residents, asks the Minister of Health to investigate the problems that have been highlighted with the Orkambi drug review; to restructure the Drug Benefit Council so these mistakes are not made again; and asks that Orkambi undergo a fair drug review that considers the scientific data thoroughly, accurately and in the appropriate context.
Orders of the Day
Hon. M. Farnworth: In this chamber, I call Committee of the Whole for third reading of Bill 17, Motor Vehicle Amendment Act. In Committee A, I call the continued estimates debate on the Ministry of Mental Health and Addictions.
Because we’ll be going into committee here and the Mental Health estimates may in fact finish this afternoon, after them, I will be calling the estimates for the Ministry of Health.
Committee of the Whole House
BILL 17 — MOTOR VEHICLE
AMENDMENT ACT,
2018
The House in Committee of the Whole (Section B) on Bill 17; R. Chouhan in the chair.
The committee met at 2:47 p.m.
Hon. M. Farnworth: This is Bill 17. We had a good discussion on it already, and I think that in the interests of time, we’ll just get it going right to the member for Prince George–Mackenzie.
On section 1.
M. Morris: I’d just like to make a general statement here if I could, Chair.
I’ve gone through the bill. The numbering system is a little confusing. The amendments are a little…. It took me a while to read through them. But I understand where the minister is coming from and where his staff is coming from — the fact that the federal legislation, the Criminal Code amendments, are still tied up in the Senate. That’s been problematic for us.
I don’t have any issues up until section 7. In section 7, I just need some clarity here going through that. It’s got….
The Chair: Member, are we passing sections 1 to 6?
M. Morris: Yes, Chair.
The Chair: Okay, let me do that first.
Sections 1 to 6 inclusive approved.
On section 7.
M. Morris: The effect of the driving prohibition — I just require some clarity here. I was reading through that. The prohibition starts immediately. Just let me have a look here. Under section 94.2(2)(a), it “takes effect immediately on service of the notice of driving prohibition.”
Then further in the section, under subsection 3(a), it talks about “the notice acts as a temporary driver’s licence that expires 7 days after the date it is served, and (ii) the driving prohibition takes effect on the expiration of the temporary driver’s licence referred to in subparagraph (i)….” I’m a little confused as to when it takes effect immediately and when this temporary driver’s licence takes effect for seven days.
Hon. M. Farnworth: Currently the ADP, the administrative driving prohibition, for alcohol doesn’t take effect for 21 days. It’s been that way for a very long time. This act is now being modernized and bringing it into line with what’s already at the federal level. So it will now take place immediately upon the serving. For drug-impaired driving, though, it will not take effect for seven days.
M. Morris: If I understand this right, the alcohol part is effective immediately, and the drug impairment takes place seven days later. Is this as a result of the federal legislation? Is this the timeline that the federal legislation has, or is this unique to the prohibition section?
Hon. M. Farnworth: In the case of alcohol, it brings it in line with the IRP, which we currently have in place, so that’s the same. In the case for drugs, the reason for the seven days is because if, for example, you have to take a blood sample, it has to go get tested, and it’s going to take time to do that. It puts it in line with the…. When the penalty comes in, it’s seven days after, and you’ve got seven days to get your affairs in order. So it coincides with that, and that’s the reason for the changes and the time around the drug impairment.
Sections 7 to 12 inclusive approved.
On section 13.
M. Morris: Again, just a bit of clarification for myself in reading through this. Section (1)(a) talks about alcohol. It’s three hours attributable to alcohol, so anytime within three hours after operating a motor vehicle pertaining to impaired driving, right? The next sections, (a.1) and (a.2), talk about the drug concentrations within two hours after ceasing to operate a motor vehicle.
I’m wondering why we have three hours for alcohol and then two hours for drugs and then two hours for a combination of drugs and alcohol in the system.
Hon. M. Farnworth: The three-hour time for alcohol mirrors existing legislation. The two-hour time for drug and drug and alcohol mirrors what is in the proposed Bill C-46, which is currently in the Senate.
M. Morris: So section (1)(a) represents existing legislation. Is that what I heard you say? Okay.
And sections (a.1) and (a.2), the proposed legislation that is coming with that federal bill…. Will section (a) then be changed, or is the federal legislation changing with respect to that three hours? Is it going to be two hours?
Hon. M. Farnworth: This is just an example of the complications that we are facing with this. Part 1 is what is. Parts 2, which you talked about, are what will be when C-46 comes into effect. But C-46 has two parts — one that will come into effect sooner, and then part 2 will come into effect later. When part 2, which is later, comes into effect, then section 14 of this bill will, in effect, override that part of section (1), and it will go to whatever is in C-46. We expect that to be two hours.
M. Morris: So this section basically talks about what the superintendent considers when he’s doing a review. I believe I’m right, there.
So in looking at section (a.3), in respect to a driving prohibition resulting from the circumstances described — evaluation of the person was conducted by an evaluating officer, who complied with the requirements that are prescribed for the purpose of the subsection, and then the analysis of the body fluid.
If we’re looking at a…. A peace officer is driving down the road, and somebody is driving erratically. He pulls him over. They do the sobriety testing — the bodily fluid testing and whatnot — and they prohibit him from driving from that point forward.
What’s the difference here versus a roadblock that’s set up, a CounterAttack program set up downtown, and people are coming through? There’s no driving evidence; they’re just caught in the line. The officer suspects that an individual is probably high on THC. Is there a sequence that needs to follow for the police officer if he suspects that there’s THC?
Does a drug recognition expert need to be there, right on the spot, to identify — if I follow this — the fact that that individual is intoxicated by drugs? Then the demand for the bodily fluid — the saliva tests, or whatever — the result might come…. Is this laying out a sequence for the superintendent to look at, to make sure that sequence is followed, or does it matter which happens first?
Hon. M. Farnworth: The member is correct. It is laying out a sequence. If you’re at the roadblock and the officer suspects, it would be the standard field sobriety test that takes place. If they feel that you are impaired, then it would be to the station for the drug recognition expert.
That would be the sequence that then would go on to the superintendent.
M. Morris: Just with respect to the sequence. If it’s a CounterAttack roadcheck program, the individual…. When is the saliva test administered? If we have a drug recognition expert back at the office, it would be a significant burden on resources to have to go back to the office all the time to have that individual checked.
When is the demand made? When does the prohibition take effect in a roadcheck, in a CounterAttack roadside check type of a situation, without involving going back to the office for further testing? If that makes sense.
Hon. M. Farnworth: Again, the member is outlining some of the challenges we face, so we know exactly how this is going to function at the federal level.
The sequence that we’ve outlined to you — the roadside standard field sobriety test, then to the station for the DRE — is what will be in place until such time as we know exactly what the saliva test, assuming that the saliva test is what we end up with…. At that point, then, the saliva test would be administered at the roadside check, and then it would go to the next step. I hope that makes sense.
M. Morris: Just so it’s clear in my mind. So pulled over. Officer suspects that the individual’s been using cannabis or some drug. The saliva test or the body fluid test is administered. Looking at this section and the superintendent’s things that he has to check off in a review here, can the officer prohibit the driver from driving at that particular point? Or does it need to go to that next level, to the drug recognition expert at the office?
Hon. M. Farnworth: Under this legislation, it will be going back to the office for that DRE, regardless of what model is done at the roadside.
M. Morris: I take it from looking at this, this is going to have a very significant impact on policing resources for the CounterAttack roadchecks by adding this element to it, versus the previous legislation where there were no drug impairment provisions in the immediate roadside prohibition legislation. Just by alcohol, a blow on the roadside screening device, you’re over .05 percent or whatever it is, and it blows a fail. They can do that right at the site there as well.
This is going to add an extra element and probably a significant impact on policing resources at the local level.
Hon. M. Farnworth: The process that’s in place in fact actually mirrors what would happen today if you were suspected of drug-impaired driving. The challenge, of course, is that the technology for detecting drug impairment is different from that for alcohol. Right now you can detect the alcohol level right at roadside. We, at this point, cannot do that.
Now, maybe the feds know something that we don’t know, but you still have to do that DRE, which would be done back at the station. Now, as legalization takes place and as, all of a sudden, there is a lot of attention that has been focused on the technology around this, I would fully expect the technology to improve over time.
At some point, you’re, no doubt, likely to have something that would work at the roadside in the same way it does for alcohol. But at this point in time, under this legislation and within the framework that C-46 is taking place in, it would require the DRE to take place back at the station.
Sections 13 to 29 inclusive approved.
Title approved.
Hon. M. Farnworth: Before I report the committee rise and report the bill complete, I would like to recognize the very capable ministry staff who assisted us in answering the critic’s questions: Steve Roberts, deputy superintendent of road safety; Jeremy Wood, director of legislation, RoadSafetyBC; and Patrick Glanc, policy analyst, RoadSafetyBC. I’d like to thank them for their assistance today.
With that, I ask that the committee rise and report the bill complete without amendment.
Motion approved.
The committee rose at 3:09 p.m.
The House resumed; Mr. Speaker in the chair.
Report and
Third Reading of Bills
BILL 17 — MOTOR VEHICLE
AMENDMENT ACT,
2018
Bill 17, Motor Vehicle Amendment Act, 2018, reported complete without amendment, read a third time and passed.
Hon. M. Farnworth: I call committee stage on Bill 27.
Committee of the Whole House
BILL 27 — PILL PRESS AND RELATED
EQUIPMENT CONTROL
ACT
The House in Committee of the Whole (Section B) on Bill 27; R. Chouhan in the chair.
The committee met at 3:14 p.m.
On section 1.
Hon. M. Farnworth: Again, a piece of legislation that my colleague, the critic, and I have had some discussion around, pill presses, as part of the initiatives dealing with the opioid crisis from the enforcement perspective. With that, I welcome the remarks and questions from the critic.
M. Morris: I just want to make a couple of general comments at the beginning here. I, too, think that everything needs to be done to address the opiate crisis that we have in British Columbia and across Canada and, in fact, around the world.
The only criticism I suppose I have on this particular bill is the…. I truly believe, and I’ve gone through the federal legislation, the CDSA, that Bill 27 is very comprehensive. It covers a lot of ground, but I think it’s a duplication of the CDSA in many, many respects.
It’s creating another level of bureaucracy at the provincial level that legitimate pill press owners have. They need to comply with the federal legislation. They need to comply with Bill 27 once it comes into effect here….
Interjection.
M. Morris: Sorry. Very comprehensive legislation, another level of bureaucracy for the legitimate pill press individuals in British Columbia, but it covers all of the bases here. It might cause some confusion in the law enforcement field, as well, when you’re dealing with the federal legislation and a provincial piece of legislation.
Other than that, I don’t take exception with any of the sections in Bill 27.
Sections 1 to 27 inclusive approved.
On section 28.
Hon. M. Farnworth: I move the amendment to section 28.1 standing in my name on the orders of the day.
[SECTION 28.1, by adding the following section:
Amendment to this Act
28.1 Section 5 (2) (g) (i) of this Act is repealed and the following substituted:
(i) this Act or the Cannabis Control and Licensing Act, .]
On the amendment.
Hon. M. Farnworth: This amendment modifies section 5(2)(g)(i) of the bill by adding a reference to the Cannabis Control and Licensing Act. This was put in before, and now we have to do that because of the Cannabis Control and Licensing Act, which will need to be as part of this.
Amendment approved.
Section 28 as amended approved.
Section 29 approved.
Title approved.
Hon. M. Farnworth: I move that the committee rise and report the bill complete with amendment.
Motion approved.
The committee rose at 3:17 p.m.
The House resumed; Mr. Speaker in the chair.
Reporting of Bills
BILL 27 — PILL PRESS AND RELATED
EQUIPMENT CONTROL
ACT
Bill 27, Pill Press and Related Equipment Control Act, reported complete with amendment.
Mr. Speaker: When shall the bill be considered as reported?
Hon. M. Farnworth: With leave, now.
Leave not granted.
Mr. Speaker: Leave has not been granted. When shall the bill be considered as reported?
Hon. M. Farnworth: Next sitting.
Mr. Speaker: So ordered.
Hon. M. Farnworth: I call second reading on Bill 23, Local Government Statutes (Residential Rental Tenure Zoning) Amendment Act.
[R. Chouhan in the chair.]
Second Reading of Bills
BILL 23 — LOCAL GOVERNMENT STATUTES
(RESIDENTIAL RENTAL
TENURE ZONING)
AMENDMENT ACT, 2018
Hon. S. Robinson: I move that Bill 23, the Local Government Statutes (Residential Rental Tenure Zoning) Amendment Act, be now read a second time.
I’m pleased to be introducing this important piece of legislation. We know that we urgently, urgently need more rental homes in British Columbia. Communities across our province are experiencing low vacancy rates due in part to a shortage of rental supply and the high demand on rental due to the increasing costs of home ownership.
We also know that it’s been years since many communities have seen purpose-built rental being built in their communities. As a result, too many British Columbians are suffering because of these conditions, and we know that, collectively, we need to act.
We know that local governments are seeking innovative new tools that will help them deliver the housing that is needed throughout communities in our province. And we heard from the Union of B.C. Municipalities that one of the authorities that could assist local governments to respond to the housing crisis is the ability to zone for rental housing.
Under B.C.’s local government land use planning framework, zoning bylaws are a key tool for managing land use and density in specified areas. Currently, a zoning bylaw cannot regulate the tenure of a use, whether that person is an owner or a renter.
This bill will provide local governments with a new enabling authority to zone lands such that rental is the only form of occupancy permitted. This authority will apply to multifamily residential, and it will be scalable. That is, if the local government so chooses, they will be able to apply the authority broadly, or they can limit it to a portion of housing units within a building.
It will not, however, override any existing rules regarding rental that a strata corporation may have in place. And, importantly, this authority can also protect existing rental tenure. It’s an opportunity for local governments to protect their existing rental housing stock. While we know that a new rental supply is an important component of any community’s housing stock, it is really, really important that they have the ability to protect housing stock that is currently being used as rental.
We also want to ensure that housing owners are protected. That’s why we’ve made sure that there are provisions that will allow existing housing to continue as non-conforming in any area where a local government chooses to adopt a residential renter tenure bylaw. Similarly, any development that is in process and has been issued a building or development permit will be protected as non-conforming if a residential rental bylaw would otherwise apply.
[L. Reid in the chair.]
Finally, the bill also makes a number of amendments that will ensure that this new authority works within the existing land use planning framework, including ensuring that changes to a residential rental tenure bylaw cannot be made through different permitting processes.
Everyone in this chamber represents communities where housing is a real significant challenge, and I would encourage all members to support this bill in order to have yet one more tool that is available to local governments, that is available to people in our province, so that we can have the kind of diversity of housing stock that has been sorely lacking. I look forward to hearing from other members of this chamber.
T. Stone: It does give me pleasure to rise and speak to second reading of Bill 23, the Local Government Statutes (Residential Rental Tenure Zoning) Amendment Act, 2018 — a bill with a title that’s quite a mouthful.
That being said, there’s certainly no quibble on the part of the official opposition with the suggestion that there is an urgent need for additional rental supply in communities across British Columbia. No question about that. There are indeed, as the minister pointed out in her opening remarks, low — and in many communities, historically low — vacancy rates that reflect the challenge that exists for many British Columbians today. That is, an inability to access rental units in the communities within which they choose to live.
There is no question that more purpose-built rental units are needed in communities across not just the Metro region of the Lower Mainland but in communities all over British Columbia. Now, this legislation, this bill, as presented by the minister, is being positioned as yet another tool, as the minister describes it, a tool for municipalities to play their part as partners in addressing the affordability challenges across British Columbia.
This bill allows municipalities to zone specific areas exclusively for rental properties. They must undertake a hearing to make this change. So as is currently the case for any zoning change that a community or a local government wishes to make, there is a requirement to undertake a public hearing to make that change. I’m pleased to see that that requirement will also apply to these exclusive rental zones.
The rental-only zoning would not apply to or would not affect the following:
(1) stratas that have rules preventing rentals;
(2) any homes that were existing prior to the change of zoning to rental only, and that’s very, very important, I think, for homeowners to know across British Columbia;
(3) any homes that were already under development when rental-only zoning is implemented, also very important;
(4) any renovations that do not add additional housing units to a property; and
(5) sales of an existing home within rental-only zoning.
Those are all items that would not be affected by a rental-only zoning area.
Rental-only zoning does apply to the following: if a strata is dissolved, the property will then be bound by the rental-only zoning that is in place. Secondly, if renovations or construction of an exempted property would add any additional or new units, those would be bound by the rental-only zoning.
Of course, there is a power within this bill that provides cabinet with the ability to prescribe regulations regarding when rental-only zoning is authorized and no longer authorized.
Those are the technical highlights, the details, of this bill, Bill 23. Certainly on the surface of it, it doesn’t appear that this would cause a tremendous amount of disruption. But I do want to say that I think it must be noted that the development community can build rental units today. They don’t need to be told.
In my own home community of Kamloops, we seem to be entering a period of pretty significant construction of purpose-built rental units by the private sector. We have a development that will go a long way to meeting the needs of students up by our university on McGill Road. At Thompson Rivers University, a private developer is putting up four buildings. It’s all been approved. The permits are all in place. They’re in in the ground, doing work now. This will provide, I believe, up to several hundred units of rental housing.
This is the same company that built two purpose-built rental projects on Summit Drive, not too far of a distance from the university. There’s another company that is about halfway through construction of a purpose-built rental property, also on Summit Drive in Kamloops. I believe it’s about 75 units of rental housing. These developers are making these decisions absent of being told, through zoning, that that’s the type of product they have to build at these locations.
My point is that I don’t actually believe that this tool, as the minister describes it, is really going to make that much of a difference. The development community has the ability to build this kind of product today and, in communities like Kamloops, is building this product.
Again, I do not want to underplay or understate the importance, from an affordability perspective, of ensuring that we see the kinds of results that are taking place voluntarily in Kamloops through the construction of significant numbers of units of purpose-built rental housing.
We certainly want to see that in communities across the province. I think we can all agree that that’s not happening in every community across this province. But I don’t believe that this piece of legislation is, in and of itself, going to do much to change the status quo.
The true cynic in me would go so far as to suggest that, this being one of 30 points of a 30-point plan, the government seems to be intent on focusing more attention on a 30-point plan than the actual effectiveness of the points in that plan. I don’t believe that this tool will be that effective. I don’t believe that very many municipalities will actually utilize this tool. I believe that it’s largely window dressing in the context of a 30-point plan on housing affordability.
I also think that we have got to keep our eye on some unintended consequences. Talking with some mayors around the province and some folks at the UCBM, there is, in the back of some people’s minds, a worry that this tool, if not used appropriately, in certain communities could have the impact of actually downzoning property, reducing the value of land in different parts of different communities.
There are also others in local government that have suggested to me that when they consider the pursuit of the ideal neighbourhood, they think of a mix of people living in that neighbourhood. They think of, you know, Bob and Edith, who’ve lived in their wartime home down the street two blocks away for the last 50 years, as well as university students living in purpose-built rental housing, as well as some affordable housing, as well as residential neighbourhoods where people own their homes — modest homes.
It’s when you have that really nice mix of different types of housing product, different income levels, different types of people all living in a neighbourhood together that you really achieve that true, vibrant neighbourhood that I think we would all, in this House, suggest we live in or we have lived in. We know what that looks like. I’m not sure that this tool, if used inappropriately, lends itself well to actually creating that kind of a truly broad, mixed neighbourhood.
Or we could see in some communities huge swaths of land being zoned for purpose-built rental housing only, and those areas would be absent the other types of housing product and, therefore, the folks that would live in those other types of homes. So I think we want to keep our eye on that.
Also, I’ve heard from some that, again, if this tool, when used, has the effect of driving down the value on certain parcels of property, some developers may choose not to actually develop those pieces of property. So you may actually end up with the perverse effect of reducing supply with a measure like this. These are potential unintended consequences that I think we all would be well obliged to keep our eye on.
The last point that I think is worth noting at this juncture, second reading on this bill, is that this bill again represents another missed opportunity to actually address the lack of affordable market housing — people who want to get into the market and purchase a home. I refreshed my memory again today in looking through the government’s 30-point plan on housing, and there’s a lot in there that I think is really just window dressing. There’s certainly not a lot in there that I can find — and certainly not many announcements that this government has made — that relates to the development, incenting the development, of market housing and housing that people can afford.
There have been arguably…. I will credit where credit is due, and I think it’s largely built on a good track record of our former government. This government has built on that and is moving forward with investments on the affordable housing front.
We had announced almost $900 million for affordable housing projects across British Columbia, and we built hundreds and hundreds of millions of dollars worth of affordable housing projects. That’s all worthy. That’s all important, and we need to see more built.
We also know that more needs to be done on the rental housing side, which is what this bill specifically attempts to address through this one new tool. We also know that while much progress was made, there’s more that needs to be done from an assisted-living perspective. I know in Kamloops, ten or 12 years ago, there were long wait-lists. That’s not the case today. Why? Because a lot of that product was built, and thankfully so. Do we need more? Absolutely.
If you think of your kids in their late teens or early 20s or perhaps even a little bit older, in their mid-20s, and they have got that first job. They don’t want to rent anymore. They want to actually get into the housing market. They want to purchase.
Where are the initiatives from this government that actually are about driving market supply of homes — not for rent but for purchase? This government hasn’t addressed or embraced strategies related to densification and working with local governments on densification along transit lines.
We passed legislation in this House three or 3½ years ago to assure the province’s air rights along transit lines. That was all with densification in mind so that when the Millennium Line extension was completed, you would hopefully see — in communities like Port Moody and Coquitlam — the community going up and going up near transit stations.
You look at the existing transit lines and where they intersect in the city of Vancouver, and where is the densification? We have the opportunity, if done right, on the front end of massive investments in transit… Through two lines in Surrey, which are desperately needed, and the Broadway line that is also a worthy project in Vancouver…. It’s billions of dollars of investment that if done right should also drive density and should also, as a result, ensure that there is a broader array of market housing available for people for purchase.
As well, why this government does not seem, to this point, willing to embrace the suggestions coming not just from us in the official opposition but from many other quarters with respect to working with local governments to accelerate the approvals process for the housing supply that developers want to build today…. Why this government hasn’t taken any initiative on that front is quite baffling.
Pick whatever number you want. I’ll go with the number that I understand to be accurate — roughly 120,000 units of housing in Metro Vancouver that are in some stage of approval at the local level. We’ve suggested, in the opposition, that the government could get creative working with local governments to incent accelerated approvals at the local level to get some of that product on stream faster.
I would point out that there is a component of that product which is currently, to varying degrees, languishing in local government approvals that represents purpose-built rental housing projects. Let’s get creative here too. The minister likes to talk about tools. Let’s develop a tool with local government to incent faster approvals processes to bring some of that 120,000-unit backlog on line across Metro Vancouver.
Last but not least, there are other ways to incent the construction of purpose-built rental product. One only needs to look south of the border to Seattle, which is very comparable to Vancouver and the Lower Mainland in many ways. It has many of the same kinds of challenges — transportation and housing and so forth, rapid growth. But there’s a much larger piece of the product that’s been built in Seattle over the last ten years that’s represented in the form of rental product than in Vancouver. And it begs the question: why?
When you have those conversations, you determine that there were a number of targeted tax measures, incentives that had the desired effect of actually incenting, encouraging, rewarding decisions of the development community to actually build a rental product. And if people aren’t…. If the vacancy rate gets too high, they dial back the amount of product that they’re bringing on stream.
Again, I think this bill isn’t going to make much of a difference. I think it’s largely window dressing. I think it’s an opportunity for the minister to stand in the House here, for the government out in the hustings, to point to another point of a 30-point plan as if it’s this comprehensive plan that was developed with a lot of rigour and that’s got a whole bunch of detailed initiatives that are going to really bite and take hold and help.
This is not going to help. This is not going to make one iota of difference to encourage more rental product in communities across British Columbia — product that’s being built by developers in communities like Kamloops, as I mentioned earlier today — without this kind of a tool being required.
We will canvass these issues in a lot more detail in committee stage. But I would, again, take this opportunity to encourage the government, to encourage the Minister of Housing to recognize….
The affordable social housing — absolutely critically important, some good work being done there. Housing to meet the needs of the most downtrodden in our province, those who are most down on their luck — there are worthy projects there. Incenting purpose-built rental housing — absolutely important to do.
But where is the plan to drive market housing, housing that people can buy? That’s the thinnest piece of this government’s housing plan, with no measures announced on that front to date whatsoever. Unless the government begins to take some steps on that front, they will fail at addressing the affordability challenge for many, many British Columbians across British Columbia.
A. Olsen: I started with very brief notes, and they seemed to grow and grow and grow, the longer that the previous member spoke.
It’s an honour to stand and speak to Bill 23, a bill that starts to take action on developing a zone specifically for residential housing. I think one of the most important pieces of this bill and one of the first things that I want to highlight with this bill is that it adds a level of protection and preservation of rental housing stock that is currently in the market.
We’ve seen a history over the past number of decades — two, three decades — where purpose-built rental housing, which we were doing very, very well in our country and in our province for a number of years, started to turn into strata units, condos. So we lost a lot of the rental housing units that we had in our cities, and they turned into condo buildings, strata buildings.
One of the things that this tool allows is for municipalities to identify important buildings that exist as rental units and to say these units are going to stay as rental. So whether they be in high-density areas, and the property goes back up for sale, developers will know that the future of that property will remain as part of the rental stock.
