The committee met at 1:32 p.m.

[M. Dean in the chair.]

Point of Order

Hon. J. Darcy: I would like to ask the Chair to make a ruling. I do not believe that the member can ask a question about legislation that is before the House.

The Chair: Thank you, Minister.

Yes, this committee is not a place for debate on legislation. Thank you.

Debate Continued

J. Thornthwaite: Does the minister have the number of non-fatal overdoses that have occurred in B.C. this year and last? The reason why I’m asking is that there was a report by the B.C. paramedics that on Friday, June 26, B.C. emergency health services responded to 131 overdoses across the province, double the daily average on that one day.

The reason why I’m asking is because we do know that overdoses, non-fatal overdoses, have consistently gone up before COVID. Yes, there was a reduction in the deaths, but not in the amount of total overdoses, which is a reflection of people still not getting the help that they need.

My question, specifically, is: does the minister have the results or the number, the total number, of overdoses that the B.C. paramedics had to revive last year and this year? Is that information available?

[1:45 p.m.]

Hon. J. Darcy: I’m certainly very well aware of the number of overdose calls — that we had the highest day ever, 131 calls in one day.

I would direct the member…. There are regular updates, as well as annual updates, on the BCCDC website. The member can either get the total information there — I’m not in a position to calculate it myself at this moment — or we can provide it to her. But there are regular updates there. As I said, the information is publicly available.

I do want to say to the member opposite that if people are overdosing, we encourage a call to 911. We encourage that. I’m glad to hear the member acknowledge — I think it’s the first time I’ve heard her acknowledge on the record — that overdose deaths were actually going down.

I referred to the BCCDC website, where all of this information is available, but I think it’s important for the member, also, to remember what the BCCDC has said about the reason that the death toll was going down. Not nearly far enough — that goes without saying. These are not numbers. These are people who have been lost to their loved ones and their communities.

The BCCDC was clear that 6,000 deaths have been averted as a result of three specific interventions. There are many others, but as a result of three specific interventions, 6,000 deaths were averted.

That was as a result of a massive distribution of free naloxone kits across the province. I think we’re in the vicinity of close to 200,000. I can get that figure for you, but a massive distribution of free naloxone kits. Something in the vicinity of 50,000 to 60,000 of those have been used to reverse an overdose. That’s made a big difference.

The BCCDC also referred to the massive expansion of overdose prevention sites and safe consumption sites, where there have been well over a million visits now, thousands of overdoses reversed and not a single death.

The third thing to which the BCCDC attributed the averting of 6,000 deaths was the significant increase of access to medication-assisted treatment. As the member knows, we are continuing on those fronts as well as many, many other fronts, as we we’ve spoken about earlier.

We do not want to discourage people from calling 911. It’s really important that we work together to combat the stigma associated with this. We want people to be able to call 911. We have a new app that is available that about 1,000 people now have downloaded, which is really important. That’s an app. It’s already saved some lives, because it activates a call to 911 if the person has not responded to an alarm at the 50-second point. At 50 seconds, an alarm goes off. If they haven’t responded at 75 seconds, it’s an automatic call to 911.

I think it’s important that we…. It is very worrying, of course, that the number of overdose calls is going up. But it’s really, really important for us all to speak with one voice in recognizing the reason for that. The coroner has been crystal clear. The principal reason for the spike in overdose deaths and the increase number of overdose calls is the extreme toxicity of the drug supply.

To suggest that it is arising for another reason…. The coroner has been clear. Dr. Bonnie Henry has been clear. Toxicity of the drug supply — number one factor. That’s a result of the disruption of the drug supply with COVID-19.

[1:50 p.m.]

Also, the isolation that people have been living in because of the physical distancing, and because people have not been accessing the health services that they might have before. They haven’t been accessing harm reduction sites. They haven’t been going to their family doctors, clinics and are often hesitant to go to emergency rooms as well.