I think that the previous member highlighted some important reasons for why we would want to keep rental units in and around universities, for an example, and colleges. We would want to ensure that, in fact, those units stay within the rental stock. As well, there are a number of other reasons why we would want to keep rental units, and I think what we’ve seen is actually a gutting. What I hear on a regular basis is that there’s been a gutting of the rental stock in our communities and in our cities, and it’s created a serious imbalance.
In fact, I would say that in the last election, the biggest issue that I heard at the doorstep day in and day out was housing. The biggest problem that people faced in my riding and in ridings right across this province was a substantive housing challenge.
So while members in the official opposition stand and talk ad nauseam about the amazing housing plans that were put in place, I would suggest that, in this case, elections were either won or lost on a substantive housing challenge — whether it be going and leaning in too heavily to just the markets, saying: “The market’s going to fix everything for us. We’ll just let the market fix it.”
I think that there is some confusion amongst the free enterprise coalition on this really. Just leave the market. We’ll just increase supply forever and ever and endlessly increase supply — like there’s an endless supply of land out there to just keep building and building and chasing — building new schools, increasing costs everywhere in our society, in order to just continue to endlessly build supply.
We know that that doesn’t work. You can’t just continue to endlessly build supply. You create communities that people don’t want to live in. They’re not nice communities. They’re not diverse communities. As the member before me was saying, it’s important that we have diverse communities. I think that one of the things that this bill does is it ensures that there are going to be renters and that part of the demographic within our communities.
The narrative that we hear quite often is: don’t raise taxes and ignore the social problems. Those two have to come hand in hand. You can’t not raise taxes and pay for social programs and support people. So that’s another part of it. We’re going to build houses endlessly, and we’re going to ignore the social problems. As we found, that was probably the quickest way to the opposition benches, to take that approach.
We as a government have a responsibility to find balance and to legislate balance. One of the ways that we do this is we create zones such as this. We’ve created many zones in our cities. In fact, every piece of property that has anything built on it is part of a zone, whether it be a residential zone or a commercial zone or an industrial zone. Then we take those zones, and we further break them down to residential single-family or residential multifamily zones.
As those on both sides of this House that have been in local government know, the reality is that we need to have zones to ensure that our communities are balanced. I think that one of the threats that was identified in the debate here today was that, all of a sudden, there are going to be vast swaths of communities that are only going to be rental — which would be similar, I guess, to the vast swaths of lands in my communities that are residential single-family, or the vast swaths of lands in my community that are residential multifamily.
I would suggest that the planners and the city forefathers that built our communities like that didn’t build enough diversity, frankly. In fact, it’s causing a lot of these same problems — increasing costs, pushing children and youth and young families out of communities, making them essentially just retirement zones, which is a substantive challenge. It’s happening in my riding. We’ve got great schools. Yet by having it just left to the market, there’s less diversity in our communities.
I think that this is the government’s role. I think it’s very difficult to just argue that real estate is a free market. I think the fact of the matter is that every piece of property, every building built, is in a zone, is in a regulated environment. The real estate industry is a highly regulated environment. Some would suggest it needs to have more regulation even. So this is a highly regulated area. I think that there are high costs to imbalance.
City planners and city decision-makers, community decision-makers, have got to weigh those costs very carefully — the social, environmental and economic costs of having too much of one type of housing or one type of zone and not enough diversity. I don’t think that municipal governments necessarily….
I mean, there is, obviously, a chance that they may zone vast swaths of rental housing. I would suggest that they should use this and that they would use this new tool at their disposal to preserve rental units within their residential neighbourhoods. And to ensure that the market, which would say, “This would be a great piece of property to go from being a rental unit, a rental building, to a strata building or a condo building….”
Of course, the developer and the development community could gain a lot more profit from doing that, from making that move. It might not be what’s in the best interest of the community. So this would be a tool for city councils, for town councils, to use.
I think it’s important for us to be giving tools, and this is an example of a bill in which the provincial government is enabling another tool for municipal councils to use. I think that that is important. As someone who comes from local government and someone who champions the local level of government and the decision-making that’s made on the ground, I think that it is important that the provincial government is providing tools.
In fact, I think that we could do this a lot better. Provide tools to local decision-makers. They’re the closest to the people and have the most direct access.
To that point, I think another interesting point that was raised is that the provincial government should get involved in accelerating the approvals process — and then long and loud complaints, in fact, that there are X number of units being held up by city councils, like that is, somehow, just a recent situation, that it’s not been a situation or a complaint that’s been going on for many years.
I would caution, though, in fact, the provincial government getting involved in local government and “accelerating approval processes.” Of course, there’s a public hearing process in which local governments have to work with the local community to ensure that the local community is aware of what is being proposed in their neighbourhoods. That process does take some time.
Where I think that municipalities might be able to accelerate the process is in some of the application timelines. Perhaps that could be the case. But again, I think that it’s important that inspections and building inspections and such play out over an appropriate level of time to ensure safety.
It’s easy, I think, to say: “Oh, the provincial government should jump into the middle of these and accelerate these approval processes.” But I think that there are also some drawbacks to that in that a very fundamental part of the job of a city or district council is to engage the community and to ensure that they’re aware of how their communities may or may not be changing.
At this stage, I’m going to take my seat. I just wanted to point out that I think giving the local governments the opportunity to use this as a tool in order to direct, guide, preserve and, indeed, in the future perhaps build new rental housing stock by using this zone, I think, is a good start.
Perhaps, as we work to unpack some of the challenges that were inherited and that have been dealt with over the past year with respect to a wildly unsustainable housing market, more tools will be given to the municipalities in order to be able to make some of the decisions that they need to, in order to make both market and non-market houses, homes, available for people.
I thank the minister. I look forward to the committee stage of this bill, and I’ll take my seat at this time.
Deputy Speaker: Seeing no further speakers, the minister closes debate.
Hon. S. Robinson: I appreciated hearing, from members of this House, their comments around this bill. It’s interesting to note that the members opposite don’t seem too hopeful. That might explain why things have gotten so discouraging for so many, because we need to remember that this is about people.
I appreciate the comments from down the way, my colleague from Saanich North and the Islands. We need to remember that this is about people. There are 1½ million renters in British Columbia, and there are some people who want to continue renting. It’s their preferred style of tenure.
Making sure that we have the options, again, for local governments to deliver what their communities need is critically important. This is a tool that local governments have asked for, and I’m very proud as a minister to be able to deliver that for them.
With that, I would like to move second reading of Bill 23.
Motion approved.
Hon. S. Robinson: I move that the bill be referred to a Committee of the Whole House to be considered at the next sitting after today.
Bill 23, Local Government Statutes (Residential Rental Tenure Zoning) Amendment Act, 2018, read a second time and referred to a Committee of the Whole House for consideration at the next sitting of the House after today.
Hon. D. Eby: I call Committee of the Whole on Bill 20, Insurance (Vehicle) Amendment Act, for committee stage.
Committee of the Whole House
BILL 20 — INSURANCE (VEHICLE)
AMENDMENT ACT,
2018
The House in Committee of the Whole (Section B) on Bill 20; L. Reid in the chair.
The committee met at 4:04 p.m.
Hon. D. Eby: I look forward to the members’ questions about this bill.
On section 1.
J. Yap: On section 1, would the minister explain the purpose behind the proposed changes in definition to “driver’s certificate” and “owner’s certificate.”
Hon. D. Eby: The issue, in part, was ensuring clarity in the act. Sometimes a certificate is not issued to the owner — for example, in the case of a garage and a garage certificate, where they may not be the actual owner of the vehicle. It was aimed at providing some clarity in the act around that.
I apologize. I failed to introduce staff who are here assisting me today — Holly Cairns, acting ED, Crown agencies; Nida Bindra, counsel, Ministry of Attorney General; and chief legal officer from ICBC, Jason McDaniel.
J. Yap: With this change, just to be clear…. I heard what the minister said. What is the ultimate rationale or goal of this change, in terms of insurance offered by ICBC?
Hon. D. Eby: There’s no substantive change. It’s just meant to clarify matters.
J. Yap: With respect to “health care practitioner,” the definition, how inclusive is this definition? Doctors are referred to, nurse practitioners — and then a reference to what seems to be all others. I’m wondering how inclusive this definition is.
Hon. D. Eby: The intent here is to provide quite a comprehensive list of care providers in terms of defining who is going to be able to prescribe fees and receive payment for benefits under the act. It will include a broad variety of practitioners in the regulations as well.
J. Yap: Just to be clear, the minister used the term “broad.” Potentially could this, for example, include doctors of chiropractic, traditional Chinese medicine, podiatry, optometry? Could these professions be included?
Hon. D. Eby: Examples are occupational therapist, physiotherapist, massage therapist, acupuncturist and psychologist.
M. Lee: I’d just ask about the use of the term “health care practitioner” in the act. Obviously, we have to consider when this term is being utilized in this proposed bill. For example, under section 28.1, a health care practitioner must provide what’s being proposed, a report. Given the nature of the definition of the proposed term of “minor injury,” I just wonder about the scope of this definition in terms of a health care practitioner.
There’s some wording in this act that suggests that depending on the type of practitioner, they’ll provide a different form of report, depending on the nature of what’s being….
I just wanted to sort of have the Attorney General walk us through how the differentiation will work and whether a nurse practitioner, for example, is intended to comment on psychological or psychiatric or chronic pain syndrome — for example. How do they differentiate between the use of “health care practitioner” with the reports that need to be provided under this bill?
Hon. D. Eby: This requirement to provide reports has always existed in the legislation. The member is correct in noting that the reason for providing different reports for different practitioners is that you wouldn’t want to be asking an acupuncturist about a psychological injury. You want reports from people who have various specialties and expertise based on their expertise, and that’s why there would be different reports for different practitioners.
A. Weaver: On this actual theme of definition of “health care practitioner,” I have four specific professions. I’m wondering if they’re included within the present definition of health care practitioner and, in particular, the subdefinition of a medical practitioner.
The first one is registered psychologists. The second one is psychiatrists. The third one is chiropractors, and the fourth one is physiotherapists. Would those four be considered health care practitioners under the definition of “medical practitioner” here?
Hon. D. Eby: Physiotherapist, psychologist and chiropractor will all be in the regulations, so they would be under (c) in the definition, “a person in a prescribed class of persons….” And then a psychiatrist is a medical practitioner so is captured by section (a) of the definition, “a medical practitioner.”
Section 1 approved.
On section 2.
J. Yap: Can the minister walk us through why the definition for “accident” included in the bill was chosen?
Hon. D. Eby: The act previously had multiple descriptions of accident. It described accidents as vehicle accidents and also as motor vehicle accidents. This is a housekeeping amendment to ensure the consistent usage of the term in part 1 of the act.
J. Yap: I’m just wondering if there was consideration given for such a narrow definition of accident and if there were any other possible definitions of accident considered at the time of drafting.
Hon. D. Eby: It’s very specific because part 1 of the act relates to basic insurance — and this is car insurance — so “an accident arising out of the use or operation of a vehicle.” This definition applies to part 1 of the act — which is, again, the basic insurance — without restricting what optional insurance may apply to. Perhaps that addresses the member’s question.
J. Yap: Can the minister walk us through the reason for repealing the definitions of additional premiums, basic premiums and point penalties?
Hon. D. Eby: This is a cleanup of provisions. The way that it works is that your rate class and territory are related to your basic insurance cost. Then the claims-rated scale, which is a based on…. We’ve been talking about high-risk driver and lower-risk driver. The claims that you may have made — and they may affect your premium — are the additional premium.
This will all be under the rate review process that is underway. It will all be in a global amount. It won’t be broken out into additional and basic premium anymore. That’s why we don’t need these definitions anymore.
This is a bit technical. I just want to confirm that I didn’t make any errors in that. Okay, I’m getting the nod. That’s good news.
Section 2 approved.
On section 3.
J. Yap: What kind of personal information would the legislation be requiring the applicant to share with the corporation?
Hon. D. Eby: ICBC can already request this information. The intent of the amendment was to ensure that it was clear that ICBC could request this information about any intended driver of the vehicle. That type of information includes driving history information, accident history, perhaps where the individual lives, the type of vehicle they drive and how they intend to use the vehicle.
J. Yap: Will this information be decided through regulation, if it has not already been decided on?
Hon. D. Eby: The regulations related to how ICBC sets rates — that information goes through the BCUC application process. ICBC is limited, by law, to only being able to collect information that’s relevant to setting rates, so it can only collect information that is relevant to rates. There is the BCUC application process for regulations related to rates.
J. Yap: Will the minister confirm that the Office of the Information and Privacy Commissioner was or will be consulted in what information will be shared with the corporation?
Hon. D. Eby: Yes.
J. Yap: Does the corporation, then, have the right, under the way this section is written, to ask for additional information from the applicant?
Hon. D. Eby: As far as this section, this is only related to information collected in relation to how ICBC sets rates, so any other information would not be permitted to be collected, under this section.
J. Yap: I hear what the minister says, but in the event that there is a disagreement on that, what powers or rights would an applicant have to either appeal or dispute the requests of the corporation should they feel the corporation has asked for too much information or information they deem sensitive?
Hon. D. Eby: It depends. There are a number of remedies available to an individual where they believe that a Crown agency is asking for inappropriate information. They can complain to the Privacy Commissioner. They could apply for a judicial review, for example, if they were refused insurance on an illegal basis, for refusing to provide information that ICBC was illegally attempting to collect.
There are safeguards in place to ensure that that happens, but it’s a bit speculative because ICBC collects a very defined set of criteria around setting rates: where you live, how you intend to operate the motor vehicle and your driving history. These are key criteria that are quite established in the car insurance world.
M. Lee: I just wanted to clarify. In terms of the way the Attorney General just referred to information required to set rates, that seems to include where you live, how you intend to operate the vehicle and driving history. Is there any other information required in that category to determine rates?
Hon. D. Eby: We will come in a later section to an area where there is a framework to expand the criteria that ICBC uses, specifically to determine risk. Specifically, distance is one example of that. The distance that you drive in your rate class may affect the risk that you’re in an accident. ICBC is looking at that. That was one of the engagement pieces that was in our consultation with British Columbians about the rating review process.
There are some categories — it’s important to be clear on the record — that are not and will not be part of ICBC’s risk rating process that are used by other insurers. Gender is not and will not be used. Marital status is not and will not be used. Age is not and will not be used. Sometimes that’s conflated with driving experience. Driving experience will be used, but it’s not based on age. And credit scores — some insurers use credit scores. ICBC does not.
There are categories, in the spirit of the member’s question — I want it to be clear on the record — ICBC is not using and will not be using.
M. Lee: Thank you for that response. When I look under subsection (2.1) as proposed under Bill 20, against the current section 11(2), the amendment proposes that we strike the word “information,” and then this will operate to only deal with information.
When we read this together, having deleted the word “information” from the current 11(2), then we’re left with “statements and reports,” including “the content required by the corporation”. Is there a reason why “information” was separated out this way to be qualified in this manner?
Hon. D. Eby: The Freedom of Information and Protection of Privacy Act of B.C. requires an explicit legislated ability to collect information. So “information” was pulled out and given a broader provision so that it’s really, really clear that ICBC has the ability to collect information, not just about the applicant for insurance but also about intended drivers for the vehicle.
Without this, you might be able to say: “Well, there’s not a clear, legislated provision to collect information about an intended driver of my vehicle. ICBC doesn’t have the lawful authority to do that.” That’s why it’s set out in more detail, just to be completely clear and avoid any concerns under the Freedom of Information and Protection of Privacy Act.
Sections 3 to 7 inclusive approved.
On section 8.
J. Yap: Can the minister tell us why April 1, 2019, was the date that was settled on?
Hon. D. Eby: That was the earliest date that ICBC believed they could be prepared for all these very significant changes.
J. Yap: With regards to information shared in the reports, how can British Columbians believe that the corporation may not use a pre-existing injury or condition to minimize amounts paid and possibly keep them under the cap?
Hon. D. Eby: The basic principle of tort law is that it puts you back in the position that you were in but for the injury that was caused to you by somebody else. In that respect, pre-existing conditions are relevant in determining the damages that were actually caused by the accident, and it is information that is relied on by ICBC. It’s also relied on by the plaintiff’s counsel in arguments and will be relied on in disputes that go to the civil resolution tribunal under this system, as well, and it will be relied on in matters that go to B.C. Supreme Court for injuries that are not defined as minor injuries. That principle is not affected here.
The question about: what if ICBC misused information somehow that they had access to? There is no greater risk under this legislation than already exists currently. ICBC has robust internal controls, audit processes to ensure that information that is within the custody of the insurer is not misused. In addition, anyone that has a concern about that can file a complaint with the Privacy Commissioner and, in addition, could potentially sue ICBC for that misuse.
There are, as in all Crown agencies and government agencies, safeguards in place to prevent and detect and ultimately to remove anyone that would misuse information that they obtained as a result of having access to it in their job.
J. Yap: On the regulation side, does the minister foresee any changes to this section with regards to information that can be shared?
Hon. D. Eby: We’ve just done a quick review. If the member could direct us to the regulation-making power that he is concerned about, we’ll attempt to address the question.
J. Yap: How does ICBC plan to use the information that is shared by health care practitioners?
Hon. D. Eby: There are three key ways in which ICBC anticipates using this information from these reports. One is to assess an individual’s needs for care. The second is to administer and pay benefits to practitioners that are providing care. And the third is to quantify the value of the individual’s claim in terms of compensation.
J. Yap: I thank the minister for that. Is ICBC required to inform the injured victim on what information they have requested, what has been received and in what form or manner they requested and received that information?
Hon. D. Eby: There are a number of ways in which individuals could access these reports in their entirety. The first is if there is a dispute over the injury, for example, or compensation or access to benefits. Whether it’s in the civil resolution tribunal or in B.C. Supreme Court, it would be disclosed as relevant to the litigation or the dispute.
The second way an individual could access this is they could potentially file a freedom-of-information request with ICBC for their own records.
The third is they could get it directly from their practitioners. The practitioners providing these reports are the individual’s own physiotherapist or family doctor or psychiatrist or psychologist, so they could get those reports directly.
[R. Chouhan in the chair.]
M. Lee: Under what circumstances would a claimant need to make an FOI request, though? They wouldn’t be able to get it from their own health practitioner.
Hon. D. Eby: These are not exclusive ways to obtain these records. These are complementary ways. So they could all be happening at the same time. You could be asking your doctor at the same time as you file an FOI. It’s important to note that an individual could file a freedom-of-information request at any time in the process.
Also, these reports aren’t intended, really, to be secret. They’re the basis on which ICBC is making determinations around benefits. If they’re refusing to pay benefits, I can’t think of any reason why they wouldn’t be quite explicit about what that reason is — that there was a report from a health care practitioner that this will not assist you.
There are just a number of ways in which individuals could get this. If ultimately there was a dispute about, “I think that I’m entitled to this benefit; ICBC says I’m not,” individuals can go to the civil resolution tribunal to resolve the dispute, in which case they would get access to the full report and be able to use it to make their arguments in front of the CRT.
M. Lee: I know, of course, we’ve had the opportunity to go through Bill 22 and the CRT regime. In the context of that response, I’m curious for this House just to know how a claimant will be informed of their abilities to access information in terms of the ICBC file and in the context of a dispute — just the way this is coming up in terms of reports.
If there are other reports that are being done by ICBC, I’m curious as to how that claimant will have the knowledge to know that they can exercise his or her rights under the FOI regime.
Hon. D. Eby: There are a number of ways in which an individual could determine how they might be able to access these reports. The civil resolution tribunal process will have an on-line process for people to ask questions and to resolve issues that they have, potentially even before getting to the CRT. Once they’re in front of the CRT, they would be advised by the adjudicator about documents and assisted through that process.
If they ask the ICBC adjudicator that they were dealing with, “How do I get a copy of this record?” that individual would tell them how to get a copy of that record. If they ask their physician, I’m sure their physician or their other medical service provider would advise them about what the process is for that office, how much they charge for copies, that kind of thing.
Really, at any door, whether it’s at their physician’s office, at the CRT or at ICBC, they could ask the question, “How do I get a copy of that record?” and they would get a response. There are a number of ways in which they could get this information.
M. Lee: I suppose, as we hear that response from the Attorney General, it suggests the complexity that a claimant will be faced with to navigate the new CRT regime.
Obviously, going to something that appears to be more dispute resolution–based, of course, which is the nature of the CRT, just raises the question as to the onus that it places on the claimant to figure out what questions to ask and what information to receive. And to actually have to make an FOI request to get access to their medical reports strikes me as something that is troubling, in terms of the onus and the responsibility it places on the claimant, somebody who may not be as fully understanding of the process that is being proposed by the government.
Hon. D. Eby: I’ll take that as a question. The current section 28 of the insurance act might alleviate the member’s concerns. “If any of the following persons attends to, diagnoses, treats or is consulted by a person injured in a motor vehicle accident in British Columbia, he or she must, whenever the corporation requests, provide the corporation, as soon as reasonably practicable, with a report of the injuries and their diagnosis and treatment and a prognosis, in the form the corporation prescribes” — medical practitioner, nurse practitioner, chiropractor, dentist, a person entitled to practise physiotherapy, an employee of a hospital defined under the Hospital Act.
This is very, very close to the current provision that’s in front of the House for committee stage here. The policy of requiring these reports hasn’t changed. In fact, instead of getting more complex for minor injuries, individuals are going to the civil resolution tribunal, which is designed to assist individuals who are unrepresented. That’s the whole design of this system. B.C. Supreme Court is not designed for individuals who are unrepresented.
Rather than getting more complex in terms of dispute resolution…. The member may have concerns about a limit on pecuniary damages, or they may have concerns about the definition of “minor injury,” but one thing I hope is very clear is that the CRT is a process that is manifestly more user-friendly for self-represented litigants than B.C. Supreme Court. So actually, things are getting easier for people to understand what their rights are and what the process is for claims under $50,000 and for minor injuries.
M. Lee: This is actually my concern. When we go to court, as the Attorney General just underlined, it’s not designed for unrepresented litigants. CRT is. But that’s the concern.
I appreciate that under section 28 of the existing act, there is this provision for medical reports and that 28.1 tracks that language, which is another question to come. But in the first place, the regime that’s being presented to British Columbians has changed, or is about to change, as being proposed by the government.
Again, these medical reports that the corporation has the ability to request, to get access to, creates what is arguably an unlevel playing field in terms of the information that will be received by the corporation, put forward in front of the CRT tribunal and put in a situation where the claimant already has his or her medical history, diagnosis, condition, prognosis and treatments all laid out — so without the claimant recognizing his or her own rights, in terms of that process.
I’m concerned about this particular provision and whether this does create an unlevel playing field for the claimant himself or herself.
Hon. D. Eby: I can alleviate the member’s concern. It doesn’t create any change from the current system. It doesn’t create any more or less of whatever your perception was of the existing playing field than is currently in place, in terms of the information that’s requested from health care providers.
In addition, individuals…. This is a report that comes from their own health care practitioner, so they can access that record from their health care practitioner. I’m not sure I’m following what the member’s concern is here. In front of the civil resolution tribunal, the bill that we debated and passed and the member voted for, people have the right to bring a lawyer with them. They have the right to consult a lawyer to get advice. All of these things still exist.
M. Lee: Then the purpose of section 28.1 is to provide and require more information than is currently provided under the act. Is there any concern there, in terms of the nature of that information being requested, given the concern I raised about an un-level playing field under the CRT?
Hon. D. Eby: It’s not correct that it requires the disclosure of more information. What it does do is it includes a greater list of practitioners who are included in this list because we are increasing the categories of practitioners who can provide benefits paid for by ICBC that have not previously had those treatments covered by ICBC in this province. So the list of potential health care practitioners has expanded because the list of health care practitioners who can provide care with benefits paid for by ICBC has expanded. But the information itself has not expanded.
M. Lee: Just to clarify that point, though, in terms of the list of information that’s being required under section 28.1. When I look at that against section 28 under the existing act, I am seeing words which further, in terms of nature and extent of the injured person’s injuries, the injured person’s condition at the time health care was provided…. Diagnosis certainly is covered. Treatment. I believe those are the ones that I would be focused on in terms of the additional expansion of the requirements for the report. Can the Attorney General please confirm that that is the case?
Hon. D. Eby: This is not an expansion. The previous section talked about diagnosis, treatment and prognosis, which reasonably would be expected to include both (a) and (c) — “the nature and extent of the injured person’s injuries,” which is (a), and (c), “the injured person’s condition at the time health care was provided.” The intent of the drafter was just to be very explicit and clear about what is and is not included in the report.
M. Lee: I think we’re now at another specific point about this provision that bears some discussion. I would suggest that with the wording in 28.1(2)(b), “the injured person’s diagnosis,” and in (d) and (e), we have the words “treatment” and “prognosis” separate. The way I’m reading this, “nature” and “extent” in (a) and “condition at the time health care was provided” in (c) are intended for something separate and in addition to what’s currently under the act. This is relevant, of course, for the definition of “minor injury,” which we will, of course, discuss at length.
But in terms of how this is being established, the baseline for which health care reports are being provided to the corporation at the outset, I’d like the Attorney General to comment on the purpose for which to require, under…. For example, if we talk about 28.1(2)(c), “the condition at the time health care was provided,” what is the intent for the corporation to gain that information at this juncture, information that was not previously required under the act?
Hon. D. Eby: The original section has been around in this version or a similar version since 1979. Information and privacy law was a very different beast in 1979 than it is today. In particular, the Office of the Information and Privacy Commissioner and the legislation in B.C. require explicit legislative authority for collecting information. So the more specific you can be about the kind of information that you want and that you need in order to do the work, the firmer the legal ground upon which your requests rest.
It is really difficult to imagine a scenario where an insurance company that is facing a claim for an injury does not need to know the nature and extent of the injured person’s injuries. You have to know that information. Otherwise, you can’t deal with the three areas that I told the member ICBC intends to use this information for: to assess the needs for care, to administer and pay out benefits, and to quantify the claim by the individual.
It’s similarly impossible to imagine that the injured person’s condition at the time that health care was provided, when they came in to request the health care, wouldn’t be relevant or it wouldn’t be necessary information for assessing the needs for care and quantifying the claim of the individual. So this is necessary information. It’s not strange or unusual information. It is information that is explicitly needed for the work.
There’s no way that ICBC in 1979 didn’t collect information about the nature and the extent of the injured person’s injuries or the injured person’s condition at the time health care was provided. It was just all contained in the overall, “We just need the person’s diagnosis,” which imports that you need to know where they’re at healthwise.
In this modern era, we need to be explicit about the information. I think providing more detail to people is more beneficial. But, again, I want to underline that this is not an expansion of information. This is necessary information that is collected by ICBC, has been collected since ’79 and will continue to be collected. It’s just a little bit more explicit.
M. Lee: So if it’s been collected by ICBC since 1979, is there a baseline, then, that ICBC has a data pool on, in terms of minor injury claims? As to the kind of conditions “at the time health care was provided,” I’d like to clarify what that exactly means. But just in terms of the point about 1979, does ICBC have a data pool of health care conditions which are relevant to minor injury determinations that goes back to 1979?
Hon. D. Eby: The definition of “minor injury” is new to this legislation. Because that definition did not exist previously in 1979 or at any point until, hopefully, this bill passes, there’s no categorization of injuries according to the definition that’s in this bill that hasn’t passed yet.
M. Lee: Well, let me clarify the question then. In terms of the nature of minor injury, minor injury, of course, as currently proposed under this bill, has subcategories of potential types of injury that might be included in a minor injury. Those include, of course, for the first category, abrasions, contusions, lacerations or sprains or strains.
Again, just given the response we’ve heard, I’m wondering whether, for example, in that particular category, there is a pool of data that refers to the kind of condition that would have been categorized as a minor injury, even if it’s under these terms, as opposed to using the term “minor injury” itself.
Hon. D. Eby: This section has no connection with the definition of minor injury. The health care practitioners who fill out these reports are providing information according to the five categories here. It doesn’t relate to ICBC’s actuarial data about injuries.
I think what the member is asking is: does ICBC have actuarial data around categories of different types of injuries? Absolutely, they do. All insurance companies do. They have been coded over different years for different categories, different types of injuries. I don’t think we’re able to provide the member with assurance that the records from ’79 exist in a form that is usable. But certainly ICBC actuaries rely on data collected by ICBC in terms of setting rates, knowing where rates have to be set in order to pay out when people make claims in relation to automobile collisions.
Perhaps it’s useful for the member to know, just to confirm, that the issue that brings the bill in front of the House, the issue that brings both this bill and the CRT bill into the House, is that ICBC’s actuaries looking at the cost of existing claims that are going forward say we would have to increase car insurance rates by $400 per driver if we wanted to get premiums collected to match the payouts that have to happen based on injuries.
That is the basis for why we’re talking about this today. It is certainly true that ICBC collects this information to be able to project how much they need to charge for car insurance so that, ideally, they’re at least breaking even, which is obviously not the case today.
M. Lee: Well, since the Attorney General referred to that, I just would like to ask a question which is related to that overall narrative that’s being created by the government. If I could just ask, then, in terms of the actuarial pool relating to types of conditions, which is what we’re speaking to: has there been a change, then, in terms of the way that ICBC reviews and sees from an actuarial basis these particular types of conditions?
Hon. D. Eby: There’s a proposed change. That’s what this bill is about, in part, and I’m sure that we’ll get to that section eventually. So there is a proposed change. The proposal is to categorize certain injuries as minor injuries and to have them follow a more proportionate dispute resolution process. Claims under $50,000 would go through a more expedited tribunal process rather than to B.C. Supreme Court with multiple experts.
The message that this bill brings to British Columbians is that government will no longer tolerate having ICBC premiums, paid by British Columbians across the province, pay for an incredibly expensive B.C. Supreme Court process that takes years to resolve, involves multiple experts, for what are more minor injuries. There should be a process that is proportionate to the type of injury. This bill proposes that categorization, but that change won’t happen until the bill passes.
M. Lee: I guess I was merely trying to suggest the indication that certain minor injury claims — even though that term the Attorney General is referring to is not actually a term that’s being utilized within ICBC — are being reclassified in terms of the assessment into claims that are larger than minor injuries even though, again, that term is not being utilized. That’s what I’m referring to when we talk about dealing with costs for ICBC.
I’m asking the question: what has been reclassified from a minor injury into something that’s no longer a minor injury — even though that term is not being utilized within ICBC?
Hon. D. Eby: Yeah, the member can…. I’m certainly supportive of the idea that we pass the following sections and get to the definition of “minor injury.” It provides guidance. In addition, I posted, on the Ministry of Attorney General website, a white paper that indicates our intentions in relation to regulations around what a minor injury is, how we intend to define it. But that doesn’t happen until the bill passes.
M. Lee: Let me try this, this way. In terms of the minor injury definition, when we talk about sub 28.1(2)(c) in terms of an injured person’s condition at the time health care was provided, first of all, we’re talking about a condition not at the time of diagnosis. Is that correct?
Hon. D. Eby: One of the intentions of this act and some of the provisions are to be responsive to how someone, an individual, is healing or recovering — or not — from an injury suffered in a car collision.
In order to be able to determine how somebody’s recovering or that they’re not recovering — in fact, they’re getting worse — you need to know the injured person’s condition at the time that health care was provided, whether it’s when they go to their family physician and they say, “Listen, this neck injury I have isn’t getting better. In fact, it’s getting worse,” or when they go to their physiotherapist and they say: “You’re prescribing this exercise, and I’ve been doing it, and actually I find myself increasingly disabled.” You need to know whether their condition is improving or whether it’s getting worse.
Health care is provided when someone receives an injury over the duration of the healing process of the injury. In order to determine the quantum of an individual’s claim, to determine whether it’s a minor injury or a serious injury and assess their needs for care, you need to know their condition at the time that they receive the health care. Without that information, you’re not able to do it.
M. Lee: In the definition of “minor injury,” we talk about consideration around serious impairment and whether the condition resolves itself within 12 months. At the initial onset of this health care report, is it intended that this assessment would contemplate that? Or is that something that’s separately dealt with under prognosis?
Hon. D. Eby: I think the member…. I think where we’re losing each other here is that the member is thinking about the health care report as being when the person attends the emergency room or their family physician or physiotherapist immediately after the accident for their initial visit to assess their condition immediately following the accident.
But in fact, these reports are generated throughout the lifetime of the injury that the person receives in the accident. Part of it is knowing how the person’s prognosis is going as they receive treatment over the lifetime of the injury. It’s especially relevant because — the member’s right — this act contemplates that if someone is significantly impaired in various activities, an injury that would initially present as minor might actually be no longer classified as minor.
You actually need to know the injured person’s condition at the time health care is provided, not just at day 1 but all the way through the lifetime of the injury, in order to properly assess the needs for care, to quantify the amount of the claim and to administer and pay benefits. That’s why that’s here.
M. Lee: Thank you for that clarification. I’d just like to ask then…. I understand that that might be through the course of treatment, but at some juncture, of course, this matter might be resolved in front of the CRT.
In that case, when that health care report goes in front of the CRT, presumably that’s going to be the most up-to-date health care report, which again will assess a condition at that particular point in time. Is that intended to be a forward-looking assessment? Or is it at that particular state of condition at the time that the report is dated?
Hon. D. Eby: The reports are diagnosis, condition and prognosis. What is going on with the person? How are they are doing right now? And what is the likely outcome, or what do you see going forward in terms of this person’s outcome?
Those are the three key pieces, both under the old act and, as we’ve been through, under the proposed amendments here.
M. Lee: Just under section 28.1(4), it refers to: “The form of the report and the manner of providing the report….” Again, we acknowledged earlier that it may be different for different health care practitioners. But what’s intended by the word “manner,” in terms of what manner are we referring to when we’re talking about how this report might be provided?
Hon. D. Eby: Some practitioners may be providing certain types of reports more frequently to ICBC than others. They may establish an on-line submission process for certain types of reports for certain categories of health care practitioner. Some practitioners might be providing paper reports. Some might be providing on-line reports.
The provision is meant to capture that they may be delivered in different ways, depending on different classes of practitioners, and they may contain different information, as we canvassed earlier. Different practitioners have different areas of expertise, and we don’t want practitioners not expert in one area talking about an area of expertise of another practitioner.
J. Yap: Following on from my colleague’s line of questioning. I understand that in order for an injury victim to qualify for a major injury, if I can express it that way, they will be required to show that they followed best practices in the treatment of their injuries.
Can the minister confirm that this is the case?
Hon. D. Eby: The act creates the regulatory authority to establish prescribed treatment, which will be designed in partnership and consultation with physicians. The issue isn’t minor or major injuries; the issue is serious impairment. So if you’re seriously impaired and you’re not healing the way that is expected, you might be asked to follow a particular treatment regime, which is best practice prescribed in consultation with physicians, delivered through your own personal physician, as well, supervised by your own personal physician, in order to, hopefully, get you back into a better place.
I see staff just…. There might be one piece to add here. There isn’t anything to add.
J. Yap: Can the minister tell us who will have authority in terms of deciding what those best practices are?
Hon. D. Eby: The member is on section 29 of the bill. We’re on section 8 currently. Section 29 includes regulation-making powers, including the ability to set regulations around prescribed treatment for people who are injured.
J. Yap: Can the minister tell us how the best practices will be decided upon with regards to definition?
Hon. D. Eby: In consultation with the medical community.
J. Yap: Thank you for that, to the minister. I’m hearing that the minister will be bringing in outside help in terms of helping with this definition. Possibly medical experts, other jurisdictions?
Hon. D. Eby: We’re consulting with medical experts here in British Columbia in relation to section 29 of this bill.
J. Yap: Can the minister tell us if the form or manner in which ICBC can request information under this section will be standardized? Or can they ask different practitioners for different information in different forms related to that patient?
Hon. D. Eby: Within a class, ICBC could potentially ask different practitioners for different information.
J. Yap: Will this be centralized to the primary care practitioner who responds to these requests? Or is ICBC free, say, to ask a chiropractor for information, then ask a GP for information and then ask an RMT for information and not tell the other practitioners what they’ve requested or received from which practitioners or what form or manner in which they’ve received that information?
Hon. D. Eby: ICBC doesn’t have legal authority to share a person’s individual medical information among different practitioners. They could certainly ask multiple practitioners. If you’re seeing a massage therapist, a physiotherapist, an occupational therapist and a family physician, they could easily, and do, ask all of those people for reports.
J. Yap: This relates back to what was discussed under Bill 22, the power dynamic here being quite significant — an individual going up against a Crown corporation and government, ultimately. Will the minister commit to a standardized manner or form in which ICBC can request information and ensure that there’s transparency and communications about information with the individual and medical practitioners?
Hon. D. Eby: I’m afraid the member is asking for something that’s not possible, which is transparency about personal medical information and also about a standardized form for health care practitioners when their expertise varies from field to field. I’m afraid I can’t make that commitment to him.
A. Weaver: I just have a couple of quick questions for clarification on section 8. Section 8 deals with section 28.1. In particular, it says several criteria that a health care practitioner referred to in subsection (1) must provide.
My question to you is: does this, in any way, enable ICBC to not accept the results from a single health care practitioner and insist that the patient go and see another health care practitioner or not?
Hon. D. Eby: All insurers have the ability, in relation to personal injury or disability, to compel insureds to attend a certain medical practitioner. The intent of this section is to avoid that, where possible. You are going to your own physician or your own physiotherapist or your own chiropractor, and ICBC can get that information directly from them. That’s what this section enables.
A. Weaver: Thank you for the answer. If said patient were to not like the opinion that was received by one practitioner and went to seek an opinion from another practitioner, would both of those opinions be required to be sent along to ICBC, yes or no?
Hon. D. Eby: If an individual went to multiple practitioners to get different opinions, in theory, yes, ICBC could ask for those opinions from the different practitioners that an individual saw. Whether the individual is motivated by wanting a second opinion or simply feeling that they weren’t receiving adequate service from one service provider and switched to another service provider, ICBC could get records from both under this provision.
A. Weaver: With respect to section 28.1(2), and then the (c) in there, it talks about “the injured person’s condition at the time health care was provided.” This is rather broad. What are the limitations upon such a request? Are there any such limitations? Is this person’s condition relevant to the accident, or is ICBC able to get the entire medical history of a patient as part of this process?
Hon. D. Eby: ICBC is legally restricted to only asking about information that’s relevant to the claim — so the person’s condition at the time health care was provided relevant to the accident, injury.
A. Weaver: My final question is: to what extent is the information that is being sought from the health care practitioner protected by the personal information and privacy act? Is there a requirement for ICBC to work within the context of that act? And is that agency or is the Privacy Commissioner being consulted as part of this process?
Hon. D. Eby: Yes, ICBC is bound by the Freedom of Information and Protection of Privacy Act, which, in part, has a complaint mechanism overseen by the Privacy Commissioner for British Columbia.
M. Lee: Following on the question from the member for Oak Bay–Gordon Head, I’d just like to ask about sub 28.1(2)(c), again, on “condition.” When we say it’ll be information related to matters which are relevant to the claim, in the instance of a psychological or psychiatric type of minor injury under the proposed bill, what are the limits there?
Hon. D. Eby: If you’re making a claim or asking for benefits or treatment in relation to an injury that is psychological in nature that results from a car accident, then that type of injury would be treated no differently than a physical injury in terms of this subsection. The person’s condition at the time health care was provided to address the psychological condition is relevant to the claim.
M. Lee: If a person is involved in a car accident and they have some pre-existing mental impairment, a challenge with mental health, is that not something that would be relevant or related to this potential condition assessment?
Hon. D. Eby: ICBC is only able to access information if it’s relevant to the claim. I think that for the member and others, related to questions about what information ICBC could collect, it’s only information relevant to the claim — so only to the extent that any pre-existing condition is relevant to the claim.
M. Lee: I think this is the challenge with this bill in terms of getting definition around what’s required under the bill, particularly when we’re talking about mental health, for example. Would the Attorney General not see the need to…?
If these words are being read into this section, should it not be made explicit that the information required under this section is relevant to the claim? If that in itself is the right way to describe the kind of information that’s needed here, should there not be a more explicit definition and limitation around the kind of information that these reports are being required by the corporation to be submitted to them?
Hon. D. Eby: Yes, I agree with the member. Subsection (1) says: “This section applies to a health care practitioner who provides health care to a person injured in an accident occurring in British Columbia….” So it narrows it to a health care practitioner providing health care in relation to a person who’s injured in an accident. It’s not broader than that. It’s the first subsection there, sub 28.1(1).
M. Lee: I appreciate that the type of health care practitioner that would be drawn into this section is, as the Attorney General just indicated, under subsection (1). But what I’m referring to, of course, is under subsection (2), which is the nature of the information that’s being required to be provided in the report.
Clearly, it is involving someone who is a person who’s injured in an accident. That’s the reason why the person is seeking medical attention or health care attention from a health care practitioner.
What I’m suggesting and asking the Attorney General is for his assessment as to whether it would be fair and reasonable to ensure that there’s full understanding of the full extent of the information that’s going to be required, particularly when we’re talking about “condition” under sub (c).
Hon. D. Eby: The basic principle of statutory interpretation is that you have to read the section in the context in which it appears. So this whole thing is section 28.1, and subsection (1) says this applies to a “health care practitioner who provides health care to a person injured in an accident.”
Subsection (2) then says: “A health care practitioner referred to in subsection (1)” — that is, a health care practitioner who provides care to a person injured in an accident — “must provide…a report that includes the following information…(a) the nature and extent of the injured person’s injuries,” which obviously relates to the injuries from the accident; “(b) the injured person’s diagnosis,” which obviously relates to the injuries received from the accident; “(c) the injured person’s condition at the time health care was provided,” the health care that was provided in relation to the person injured in an accident; “(d) the treatment provided or recommended by a health care practitioner….” Obviously, it’s not related to the person’s dietary needs, or perhaps they have a pre-existing health care condition that’s totally unrelated.
Let’s say they had osteoporosis, and they were in a car accident, and they had a bunch of broken bones as a result of the accident that maybe someone wouldn’t have had in a car accident. Then it would be relevant to say: “Listen, this person had advanced osteoporosis, and as a result, they had all these broken bones as a result of the car accident.” Then, certainly, that would be relevant.
It’s not accurate and it’s not useful to pull out the word “condition” from one subsection of another subsection of a larger section, and then say: “Well, this provides a wide licence to collect all kinds of information.” It’s simply not the case. It’s embedded in two different subsections, and the whole subsection is titled, “Health care reports for accidents,” so that’s what the information is related to.
M. Lee: I think we’re understanding each other in terms of what we’re referring to. The concern, again, around “condition” is a person’s condition at the time that health care was provided would suggest, as the Attorney General has indicated, that it’s only the condition information that’s relevant to the accident or the claim.
I’m still unclear, for the benefit of this discussion, what that relates to. Does it relate to the condition as a result of the accident? Or does it relate to something else? That was really the point of the question, I believe, from the member for Oak Bay–Gordon Head.
Hon. D. Eby: It may ease the member’s concern to know that, for example, in the previous section, where it said that you have to provide a report about the injured person’s diagnosis, it has never been an issue. It’s never come up that someone was confused about what the information and collection authority was for ICBC or what the information provision obligation was for a health care provider. It was straightforward. It’s in relation to the accident.
You could add the words “the nature and extent of the injured person’s injuries in relation to the car accident for which they are receiving health care” to each of these subsections, but it’s not necessary, because the heading of the section is: “Health care reports for accidents.” Subsection (1) talks about a person injured in an accident, and the health care practitioner provides health care to that person. Then subsection (2) refers back to subsection (1) for additional certainty. So it’s the injured person’s condition relevant to the car accident at the time health care was provided.
M. Lee: The reason why I am prolonging the discussion on this particular provision is that I believe it is relevant in terms of what baseline is being established, even though, as the Attorney General indicated earlier, it is an evolving set of reports as a claimant’s health, hopefully, progresses in a better way post-accident.
It does set a baseline in terms of how…. When I read the new definition…. It hasn’t been there in the past, right? ICBC has not been requiring reports of this nature dealing with a “minor injury” definition of the kind of scope that is being proposed by this government. That minor injury definition, of course, includes terms around serious impairment and the length in which a condition prolongs itself. Again, the word around condition has been given more import under this definition of minor injury; hence the concern around the scale and scope and the extent for which this condition term can be utilized.
That’s the concern. I think it’s more just being a definition around relevant to the accident, meaning…. I understand that that is potentially the way that this section could be interpreted and the way the Attorney General is suggesting, but that only takes us so far.
Again, I’m asking the question whether a condition would be interpreted as including any pre-existing condition or any other condition which may have some relevance to the accident at hand.
Hon. D. Eby: ICBC currently, before this bill is passed, in doing its work, needs to know how the person’s injury is progressing or not. This is why there are six experts attending B.C. Supreme Court on each side. They’re all providing opinions about how the person’s injury is progressing or is not progressing — what is the person’s condition at the time that they were assessed by the medical experts? — in the battle of experts that is now costing British Columbians a loss of $1.3 billion for minor injuries.
This is critical information to assess a person’s claim. It is not new information. It is information that ICBC needed, it is information the plaintiffs needed, and it will continue to be so. It was always understood to be included in the definition of subsection (b), the injured person’s diagnosis.
To say that ICBC didn’t need to collect this information before is not accurate. And it didn’t change simply because a subset of injuries now will have a limit on the maximum pain and suffering award and will also be directed to the civil resolution tribunal instead of B.C. Supreme Court. This didn’t change. It’s not relevant to the…. It would exist anyway.
If we were cleaning up the act today and we weren’t doing civil resolution tribunal and we weren’t doing a definition of minor injury, ICBC would still need to clarify that they have the authority to collect this information for the purposes of doing their work. In 1979, when this was originally done, they didn’t need to be quite so explicit. Now, under current freedom-of-information rules, you need really clear legislative authority.
I’m not sure I can address the member’s concern. I don’t even really understand the scenario that the member is talking about, where this information wouldn’t be relevant and where the individual wouldn’t want that information to be available to the civil resolution tribunal or B.C. Supreme Court. I can’t imagine a scenario where you’re not going there and saying: “Look, I’m not getting any better. Look at my doctor’s report. My condition at the time the doctor saw me has not improved. I’m getting worse.” This is exactly the information you want in front of the court or the tribunal. So I don’t even understand what the concern is.
As I said earlier, pre-existing conditions are only included in this to the extent that they’re relevant to the claim. If they’re not relevant to the claim, it doesn’t matter that the person has diabetes — to their whiplash. I’m just using those as examples. I’m not a doctor. Maybe something about diabetes may cause someone to be more vulnerable to whiplash. I don’t actually know that. I’m using it as an example.
An irrelevant pre-existing condition is not contemplated here. These are pre-existing conditions that might have some relevance to the claim and that the person may themselves want to bring forward.
M. Lee: Well, thank you to the Attorney General for that further explanation and clarification around pre-existing conditions as being relevant to the claim.
The Attorney General made a statement there that I just wanted to clarify. Is the Attorney General suggesting that the figure the government has provided, the $1.3 billion, is related to minor injuries itself? Or is there something else?
Hon. D. Eby: The cost of administering claims that are minor injuries was up more than 260 percent in the last ten years. In addition, these claims going to B.C. Supreme Court take years to resolve. They involve expert reports that now cost in excess of $10,000 each to obtain. The system is broken.
ICBC, as a result, and the government have two options. One is to increase driver premiums by $400 per driver to close the gap. The other is to find a more expeditious way to resolve less serious claims. It’s not to say that someone’s suffering is not serious to them and to their family. This is serious stuff for a lot of people. But there are people who are rendered quadriplegic in accidents who have had their benefits frozen in time for 25 years because ICBC hasn’t had enough money to increase those benefits.
I don’t think anyone benefits by having a system where it takes two years to resolve an accident claim in B.C. Supreme Court and where the system spends tens of thousands of dollars on expert reports when the claim could be resolved in a matter of months in the civil resolution tribunal, an independent tribunal. So yes, these were policy choices by government around the difference between increasing premiums for drivers or finding better ways to resolve disputes for more minor injury claims that individuals might be facing so that it’s a proportionate system and it’s one that’s sustainable.
We are the last province in Canada to make these changes, and it shows. That’s why ICBC’s losses are so significant. All insurers across North America are facing pressure around distracted driving, increasing accidents, and so on, but there are insurers in Canada, including the public insurer in Saskatchewan, that are doing okay. They have been successful in part because they have gotten the costs of minor injury administration under control, and that is what our intention is here.
M. Lee: Again, just to clarify, given the Attorney General has laid out the government’s view on this, what is the expected saving to the government, then, based on this change in terms of the minor injury cap?
Hon. D. Eby: Between the changes in administration of minor injury disputes, putting them in front of the civil resolution tribunal and a limit on pain and suffering awards of $5,500 for minor injuries, there is projected to be a $1 billion savings for ICBC. That is after increasing benefits for people who are catastrophically injured in motor vehicle accidents, who are rendered quadriplegic, and, in addition, increasing benefits for people who need to access benefits — whether physiotherapy, chiropractic, counselling, acupuncture — to actually cover the out-of-pocket expense, the market expense, of these treatments rather than some fraction of it that was set in 1993.
I don’t know if the member recalls, in 1993 a movie ticket was $5. Good luck going to a physiotherapist and telling them you’re able to pay them what they got in 1993 for physiotherapy and have them not ask you for an additional charge out of pocket. We’re increasing those benefits as well. That’s how significant the costs are of administering these types of injuries and how significant the anticipated savings are if this is successful, which we hope it to be.
M. Lee: I think we’ll have an opportunity to review the breakdown around how that $1 billion projected by the government would break out in savings.
To get back to the matter at hand, on condition, there is the serious impairment language in the 12-month condition going forward. With this inclusion in the report, even though the suggestion is that it ought to have been in there before…. What’s the implication in terms of this information and this condition being described at this juncture before going to CRT and then having that condition continue and persist over the 12-month period, in terms of how the condition gets settled and determined at this juncture versus a later juncture? What are the implications there in terms of the change in the nature of that condition?
Hon. D. Eby: This section relates to reports filled out by health care practitioners. The sections that the member is interested in come later in the bill.
J. Yap: I appreciate the minister’s answers. Just to clarify, moments ago he mentioned this projected savings of $1 billion, which would result from these changes, including the minor injury caps and a few other references. What period of time is the minster referring to on that $1 billion savings?