Let’s be clear. The principal reason is the extreme toxicity of the drug supply. That’s why our response has to be multifaceted. And one of those needs to be…. In addition to recovery beds, in addition to substance use integrated teams to keep people connected to the health care system, it’s also about continuing to expand access to safe prescription medications as an alternative to that poisoned drug supply.

J. Thornthwaite: I just want to put on the record that I asked my question at 1:42, and it’s now 1:50. The point is that my question was very succinct, and I’m getting an eight-minute lecture. I would appreciate, given the timing for estimates for all of us — we’re all trying to do our jobs — if the minister could at least reduce the amount of time that she speaks in lecturing me. I ask specific questions, and I’d just like the answers. I’m not getting them.

I’m going to go on. On April 18, the minister released an op-ed. It said: “Across the province, safe prescription alternatives to the unpredictable and toxic drug supply can be safely prescribed and delivered to those in…need. This includes providing safer alternatives for people with addictions to alcohol, opioids, tobacco, stimulants and benzodiazepines.”

Can the minister provide me with what those exact alternatives are for those substances?

Hon. J. Darcy: If the member wants a very succinct answer, the answer is that all of those are contained in the risk mitigation guidelines, which are a public document.

J. Thornthwaite: Does the minister know the cost or the budget for all of those alternatives?

[1:55 p.m.]

Hon. J. Darcy: To the member opposite, I’m sure she can appreciate that this is…. As days and weeks and months go by, the uptake is different and is increasing. This is a good thing, because it means that we’re separating people from the illicit drug supply which is poisoning people.

I can give the average cost per day for various medications that are on the list under the risk mitigation guidelines. Buprenorphine/naloxone, average $6.60 per tablet per day. Hydromorphone, average $2.94 per tablet per day. Kadian, average $20.89 per tablet per day. Methadone, average $10.97 per tablet per day.

I think the significant thing to know is what the uptake is in these areas and where we do have direct information. Of course, this is information we need to gather from PharmaNet. It’s not available on a daily basis.

The biggest uptake — and this was expected — has been in the area of hydromorphone, which is the prescription alternative to opioids. We have approximately 1,300 more people in the province who are now being prescribed prescription hydromorphone than we did before the risk mitigation guidelines were announced.

J. Thornthwaite: On May 23, Dr. Bonnie Henry said: “We’re looking at making it protocolized so that people can have access without having to see a physician, necessarily, for the prescribing piece.”

What is the definition of protocolizing the process to allow people to not require a doctor’s note to receive a prescription? Is the fact that physicians feel uneasy prescribing safe supply due to liability reasons…? Is that the reason why the ministry wants to protocolize the prescriptions, because the physicians are uneasy about prescribing it?

[2:00 p.m.]

Hon. J. Darcy: I was, certainly, very well aware of Dr. Bonnie Henry’s statement on this. We all follow her very, very closely in many different aspects of our lives these days.

Certainly, our ministry works very closely with Dr. Bonnie Henry and her office — the provincial health officer’s office — the Ministry of Health and the health authorities on how we can expand treatment options for people, how we can expand access to medications under the risk mitigation guidance. Any decisions or any actions on that, of course, would be made on the advice of clinical experts.

Dr. Bonnie Henry is held in incredibly high regard, I know, by the member opposite, by everyone in this province and by people across the country and around the world for the way that she has taken us through this pandemic, this unprecedented situation that we’re dealing with.

We are consulting, we’re working closely with Dr. Henry, the Ministry of Health, health authorities and clinical experts. They tell us that, as in other fields of health care delivery, team-based care is very important. It’s important in terms of expanding access to care. It’s important in terms of providing truly holistic care and wraparound care.

We’re doing that in primary care. We’re doing it in substance use care. I talked about substance use integrated teams earlier on — intensive case management teams. We all know that multidisciplinary teams are the way that we need to go, with everybody working to the full scope of their practice and their expertise. But again, working in teamwork with each of them playing a role.