Hon. D. Eby: That is an annual savings.
Sections 8 and 9 approved.
On section 10.
J. Yap: To the minister: we note the removal of a number of references to the point system, for example, in section 34. Is it the government’s intention to do away with the points penalty system?
Hon. D. Eby: No, there’s no change intended. It will always be relevant to premiums. It’s about whether it’s contained in the old concepts of “basic premium” and “additional premium” or where we intend to go, under planned rate design changes: to a consistent premium. The point system will still exist, in terms of its relevance to setting premiums.
J. Yap: Just to be clear, the point system will not be replaced, even though, from what I read, it’s being deleted from the legislation. Is that the case?
Hon. D. Eby: The factors that go into the point system will always be relevant to setting a premium. I can refer the member to subsection 34(2)(g)(vi), for example, where “the number, nature and kind of violations or offences referred to in subsection (3) (b) committed by the person, if any” are “within a period established by the corporation.” The member can see there that the same considerations around the points continue even though that section is repealed.
J. Yap: Yes, I see that. I appreciate the minister referencing those sections. However, the point system is one that has been understood and accepted by British Columbians for many years. I have the impression that there’s going to be a change to a new system of assessing risk.
If we’re moving away from the point system — although the elements of what goes in the points, the minister confirmed, will continue to be considered — what will this new system look like? How would British Columbians learn more about it, to have confidence in it?
Hon. D. Eby: Division 28 of the Motor Vehicle Act regulations sets out the points for various offences. That is not changed by this act, and it will continue into the future.
[L. Reid in the chair.]
The member is correct in that if the point system changes in the future, the act creates the flexibility for ICBC, without opening up the act, to be able to respond to that and to refine it, following consultation to ensure that it’s responsive.
I will challenge, a little bit, the member’s suggestion that British Columbians are accepting of the current system around how rates are set. We had an engagement with British Columbians about how rates are set for higher-risk and lower-risk drivers, and we should have those results out shortly.
The reason for the consultation was, in part, regular correspondence — certainly received by my office and by ICBC — from people who believe that they are good drivers, not having had at-fault accidents or tickets, believing that they’re paying too much and subsidizing people who are high-risk drivers. So there’s not a lot of satisfaction around the current rating system in terms of that.
We’ll have some feedback for members through the consultation that we did and provide more detail about that engagement shortly, I hope.
J. Yap: Thanks to the minister for his response.
What I did say was that British Columbians understand the point system. It sounds like the minister is announcing — maybe he didn’t intend to — that the point system, as we have lived with it and understood it over these years, will be phased out, although the elements that go into the point system will continue, based on section 34, which the minister referred to.
With this new approach, using those elements, what will that look like? How will British Columbians have confidence that they’ll be treated fairly?
Hon. D. Eby: I appreciate the member’s clarification, and I’m sure the member will appreciate this clarification. It certainly wasn’t my intention to announce something that’s not happening: the end of the point system.
Division 28 of the Motor Vehicle Act has the regulations with the points in it. We don’t have any understanding that that is going to change at all. These are points that are used by ICBC in setting rates and determining it. It may be, in the future, that a future government changes the point system.
This act provides the flexibility around how ICBC looks at…. If there are no points…. You don’t want to put points in here if you don’t have to. What ICBC is looking at is not the points, specifically. They’re looking at the number, nature and kinds of violations or offences. Currently that’s governed by the point system. In the future, some future government might change that. It provides flexibility to talk about what, actually, the concern is — the number, nature and kinds of violations or offences — and incorporates the current point system as well as being flexible into the future if the point system changes. ICBC is still able to set premiums appropriately under the act.
J. Yap: For consideration around a fleet of vehicles…. If, say, a registered employee is in an accident and found at fault, will the owner of the company be charged a higher premium, or will responsibility for paying the higher premium be on the employee’s insurance, or both?
Hon. D. Eby: This act doesn’t change anything in relation to fleet vehicles.
J. Yap: How will the minister’s references to charging bad drivers more factor into this section?
Hon. D. Eby: This is the enabling legislation that sets out the clear authority for ICBC in how they set premiums. This isn’t the rate design itself. Rate design is how you use these different factors to set rates. That was what our engagement was about. This would provide ICBC with the legislated authority to use these different considerations in setting rates, but it’s not….
Think about it as like this is the grocery store. This isn’t necessarily what the recipe is. You’d take these different components and determine risk, based on consultations with British Columbians: which should be weighted, how they should be weighted, over what scan period and what period of time, the number of at-fault accidents, and so on. That is the rate design process. This is just the enabling section.
J. Yap: A “municipal bylaw relating to the regulation of…traffic” is mentioned as a reason that someone may be charged a higher premium. Can the minister explain what this pertains to?
Hon. D. Eby: Municipalities can set speed limits on non-arterial roads. That’s an example of a municipal bylaw. If you’re not following the rules of the road, whether they’re set by a city or by the Criminal Code or by the Motor Vehicle Act or Commercial Transport Act, it could be a consideration for ICBC if you’re not following the municipal speed limits.
J. Yap: So for example, hypothetically — I’m sure this would never happen — if the minister were maybe running late for a cabinet meeting and forgot to pay his parking fees and parked outside on Menzies, received the ticket, say, one or more times, would the minister be subject to a higher premium from ICBC as a result of the parking violation?
Hon. D. Eby: The member is right. That would never happen — he said, laughing. Seriously, though: everyone, pay your parking tickets.
The municipal bylaw provision and the other provisions are related to actuarial risk. There is no actuarial risk — although, there is certainly political risk — associated with unpaid parking tickets or parking and failing to feed the meter. This is around things that you do when you’re driving that increase the risk of an accident — moving violations, and so on.
J. Yap: I’m hearing the minister stating that with regard to including municipal bylaws, a simple mistake such as forgetting to pay for parking would not result in higher premiums.
Hon. D. Eby: This is a pre-existing provision, because municipalities do set things like speed limits. Speeding through a school zone, for example, is certainly an example of a high-risk activity that we would definitely want to capture in setting rates — if someone’s driving 60 through a 30, in a school zone, or 70 through a 30.
These are the kinds of things that we asked British Columbians about, actually: what nature of moving offences should contribute to rates? What we want to do is capture British Columbians’ understandings of what higher-risk driving is. That’s why we did the engagement, and that’s why this enabling statute allows ICBC to consider things like municipal speed limits — as it always has.
To confirm for the member: no, parking your car and failing to feed the meter is not associated with actuarial risk so would not be considered as something related to rate setting.
J. Yap: Some traffic bylaws have broad powers. Say, for example, a person was ticketed with a jaywalking infraction, as per section 10 of Victoria’s traffic bylaws. Would they then be subject to higher premiums despite being ticketed while not operating a motor vehicle?
Hon. D. Eby: This isn’t a new provision; this is an existing provision. The municipal bylaws relating to the regulation of vehicular traffic are intended to capture things that you might do in a vehicle that increase your risk of having a collision. Because we don’t provide pedestrian insurance, the proclivity of someone to take a risk, like jaywalking, is not relevant to setting their rates as a driver.
J. Yap: Another example: would an individual operating a motor vehicle who drove on a newly painted line and received a ticket under Victoria’s bylaws be subjected to a higher premium as a result of driving over the new paint and getting that ticket?
Hon. D. Eby: I think it’s important again to draw the distinction between what this is and what rate design is. This is enabling legislation that allows ICBC to consider various factors, putting them together, weighting them and determining how to set premiums for lower- or higher-risk drivers. So of course municipal bylaws relating to the regulation of vehicular traffic are an area where ICBC needs authority to consider a driver’s behaviour in relation to things like municipal speed limits.
The actuarial risk associated with driving over a painted line or jaywalking or parking at an expired meter is nil. What ICBC is trying to do is not assign actuarial risk where none exists. They’re trying to ensure that people who engage in higher-risk activities pay higher premiums. Those high-risk activities are not drawn out of a hat. They are based on actuarial tables that show that people who engage in these activities more frequently involve themselves in more accident-related claims.
It’s a fun exercise to go through different municipal bylaws that can only tangentially be described as relating to the regulation of vehicular traffic. It’s not useful from the perspective of ICBC’s rate design. They put out some discussion pieces, and there was an engagement with British Columbians that shows the clear direction and consideration of the corporation around rate design.
J. Yap: One more example. If someone receives a parking ticket when they move to a neighbourhood, park in the wrong residential spot and then receive a ticket due to an innocent mistake, will they be subjected to a higher premium?
Hon. D. Eby: The answer around parking has not changed since the member last asked it. It’s not relevant.
J. Yap: I ask these questions because there’s such a range of bylaws in effect across our province — even provincial laws that are open to interpretation and could result in an assessment of risk and therefore higher premiums for people who did not really commit a serious offence.
For example, there was a woman in Nanaimo in 2012 who was given an $87 fine for parking and leaving her windows open on a hot day. She was told by the police she was in contravention of subsection 191(2) of the Motor Vehicle Act.
Can the minister let us know what work has been done around these type of violations to ensure these people are not caught up in higher premiums for seemingly innocent mistakes or innocuous offences?
Hon. D. Eby: This feels a little bit like those newspaper columns about: “Did you know that it’s illegal in Vancouver to have a crocodile in your backyard swimming pool?” You know, these kinds of fun, antiquated or sort of strange municipal laws about which people don’t understand what the original intent or original problem was.
I’m not familiar with the case the member describes. It sounds very strange to me. In any event, the challenge is that there are lots of municipal bylaws that relate quite directly to vehicle risk.
Speed limits are the most direct example. If you are repeatedly speeding in excess of speed limits in a significant way — we’re not talking here about five kilometres over; we’re talking about repeated moving violations that are significant — then ICBC absolutely…. Actually, we would consider ICBC negligent — I would consider them negligent — in not considering that someone has a whole bunch of multiple-demerit-point speeding tickets in setting insurance rates, or even whether the person is qualified to drive. That kind of driving increases risk for everybody else who is on the road.
This provision existed. It’s not new. It has not been used in the past to assign higher premiums to people who get parking tickets. It won’t be used in the future to do that. I hope that addresses the member’s concern.
J. Yap: Has there been work done to understand and help municipalities with some of these bylaws that should be repealed so that individuals are not stuck paying higher premiums for seemingly archaic or trivial fines, or the risk of it?
Hon. D. Eby: I guess that would be something worth doing if these were set by a computer or some sort of an algorithm that was unable to distinguish between a moving violation that had actuarial risk and a violation that had no actuarial risk. But it’s not.
The rate design process is done by ICBC actuaries, by people. They look at the engagement that engaged tens of thousands of British Columbians from across the province about what they felt comfortable with in terms of how much additional premium someone should pay if they’re a high-risk driver, how many different types of issues, whether it’s at-fault accidents, penalty point offences, roadside suspensions for impaired driving.
There’s no need to comb through municipal bylaw books looking for obscure bylaws, because these are big ones. These are big violations that everyone goes: “Yeah, you know, maybe you shouldn’t drink and drive.” If you do, not only do you face significant fines, penalties and suspensions, but your insurance can and should go up because you’re a higher-risk driver.
These are the big ones. These are not “leaving your window open on a hot day” bylaws.
J. Yap: I know the minister has stated that good drivers should pay less, but there is seemingly no further information about how this can be achieved. I would like to ask how.
Hon. D. Eby: The engagement posted by ICBC with British Columbians went through some proposals, but the working theory is quite straightforward. If you imagine all the premiums collected from across the province as a pie, each person who is driving is responsible for a slice of that pie of premiums. So higher-risk drivers get a bigger slice of the premium pie, and lower-risk drivers get a smaller slice. It’s a bit contrary, because most people would want a bigger slice of pie.
But anyway, the way that this works is the more of the pie that’s taken by high-risk drivers, the less pie that’s left over for good drivers, which is actually a good thing — maybe I should be using golf scores — because that means that there’s less premium that has to be paid by good drivers.
One of the questions, for example, was: how much additional premium do you think a higher-risk driver should pay in a given period of time? The reason that question is significant is that if a higher-risk driver is paying more, if they’re taking up more of the pie, that means there’s less premium that has to be paid by the good drivers and the greater the discount is that you can give to the good drivers.
This is not a revenue generation piece. This is: how do you divide, in a revenue-neutral way, the premium pie so that…? Maybe it’s a really disgusting pie. You don’t want a big piece, right? You just want a small piece. The high-risk drivers have a bigger piece of the premium pie, and the low-risk drivers have the smaller piece, which is what they actually want.
So the more premium that’s paid by high-risk drivers, the greater discount you can give to good drivers, the people who write to my office every day and say: “I’ve been driving for 25 years. I’ve never had an accident. I’ve never had a speeding ticket. Why am I paying the same insurance as my neighbour that’s had two at-fault accidents and an impaired?” These are important questions, and we’re talking about how to apportion the premiums between high-risk and low-risk drivers. But that’s how it works in theory.
J. Yap: I’d like to follow on what the minister shared with us. I have heard surveys that have shown consistently that 99 percent of drivers feel they’re safe drivers, good drivers. The challenge, then, would be to slice up that pie in a way that reflects the reality as opposed to the perception. Has the minister given some thought to how that should happen based on his analogy about sharing the pie?
Hon. D. Eby: I agree with the member. I’ve heard, as well, that the majority of people believe they are better-than-average looking and of above-average intelligence, which, of course, we can’t all be, right? The same thing applies to drivers. Most people believe they are above-average drivers in terms of their ability.
The member is right. It is a political challenge. And that is why this work hasn’t been done, in my opinion. It is risky to go out and say: “Listen, you’ve had multiple at-fault accidents. You have been driving while impaired. You have multiple penalty point tickets. You have to pay a lot more insurance.” There are, surprisingly, a lot of people in this situation in British Columbia that are high-risk drivers.
That’s why I think it hasn’t been done, but that doesn’t mean it shouldn’t be done. When people come to this province from other provinces, they say: “Well, why am I paying so much in B.C., and in Ontario, I only paid this amount?” Actually, Ontario’s rates for comparable coverage are higher that British Columbia’s rates. But Ontario has a more refined rating structure, done by private insurers, where they compete for good drivers because good drivers are higher-profitability drivers for insurers, and good drivers are better rewarded in those provinces. And high-risk drivers pay a heck of a lot more in those provinces.
So there is a way to achieve the policy goal, I believe, of providing some reward for people who are driving within the rules and who are not getting in at-fault collisions, and so on, with lower premiums and to say to people who are not driving well, who are driving in a high-risk manner: “This is not cost-free. In fact, your driving behaviour, your multiple distracted-driving tickets, put you in a high-risk category. You are driving up costs at ICBC in an unsustainable way, so you have to pay more for your insurance.”
Most people will, I believe, agree with that. But I agree with the member that there is some political risk in it, which is why I believe it hasn’t been done in a meaningful way for a long, long time.
J. Yap: Thank you to the minister for that. Are there some preliminary criteria for good drivers and bad drivers that ICBC or the minister has established?
Hon. D. Eby: Yes, section 34.
J. Yap: How do we determine a bad driver other than by tickets and accidents?
Hon. D. Eby: Section 34 discusses a number of different categories of considerations that ICBC can make in terms of determining appropriate rates. Subsection (3) talks about: “A premium for a driver’s certificate may be based on one or more of the following: (a) the details of any accidents involving the driver…(b) the number, nature and kind of violations or offences committed by the driver…(c) the number, nature and kind of suspensions or prohibitions imposed on the driver…under the Motor Vehicle Act…(d) prescribed criteria.” That, as an example for the member, might include distance. That is something that we discussed in the engagement. It gives the member some idea about the criteria.
M. Lee: Just before we leave the pie analogy and the other analogies that the Attorney General was sharing with us, I appreciate the explanation of where the government is. In terms of the framework that’s being established here in section 34, I appreciate that on the rate design, there’s some further work that the government is doing. But at this juncture, when we’re bringing in a framework under Bill 20 which is balancing, in the government’s view, how to best deal with ICBC in areas of product reform, can the Attorney General share with this House what the expected saving will be in the rebalancing between bad drivers and good drivers in terms of savings to British Columbians?
Hon. D. Eby: Well, it’s an easy answer. It’s zero. It would be a revenue-neutral shift between higher-risk and lower-risk drivers.
Just to clarify my last answer, for subsection 34(3), I was talking about premiums for drivers’ certificates. Subsection (2) talks about premiums for certificates other than a driver’s certificate, which has a more comprehensive list. I don’t think I clarified that at the beginning.
M. Lee: When we say zero, then, there will be no increased cost to good drivers as a result of this. There would be savings. On the bad drivers, there will be more additional costs but no overall savings to government in terms of how this is being dealt with.
Hon. D. Eby: Yes, the member has it exactly right.
J. Yap: Just to get back to where we left off in terms of how we determine a bad driver, would the converse be true? We determine a good driver by lack of tickets, accidents, etc.?
Hon. D. Eby: When you’re talking about driver behaviour, yes, that’s absolutely correct. There are other variables in setting premiums: for example, the region where the vehicle is being used and the use of the vehicle. But when you’re talking about drivers, that’s exactly right. It’s length of experience driving and the absence of violations, moving violations or at-fault accidents, these kinds of things.
J. Yap: I’ll run through an example. Someone is involved in a small fender-bender, going at a very slow speed, say five kilometres, trying to get out of a tight space, and there is no one in the other car. Damage is around, say, $500, and the at-fault driver pays that out of pocket but has no other infractions. Does the minister believe that this driver would be a bad driver and should pay higher premiums?
Hon. D. Eby: This isn’t the rate design itself. This is enabling legislation that allows ICBC to set rates and to consider these different criteria. It’s important for the member to know that this is exactly the subject of consultation we engaged with British Columbians about.
How much you should be able to pay out of pocket and avoid an increase in your premium, for example, was one of the specific questions, actually, on the engagement — and how many at-fault accidents over what period of time should affect your premiums. This is something we engaged with British Columbians about, around the rate design. But this is not the rate design itself. This is just the enabling piece.
J. Yap: I know the minister has mused about electronic devices, using technology to help gauge this. Can he update us on where he and ICBC have landed and what work is taking place in this area?
Hon. D. Eby: There have been some changes already around distracted driving. For your second distracted driving violation, there is now an additional financial penalty on your insurance. When all of the penalties are added up together for your second distracted driving ticket, I believe it’s about $2,000 additional that someone has to pay.
We have also provided police with new equipment in terms of being able to detect and issue tickets in relation to distracted driving. There’s also a pilot program in relation to technology in a car that prevents an individual from using their phone while they’re driving. That pilot is ongoing and is not concluded yet.
J. Yap: Putting on his former hat as head of the B.C. Civil Liberties Association, can the minister tell us what privacy concerns he would have with ICBC equipment in a car, tracking a person’s movements and access to personal data such as GPS locations, time of day, etc., and whatnot?
Hon. D. Eby: I agree with…. Certainly, putting on the hat that I wear now, the concern would be if that was somehow mandatory. If the government of British Columbia decided that all British Columbians needed to put GPS tracking devices in their cars, that would obviously be a concern for privacy advocates, not just at the B.C. Civil Liberties Association but, I imagine, within government itself and with the members in this place. Nobody is suggesting that.
What, instead, is being looked at is if someone decided to take a device into their vehicle that restricted their ability to use a cell phone, that measured things like sharp cornering and sudden acceleration, would they then qualify for an insurance discount of some kind? Or would that be an appropriate response in a situation where there is a new driver or a situation where someone has had multiple distracted driving tickets?
Those are the very early discussions. But the first questions are: does the technology work? What information does it collect? Is it useful? That’s why volunteers, and there were many volunteers, who signed up to ICBC to test these for us…. It’s based on successful pilots and successful projects in the United States that have done exactly this.
We’re pretty excited to see what the results are. But I would join the member in being concerned about any suggestion that these would somehow be mandatory or that government track where vehicles go, through provincial legislation or otherwise.
J. Yap: Does the minister believe that the technology, as great as it is, could possibly glitch and give a bad reading, thus putting a person into a class of driver they may not truly belong in?
Hon. D. Eby: That is exactly why we’re doing the pilot.
J. Yap: On the regional rate-making formulas. Does the minister intend any changes under legislation to be made to this formula?
Hon. D. Eby: This is enabling legislation that enables ICBC to consider region, which they do currently, in setting insurance rates in British Columbia. Regions like the Lower Mainland, where there’s lots of traffic and there’s a higher risk of collision, are higher-risk regions, and there’s an increased premium that’s associated with that. For more rural regions where you’re on a big, empty, flat road and you’re at less risk of a collision, there are lower premiums associated with that.
ICBC already considers it, and they will continue to consider it, going into the future and setting rates. I was going to say that we asked about it in the rate design, but we didn’t ask about it in the rate design. But it is something that ICBC currently considers, and they will into the future in setting rates.
J. Yap: The minister talked about the Lower Mainland, where there’s a relatively larger population. Will people in Vancouver and Surrey be paying more or less under this new formula?
Hon. D. Eby: They already do pay more for insurance.
J. Yap: Will people in Quesnel and Williams Lake pay more under this new formula?
Hon. D. Eby: There’s not a new formula. For a long time, people in the Lower Mainland have paid more and people in Quesnel and Williams Lake area have paid less because of the reasons that I outlined: that collisions are more frequent in the Lower Mainland due to traffic and the number of vehicles on the road.
J. Yap: Would there be a differentiation between regions of the province, other than urban-rural? For example, drivers in the Kootenays versus drivers in the Stikine and Skeena?
Hon. D. Eby: There are multiple regions, and the regional variation is based on risk for driving in those areas. One can imagine a region of the province that’s more mountainous with a longer snow season and ice season might be a riskier region than a region that thaws more quickly and that’s flatter with better visibility, although both might be rural.
The actuarial calculations are not based on urban-rural. They’re based on the number of collisions and the risk of collision.
J. Yap: Based on the minister’s response, I take it that somewhere in ICBC or perhaps within the minister’s office there is an actuarial risk assessment of regions of the province.
Hon. D. Eby: Yes, ICBC actuaries would know the risk of having an accident in various regions of the province and where accident risk is elevated. In fact, one of the pieces of work that ICBC and the Ministry of Transportation are working on is identifying high-risk intersections, roads, provincial roads, in order to identify remedial repair work or measures that could be put in place — rumble strips, additional guardrails or so on — to reduce claim frequency in those areas.
J. Yap: With the risk assessment by different regions, would there be shifts over time? Is that information private, or is it available so that there can be some learning between regions?
Hon. D. Eby: Over time, as density changes and traffic changes in a certain area or region of the province, then accident risk changes. I’m not sure I can provide more clarification.
Sections 10 to 16 inclusive approved.
On section 17.
J. Yap: Let’s start with the indirect collection of information, noting that there were concerns about how government is collecting information, such as IP addresses and other personal identifying information. What is the minister’s intent with the authorization of indirect information in this section?
Hon. D. Eby: Our intention is to shift insurance away from the vehicle and towards the driver so that it is the drivers who are using the vehicle that set the risk rather than the owner of the vehicle. This allows for ICBC to collect information, in relation to listed drivers who will be using a particular vehicle, about their driving history and the risk that they present, in order to set a premium.
J. Yap: How does the minister see these regulatory powers evolving, and what does he see them extending to, to further encompass over time?
Hon. D. Eby: The piece that’s significant and new here is (d.2), which talks about “authorizing the indirect collection of personal information about a person named in an application for a certificate” — for an insurance certificate — “as a driver of a vehicle specified in the certificate.”
The idea here is that when you go to your broker and you say, “I’d like to insure my vehicle,” and they say, “Well, who will be using the vehicle?” you say: “I’ll be using it, and my partner will be using it, and our 17-year-old child will be using it.”
Then they look at the risk profile of the drivers, and they set the premium according to the drivers who are using the vehicles. That allows for them to look at the risk profile of the other two drivers, other than the owner of the vehicle, and authorizes the indirect collection of personal information — namely, that person’s risk profile: the driving history, moving violations, at-fault accidents, and so on.
It has to be set out explicitly that ICBC has the authority to do that because if not, then collecting any information about the person’s risk profile in order to set the premium would be illegal. That’s the piece here that is different. Everything else should be and is intended to operate the same way as it did previously.
M. Lee: I just wanted to ask, as a follow-up to the previous question from the member for Richmond-Steveston, about the “indirect” nature of the collection of personal information. What does the indirect refer to?
Hon. D. Eby: The Freedom of Information and Protection of Privacy Act says that you’re not allowed to collect information about a third party from somebody else, except in certain circumstances. One of those exceptions is where the specific provision authorizes the indirect collection of information.
That’s why you see this language “authorizing the indirect collection of personal information….” The person who shows up at the broker will be providing personal information about third parties, and there needs to be explicit legislative authority for the broker and, by extension, ICBC to collect that information in determining premiums for the vehicle.
M. Lee: Just as a point of clarification, then: is some of that information already being collected by virtue of what is under new subsections 34(2)(d) and (e) — in respect of other drivers of the vehicle?
Hon. D. Eby: I was just clarifying my last answer, and I’m afraid I missed the first part of the member’s question. I’m wondering if he could repeat it.
M. Lee: Sure. Let me just say that in respect of the information required — whether that is already covered under subsections 34(2)(d) and (e), in terms of the information relating to other drivers of the vehicle.
Hon. D. Eby: Section 34 is about setting rates and the information that ICBC can collect to set rates. Section 45 is about regulation-making power. So the member is right that it is repetitive, but in terms of the regulations — setting out what information is allowed to be collected — that’s what this section is about.
Section 17 approved.
On section 18.
J. Yap: I’m wondering if the minister can tell us why he settled on five years to review the fees under this section.
Hon. D. Eby: Under the current act, it was a real mistake, in my opinion, that there weren’t a couple of things established. The first was that the rates paid for accident benefits weren’t tied to CPI, to inflation. The second was that there wasn’t a regular review scheduled to ensure that the rates paid for benefits stayed up to date with what practitioners were charging. The effect of that was that rates didn’t change for 25 years.
The rates that were paid for physiotherapy or for other health care practitioners or other benefits, like wages lost as a result of an accident, didn’t change for 25 years. This drove a lot of people to litigation, and it meant that ICBC was paying just a fraction of the actual cost of benefits.
When we re-establish market rates for benefits for various service providers — health care practitioners, and so on — we want it to be really clear that we didn’t want the same situation to repeat. So we put two safeguards in. One is they’re tied to inflation, to the CPI. Given that CPI doesn’t relate directly to what physiotherapists are charging or what a certain practitioner might be charging, we didn’t feel that that was enough. We also said there should also be a review, on a regular basis, to ensure that inflation is actually capturing what various practitioners are actually charging.
Part of it was about ensuring that the review needed to be tabled so that it was public. If the gap started to grow between what ICBC paid for benefits and what people were actually being charged, that would be a public discussion in the Legislative Assembly, and people would know that. I’m afraid that, over the extended period of time that benefits weren’t changed, it wasn’t as much of a public discussion as it should’ve been.
There are two safeguards. If it was just the review, I’d agree with the member. It’s probably not sufficient. But tying it in with CPI and then doing the review every five years to ensure that CPI is keeping up, and then having that review tabled in the Legislature, I hope will be a sufficient safeguard to ensure that we don’t find ourselves in the situation where we are currently, where ICBC’s paying out 1993 benefit levels to people in 2018.
J. Yap: Can the minister tell us what input, influence and level of involvement he expects a minister would have in this review process?
Hon. D. Eby: The section sets out the involvement of the minister. The minister is responsible for initiating the review. It has to be done in consultation with ICBC and any other person or organization the minister considers appropriate. Disability advocates are a good example of the type of other person or organization that would be appropriate in this situation.
The minister must ensure that the report on the results is submitted to the minister within a year after the start, and it may — it doesn’t have to — include recommendations to amend regulations that are reviewed.
There is some prescription here about how that should happen, but there is also some flexibility here — and I hope that everybody who engages in this does so in good faith — in terms of the review, the terms of reference, who’s appointed to do the review and the process by which it’s done to ensure that the Legislature gets the full picture of the correspondence between the actual charges for benefits that people are paying and the actual benefits that are paid by ICBC.
J. Yap: Can the minister tell us why health care practitioners and professional medical groups are not explicitly named in the legislation as it pertains to these consultations under the five-year review by the minister and the corporation?
Hon. D. Eby: The member can see under subsection 45.1(5) that a review must be conducted in consultation with ICBC and any other person or organization the minister considers appropriate. It is left up to the discretion of the minister. I think it would be totally appropriate to be engaging with the various professional colleges and associations of various service providers, and it’s exactly the intention of the section — that they, the government and the public, should know what the current rates are.
I think that if this review took place and it was tabled in the Legislature without talking with those organizations, certainly that would be a very public issue, and it might undermine the intention of not talking to them in the first place.
Regardless of who is consulted with, this thing has to be tabled in the Legislature. I’m sure a vigorous opposition, no matter which party, would be quick to take that report and consult with the groups the member describes. Any minister that is asked to take on this review would wisely consider a broad consultation in establishing this review. That’s why we set out a one-year period for the review to take place.
J. Yap: I appreciate that. However, the minister would have the discretion on selecting who would be consulted. Certainly, those stakeholders that I mentioned, and that the minister agrees with, would be obvious ones to engage with. Why not explicitly state within the legislation so it’s understood that they will be part of this process?
Hon. D. Eby: The intent here was to not limit. It’s hard to predict in five years who will have interests in this and which organizations will be active and which less so.
A great example is nurse colleges and associations and the transformational changes that have been taking place in nursing, in the LPNs and RNs and so on. The reason I’m thinking about them is they were just in the Legislature the other day. These colleges and associations are regularly changing. They’re changing their names. They’re changing their composition. Their professions are evolving.
The idea is you leave it open. You can prescribe a list of names in the legislation here. You must consult with this group and that group. But it doesn’t mean, necessarily, that that group will be a relevant group in five, ten or 15 years. Keep in mind that many of these provisions that we’re updating haven’t been changed since 1979.
Theoretically, by regulation, you could define the term of an organization or define them, but it’s not going to happen. The intent here is that the minister exercise some good judgment and go out and consult. If the minister doesn’t exercise good judgment, the safeguard is that it has to be tabled in the Legislative Assembly, where the minister will be, almost certainly, questioned about why they didn’t talk to obvious stakeholders that have an interest in this.
J. Yap: I appreciate the minister’s answer. But with respect, way back in section 1, we defined certain professions. We defined, in legislation, medical doctor. Nurse practitioner was spelled out and not left to the discretion of the Lieutenant-Governor-in-Council or the minister.
Why would the minister not include it in this instance? While it may go without saying that doctors and medical professionals and the health care profession would be consulted, why not explicitly state that they would be, rather than leave it to a broad definition of “any other person or organization the minister considers appropriate”?
Hon. D. Eby: There were a couple of categories that were explicitly defined earlier on, but there were a bunch that weren’t and that were left to regulation for the same reason. Organizations change, and the government needs flexibility. There may be a new service provider that provides an appropriate service to assist people in recovering from accidents. You might want to add them. There might be a service provider that changes how they describe themselves. Then you might want to update that. So it’s done by regulation.
I do appreciate the concern that the member has. Maybe the review of the regulation might be a one-line review by a deputy minister saying: “I looked at the regs, and everything looks fine.” But it still has to be tabled in the Legislature.
I think that the intent of this section is clear. The neglect of a minister who put forward a review that was insufficient and didn’t consult with groups interested…. It would be at the minister’s own risk.
J. Yap: I appreciate that. I am sure it’s not the minister’s intent, nor would I want him to believe I’m heading down this road. Does the minister not think that leaving such an important review process solely to the minister’s discretion, whoever he or she is, may lead to a future review being subject to politicization?
Hon. D. Eby: I think it’s important to go back to: this is one of two safeguards. There’s the regular increase with inflation on the CPI, and then there’s a review of that every five years by the minister responsible.
The issue, the mischief that we’re trying to address here, is the fact that these benefits didn’t get increased for 25 years, and there was insufficient public discussion about it. So there are two pieces here — the CPI, to link it to inflation; but recognizing that there might be a gap between CPI and certain service provider fees, a review every five years, just to make sure that we’re still on track, to be tabled in the Legislature as a matter of public discussion.
I can accept that the member is concerned that it might be an inadequate review, in which case there would be an appropriate political discussion about the minister’s capacity and performance in the job and leaving people injured in accidents with inadequate benefits. That would be an appropriate discussion, and I would hope that that would take place.
But these are two pretty extraordinary safeguards around ensuring that premiums keep up to date, especially given the fact that they haven’t increased for 25 years.
J. Yap: Did the minister seek a legal opinion on this provision, and how did it come to be settled with this definition?
Hon. D. Eby: This was drafted by legislative counsel with solicitor input and advice. I can advise the member that the intent here and the reason why it’s here is to avoid us being in the same situation as we are right now, which is that these benefits haven’t been increased for 25 years, and to put as many safeguards as were possible into ensuring that we didn’t end up in that situation again.
J. Yap: Was there consideration given to maybe handing this power to decide on the review to a deputy minister in the ministry responsible, to take it out of the hands of politicians, to give the discretion to the non-partisan public service?
Hon. D. Eby: It’s not discretionary language. At least once every five years, the minister must initiate a review of a regulation. If the minister failed to do that, they could be subject to judicial review for failing to initiate the review of the regulation, because it’s mandatory. They must do this.
In practice, with reports, where ministers must complete reports or must table a report in front of the Legislature, that work is done by the public service, but ultimately, the minister is responsible for it politically. And the intent is not that this would be some sort of unique report where the minister is out there personally dialing people up and writing the report. That’s just not how it’s going to work, not how it’s intended to work. Maybe that’s why it uses the language that the minister must “initiate” the review. It’ll be done by public servants.
J. Yap: I’m focused on this because if certain groups happen to be unhappy with who was brought in for consultation, who was left out, would it not open the Crown to a lawsuit? I’m wondering if the minister would be concerned about that.
Hon. D. Eby: No, I am not concerned about that.
J. Yap: One more time. Would the minister consider handing this off to a non-partisan member of the public service to keep it non-partisan?
Hon. D. Eby: The CPI indexing is administered by the Crown corporation and government, and the review is initiated by the minister. That is the policy direction here. It will be tabled in the Legislative Assembly to ensure accountability. In the event that the Legislative Assembly is not in session, it must be promptly filed with the Clerk of the Legislative Assembly and would be a public document which would be tabled at the first occurrence of the House sitting again.
J. Yap: I appreciate that and understand the minister’s confidence in the process. Before moving to my next questions on this section, I just want to go on record in cautioning the minister. By giving the minister such broad powers and consideration…. He really should consider moving this aspect, this process, out of the partisan political process.
Moving on. Reviewing the amendments — it must be presented within one year. Can the minister tell us how this timeline was arrived at?
Hon. D. Eby: This is meant to be a significant review, and the idea was, given the level of consultation research that would be involved, that a year was appropriate to do the work properly.
J. Yap: What happens if there is, say, a sense of urgency, say, with an election coinciding with the report? Would the minister then be put in the position to use his powers on the regulation to compel the report sooner or to possibly make a regulation change to postpone the report?
Hon. D. Eby: The power exists under the regulation-making powers and under the act for the rates to be changed at any time. An urgent situation might be suddenly a doubling in physiotherapy rates and nobody can access physiotherapy. Government could, without any report, change those rates to reflect the actual market conditions for that particular service provider to ensure that people have access.
These are just safeguards in the event that government doesn’t, as they didn’t for the last 25 years, see a need to increase the rates, or it makes the decision that we could increase benefit rates, but then we’d have to increase premiums too, and we’d rather not increase premiums so we’ll just let these benefit rates ride, because we’d rather not have the discussion about premiums or ways for ICBC to reduce costs.
These are safeguards to make sure that the discussion takes place if government is reluctant to do it.
J. Yap: Is there any consideration given to recommendations provided through this consultation being binding with respect to changing the regulations?
Hon. D. Eby: The actual ability to pass the regulation is cabinet’s, so it would be a recommendation to cabinet and a public one at that, because it’s tabled in the Legislative Assembly.
J. Yap: Given that this report will be delivered to the Legislature, as is proposed, has the minister given any consideration in respect to moving it directly out of the legislative political process and to an independent officer of the Legislature — for example, the Ombudsperson — to receive the report?
Hon. D. Eby: This section contemplates that the minister would initiate the review and that it would be done within the ministry responsible for ICBC at that time.
J. Yap: What provisions does the minister foresee in a circumstance, say, where costs do not keep up with inflationary pressures? What would the minister do?
Hon. D. Eby: There are three scenarios. One is the event that government is made aware of the gap between benefits that are paid and the actual cost of the service, and government acts independently. In the event that government fails to act, there’s the CPI provision, which is intended to, at least, keep benefits paid within striking distance of the inflation and service-provider costs.
In the event that these two diverge and government fails to act proactively, the review is meant, functionally, to shame government. If government refuses to act, there will be a report created — that points out that unavoidably, by description of what it should look at, which is the amount paid for benefits and the actual cost of those benefits or the actual need for those benefits — to shame government into action.
If a government is shameless — it could happen, you know — these are the provisions that I believe were needed, are needed, to encourage governments to do the right thing and keep benefits up to date, so we avoid the situation we’re in currently where they haven’t changed for 25 years.
J. Yap: I appreciate that. However, it cannot be stressed enough the power dynamic that needs to be front and centre: the minister having final say over who is consulted and what is implemented. This could present itself, at least, as a conflict.
I appreciate that the minister feels this can work. But the minister is a shareholder for ICBC, which has a material impact on the budget of the province, which, unless it’s balanced, could affect the minister’s — whoever he or she is — total pay. So how does the minister ensure the best interests of the injured would be represented in these reviews — and those with what would be a vested interest — to keep the payments fair?
Hon. D. Eby: There’s no way to legislate common sense. We’re doing the best we can here to provide not one but two different safeguards to avoid the situation that we’re in, which defied common sense — that benefits for ICBC didn’t change for 25 years, that wage-loss benefits were set in 1993, that physiotherapy benefits were set in 1993 and didn’t change until…. We are going to change them now in 2018.
That someone who is rendered quadriplegic had a lifetime benefit of $150,000, which was wiped out shortly after buying a van and a chair so that they could just get around and then had no additional entitlement to benefits — these were shameful things. What we’re doing here is trying to put some safeguards in as best we can.
I agree with the member; it is not foolproof. Someone who wished to get around paying benefits to people who were injured in accidents at a level that’s appropriate for the market could do so.
But there is no way to legislate and make it mandatory, because even if you put that provision in here — and I’m not quite sure how you would define it and set it — they could just repeal it. Someone committed to the cause of denying people benefits could do that. I accept the member’s argument.
A. Weaver: I just had a couple of questions on this section to seek clarification. The questions are with respect to fees charged by health care providers or practitioners under three potential scenarios.
My question to the minister is this. Let’s suppose there are three people. One person goes to a health care practitioner, and that health care practitioner agrees to charge a certain amount that’s well within the fees, as prescribed under this act here.
A second one goes there and is willing to charge a little bit more. But the person actually has a benefit plan of some form that is allowed to step in or works with WCB or works with ICBC in some manner.
And the third goes to a physiotherapist, who decides that they’re going to get the service, but ICBC is only willing to pay a certain amount. They’re going to have to bill and charge the additional amount.
Is this covered in some way so there can be no additional billing, no additional attempts to tap into third-party insurances? What does this section do with respect to those health care practitioners who don’t agree to pay the price as set by this regulation?
Hon. D. Eby: In the first scenario, where the person goes in and the benefit level paid by ICBC either exceeds or is equal to the service charge, then obviously, there’s no issue there.
The second scenario. Where someone’s got a long-term disability arrangement of some kind or insurance of some kind that might top up benefits — so they go into the service provider and then there’s an additional charge — that would be dependent on the person’s insurance terms and whether they covered that kind of thing. It’s certainly possible that that could happen. There is no rule against that happening here.
In the third scenario, where someone goes in and the service provider is charging what could be called a user-fee or an additional charge on top of what ICBC will pay in benefits, we looked at saying, “No, you are not allowed to do that” — just to ban it outright in the act. The risk of doing that is that you may limit people from accessing the health care provider of their choice. We decided to leave it as, okay, ICBC will pay market rates, and then people can choose their provider. If they want to pay extra to go to practitioner X when practitioners Y and Z are charging at the ICBC rate, then they can choose to do that.
There are a couple of ways in which ICBC can encourage providers to charge at the market rate. One is direct pay, where ICBC pays the provider directly. It’s invisible to the individual who comes in for the appointment, and it’s much easier for the provider to administer. ICBC could easily say to someone who’s charging in excess of their rates: “Look, we’re not going to do direct pay with you, because you’re charging beyond what we’re willing to pay.”
The other is that ICBC can provide a list of providers that are offering services at the set rate in the area of the person who is injured in the accident, and in order for the practitioner to be on that list, they need to be at the rate set by ICBC. That’s a fairly significant stream of customers.
So there are a couple of ways for ICBC to motivate that through carrots. We looked at the stick, and we decided not to do it out of a risk that someone may be denied access to the health care practitioner of their choice because the health practitioner says: “No. We don’t do ICBC at all. We refuse to do that.”
A. Weaver: I just wanted to quickly follow up. I do note the hour. I would like to thank the minister for taking this approach of focusing on the patient as opposed to focusing on litigation. I do notice that that is a theme that we’re seeing through here, and we’ll be exploring this further at committee stage. The focus is on recovery and the patient now as opposed to litigation and getting funds after the fact, which is historical. There’s no comment here.
I do want to stand and note the hour and suggest that perhaps we would like to adjourn for the day and continue at some other time.
Hon. D. Eby: Noting the hour, I move the committee rise and report progress and ask leave to sit again.
Motion approved.
The committee rose at 6:49 p.m.
The House resumed; Mr. Speaker in the chair.
Committee of the Whole (Section B), having reported progress, was granted leave to sit again.
Committee of Supply (Section A), having reported resolution and progress, was granted leave to sit again.
Hon. M. Farnworth moved adjournment of the House.
Motion approved.
Mr. Speaker: This House stands adjourned until 10 a.m. tomorrow morning.
The House adjourned at 6:51 p.m.
PROCEEDINGS IN THE
DOUGLAS FIR ROOM
Committee of Supply
ESTIMATES: MINISTRY OF
MENTAL HEALTH
AND ADDICTIONS
(continued)
The House in Committee of Supply (Section A); S. Chandra Herbert in the chair.
The committee met at 2:52 p.m.
On Vote 35: ministry operations, $9,983,000 (continued).
J. Thornthwaite: To everyone, welcome back. I just have some follow-up questions from yesterday, and then I’ll be asking some new questions. I do have some colleagues that are coming in that were unable to come in yesterday because of the excitement that was occurring in the other House, but they’re not here yet. So I’m just going to carry on.
My follow-up from yesterday, and I do have the Hansard. The minister kindly provided this information. There were 800,000 visits to overdose sites, 5,300 reversed overdoses, 90,000 Take Home Naloxone kits, and 20,000 of those were reversing overdoses.
What I would like to know from the minister is if she has a cost breakdown on those numbers.
[R. Kahlon in the chair.]
Hon. J. Darcy: The member asked about a couple of cost breakdowns related to the overdose crisis. Out of the $322 million over three years that our government invested last September….
The member referred to 800,000 visits to overdose prevention sites and safe consumption sites. I want to just point out that that was a number as of the end of February of 2018. The numbers are rapidly increasing. I would expect that when we get the numbers for the end of March and then the end of April, we will see that number is going to go up significantly.
As I mentioned yesterday, we have committed $30 million over three years to the safe consumption sites and overdose prevention sites. I do want to underline that at many of these sites, at all of these sites, there are other services that are also provided. These figures refer to all of the services provided at all of those sites.
For naloxone, the member cites the figure that I referred to yesterday about the number of kits that have been distributed, which is in the vicinity of 90,000. She also mentions that we only know of 20,000 that have been used to reverse an overdose. I think it’s really important for the member to understand that with that many naloxone kits in circulation, they may well be being used to reverse overdoses. These are the ones we know about. If people have them in their families, if people have them amongst circles of friends….
These kits are now available. As the member knows, we’ve significantly expanded, through a partnership with the Pharmacy Association in British Columbia. We now have over 1,000 locations where people can get the Take Home Naloxone kits for free. That includes the overwhelming majority of community pharmacies, where you can now get a naloxone kit for free, together with a little training.
The fact that we only know that about 20,000 have been used to reverse an overdose does not mean that there could not be…. You know, I’m not going to speculate about the figures. Speculation is not a good idea when it comes to numbers, but it could be easily double that. We just don’t know. It’s a very good thing that there are that number of kits out there, because that means that people are in a position to help to save a life.
As far as the money that has been allocated in the budget update, in 2017-18, we added $2 million to the program, which is a program that is offered through PHSA. We added $2 million, for a total of $4 million. The same for 2018-19 — an additional $2 million provided to PHSA, for a total of $4 million. And for 2019-2020, an additional $2 million, for a total of $4 million.
J. Thornthwaite: That was just to confirm. So those figures were for the naloxone kits as well as the cost of the overdose prevention sites, or just the naloxone kits? I just didn’t understand the breakdown.
Hon. J. Darcy: Well, they were two distinctly different questions, and I answered with two distinctly different answers. One answer was in response to your question about overdose prevention sites and safe consumption sites. I repeated the answer that I gave to your identical question yesterday, which was $30 million over three years for all of the overdose prevention sites and safe consumption sites.
We also talked yesterday about how the number of overdose prevention sites has gone up from…. I think the number was 24, and it had gone up to 45. I can double-check that number, but it’s certainly in the Blues, the transcript from yesterday.
The question about Naloxone kits was a completely different question. I’m not understanding the member conflating the two questions, because they were two distinctly different issues, two distinctly different budget items, and I’ve given answers to both of those budget item questions.
J. Thornthwaite: Okay. Well, then I’ll just confirm this. For the 90,000 naloxone kits that have been provided in the pharmacies, that would be encompassed in the $2 million for PHSA and the extra $2 million for PHSA in the next year. Is that correct?
Hon. J. Darcy: The Take Home Naloxone program, which is what I referenced and which is what I understand the question was about, is administered through the PHSA, the Provincial Health Services Authority. I gave the figures for that already.
In September, our government, in its budget update, doubled the number that was being allocated to the Take Home Naloxone program. It had been $2 million annually previously. We increased it to $4 million. That is the figure for 2017-18 from our budget update, which was an additional $2 million over what the previous government had allocated. We also doubled it for this fiscal year and next fiscal year — so an additional $2 million, for a total of $4 million for 2018-19 and a total of $4 million for 2019-2020.
The member, I think, also knows — but just in case she’s not aware — that people can, of course, also purchase naloxone kits individually. Many people have done that.
We are making an enormous effort. In fact, we have literally doubled our efforts in order to get publicly funded naloxone kits out there, because we know that they make a difference in saving lives. It has, frankly, been really, really encouraging to see all of the different groups and individuals in the community who have taken up the challenge, who are providing naloxone training.
I’ve been so excited to know that the St. John Ambulance, for instance, which is one of the oldest charitable organizations in the world, has integrated naloxone training and distribution of naloxone kits in all of the training they do for first aid right across the province. We’re very excited about them taking up that challenge and about so many others doing the same thing.
J. Thornthwaite: Thank you for that clarification.
Moving on, on the naloxone. I’m wondering if the ministry has any record of people that were revived but suffered brain damage. I have a report here from St. Paul’s Hospital that they’re seeing more cases of hypoxic brain injury linked to drug overdoses, and they have documented that it costs about $5,000 a day to care for someone with brain damage.
We didn’t get any clarification on if the ministry is tracking those numbers, of those that have been revived from naloxone but are still in hospital because of serious brain damage. Does the ministry have those numbers available?
Hon. J. Darcy: Certainly, people who are working in the field of addictions and the overdose crisis are aware that there are people who have short-term, medium-term and long-term health consequences from overdoses. Our provincial health officer, Bonnie Henry, is working with a research team of ICU clinicians in order to look at the health impacts of overdose. That’s certainly very important work that’s going on.
We also know…. The member may have seen this. If not, I’m happy to forward it to her. There was a report that was out — I think it was just last week — that indicated that there are significant numbers of people who overdose, are revived with naloxone and don’t have to go to hospital. That’s, frankly, because people who are working on the front lines — whether they’re working in the overdose prevention sites or safe consumption sites, whether it’s people in health care and community agencies or whether it’s our first responders — are doing a remarkable job at reviving people — and reviving people quickly.
So there are more people who are not having to go to hospital than there were previously, which is good news for those people, those individuals. It’s also good news as far as the pressure on our emergency rooms.
I think the question that the member asks really underlines a couple of things. It underlines how critically important it is for us to be investing in both saving lives with naloxone and having more people trained with naloxone, in order to be able to revive people more quickly. It’s because the sooner that people are revived and the sooner they receive care, the less likely they are to develop short-, medium- or long-term health consequences.
It also especially points to the importance of treatment and the initiatives that we’re taking to connect people to treatment as quickly as possible. Now, I say that in context. We spoke about this yesterday. I know the member doesn’t like it when I talk about this, but the reality is that we do have an addiction treatment system that is inadequate. We need to strengthen that addiction treatment system all the way along the line. That is a central commitment, central to the mandate of our ministry: to do that going forward.
Having said that, through the work of the overdose emergency response centre, through the work of our first responders…. I mentioned this; I’ll repeat it. Yesterday I indicated that our first responders are now increasingly in a position themselves to be able to refer people for treatment, not just by taking them to the emergency room but after they revive people, we hope.
This is part of the conversation that I recounted yesterday, of meetings that we’ve held under the auspices of the overdose emergency response centre — meetings that involved ambulance paramedics, that involved police, that involved firefighters. They are very, very eager and are already becoming engaged in not just reviving people from an overdose but being involved in referring people to treatment. That’s good news, and it’s a commitment that our government takes very seriously.
J. Thornthwaite: Yes, thank you for that.
How many people…? If the minister could indulge me, does she have a record of the people that did actually go to treatment, after being revived by a first responder that saved the person with naloxone? Then, if she does have any records, how many people were sent to hospital?
Hon. J. Darcy: I’m assuming that the member’s questions are coming from a place of believing that it’s a good thing to connect people to treatment as soon as possible, which I’ve indicated many times is a major objective of the work that we’re doing at this stage.
I will repeat what I said yesterday. I think three or four times yesterday — but let’s try it a fifth time and see whether it works this time.