Clinical experts believe, and we agree with that, that building stronger multidisciplinary teams that involve nurses, nurse practitioners, primary care practitioners and social workers are an important…. It’s where we are already going and where we need to expand our work, as far as support for people living with addictions, so that we can reach more people and so that we can provide truly wraparound care for people who are struggling with addictions. That’s one of the things that’s under discussion, of course, because we are constantly searching for more ways to support people with a wide variety of options for them.

The BCCSU, as the member opposite is probably aware, provides training for health care providers, prescribers and pharmacists. There’s actually been a huge uptake amongst doctors and nurse practitioners and pharmacists of that training provided by BCCSU on the risk mitigation guidance. It is something new. We understand that. So it’s important that that kind of training be available for people, that education.

We have also recently announced that there is a 24-7 line that is available to all health care practitioners, providers and prescribers — a 24-7 line where they can reach out any time of the day or night to get advice about addictions medicine.

[2:05 p.m.]

J. Thornthwaite: On page 5 of the risk mitigation document produced by the B.C. Centre for Substance Use, it states:

“These guidelines are not intended for treatment of substance use disorders, but rather to support individuals with substance use disorders to self-isolate or social distance and avoid risk to themselves or others.

“This interim guidance document was developed rapidly to provide clinical guidance in the context of the COVID-19 pandemic. As such, it does not provide a review of the relevant literature and relies on the clinical judgment of prescribers when utilizing this guidance.”

Is the minister aware that this guidance is the lowest level of evidence-based policy, and it is based on the clinical judgment of prescribers? Why, then, are we using the absolute lowest level of evidence in a guidance document that is not peer-reviewed to treat our most vulnerable citizens? Has the minister reversed her position, over three years, of not using evidence-based recommendations?

[2:10 p.m.]

Hon. J. Darcy: I can assure the member opposite that anything that’s happening in our health care system gets rigorously evaluated all the time. I hope that the member opposite would not intend to imply otherwise.

In fact, the member for North Vancouver–Seymour recently said: “We definitely need a safe supply.” That was on CKNW, June 17, 2020. I was pleased to hear that we had support from all sides of the House for these guidelines, because that can certainly help to reduce the stigma associated with this and reinforce the message that there need to be many pathways to hope.

We are in a public health emergency because of COVID-19. Because of the dual public health emergency, the number of deaths has gone back up when it was going down. But I can assure you that these guidelines were designed by health experts, including Dr. Bonnie Henry’s, and health care professionals are the ones who are making decisions with patients about what care is best for them.

I think it’s important to understand the impacts of this interim clinical guidance. The overdose emergency response centre has led the formation of a monitoring and evaluation team, and it’s comprised of representatives of the B.C. Centre for Disease Control, the B.C. Centre on Substance Use, the Canadian institute on substance use, the First Nations Health Authority, the B.C. Centre for Excellence in HIV/AIDS, the Ministry of Health, the Ministry of Mental Health and Addictions, the Ministry of Public Safety and Solicitor General, the Provincial Health Services Authority, Perinatal Services B.C., and so on. We are very much relying on their expertise. They will be fully involved in evaluating it.

Funding is in place, in fact, from the Canadian Institute of Health Research in order to do an evaluation of the risk mitigation guidelines. I think the member should also know, if she doesn’t already, that the federal government has adopted this guidance developed in British Columbia, and it is now considered national policy. They’re very grateful for the work that’s been done in British Columbia in order to advance this really important work.

J. Thornthwaite: I’m going to ask one more question, and then my colleague from the Green Party is going to ask some questions until three. I’ll take the last half-hour.

My last question before I give it up to my Green colleague is about the $2 million pilot project within Island Health. It was a partnership — the Minister of Health in the federal.

[2:15 p.m.]

It’s a $2 million pilot project to give pharmaceutical-grade medications as an alternative to the toxic, illegal drug supply for people in the Cowichan Valley who have not responded to other forms of treatment for opioid use.

My question to the minister. Given that the Alberta government has actually cancelled some of their programs that they audited and found that there were some problems with them, if there are these pilots going on with regards to the safer supply, will there be government audits occurring at the same time?

The Chair: Minister, did you want to make a comment?