Safe consumption sites and the overdose prevention sites. We have the figures about how many people have visited. In the case of overdose prevention sites, 800,000 visits. At these sites, over 5,300 people have had their overdoses reversed, and zero deaths have occurred.
What I did explain several times yesterday — and I hope that the member appreciates the reasons for this — is that these sites were created for a particular reason. They were created — I can get out the reference, but it’s in Hansard from yesterday — in order to provide a safe place where people can consume drugs and where there are staff and volunteers who are able to use first aid and naloxone in order to be able to reverse an overdose, to give them the health support they need if they need it.
Because of the tremendous stigma that surrounds the use of drugs and the use of illicit drugs, which the member is very familiar with, these sites do not collect identifying information. They don’t collect identifying information. If they did, there would be far, far fewer people who visited them, and there would be far fewer overdoses that were reversed at these sites. That’s all about stigma.
We are very committed, as a government. I think the whole province of British Columbia knows about the work that we’ve done and will continue to do to try and break down the walls of silence to overcome stigma so that people are willing to have courageous conversations with their friends and loved ones and co-workers who they believe are using drugs so that people are more willing to seek support and to seek help to deal with their addiction. But the reality is that stigma is still enormous, and if these sites were forced to collect identifying information, it would be a barrier, and we are trying to remove barriers in order to save lives and connect people to treatment.
Part of the reason why the public health emergency was originally declared was so that, at a provincial level, through the provincial health officer, we would be able to collect data population-wide in order to really dig down, in order to have more robust data, but also to be able to analyze that data and in order to use it to guide and to help to inform how to prevent overdoses in the future. That work is happening, but it is at a population level. It is not by overdose prevention site or by safe consumption site for the reasons that I have already referred to.
I do want to underline again the significant increase in the number of medical practitioners who are now offering opioid substitution therapy. The numbers, as of the end of February: there was an 80 percent increase in the number of providers prescribing opioid substitution therapy.
Those numbers will already have gone up by now, in part because nurse practitioners, 107 of 450 nurse practitioners, have already either begun or completed the training. The guidelines were revised by their college in order to enable them to do that. And as we also indicated yesterday, and this is very good news, we’ve seen a 164 percent increase in new people on opioid substitution therapy.
J. Thornthwaite: I know the minister appears frustrated that I keep asking the same questions. The reason why I’m asking the same questions is because I’m not getting any answers. So I’m going to ask my question again.
I know the number of visits. We have said that numerous times. What I’m trying to get to the bottom of is how much this is costing. If the ministry is not identifying people…. I’m not asking for the names of people; I’m looking for the numbers. I want to get an idea of how much it is costing. Surely you must have in a budget…. You surely should have access to the numbers.
The minister mentioned the term “data.” Well, if the public health emergency provision that was introduced by our government in 2016 was designed to collect more data, where is the data from 2016 to 2018? There must be some data out there that can tell us the numbers of people that are visiting these sites.
Then I did ask and did not get an answer about how many people are ending up in hospital. They were revived but did not get help, obviously, quick enough so they’ve ended up in hospital with possible brain damage.
The minister also reiterated what she said yesterday, which is fine: 80 percent more of providers prescribing opioid substitution therapy and a 28 percent increase of people on opioid substitution therapy. Again, what I’m trying to get to is the cost: “A 164 percent increase of new people on opioid substitution therapy.” I got that from the Hansard.
What is the cost of all of these increases? That’s what I’m asking.
Hon. J. Darcy: Chair, I’m not sure what the member is trying to find out that we have not already shared with her. Let me go back to something that I said yesterday.
The previous government declared a public health emergency, absolutely, and a number of initiatives were taken, including the creation of safe consumption sites and overdose prevention sites, through ministerial orders. However, there was a serious problem in the adequacy of the funding in order to support those programs. Health authorities were, correctly, directed to do various things but, in many cases, were asked to do it within existing budgets or off the side of their desks.
When we took a look at the budgets of health authorities, when we took a look at the commitment that we’d made to escalate the response to the overdose crisis and we heard from health authorities, they shared with us — this is all in the Hansard yesterday, so I won’t repeat the numbers — the enormous cost pressures they were experiencing as a result of unfunded programs, additional programs that they were being expected to provide in the overdose crisis but had not received additional funds for.
So we looked at their existing cost pressures, we looked at the new initiatives that we needed to take, and we looked at the programs that were in place that needed to be increased. Looking at all of those things, we allocated, in the September Budget Update, $322 million over three years, the majority of that to respond to the overdose crisis — not all of it, but the majority of it.
Now, we’ve already provided to the member the costs that we have allocated for the cost of the overdose prevention sites and the safe consumption sites. I could read those into the record for a fifth time if the member wishes that, but it doesn’t seem to me that it’s the best use of anyone’s time.
We have already provided the costs of the naloxone program. There was some funding that had been allocated there, $2 million a year. We doubled that funding in each of the three years. That’s why we’ve been able to see a significant expansion in the distribution and the use of the Take Home Naloxone kits.
We have given the number of visits to safe consumption sites and overdose prevention sites. Yesterday and again today I’ve reiterated that the number of OPSs, overdose prevention sites, for instance, went up from 24 to 45 since September. I’ve reiterated the number of visits that we’ve had to overdose prevention sites. Hon. Chair, if the member wants me to keep repeating the same figures I’ve already read into the record, I’m happy to do that. But it’s really not at all clear what it is the member is trying to get at.
Surely the member shares our belief, the belief of our government — and, I believe, the belief of the majority of people in British Columbia — that it is critically important that we have invested both in harm reduction, in saving lives, as well as in moving towards building a system where we can prevent these overdoses from occurring in the first place but, in the short term and the medium term, after we save someone’s life, to be able to connect them with treatment as rapidly as possible.
We are working to do that; we are working overtime to do that. Again, there is literally an army of people — in agencies, in health care facilities, first responders, volunteers on the front line — who are throwing their heart and their soul into doing this every day, and we’re providing the financial support to be able to do that.
J. Thornthwaite: I’m not going to dwell on this. I’m still at a loss as to what the numbers are. If somebody is revived, how do they get into treatment? How many people have gone to treatment? What kinds of treatment options are there? On these sort of things, I was looking for numbers, but I’m obviously not going to get it.
Anyways, I’m going to move on. My question is about the nasal spray, the Narcan. I’m wondering if the minister is familiar with that version of naloxone and if that’s being made readily available. I understand it’s quicker and works faster and is simpler to use. I’m just wondering if the minister is familiar with that version.
Hon. J. Darcy: In answer to the first question, yes, of course I’m familiar with the nasal version of naloxone, of Narcan, as, of course, is our entire team. Dr. Bonnie Henry, our provincial health officer, is part of our team here today.
Through the B.C. Centre for Disease Control, clinicians have done a review and are continuing to review the use of naloxone, the injectable naloxone. We have had very good success.
I think all of the figures that I’ve referred to so far indicate that we’ve had very good success in the province of British Columbia with the use of injectable naloxone. We have thousands of people who have used it already. The clinical evidence is that it is rapidly effective when it’s injected into the body, and in fact, the injectable naloxone is a fraction of the cost of the nasal form of naloxone, to the tune of $75 to $3.
It’s also, I think, important to note that thousands of people have received training on injectable naloxone. There has been a very, very aggressive program in the province of British Columbia in training people. More people are being trained all the time. That’s a good thing. They’re being trained on the injectable naloxone. To do the training all over again on a new form would certainly be a challenge. We want to build on the successes that we’ve had.
There is some evidence, from the work that’s been done, that the nasal naloxone, nasal Narcan, is not as effective in some cases. Again, this work is continually being reviewed, but the evidence so far is that we’ve had very good success with the injectable naloxone and that it is a very cost-effective means of saving lives.
J. Thornthwaite: Just to follow up on that. My understanding is that…. Again, we canvassed this fact yesterday. Given that the majority of people that are dying alone and at home are the general public — in other words, they don’t have the access to first responders that they would have at an overdose prevention site — it would seem that it would be easier to have a nasal variety available for the general public, as opposed to having to train the general public. Of course, the general public is not getting trained. It’s the first responders and the people that are in the business that do.
My question is: wouldn’t it be simpler for the general public to get access to the nasal version so that they could get the drug into the person’s system quickly and more efficiently without having to be trained?
Hon. J. Darcy: Well, the member may not be aware, but for the nasal version of Narcan, of naloxone, you actually still do need training.
The member referred to it only being first responders or people who work directly in the overdose response who have been trained, but that’s actually not the case. Thousands of British Columbians have been trained. Thousands of members of the general public have been trained on the use of injectable naloxone.
There are events at which training happens. You can go to your community pharmacy, and when you ask for a naloxone kit, you receive training on the spot. There are videos on line, short videos. So training is widely available, and we are making that training even more widely available.
I mentioned St. John Ambulance, which is really doing a remarkable job and is going to include this in all of the first-aid training that they’re doing. But on this and on every other health intervention, we take our advice from the clinicians. We take our advice from the experts. This is a health intervention. This is not a question of the opinion of anyone in the ministry. We are acting on the advice of clinicians. Whether that is our chief medical officer for the province or the B.C. Centre for Disease Control, we take our advice from them.
Injectables have been found by the clinicians, and evaluated, to be highly effective. The naloxone is rapidly absorbed into the system. As I’ve mentioned already, thousands of British Columbians have already been trained on it. It is a health intervention. This particular health intervention is considerably less expensive than the nasal version.
J. Isaacs: In the fall session of the estimates, the minister stated that she was working, or the ministry was working, with colleagues across government to develop a comprehensive strategy for mental health and addictions for the province.
The minister mentioned the Ministers of Health, Children and Family Development, Education, Housing, Poverty Reduction, Public Safety and Indigenous Relations and Reconciliation. The minister also mentioned working with community service agencies and local governments, federal governments, First Nations and, more importantly, people with firsthand experience accessing the system or people who are supporting loved ones within the system.
I’m just curious. My question is: what progress has been made so far in developing the comprehensive strategy? Is the minister meeting with groups in individual meetings or conducting round-table discussions? Just what has been the strategy so far, from the meetings, documenting the issues and identifying any gaps that need to be addressed?
Hon. J. Darcy: Well, I really appreciate the opportunity to talk about the consultation I’ve been involved in and the early actions that our government is taking.
From day one — we were sworn in on July 18, and after we got our first little training about what it means to be a cabinet minister, and found the way to the washroom and that kind of thing — I hit the road and have been touring the province at every opportunity, talking to people on the front line. And by front line, I mean people who are involved in delivering services and care on the front line, whether that’s in mental health, addictions care, the overdose crisis.
Also, talking to families and to individuals with lived experience because I have always believed that we learn the most about what’s working, what isn’t and what needs to change from people who are directly involved in the system itself, on the front line — again, whether that’s people or families with lived experience or whether it’s people delivering services.
In that time frame — I’m not able to give you a number — I have met with literally hundreds of organizations in the course of that time, thousands of individuals as well. And that’s just one thing — consultations, discussions, meetings, strategizing — that I’ve been involved in. If you talk about our amazing team in the ministry, we could multiply that many times over, because they’re engaged with many more people that I’m not in a position to meet with directly.
In October we held an engagement session where we had 70 different organizations represented, and these were people across the entire range of organization stakeholders involved in mental health and addictions. It was a very successful initial engagement. Over the last couple of months, I’ve begun….
The House is sitting, so the time is limited to do this. We’ll be doing it more intensively when the House isn’t sitting. We have a series of round tables that are very targeted in order to try and really dig deeper in some specific areas in order to understand the needs going forward — what the gaps are and what the needs are.
In all of this engagement, I’m asking people what’s working, what isn’t working and what needs to change. We certainly plan to build on what’s working, and we plan to change what’s not working, and we plan to be bold and innovative in order to build that better system of mental health and addictions care that British Columbians deserve.
We are also, of course, reviewing the experience in other jurisdictions. Our staff are hard at work, looking at and evaluating what’s working in other provinces and territories in Canada and also looking at what’s working around the world and really trying to distill that and learn the lessons from that so that we can take the best practices from elsewhere and make them part of the plan for mental health and addictions going forward.
The member may also know that there are — I can’t tell you how many — shelves full of reports and reviews and analyses that have already been done on mental health and addictions care in British Columbia and on child and youth mental health. So, of course, we’re not trying to reinvent the wheel. We’re going back, and we’re examining very carefully what those previous reviews and reports have found and what their recommendations are.
All of that work will inform the plan for child and youth mental health that we are working on and will be released in the fall, and all of that work will also inform the overall mental health and addictions strategy that we will also be bringing forward next year.
I also want to underline…. I don’t know how many days we have. I think we only have maybe a few hours, but I’m in your hands. I don’t know if the member really wants me to go through everything I’ve heard about the gaps in the present system — I don’t think so — but that’s the work that we’re doing.
We are identifying those gaps, but we’re also working on solutions, and we’re working across government on immediate actions that we can take now. We’re not waiting. Our watchword when we go out and do public engagement and consultation is “Listen, learn, and act.” We are doing all of them at the same time, and that includes acting.
The areas in which we’re taking immediate action are what I’ll refer to as sort of building blocks for transformational change. We know we need to transform the system to have that seamless, coordinated system of care where you ask once and you get help fast and where every door is the right door. But in order to get there…. If there are things we can do now, we are acting on doing those things.
Some of the most important things that we’re doing, really, are about upstream investments, about action upstream in order to prevent future problems. I’m very, very proud of the work that we’ve done in the area of housing, for instance, and homelessness. As I mentioned yesterday, the overwhelming majority of the new projects to alleviate homelessness are both providing a roof over people’s heads and some sense of hope for the future and also mental health and addiction support services, as well as other social supports. That’s an integral piece of the puzzle. When I say we’re working across government, a whole-of-government approach, that’s what that means.
I’m very proud of the action that we took around youth aging out of care, because we know that youth aging out of care are a group in the population at extremely high risk, not just of mental illness but also of developing addictions. So we’ve offered significant new support and investment to youth who are aging out of care. That’s absolutely about upstream investment — also providing free tuition for post-secondary education for youth aging out of care. Again, it’s about dealing with the whole person — an all-of-government approach that is about preventing these problems down the road.
Child care, a bold initiative. It’s the first new social program in this province in a generation. That’s not just about providing more affordable child care and moving bold steps towards universal child care in this province. It’s also very importantly providing really important supports for kids at risk so that children at risk, children of different socioeconomic backgrounds, have the same opportunities to succeed in life as other children do. Again, that’s a really, really important piece of the puzzle.
I spoke yesterday, and the Minister of Health has spoken extensively, about the patient care networks that we’re developing. We think that having support for people living with mental illness and addiction is connected to those patient care networks, is absolutely critically important. It also reduces the stigma. It’s about improving access to care.
Finally, the issue of working with Indigenous people. The mandate of my ministry, as is the mandate of every ministry in our government, is to work in close collaboration with Indigenous people on reconciliation, on implementing the Truth and Reconciliation Commission calls to action and the United Nations declaration on the rights of Indigenous people. So we’re embedding that approach in everything that we do.
Our partnership with the First Nations Health Authority and the First Nations Health Council, I think, are a very good indication of that. We’ve allocated an initial $20 million over three years to working with the First Nations Health Authority on traditional healing, on land-based programs, on programs that are really about reconnecting with culture, family, community and the land and using a combination of traditional healing and western medicine.
We’re also developing our partnership with Métis Nation B.C. and with Aboriginal friendship centres, and we will be developing more actions around that. And we’re working together with the First Nations Health Council and the federal government on developing a tripartite ten-year plan for mental health and wellness.
J. Isaacs: Thank you for that information. It’s great that you’re working with thousands of people and hundreds of people individually. That’s perfect.
A group had come to my office to speak with me by the name of Vancouver Native Society. They’ve been doing outreach work in the Downtown Eastside since 1990. They have a medical clinic downtown, a dental clinic, HIV education, drop-in early-years child care. In addition to delivering all of these types of services, they also have an outreach on the streets of Downtown Eastside.
Fifty percent of their workforce is First Nations people, which, as the minister is aware, makes a very significant difference when you’re trying to build relationships with First Nations. There is that cultural component, as the minister spoke about, and the respect for elders and a complicated history that needs to be addressed.
I’m just wondering if the minister has met with Vancouver Native Society and how the decisions are being made as to determining who the stakeholders should be at the table.
Hon. J. Darcy: I wonder if the member could clarify. The member referred to Vancouver Native Society. There are a number of societies, including in Vancouver, that have those words in them. There is the Vancouver Native Health Society. There is a native youth society. There are a number of different societies. Which society, specifically, is the member referring to?
J. Isaacs: It’s on their business card, and the information that they gave me when they came to my office was Vancouver Native Society. I can’t give you any more information other than that. As I understand it, they have been requesting a meeting, and they haven’t had a meeting. They feel like they’re pretty important stakeholders. As I said, they’ve been there since 1990, providing a wide range of services. They have built a lot of relationships over the years. Fifty percent of their staff is First Nations.
They want to be a part of this discussion and at the table, and they’ve been trying to get a meeting. That’s why I was wondering how the decisions are being made as to who would be at the table and, if you hadn’t been aware of them, if that is a group that you’d be willing to meet with.
Hon. J. Darcy: I certainly appreciate the member raising the question. I’m not personally aware of a request from that organization, but I will look into it. Thank you.
J. Isaacs: I thank the minister for following up with this group.
In developing this comprehensive strategy, though, for First Nations, I’m wondering if the minister could advise if there is a separate strategy or a separate approach for First Nations who are living on reserve versus First Nations that are living off reserve.
Hon. J. Darcy: Thank you to the member for her question. I want to be clear that whatever programs we are developing that affect Indigenous people are being developed in partnership with Indigenous people. By that, I mean both urban and on reserve. I mean Métis people. I mean Inuit people — so Indigenous people in the most encompassing sense, of course. Whatever we do will be developed in partnership with them.
We are working very closely, as I mentioned already, with the First Nations Health Authority. We are working very closely with the First Nations Health Council. We are working on developing a ten-year plan for mental health and wellness proposed by the First Nations Health Council, which they hope to be a tripartite agreement between the federal government, the provincial government and Indigenous people, Indigenous organizations in British Columbia.
The approach that we’re taking to all of this — an approach that is consistent with the calls to action of the Truth and Reconciliation Commission and on implementing UNDRIP — is the approach that says: “Nothing about us without us.”
J. Thornthwaite: I’m going to just change the tack right here. The minister is very well aware of the incidences of illicit drug overdose in youth. We know, according to the February 28, 2018, coroner’s report, that in 2018, there were two children between the ages of ten and 18 that died. We do know that there’s been, unfortunately, another one since then.
My question to the minister is very, very simple. I wanted to know whether or not she’s going to bring forward the Safe Care Act.
Hon. J. Darcy: I have, as I mentioned, from day one, been speaking with people with lived experience. That includes family members. I have met with the parents of Steffanie, from Squamish, who died of an overdose. I have met with the parents of Elliot, from Oak Bay, who died of an overdose. I have spoken on the phone or in person with many other parents who have lost their kids. I’ve had a round table specifically of family members who have lost their children or other loved ones to overdose or to suicide.
I fully appreciate, as the Minister of Mental Health and Addictions and as a mother, that parents and family members are searching for solutions.
Their stories are absolutely heartbreaking. When I meet with them, I ask them to share their son’s or daughter’s or brother’s or sister’s journey and what got them to this place that they ended up overdosing. To a person, those family members have described heartbreaking journeys, disappointing journeys, frustrating journeys, as they tried to make their way through a system for mental health and addictions that has huge challenges and huge barriers to getting the care that their kids need or that their loved ones need. That has been the case with every single family, every single parent I’ve talked to.
I seek out these conversations with parents. If they call our office, if they email us to tell their story, we call them back so that we can have direct conversations with them.
The stories vary, but there are certain common themes. Those common themes are that they have sought help repeatedly. They have felt on their own, as parents seeking that help and finding that help, that there isn’t a system where there’s anyone responsible for coordinating the care for their kids and that it all comes back on families.
They have said to me, with their voices breaking and with tears coming down their cheeks, that when we talk about people on the front line, and when we talk about first responders, family members are the first responders, and we should recognize that. We should give them the supports that they need by building a better system for mental health and addictions and, in particular, supporting them to be able to access the care that their loved ones need.
Now, I can go through chapter and verse about what some of them have shared with me. I have shared some of it in the Legislature when I’ve been asked this question.
In the case of Steffanie from Squamish, she was in detox, and she was angry. After a few days, they sent her back home, back to her parents. Was there a system that said to Steffanie or to her parents: “Here’s where you could go instead”? Was there a detox program that understood? Of course she was angry. She’s detoxing. She’s living with an addiction. No, there wasn’t.
Other parents in the round table that we had described that their child was in a treatment program for addiction, but this child was also dealing with a borderline personality disorder. When it was identified that that was going on, so there was a dual diagnosis, “Sorry, that’s not the right program for your child. Take your child home and start all over,” in most cases.
We have serious, serious challenges with our voluntary system of mental health and addictions care in order to support these children — in order to support adults, as well, but, in particular, to support children.
So we are working hard, and we will be bringing forward a plan for child and youth mental health. We will be doing our utmost and taking the best advice from people on the front lines and from family members about how we build a better system — for addictions care, in this case — where people and kids do have access to the care and the supports that they need, many of the supports which are not in place now.
We will be having a big emphasis on prevention and early intervention — starting with kids in our schools and building on the Foundry model. It’s a great model, and we believe that we should build on what works as well as identifying what isn’t working and changing what needs to change.
We’ll be building that plan in partnership with the Ministry of Children and Families, in partnership with Health, in partnership with Education, in partnership with all of the relevant ministries in order to build that better plan. And we will be looking at the recommendations of the Representative for Children and Youth that dealt with issues like the step-up, step-down kind of care and the incredible inadequacies that exist in that system now.
As part of developing that plan, we will also be reviewing all legislation and all policies that can potentially impact on children at risk and youth at risk of overdosing. We will be examining the experiences of other jurisdictions, other provinces in Canada and other jurisdictions elsewhere, and any decisions that we make in the future…. When we are looking at the Mental Health Act, when we are looking at the issue of secure care, any of the decisions that will be made, will be made based on evidence of what is in the best interests of the safety of children.
J. Thornthwaite: I’ll take that answer as a no. But thank you for the answer.
I have another question, and it’s about pharmacy-grade injectable heroin that has now come available. I understand that there are going to be plans to expand it. So I wanted to know: how much is this going to be expanded? I know there was a figure that was quoted by Dr. Patricia Daly, but how many people is this drug supposed to or planning to be helping? And where will the drug become available?
Hon. J. Darcy: Before I get to that question, I just want the record to be very clear.
The member said that my answer was no. My answer was…. We can read back on the record of the transcript afterwards, but what I said was that as part of developing our plan for child and youth mental health, which we will be developing in partnership with other ministries and which we will be developing looking at the best evidence and the experience of what works and what doesn’t in other jurisdictions, we will also be looking at all legislation and all policy that could impact children and youth at risk of overdose. And the decisions that we make about legislation — whether that would be the secure care or whether that would be the Mental Health Act, or, potentially, other legislation — all of that will be guided by the evidence about what is best to ensure safety for our kids.
The treatment that the member refers to, which is the diacetylmorphine, an injectable opiate agonist treatment…. The member is probably aware — if not, she should be — that this treatment is already available in British Columbia. It is a legal pharmaceutical that is used for extreme pain — cancer patients, for example — and it has been used at the Crosstown Clinic in Vancouver for a number of years. We need to provide as many treatment options as possible for people with opioid addiction because we know that people have different pathways to hope and to recovery. Opioid agonist treatment is the first line of treatment for opioid use disorder.
[N. Simons in the chair.]
We understand — and this is based, again, on clinical evidence, based on the advice of clinicians — there’s a small population of people for whom traditional opioid substitution therapy options don’t work. For these people, we have been offering injectable formulations of opioid substitution therapies. All regional health authorities have submitted plans for implementation of injectable opioid agonist therapy and identified different approaches for using this. Some of those approaches are feasible for current and immediate expansion, and work is underway to support other models.
We are committed as a government to expanding access to injectable opioid substitution therapy for those who need it to prevent overdose and overdose death. Again, this is a small number of people who are living with opioid addiction for whom this is the recommended treatment. There are other forms of treatment that are far more widely in use to treat people with opioid addiction.
J. Thornthwaite: My question remains unanswered. How many people are planned to be offered this form of treatment, and where would they access their treatment?
Hon. J. Darcy: Can the member clarify if she’s referring to access to diacetylmorphine or if she is referring to access to injectable hydromorphone?
The Chair: Through the Chair, Member.
J. Thornthwaite: The injectable.
Hon. J. Darcy: They’re both injectable. So which is it — injectable hydromorphone or injectable diacetylmorphine?
J. Thornthwaite: Sorry, both.
Hon. J. Darcy: Just for clarity, in February 2017, the B.C. Centre on Substance Use released a provincial guideline for the clinical management of opioid use disorder — opioid addiction. They recommended Suboxone, otherwise known as…. No, I’m just going to say Suboxone, because the name is long and complicated. Suboxone as first line of treatment, methadone and then slow-release oral morphine as first-, second- and third-line treatments for opioid use disorder.
Again, this is not a government decision. This is not a decision that’s made by the ministry or by politicians. These are the guidelines that have been developed for the B.C. Centre for Substance Use, established under the previous government, who are really world leaders — certainly leaders in Canada, and respected worldwide for the work that they’re doing in the area of substance use and treatment for opioid addiction.
As I’ve already said, it is actually a small number of patients who are using injectable opioid agonist therapy. It is not the first line of treatment. The decision about which treatment a patient will be receiving is a decision that is made between the clinician and the patient, as are all other decisions about health interventions. Not a decision made by government but a decision made between the health care practitioner and the patient.
We think it’s important, and the B.C. Centre for Substance Use guidelines have indicated that it’s critically important, that there be a variety of treatment options that are available and that it include injectable opioid agonist therapy — namely, injectable hydromorphone and injectable diacetylmorphine. Today, there are 225 patients in the province of British Columbia who are receiving injectable opioid agonist therapy, that being either injectable hydromorphone or injectable diacetylmorphine.
J. Thornthwaite: Where do the patients access?
Hon. J. Darcy: Currently, these therapies are only available in Vancouver through the Crosstown Clinic and through a community pharmacy for patients under the care of physician.
J. Isaacs: We know that one out of five people will experience some kind of mental illness during their lifetime. Of course, there isn’t any restriction as to how young a person is and, at the other end, how old a person may be when they experience some mental health challenges. They could have developed a mental illness early in their life, or it could be a lifelong illness, or they can have an illness much later in life.
I’m just wondering what the minister’s steps might be in addressing the issue of residents who are in seniors care, who are, first of all, being placed into a home, and then second of all, who may already be in a home and develop mental illness during their stay at the home. I’m just wondering how these issues are currently being dealt with and how the decisions are being made as to how to deal with these situations.
Hon. J. Darcy: Thank you to the member for her question. Yes, I’m certainly aware that there are many seniors living in residential care who are dealing with mental health issues — a wide variety of mental health issues, a number of different challenges.
I certainly know from the work that I’ve done previously in advocating for improvements to seniors care that…. I don’t have the figures at my fingertips, but I know that the Ministry of Health would. We do know that over a number of years, we have seen far too many seniors…. This has certainly been in reports prepared by the seniors advocate and released publicly over the years. The number of seniors who are on antipsychotic medication who don’t have a diagnosis of a psychosis has been alarmingly high. The number of seniors who are on antidepressants who don’t have a diagnosis of depression. Those are just a couple of examples.
We do know that there is a very direct link between the quality of life that people have, the quality of care that they are receiving in seniors care, and their mental health and their well-being. It’s one of the very important investments that our government has made, which the seniors advocate has called for, which we certainly called for in opposition and which the Ministry of Health is now acting on.
Shockingly, in 90 percent of care homes, the ministry’s own guidelines of 3.36 hours of care were not being provided. In nine out of ten care homes, that care level was not being provided, so that’s one of the really significant actions that the Ministry of Health is taking.
I don’t think there’s any question that that means the bedside care, the attention — not just doing the fundamentals of the care but including the caring part of caring, the relationship building, the relational care, as it’s referred to in health terms…. There will be a far greater capacity for that to happen in care homes — more recreational therapists, more recreational assistants, activity workers. All of that plays a really significant role in the mental health and the well-being of seniors.
Other questions related to seniors care I would suggest be directed to the Ministry of Health.
J. Tegart: It’s a pleasure to be here this afternoon to ask a question in regards to concerns in my area around mental health support.
We, of course, were flooded and experienced incredible fires last year. What we’re seeing is people coming to grips with that as we go into the next season of flooding and fear about our fire season for the next year. A number of times we were promised that there would be additional support for mental health in the region.
My question to the minister is: could you outline the kinds of extra support that are available in my riding, the riding of 100 Mile area and Quesnel, to support our people who have gone through an incredible experience and are looking now for that kind of help?
Hon. J. Darcy: Thank you to the member for her question. Welcome to estimates.
First of all, I do want to recognize and acknowledge the issue that the member raises and recognize that mental health certainly is paramount to rebuilding the strength of a community, the resilience of a community, and is really essential to economic recovery as well. I certainly appreciate her work and her advocacy on this issue.
The province has been working closely in collaboration with CMHA B.C., the Canadian Mental Health Association, with the First Nations Health Authority, with Interior Health Authority, with the Cariboo Family Enrichment Centre, the Canadian Red Cross to raise awareness about the supports and programs that are available to people to address the wildfire impacts on people and communities. This campaign is one that certainly recognizes the feelings of stress and anxiety and fear and depression that may have resulted from the devastating fires of 2017.
We are also very well aware that as the season approaches again, those feelings can be revisited. Very often on the anniversary of a very disruptive experience in someone’s life, those things can very much come to the fore again, so this is not about a one-shot deal. This is about ongoing support.
We very much want to let people know through the programs that they’re not alone and that there are a variety of mental health and substance use supports in place available to them at the community level, on the ground and on line and to know about those supports to help them through their healing journey.
There are three mental health and wellness community working groups that have been established — in Ashcroft, in Williams Lake and in 100 Mile — since September 2017. They include representatives from government ministries, which provide mental health and wellness and social supports. They have representatives from Interior Health, First Nations Health Authority, community policing, not-for-profit organizations, Indigenous organizations, First Nations leadership and local school districts. So they really are about, as you know, the community coming together.
A fourth community working group is being established in Quesnel this spring. My note here is a few weeks, maybe a little…. It may already be in place but certainly being established this spring.
I mentioned already that we are working on all of this in close partnership with First Nations and with Indigenous communities.
Many communities in the Interior are already accessing psychological first-aid training, which provides a very practical framework for supporting people impacted by devastating events like this. Those include Clinton, Ashcroft, Williams Lake, Quesnel, Anahim and several sessions that have happened in Kamloops and two in 100 Mile.
In addition, the Ministry of Health has authorized the transfer of over $1 million from the First Nations Health Authority to the 28 impacted First Nations communities to support the initial wildfire recovery mental wellness supports and planning for the future.
J. Tegart: Thank you for that information.
I’m particularly interested in what the capacity is versus the demand right now. We have just today met with the Red Cross, talking about the cycle that we expect to see as people experience, again, flood and fire.
Another figure that I’d be very interested in knowing is the dollar amount in your budget this year for increased services that we expect to see from the victims of the fire.
I would just follow up that it’s great that we see $1 million committed to the First Nations Health Authority. Are we seeing a similar commitment elsewhere?
Hon. J. Darcy: The member is probably aware, but just to clarify, the Ministry of Mental Health and Addictions doesn’t actually deliver services. This is a question…. You’d need to get the answers from various ministries that do deliver those services.
In the case of mental health services and services related to recovery, those services are delivered by the Ministry of Health and, as you know, by the emergency recovery programs under the Ministry of Public Safety and Solicitor General. We certainly do acknowledge — well, we’re already into flood season — as we get closer to more floods and into fire season again, that that can be traumatizing for people and re-traumatizing for people.
I had a briefing recently from the people who work in the Ministry of Health and who were working in this area. Working together with Interior Health and with MCFD — because those are the agencies that deliver these services — they’re really trying to learn from what worked and what didn’t, what the inadequacies were, what we need to do in the future to improve the supports that we provide for people.
I know that they have already developed materials for wide circulation, so that people know where to turn for help about what services already exist, as well as putting in place plans for expanding those services going forward.
J. Tegart: To the minister: I want to thank you for the answers. I find it curious that we can announce $1 million for the First Nations Health Authority, yet not share what the dollars are for the others in the area, but I will ask at Health. We’re looking to see what the commitment is in dollars for increased services, because we know that’s going to be happening.
I’d also like to express my appreciation to the people on the ground. They’ve done an excellent job, and I know that everyone’s tired. Thank you very much, and please send my appreciation to your staff.
Hon. J. Darcy: Thank you so much.
J. Isaacs: Chair, I just want to make a correction. Earlier I said that the group that had contacted me in my office was Vancouver Native Society. I just looked in my notes and in my photos, and it’s actually Vancouver Native Health Society. So I apologize for that difference.
However, they still would like to meet with the minister. I have their contact information and can pass that on to you afterwards.
The Chair: Thank you, Member.
J. Thornthwaite: I have a question about licensing. I’m wondering whether or not that would be a Health question.
Hon. J. Darcy: With the greatest respect, perhaps you could share the question first, and then we would know.
J. Thornthwaite: It’s actually a mental health and addictions facility that had requested licensing and were rejected for some reasons that I’ve got here. I had some questions as to the criteria of evidence-based individualized programs, which is one of the reasons why they were rejected.
My question is: what are evidence-based individual programs? If she could explain what that is, because this facility did not get an explanation on that.
Hon. J. Darcy: That would be a question better directed to the Ministry of Health.
J. Thornthwaite: I have just a few more questions. I think we’re going to wrap up probably in the next 15, 20 minutes. One of the questions was: does the minister or the ministry have any stats on overdoses with methadone?
Hon. J. Darcy: Let me say first that there have been no deaths where Suboxone has been detected, which is very important. Suboxone is the first line of treatment for opioid use disorder.
There have been some deaths with methadone where people are found to have had methadone in their system, but the coroners are unable to determine what caused those deaths in most of the cases, because often, when methadone is found, it is also found in combination with other drugs and/or alcohol in people’s systems. So in so many of these cases, it’s impossible for the coroner to determine: did the person use too much methadone, or did they…?
More often than not, they can have methadone in their system, but they could also have other drugs in their system, alcohol in their system, fentanyl and carfentanil in their system. So is it the combination of various different drugs? A coroner is able to say what was found in their blood, what was found in their system after they died. It’s far more difficult to identify, if methadone is one of the things in their system, if that is what led to their death.
J. Thornthwaite: Thank you for that. I have a question that a constituent asked me to ask the minister. Are there any plans or any recovery facilities focused on non–substance use addictions like gambling, food or pornography?
Hon. J. Darcy: The member referred to, or maybe her constituent referred to, facilities. I’m going to refer to facilities and programs.
We already have programs in place, both out-patient but also in facilities, for eating disorders. Children’s Hospital is one of them. There are other programs for eating disorders. We can certainly get that information to the member.
Gambling is handled under the Ministry of the Attorney General, so I don’t have the specifics on that. I do know that there was just recently an increase in funding for that gambling addiction program.
I don’t know about addiction to pornography, specifically, but for sex addiction services, we don’t provide any of those services in British Columbia. They are provided in Ontario, and I’m told that we do pay for people to access those services in Ontario.
J. Thornthwaite: Thank you for that answer.
I have another question. The minister has been very committed to doing everything that we can to stop the stigma around mental illness, and I support her efforts on that. Certainly, I’ve been an advocate for trying to stop stigma as well.
My question is to do with a group called Stigma-Free Zone, which is run by Andrea Paquette. Her question to the minister was: is the ministry…? Maybe, again, this is a message to the Health Ministry, but I thought, considering we’re talking about mental health and addictions stigma, that it would be directed to this minister. Will her funding for the work that she does in schools and in other areas be reinstated at some point this year?
Hon. J. Darcy: Well, I’m not sure where the funding has come from for this organization, Stigma-Free Zone, and which funding decisions have been made. I’m certainly happy to look into that. You mentioned education, so I don’t know if it came from Education — or whether it’s a health authority. If there was a decision by the health authority, we’re certainly prepared to look into that.
Certainly, we have a very broad commitment to expanding our anti-stigma work. The work that we’ve done, to date, in partnership with the Canucks has, we think, generated considerable interest and support across the province. We’ve had people express that it actually has opened their minds, which is exactly what we’re trying to do.
So I don’t know the specifics in this case, but we will look into it.
J. Thornthwaite: I would be happy to pass on this information. It’s a great program. I’ve seen it in action. She’s a dynamic speaker, and she’s got a staff now. She’s grown. It’s not just her.
So my last couple of questions, and then my colleague has one that she forgot to ask, and then we will be done.
My last two questions are to do with students. I’m sure that the minister, like other MLAs here, has been visited by student associations — AMS, UVSS, Alliance of B.C. Students, Simon Fraser Student Society, etc. I really liked their recommendations — the Medical Student and Alumni Centre and the Medical Undergraduate Society — but they did have some specific asks to do with mental health, specifically post-secondary students.
I had talked about my desire to expand Foundry to post-secondary institutions provincewide, which, of course, this group is very supportive of. But they wanted to know whether or not the ministry was willing to do any research on suicide prevalence amongst this age group, because suicide and suicide ideation is becoming an increased concern at university campuses. Specifically, they had asked, for the minister, if there was any interest in evaluating suicide prevention and getting the data that we need to target this particular age group in universities.
Hon. J. Darcy: We’re certainly very interested, absolutely, in looking at what the needs are for students in post-secondary education. We certainly recognize that all through the population, there are transition periods where people are most at risk. One of those transition periods is youth leaving K to 12 and going to post-secondary education, sometimes away from their families for the first time, in other communities and so on, having to rely on themselves to a far greater extent.
I know that Minister Mark, the Minister of Advanced Education, has been touring the province, consulting with students at colleges and universities — not just universities but colleges — in order to identify what the gaps are in services to support students in post-secondary education. We will be working very, very closely — we already are — with the Minister of Advanced Education, the Minister of Education, MCFD, Ministry of Health on what that plan is for child and youth mental health going forward.
Note also that in post-secondary education, it’s not exclusively youth. There are also more adult students who are in post-secondary education. But we recognize this is a key group that we need to be supporting, and we will be doing that research. We are doing that research as part and parcel of developing our plan going forward.
J. Isaacs: This is my final question as well. This is in regards to Mayor Richard Stewart, who is the mayor of Coquitlam, who recently wrote a letter to the minister after our Coquitlam RCMP presented a report where basically the detachment had responded to 1,782 calls related to mental health, with 723 apprehensions under the Mental Health Act, which was an increase of 25 percent from 2016.
Of the apprehensions, 303 required the RCMP to wait at Royal Columbian Hospital in New Westminster for more than two hours. The longest recorded wait time was ten hours. As you probably know, the local government has to pay for the policing costs, and of course, they’re spending a lot of time waiting at the hospital because the rules state that the officer has to stay with the patient until the patient is actually admitted.
Mayor Stewart had attributed some of the problem to Royal Columbian Hospital’s triage policy, which gives a higher priority to patients that have a physical medical symptom than it does to mental health patients without noticeable symptoms. In the letter, he had asked the minister whether Royal Columbian Hospital may institute a dual-track system, which is similar to the one that’s used at Surrey Memorial Hospital, in order to expedite mental health cases and to reduce the costs associated with unnecessary wait times.
My question is: would the minister consider that this dual system would be implemented or could be implemented in other hospitals in order to prioritize getting mental health help to people faster?
Hon. J. Darcy: I’m certainly aware that this is a problem that the police in Coquitlam are dealing with. It’s a problem the police in New Westminster are dealing with. It’s a problem police right across the board are dealing with. The numbers vary — the percentages — depending on which police force you talk to, whether they say 30 percent of their calls, 50 percent of their calls, 60 percent of their calls are dealing with people who are dealing with a mental health issue. But it’s very, very high.
I want to commend the various police forces, including ours in New Westminster, who have done some extensive training of the police and actually have some designated people with mental health professional training on staff. But the reality is that police are put in this role far too often because we don’t have adequate supports in place in the community. Our objective is to get to a place where people don’t need…. It’s not the public safety system or criminal justice system that has to deal with people who are living with mental illness or with addiction or with both — that there is an adequate level of support in communities, a wide range of services appropriate to the care that people need.
So does a triage system make sense? We certainly want to learn from the experience in Surrey. As we are developing our strategy for mental health and addictions for the province going forward, we’re going to learn from best practices. That includes what happens in emergency rooms.
Surely we want to get to a place where people don’t end up in emergency rooms most of the time. That might happen in severe circumstances, whether that’s a psych emergency or a general emergency. It’s certainly not the preferred first line of treatment for someone — to take them to an emergency room.
In fact, many experts will say it can be the worst place for someone who is suffering from mental illness because it’s a traumatic experience even if you’re not dealing with mental illness. If you are suffering from mental illness, it can be a very, very difficult experience that can help to exacerbate your condition.
On the issue of how we treat mental health versus physical health, I have said many times that it is very much the mission of our ministry and of our government to get to a place where people living with mental health issues or addiction are treated with the same dignity and respect and have the same access to care as people living with any kind of physical illness. That, to us, is an overriding…. It’s a goal and a principle that needs to guide the work that we have going forward.
We need to improve mental health and addiction services across the board, a full range of options that includes improving primary care and people being able to access support for mental health and substance use through our primary care networks — I’ve spoken about that; the Minister of Health will be talking about that more, I’m sure, in his estimates — so that we’re not isolating and stigmatizing people who are living with mental health and addictions, so that they are able to access that care and support that they need in many different ways, starting with primary care networks.
The Chair: Thank you, Minister.
Member for Kelowna–Lake Country.
N. Letnick: Thank you, Mr. Chair, and hello to the minister. I’m going to be the last questioner, I believe.
Interjection.
N. Letnick: Your notebook is full? It’s finished. Well, you might not need your notebook for this one.
I received a delegation from a group in my riding….
The Chair: Member, you’re reminded, you’re not allowed….
N. Letnick: Through the Chair?
The Chair: I’m just going to remind you that you’re not supposed to use electronic devices in the chamber. It’s an old rule.
N. Letnick: Oh, okay. Well, in that case, I will put the technology down and just read from the letter. Thank you, Mr. Chair, for reminding me.
The mission of the Karis Support Society seeks to impact the community and the province of B.C. by providing safe housing, support, lifeskills and training for people caught in life-altering addiction and mental health challenges.
The Karis Support Society has been providing housing and these supports for women — in particular, women with babies or who are pregnant — through private funding.
They would like to expand their program. To do that, they are now asking me: “Is there any opportunity for provincial support?” In particular, the letter they sent me talks about a concern around recovery for women in the province. They say that the biggest barrier to women, and specifically mothers, in seeking recovery from addiction, and specifically residential recovery programs, is the fear of losing their children — who will care for their children, while they focus on their healing?
A woman may want help for herself. But without anyone to look after her kids, she will more likely remain in her circumstances until it’s either too late or the ministry has got involved and the children are removed from her custody, at which point, she will have more of a barrier to regain custody. This also increases her level of anxiety, which negatively impacts overall mental health.
They say there are only two residential recovery programs for women in B.C., with one in the pipeline — and stand to be corrected if that’s wrong. They’re also talking about private centres, which are not always financially viable for many women needing help.
Their second issue would be the funding. Karis provides recovery-focused counselling, which includes private one-on-one counselling, group therapies, extended help for families and women with children. They also provide amenities such as shelter, food for babies and women, and many extended opportunities, such as helping with budgeting, fitness, nutrition, etc.
As a non-profit organization, they provide all the benefits mentioned above and are supporting the government, as these women do not access these services through government channels. Again, it’s all been done through donations.
“If we’re able to obtain funding per bed or individual, the costs related to these women….” Even if it were just a percentage or a specific number of women per year, that would be incredible support for what they do.
I’m just putting it on the minister’s radar. If this is not something she’s prepared to answer in estimates here, to give them hope or a process — a pathway to see if there’s an opportunity for them to continue what they’re doing as a private provider through their philanthropy, their community of philanthropists — to expand that work with some assistance from the government or some partnership with the government…. That would be great to understand so that I can go back to them or connect the minister directly with them and give them some hope that they can continue their good work in an expanded way.
Hon. J. Darcy: Thank you to the member for his question. I’m not familiar with the particular organization that the member is referring to, so I would be very happy if he could provide more information to us.
I think that the member also knows, as a former minister, that estimates is not a place where a minister is in a position to make a specific commitment around a specific program, especially one that is being brought to my attention for the first time. I know that he can appreciate that.
I certainly do recognize, and our ministry certainly recognizes, that there are some very distinct and difficult challenges that are faced by women who are trying to recover from their addictions and women, especially, who have small children, who have babies. The fear of losing their children is a major, major fear and can prevent women from coming forward and seeking help.
I had the opportunity a few months ago, together with the Minister for Children and Families, to visit the Sheway program in Vancouver and the Fir centre at Children’s and Women’s Hospital, which are programs that do very much what the member is talking about.
It was quite remarkable to sit in a circle with these women and their babies and for them to share their fears of losing their kids and how they have been able to both keep their kids and begin to turn their lives around because of the benefit of a program that both helps them to heal, helps them on their recovery journey to be addiction-free and at the same time provides them with the skills — the parenting skills and the life skills — to be able to raise their children. I certainly recognize how critically important those programs are.
It is certainly an area that we are looking at, going forward, because we know that those services are not available to all women. They’re pretty restricted at the present time, so it is one of the pieces that we will be looking at as we build a better system for mental health and addictions care across the province. I appreciate the member bringing it to my attention and look forward to him sharing the information.
J. Thornthwaite: I’d like to thank the minister and all her staff for fielding all of these questions and answering them as best you could. I think we’re done.
The Chair: Seeing no further questions….
Hon. J. Darcy: I think I get to say something too, hon. Chair, in conclusion.
I want to thank the member for her questions. I want to thank all of the members of the opposition who brought forward questions. I also especially want to thank the awesome and crack team from the Ministry of Mental Health and Addictions — small but mighty and very smart and very passionate and dedicated — who have been here through I don’t know how many hours, quite a few hours, assisting me in answering these questions.
Vote 35: ministry operations, $9,983,000 — approved.
The Chair: I thank everyone for their thanks and for their work. At this point, I think we shall take a recess for 5½ minutes as the Minister of Health gets prepared.
The committee recessed from 5:47 p.m. to 5:54 p.m.
[S. Chandra Herbert in the chair.]
ESTIMATES: MINISTRY OF HEALTH
On Vote 30: ministry operations, $19,606,664,000.
Hon. A. Dix: Thank you very much. Just briefly, I wanted to introduce…. There’s going to be a number of officials coming in and out over the next days, however long our estimates take. I wanted to introduce to the members of the House someone they’ll be familiar with — the outstanding Deputy Minister of Health Stephen Brown. Stephen is the formal name, but we can call him Steve in here. He’s just done an exceptional job. People will know that the Ministry of Health, at a ministerial level, sometimes has been a short job for people. The Deputy Minister of Health’s job is even a harder job than that.
Now, of course, we have a much more open-minded and generous minister — I’m kidding, of course — who makes his job so much easier, I know. But Steve does an exceptional job, and when you look at…. While I’m only introducing him, if you look at the staff of the Ministry of Health overall, I think they do extraordinary work for the people of B.C. on a whole range of issues. I’m very proud of the work they’ve done, especially the work, obviously, we’ve done since last July — but before that, because some of the things we’re doing is a continuation of that work.
I also want to acknowledge — because, obviously, a very significant amount of our budget goes to the health authorities — the work of health authorities. This is one area where we have, of course, presidents and CEOs and many people responsible. I’ve had the opportunity to appoint some new chairs but work with our chairs at all of the health authorities.
We have a new chair in Northern Health Authority named Colleen Nyce, who is just an outstanding businessperson from Terrace who’s doing an excellent job there.
People will know that we appointed a chair of the Interior Health Authority, someone who’s highly respected both in health care, in his fields of specialty, but also as a health care leader — Doug Cochrane, who is the chair of the Interior Health Authority, who is, I think, doing a very good job in the community there.
The Provincial Health Services Authority — also someone from Kelowna. We have an overrepresentation of Kelowna, for some reason — I think perhaps because we knew that the member for Kelowna–Lake Country was going to become the critic. Amongst our health chairs, Tim Manning, who won, this year, as members will know, the Order of B.C. and who leads the Provincial Health Services Authority board.
In Fraser Health, we have Jim Sinclair, who is the former president of the B.C. Federation of Labour, former member of the Vancouver health board previously, who, I think, is well known to everyone as an outstanding person.
In the Vancouver Coastal Health Authority we have Kip Woodward, who has been chair of the board for some time and whose family is, I think, as much a part of B.C.’s history as any family you can imagine. He is a very dedicated and outstanding person who contributes to the community so much.
Then, on Vancouver Island, we have a new chair, an Order of Canada winner, Leah Hollins. They represent — those chairs — the outstanding work that’s being done every day in health authorities.
With that, expressing my thanks to all the people who work in health care every day. There are no days off for the health authorities or the Ministry of Health — not Christmas Day, not any other day. We have health care workers providing dedicated service every day. I want to pay tribute to them and thank them for all their work, and I look forward to the questions asked by the hon. members.
J. Isaacs: Thank you to the minister for his comments and opening remarks. I want to, first of all, thank the minister for being accessible and very helpful any time I’ve ever had a question or a query. That goes for his very capable and competent staff as well. They’ve been very accessible and forthcoming and straightforward with questions or queries. So I appreciate all of that and would welcome the new board members throughout the province.
It sounds like we’ve got quite a good group of people there to represent the complexities and the needs that are going to be coming forward and some of the challenges that we’re going to be facing, along with the challenges that we have right now, today. So I appreciate the staff being here, and I appreciate the opportunity to speak with the minister.
I know he’s having fun because he’s already been humming.
Interjection.
J. Isaacs: There you go.
I just wanted to start off, Chair, kind of where we left off last time in estimates. This is really with regard to the tranche of money that is being applied to seniors care over the next number of years. This is with respect to the first tranche, which was the $500 million that was announced early in March of 2017. At that time, I had asked the minister if that money had started to flow through yet to begin the improvements with the seniors care. The minister explained and advised about the announcement, and it was his responsibility to find the money.