Hon. J. Darcy: Thank you, Madam Chair. I just wanted to seek clarity about what our end time is for estimates. I think the member…. I understood we had five hours in total. Could you just indicate to me when that is completed?

J. Thornthwaite: I was told I had until 3:30, but I have my Green colleague that is going from 2:15 to three.

Hon. J. Darcy: That’s considered within the framework, Madam Chair?

I believe there was a total time allocated for estimates, and then it’s divided. I certainly recall very well from my time as critic that it is then divided amongst all of the people — the opposition parties and all the individual MLAs that want to ask questions.

If you could just let us know when the five hours is completed.

The Chair: It’s not something that I am aware of. I’ll have to get some guidance and consultation from colleagues. That’s something that’s agreed between all the parties.

Hon. J. Darcy: I just really need to clarify what the member is asking here. I read, with deep concern, a media report last night about, I believe, a safe consumption site in Alberta, where there are allegations of fraud. It was closed down — very disturbing allegations about a safe consumption site.

Is the member asking about whether she believes that every safe consumption site or this project, which is approved by the substance use and addiction program of the federal government, which is a pilot to deal with access to safe prescription medications…?

It seems to me that she’s is conflating the two and confusing them. I have to say that I find it deeply concerning and stigmatizing of any form of support for people for her to suggest that the fact that there are allegations of corruption or fraud in one particular site in one province that we, somehow, tar these other projects, many different types of projects, with the same brush.

I would really appreciate if the member clarified her question so that I’m able to answer her question, rather than her, what I have to say are, stigmatizing statements.

J. Thornthwaite: I am cutting into time with my Green colleague. The timing for the estimates is determined and agreed upon with the House Leaders. So it’s between the House Leaders, who determined how long I have. I was just reciting that. I just wanted to get that clarified.

[2:20 p.m.]

I am simply asking if there are audits that are being conducted at all by this government, because the Alberta government is doing audits on overdose prevention sites. Specifically, I was talking about this pilot project that has been announced on July 15 on pharmaceutical grade medication as an alternative to the toxic illegal drug supply for people in the Cowichan Valley. I’m just asking if there will be an audit done on this.

Hon. J. Darcy: The funding for this pilot was provided by the federal government and was awarded under the substance use and addictions program federally. All pilots that are approved by the B.C. government are certainly evaluated and monitored. That’s the whole idea of doing a pilot: to learn from it, to monitor the progress, to evaluate the outcomes. The objective is to improve care, improve treatment and save more lives.

I have no doubt that the federal government also has an evaluation process in place for this and other pilots. If the member would like me to get that information from the federal government about how they evaluate specific pilot projects like this, I would be happy to do that and pass it on to her.

The Chair: Minister, just on the timing for the committee, it is based on the agreement between the House Leaders of the parties. In the position of the Chair, I’m unable to adjudicate or make any comment on that.

S. Furstenau: I’ll just hit our start timer here on our 45 minutes.

I appreciate this opportunity to be able to ask the minister questions about mental health and addictions, which, of course, is a very serious topic and top of mind for people across the province right now.

Just to start where the minister left off…. In Cowichan, it is good news that we have gotten this pilot project. It is something that our Cowichan Leadership Group has been advocating for. We welcome the steps that have been taken, because we recognize that it is very important to treat addictions as a health issue. That is how this is being approached, and we welcome these steps.

I’m going to start with some very general questions related to budget. My first question to the minister is: how much is being spent on mental health services in B.C. per year at this moment?

[2:25 p.m.]

Hon. J. Darcy: Good to see the member.

At the time of estimates last year…. The provincial investment as a whole is approximately $2.5 billion a year for mental health and substance use. Sometimes these services are separate, and sometimes they’re integrated, but the overall spend is approximately $2.5 billion a year.

[2:30 p.m.]

That’s without some of the new investments that we have announced more recently. That’s without the new investments in child and youth mental health that we announced, flowing from the Pathway to Hope — $74 million there. That’s without the addition of $30 million for the overdose response. It’s without the recent announcement about more treatment and recovery beds. It’s without the additional money for counselling grants, which was $10 million last September.