I just want to acknowledge that I realize that that is a very responsible job, and you have a lot of accountability, but I want to ask the minister now if he was able to find the money. If it has been flowed through, what is happening with this first $500 million tranche? If he has received it, what portion of the $500 million was provincial? What portion was federal? Were there any time restraints or restrictions to the spending of that money?
Hon. A. Dix: Just to talk in general about what happened, there was an announcement of $500 million in March of 2017. I think it’s fair to say that that announcement wasn’t accompanied with money. It wasn’t a budget announcement. What was required…. So it was more a political promise — which is fair enough; it was an election period — by the previous government than it was an announcement where you’ve gone to Treasury Board and you’ve established that there’s a sum of money, etc.
The majority of that money — I think the number is $285 million — came from the federal government and was going to be laid out over the ensuing number of years. That’s part of the federal agreement that we talked about the last time we were in estimates. The majority of the money was federal money.
Of the remaining money, very little of it had been, shall we say, targeted, found or allocated. There was $20 million to address the issue of long-term care, principally in the first year of the discussion, and then the money was all back-ended to future years and not really identified, except that there was a health care budget, and there was a commitment by the previous government to find the money.
With respect to last year, we did — and you can follow up on the details of it — allocate the money that was found last year, of the $500 million. In other words, $20 million was actual, and the other was either federal or, shall we say, press release–connected. We used that money to begin the process, in particular, of achieving the goal of 3.36 hours of care per resident-day. That’s the standard in British Columbia for care in long-term care.
We began that process, as you would expect…. Given the sum of money, and the sum of money going forward, you couldn’t simply start spending that money dramatically in one year. What we did…. That money was obviously in the first-year expense. We’ve got the detailed numbers. It started the process of slowly moving us towards provincial standards. So we were already taking some steps last year.
Members will be familiar with the seniors advocate report which showed, in 2016, that 92 percent of care homes didn’t meet standards. A goal of the $500 million plan — one of them, because there were other goals — included meeting that, on average, across every health authority over a period of years.
Unfortunately, the one thing that was problematic for that was that, of course, the significant bolus of money came from the federal government, and the federal government was never going to allow that money to be used for the purpose that it was designated for in the press release that was announced.
Those were challenges that we faced, but money has flowed. We’ve made some improvements, and we can get into the details of that, I’m sure, in follow-up questions. We’re starting that process. As the member will know, we have a short period of time before the end of today.
That challenge…. If you take the 3.36 challenge. There are other series of goals with the seniors plan. The $500 million, and then the additional $548 million we’ve found in this budget around home care; respite care; support for assisted living; adult day programs; long-term care, of course. This is a broad seniors plan and improves primary care for seniors. That’s all part of the plan that we want to see.
On the 3.36, as we discussed, there are two significant challenges. There’s the money. I think it’s fair to say, given the extraordinary investment in seniors care in the budget presented by the Minister of Finance in February, that the money has been found. Then there are the people.
According to the Ministry of Health, according to our analysis, it will require 1,500 net new staff people to reach the 3.36, to go from where we are to where we need to be. That’s in a context where there is a relatively aging care aide population. So we have to replace all of the existing care aides, for example — those are the first 900 of those 1500 — and then we have to find 900 more. That’s true of LPNs and RNs, and of course, there are demands throughout the health care system.
In short, the plan is the $500 million now, plus the $548 million. Only a small amount was ever designated to be spent in the first fiscal year of the plan — $20 million of that and a smaller percentage, I think $28 million, of the federal money. That money, of course, has been spent in the first year of the plan. I’ll get into the details of that. But the main part of the plan, of course, is over the next three years.
J. Isaacs: There was also $189 million that was in the budget update, which was, again, going to be over three years of additional funds for seniors care. I’m just wondering if the minister is able to confirm that this amount was negotiated with the federal government, that the money has been secured, and if so, if that money has begun to be spent and how that money will be allocated.
Hon. A. Dix: Well, we signed the deal in August of last year. That established the money. But part of that deal…. In the first year, there was some flexibility around that deal, but the intention of the federal government is to support home care and care in the community, as opposed to long-term care. That’s their intention. They see it as a home care initiative, but that can include respite. That can include other forms of care, of course, in the community.
The basic deal on the money was established and signed, and now we’re negotiating the detail of it in future years. Obviously, the federal government wants to have some say in how their share of the money is spent, and they will. We’re in the process of working that out with them now, with a focus, in their funding — not exclusively, but a focus — of using that money to improve access to home care in British Columbia.
J. Isaacs: Just moving on to the next tranche, which was the $548 million. Can the minister provide a breakdown of what portion of the $548 million is provincial and what portion may be federal? Also, what will the allocation of that money be, in terms of seniors spending over the next three years? What types of expenditures are expected out of the $548 million?
Hon. A. Dix: So $548 million is provincial and zero is federal, of that. The federal money…. I mean, we could add. We could make it more than $548 million and add the federal money to that. But just to separate, just for our understanding here…. Of that $548 million, that is all net new provincial money.
The priorities are the ones that we’ve set out and discussed, and hopefully they will evolve based on what people tell us on the ground, where the greatest need is. That’s the process being worked on now.
The first, I think, is both the human resources demands and the need to improve care standards in long-term care — so the 3.36, which is a significant portion of it. Obviously, improving both the hours and the quality of home care is significant.
Increasingly, home care, in recent years, has been focused on post-hospital care, but there’s also an important aspect for seniors — critical to allow seniors both to remain at home longer and also to live a higher quality of life for longer. I don’t know many people who want to be in long-term care when the alternative would be to be in their home in some fashion. So there’s a home care and home support portion.
Also, connected to that, there’s home care, with people coming to a home — either professionals, such as nurses, or home care workers. That’s this element of home care. There’s also a very significant need — this is an area, I think, that over recent years, we’ve lost ground on: adult day programs, which have some importance in supporting people as they live at home. Some of that is more medical; some of that is more social in its necessity. But we need to focus, as well, on adult day programs.
We can’t just build long-term care or just build hospitals. We have to create the ability in the community. Of course, if adult day programs are successful, it’s also the most efficient expenditure of money. We have to balance adult day programs with the fact that so many people — I know in the member’s community and in mine — are taking care of seniors. There’s a need both for the seniors themselves, in some cases, and for caregivers, who see themselves as under stress.
The member will have met with the seniors advocate, who’s made the case about that and who said that — as I think the number was — 30 percent of caregivers are under stress. For some, the level of stress is much higher than that. They consider themselves under real duress. So we have to, in that case, try and create some degree of respite.
Then there are other aspects we need to do that are partly seniors care and partly not, which are, of course, ensuring improvements in end-of-life care. This involves lots of people in the community and is a difficult subject because, historically — this is not the last 16 years; it’s the last 60 years — that area of care has had much more involvement with the community, in some ways, and much more support of volunteers and community members. But what we’re seeing now is a greater need to address all of those sets of issues.
Those kinds of things are sort of the menu of things. There’s home care, shall we say — nurses, professionals and OTs. There are home care workers. There’s long-term care. There’s respite care. There are adult day programs. There is the whole hospice and palliative care side, which is very important.
Then there’s the human resources side of it, to make sure that we have people for all of those. In the context of other ambitions that we have as a society, to improve child care and others, we only have one pool of workers. We sometimes talk about the growing number of seniors in our society, but that means that the number of seniors vis-à-vis the number of people of working age is changing. This is a fundamental change in society that all governments are facing, all governments will face in the future — I think, 2½ times as many people over 75 in 20 years.
If you look at the consumption of health care services, that inevitably will put pressure on those. So we have to create institutions that are resilient. We have to build them up and build them out but especially support the ability of people, as long as possible, to live life.
It’s because part of the seniors plan that I think the ministry and people who work in seniors care talk about the most — the care providers, the private sector, the Ministry of Health, the non-profit sector, many churches and other religious institutions that operate in care — is ensuring that people have a quality of life, as well, so that they live and don’t just endure. That has to be the focus as well.
There’s enormous, justifiable focus in all of this on the safety of people in long-term care. But we also have to have programs and institutions that allow people to exercise their liberty, whether they’re nine or 99.
J. Isaacs: Thank you to the minister for the very thorough answer. Just with regard to the 3.36 direct-care hours — I know this is the level of care hours that we’ve been trying to get to — the average health authority has been between three and 3.1 hours. I’m just wondering if there has been any improvement in reaching the desired 3.36 hours.
Dufferin Care Centre, which is in my area, just got a lift. So they’re thrilled that they’re going to be at that 3.36 hours. But I’m just wondering, on average, if you are finding that those lifts are coming through and that we’re getting to that 3.36.
Hon. A. Dix: Well, we’re just starting. I think the truth is that…. I mean, the first tranche of money in the last fiscal year was small, so the increase came in late in the year, and the increase was roughly from 3.11 to 3.13. The focus, initially, on the care hours was…. Almost 50 percent of workers in long-term care are care aides who are part-time or casual. The most immediate thing we could do to have the most immediate impact was to move those people to full-time. That doesn’t always mean you have a net increase, because often people have two or three or four positions, right? So if they’re becoming full-time in one, you might lose them in another, but that was seen as a good way to go about it.
Care homes such as Dufferin, I think, have been entrepreneurial in responding to our call in that regard. I should say that — because the member asked for details on the money — we have some from the last fiscal year. I’ll be sharing information with you. I think what we’ll try and do is…. There are usually FOIs about estimates books. We’ll try and just get as much information as we can to the members opposite so that we can avoid some of those processes.
On the provincial money, of the $20 million, I believe the largest portion was spent on increasing the direct care hours. That was $6.3 million of it. But a very significant portion, which was…. Most of those new funds targeted contracted facilities, and most of the emphasis was on hiring new care aides. So 77 percent of the money went to contracted facilities, either private or non-profit in that case, and 67 percent of the money went to hiring new care aides. If you look at that portion, the direct care aide portion of it, then that…. We saw a small increase in relative terms, but for some care homes, obviously, a significant increase.
If we’re looking at it into the future, clearly the 3.36 will be more focused on private and non-profit care homes than it will be on health authority–owned and –operated, which tend to have much higher average staffing levels now. If we’re moving the average up to 3.36, the biggest impact on that is raising up the contracted sector. We’ve added new contracts this year, for example, in Langley and Chilliwack. They were added at 3.36, so they raised the average, inevitably. They’re new beds, public beds, in private care in the system. But the largest need, if you will, in terms of raising care hours, is in private and contracting. The lowest levels you’ll find are in the oldest care homes, especially, so some of that will require capital improvements as well. You’ll see some of that in the system.
J. Isaacs: I appreciate that. My thought was that the average direct care hours in private homes were more at the 3.02. You can correct me if…. That’s about right? Okay. So there are less hours in the private homes than in the non-profit-owned care homes.
Is there any thought about balancing that out a little bit so that whether or not you’re in a publicly funded home or in your private care facility, that one would expect to get the same direct care hours? Does that make any sense?
Hon. A. Dix: Effectively, that’s what’s happening here. I mean, the intention is not to reach the hours of 3.36 by taking the public care homes up to 3.6 and leaving the others at three, if you will. Approximately one-third of care homes in B.C. are health authority–owned and –operated, and the rest are private or non-profit. I think those are pretty close. The private for-profit and the private non-profit are pretty close in terms of care hours. Some care homes are actually quite low.
What’s happened over time is, because there’s a demand…. We have an aging population. You have the 27,000, 28,000 beds available. The level of acuity — how sick people are — in long-term care has increased. Historically, there were homes that were available that had much less comprehensive care than now. To some degree, the care hours for some care homes — you can think of particularly non-profit care homes — are historically low. You’ll see care homes in the 2.7 to 2.8 range, which are often non-profits.
The more modern care homes tend to have…. Within the private category, the more modern ones, which are principally private, have a higher level of staffing because of new agreements, because they were built new, etc. Those are the complications of it. There has to be a lifting up and an improvement there.
You know, there are some genuine challenges because — and this is just what happened under the previous government — private care homes advanced and non-profits didn’t advance, because the emphasis in the funding system is on access to capital, and private care homes had a better access to capital intended to win more RFPs — not in every case, but overwhelmingly they did. So the private for-profit has gone up and the non-profit has gone down relative to that. The health authority–owned and –operated has stayed fairly stable.
What is true is that the older care homes tend to be more non-profit, tend to be more health authority–owned and –operated. This presents a challenge into the future, because as we upgrade some of those…. We’ll be talking about Dogwood, but you have…. In Vancouver, you know that there are health authority–owned and –operated care homes that have multiple-bed rooms, right? The modern standard is not that. These are people’s homes, as well as being health care facilities.
That’s going to be a challenge in the future for the health care system. If one-third of the beds are health authority–owned and –operated, how do we find the capital? We’ve focused capital on acute care in recent years — both the previous government and ourselves in the first year. How are we going to find the capital both to build potentially new health authority–owned and –operated capacity and, just as importantly, bring up and renovate and maintain our existing stock of health authority–owned and –operated beds?
Really, in this initiative — the 3.36 initiative — the disproportionate amount of the money is going to go to private care homes with public beds. They’re part of the public system. That’s where the majority of the money will go, because that’s where the care homes, whether they be non-profit or for-profit, have the lowest staffing levels today. Yet you have to raise them up.
You have to do one of two things. You either have to raise all of the health authorities way up and increase the gap, which we’re not going to do, or you have to raise them up to at least closer to the 3.36.
J. Isaacs: Can the minister advise where the 3.36 direct care hours came from and if there is a standard funding formula for that? For example, would it be correct to say that three hours are related to clinical care and 0.36, if we’re getting to that number, is related to a mix of care such as occupational therapists and other services?
Hon. A. Dix: The 3.36 was established around 2009. There were issues around it at that time. Members might recall that there were some significant initiatives by the government and the B.C. Care Providers, the HEU and others at that time. Then the issue went away a little bit. As sometimes happens in life, other priorities took hold.
But the 3.36 measure is established by the Ministry of Health in British Columbia. It establishes the care standard. And the member is quite right — that the three is nursing, and the 0.36 is allied health.
J. Isaacs: Can the minister describe just what the services are that are provided under the clinical care? That would be the three hours.
Hon. A. Dix: I’m going to read something into the record here. He’s just taking notes. He’s going to deliver…. I’m going to read this, and then…. We’ll just share it, if the member wants, on the record, because it’s a useful note in describing these things.
“Direct care worked hours are a subset of worked hours, as defined above, include only the hours worked by staff or contracted service providers, including RNs, RPNs, LPNs, care aides and allied care in the direct delivery of services to residents.
“Direct care consists of one-to-one first level of care interaction with residents, i.e. hands-on patient care, and other clinical related interactions — e.g., with family members and physicians. It includes care coordination, assessment, planning and delivery treatment.
“Allied care” — the other thing — “includes both professional and non-professional direct care providers. Pastoral care and volunteer coordinators are not considered to be direct allied care providers. The criteria to apply, to distinguish between what is characterized as professional versus non-professional, is whether or not the professional has a regulatory college in B.C. — i.e., those with a regulatory college in B.C. are categorized as professional.”
I’ll just give you some of the examples of allied care so that you know what that portion of it is, because I think we have a sense of what the direct care is. It’s occupational therapists, physiotherapists, dietitians, social workers, speech language pathologists, recreation therapists, rehab assistants, activity workers, respiratory therapists and music art therapists — depending on people’s care plans and sometimes even the makeup of the institution.
We all visit people all the time in care homes that our constituents are at. Sometimes the makeup of what constitutes the 3.36, or whatever the number is, in a particular care home will emphasize different parts of allied health — right? — depending, sometimes, on the access and the professionals who have just been hired and partly due to the care plan of the individual resident, whether they be senior or otherwise.
J. Isaacs: Thank you for that answer. My next question is just going back to the two tranches of money and the $548 million and the $500 million. A significant portion is going to go to the lifting to get to the 3.36 hours. But I also want to know what the new funding might mean in terms of the number of new care beds for this year in the province, provincewide. And also, if you could break it down by health region.
Hon. A. Dix: We’ll get the number by health authorities. I don’t know if it’s the magic number or not. The number that was estimated to bring the existing beds up to 3.36 on an annualized basis — so we would be building towards that — is $110 million to achieve that. And then, of course, you have to keep achieving it every year. It’s not a one-time business. So it will be raising to that level.
That’s what’s required to have the existing beds meet 3.36. Then, of course, part of the plan is, as we go, to increase the number of beds. We’ll get the member some information about where that’s been in the last year, so we get a sense historically, and what the expectations are for this year.
J. Isaacs: What I was hearing is — just help me if I misunderstood — the $110 million is going to uplift the 3.36 hours for existing beds. Is there a number that’s available for the new beds, or is that still coming?
Hon. A. Dix: With respect to the 3.36, just to be clear, we’ll be building towards that. So it becomes $110 million in the third year of the plan, when you reach that level, and it will actually take those years, for the human resources reasons I talked about. Even if we could spend it now — we decided we’re going to front-end it, and we’re going to do this now — we need three years to build to that, and we’re going to do that systematically over time. That’s the $110 million for the existing beds.
The new beds won’t affect the 3.36, because as was the case recently in Langley, as was the case recently in Chilliwack, those new beds, incremental beds, will be brought in at 3.36. So they will effectively not change the average at all.
The expenditure is going to have to be to existing beds whose staffing allocation is obviously below 3.36 in order to bring the average up. Even though it’ll be an average in each health authority, the overwhelming majority of the beds are going to have to be fairly close to that because of the way averages work. You couldn’t leave someone at 3 when most of the public beds will be at 3.36, 3.37, 3.38.
I should say that other provinces…. The 3.36 is an important rule and a target and a good goal, one that was set based on the evidence under Minister Abbott, who was the Minister of Health at the time, but it’s not a magic number. It’s the standard that we have set and the goal that we are achieving.
Some jurisdictions are lower, and other jurisdictions are even more ambitious than that. This will be a subject of a debate in other jurisdictions, but we’ve got so much to debate in our jurisdiction that I don’t think we need to get into that.
J. Isaacs: Can the minister advise what percentage of funding by health authority is currently dedicated to senior spending? And is the minister seeing any trends developing that are related to health authority spending on seniors care?
Hon. A. Dix: Well, I can give the member just a sense of the numbers for ’17-18. These are the budgeted numbers. The numbers for ’17-18 are $3,159,700,000. Obviously, given the evolution of the population, those numbers are going up. They’ve gone consistently up over time, and they’re going to go consistently up over time.
With this new investment of significant provincial money, a very significant portion of it, most of it, will be distributed through the health authorities, except in cases where we’re training, and we’re investing in training, for example, for care aides, and so on. This will be a further dramatic lift in the expenditure on seniors care across health authorities.
I can also give the member the numbers by health authorities as well, from the ’17-18 year — just to give a sense. The numbers are: $924.9 million in Fraser Health; $626.3 million in Interior Health; $232.9 million in Northern Health; $738.4 million in Vancouver Coastal Health; and $637.2 million on Vancouver Island.
We could further break that down for the member, from community to residential. In Fraser Health, the community number is $329.1 million, and the residential number is $595.8 million, which gives you a sense of the distribution. I’ll share the numbers with the member. We don’t have to go over all of them, but that gives you a sense. In all of the health authorities, the larger number is residential. The smaller number is community. Of course, all of the numbers are very large in absolute terms.
J. Isaacs: I just want to go back to the 3.36 hours again, for the residential care. Often there are other folks in community living where they have a brain injury or they have MS or there are mobility issues or a chronic disease or something. Do they qualify at the same 3.36 hours if they’re living in that care home?
Hon. A. Dix: The 3.36, I think, as we discussed, is an average, so across the care home. There would be days, if the member was there and the member from Kelowna was there, where the member from Kelowna might get more and the member from Coquitlam would get less and so on.
With respect to people with other serious conditions, they’re likely to get more. They might be getting care from the outside, people coming in and providing care in additional programs. But the numbers don’t distinguish between who’s receiving the care. We do them by care homes, so you’ll have a number of hours, you’ll have a number of residents, and that will define what you’re talking about.
Obviously, that’s why we have care homes that manage their allocations in that way. There might be a day, if a resident were getting a bath, for example, and they were getting a bath on a different day from another resident, that they would be well above their share of the 3.36 in that day. It’s an average across a care home, and then, obviously, the target is an average across a health region.
Many care homes — and this is particularly true, I think, in the Interior and the north, but everywhere — have a diversity of people in them. We think we know who’s in care homes. In fact, there’s a diversity of people, and this is sometimes a concern.
The member will have met with people who are younger who, for different reasons…. We had this discussion, I think, on Monday with people from the Multiple Sclerosis Society, right? We had that discussion, and they felt that often the conditions in care homes, where the available bed is…. The flexibility of the system in the north is even less, in terms of the number of care homes in a geographic area, than it would be in Metro Vancouver or in the Tri-Cities or wherever. Those are significant issues, as we work on issues of quality of care for people. We have to, I think, listen to people as well.
Some of the people who are, say, non-seniors in care homes and non-vulnerable seniors in care homes often find the experience challenging, because they may not have, as a social question, as much in common. They may not be in the care home for reasons other than what one would broadly call physical disability.
N. Letnick: Thank you to the minister. We’re going to be breaking soon, and I know the minister is sad about that, and actually, so are we.
Interjection.
N. Letnick: Well, I think we’re going to have some overtime tomorrow — through the Chair — Minister, and then probably again on Monday and who knows after that.
The minister brings up a very good point that was brought up by the people from the MS Society — that they have young people with MS that are in residential care with seniors. They’re taking care of their physical needs, for sure, but obviously, there’s more than just their physical needs. What happens to them — their social life, mental health is probably impacted.
I don’t want to speak for them. They can speak very well for themselves. And the minister has, I think, described some of the concerns and the government’s desire to listen to them and, hopefully, do something.
They did send me a research paper on the comparative costs of home care and residential care, which was produced in 2004. And it was kind of funny to see the names on this, including Marcus Hollander, PhD, because I read a whole bunch of his research papers when I was working on my PhD in health economics. I was going: “Wow, this is déjà vu.”
Through you, hon. Chair, I’ll give this to you for the minister. If he wouldn’t mind, or the staff, having a look at this — obviously not today, but maybe when we come back tomorrow — to put on the record if there’s any analysis that’s been done on the costs of keeping someone at home in, let’s say the case of MS, and taking care of them at home versus putting them into residential care with a group of seniors.
They, themselves, say they would prefer to stay at home, if they could. So I’d like to know, on their behalf, is it a cost issue? Or is it something else that is — not forcing us — that we’re choosing, as governments, the past government and the current government, to put them into the situation that they believe is actually more expensive, both in terms financially as well as in terms of their health.
Hon. A. Dix: I haven’t read the study. I expect I know what it says — that in the broadest sense…. It’s understandable. I mean, our costs per day, the collective costs around home care, are less than they are in residential care. That said, residential care is the appropriate place for a whole bunch of people, right?
It’s a complicated issue as well. In some communities, seniors in residential care and their families have some concern about others who are in their care home. We’ve heard this story. We’ve heard this experience. We’ve heard cases around this in communities from Fort St. John to Prince Rupert as well.
But I think the member is right. That’s why it’s such a preoccupation of ours to focus on care in the community, on respite care, on supporting families who are doing an extraordinary job with care.
These are, I would say, new circumstances, even in history, if you think of types of care. We’re not in the community living debate here. But there are people who are living with developmental disabilities decades longer than they did in our lifetimes, in the member’s lifetime and my own. So this is an entirely new societal problem. And — joy — people are living longer. Their quality of life is higher.
When we started public health care in Canada, people lived to the age of 70. We’re now, on average, at 82, 83. Our average age when we hit 65 is much longer than that. This is transformative, and it’s wonderful. And we have to treat people in a system, as much as we can, as individuals and not as numbers or statistics.
I think this is the message that I take, as well, from many of the people I’ve met, who’ve called for more supports in the community, whether they be adult day programs, home care or home support programs — that we’re never going to be able to build a residential care system big enough to establish the need, unless we have robust communities of care.
That’s a focus that, certainly, Sharon Stewart, who does an outstanding job on these issues in the ministry, and Steve Brown and many of the people who work in seniors care especially, are emphasizing.
There’s a very famous book, which the deputy minister has given to about 700 people, so he’s made it more famous. We’re all saying the same things to each other in meetings and not sure why. It’s a book by Atul Gawande, which is called Being Mortal.
It talks about not just the care people receive but its quality and the quality of life and what it means to emphasize safety, in care, over liberty — of not being able ever to go to a fridge and choose what you want to eat, taking the risk that it might not be the right thing — and the choice against the safety, and the criticism that comes when mistakes are made.
These are things that I think all of us have to consider as a society, as we have more people who are older and we want quality of life to be better. We shouldn’t ever think of that as a bad thing. It’s a wonderful thing. It’s a wonderful opportunity for us as individuals and as a society. But it’s going to challenge us in new and interesting ways.
With that, hon. Chair, with that short response to the member’s short question, I’m going to move that the committee rise, report progress and ask leave to sit again.
The Chair: Yes, please give the script a quick look, and read that.
Hon. A. Dix: I’m trying to close the deal here. Okay, I move that the committee rise, report completion of the Ministry of Mental Health and Addictions and report progress — only progress, alas, for me — on the Ministry of Health and ask leave to sit again.
Motion approved.
The committee rose at 6:46 p.m.
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