Then, during COVID-19, we added another $6 million in order to stand up those counselling services virtually and to expand from the original 29 agencies to a further 20, for a total of 49. It’s without the recent announcement of beds, without the recent announcement of COVID relief support for the recovery sector, without the risk mitigation guidance.

We are continuing to make many announcements — two in the last week alone. The starting point is about $2.5 billion, and then we have a number of new investments on top of that.

S. Furstenau: Thanks to the minister for those figures. That’s quite helpful.

I guess my follow-up question is a bit more of a philosophical one for the minister, which is: we know that people accessing physical health treatment, going to the doctor for an injury or an illness, for physical health, have access to that through the MSP system. For mental health access, it’s much more tricky for people. It can often be seen as very expensive — not able to afford. Because it’s for mental health services, it can often be…. The onus is on the individual.

Can the minister speak to this lack of equity between what we would consider physical health and mental health? How do we reconcile that? How is this being addressed, for example, in the primary care networks?

Hon. J. Darcy: Can I just request that after the answer to the question, we take a short break?

Thank you to the member for the question — a really good question and an important one, philosophically and practically. The member is right. It’s a big challenge. We’re very proud in British Columbia, very proud in Canada, that we have a universal medicare system. But the reality is that there are significant gaps in that, significant parts of our health care system that are not covered by the Canada Health Act, for instance, and are not funded by the federal government to the provinces.

Certainly, much of seniors care falls into that category, as does much of mental health and addictions care. We certainly share the member’s concern about that, because we don’t believe that access to mental health and addictions care should depend on the size of your bank account. Too often, it does now, which is why we’re really focused on trying to expand access for individuals to publicly funded care wherever we can.

I think, I believe, as the member does, that we need to get to a place — we have a long way to go — where we do have equity between physical health care and mental health care. Absolutely, we need to get there. People should not have to pay for counselling to the tune of $150, $250 or more per hour. That’s why we invested in community agencies that provide counselling at no cost or low cost — sometimes free, sometimes a sliding scale based on income.

[2:35 p.m.]

As we discussed in response to an earlier question, Member, one of the recipients of these grants said: “You could’ve created a shiny new program with government’s name all over it, but instead, you chose to build capacity in community agencies for counselling.” That is exactly what we’ve done. That’s to address the issue that you’re talking about, which is equity. We helped to stand those up virtually in order to expand access even further.

We are integrating. This has been one of the things that our ministry has certainly pressed for from its inception, which was three years ago today. That is the integration of mental health and substance use into primary care.

As the Minister of Health is rolling out primary care networks across the province, we’re seeing mental health and substance use professionals as part of those teams, which is critically important, both to improve access without having to pay for it — so equity — but also to reduce stigma. It’s about saying mental health and substance use issues are health care issues — period.

We’re seeing that in primary care networks. We’re seeing that in several of the urgent and primary care centres. We’re seeing it in a new nurse practitioner–led clinic in Nanaimo — the first of many, I understand, but the first one. It includes mental health and substance use clinicians.

Certainly, we continue to press the federal government to increase the funding to the provinces for mental health and substance use, because this needs to become a truly integral part of our health care system.

The Chair: Members, we will now take a short recess for five minutes. Thank you.

The committee recessed from 2:37 p.m. to 2:42 p.m.

[M. Dean in the chair.]

S. Furstenau: Clearly, it’s a very significant piece of the news right now that overdose deaths have been at an alarming rate, very high. I know that the minister takes this very seriously and has done a lot of efforts. But the overlay of the COVID pandemic on top of this health crisis of addictions and overdoses is significant.

My question around this, to start with, is: is the ministry monitoring and tracking the impacts of COVID-19 on addictions and overdoses in British Columbia, and if so, how?

[2:45 p.m.]

Hon. J. Darcy: Yes, we certainly do, as a ministry, of course, track overdoses in general, overdose deaths and overdose events as well as try and track the impact of COVID-19 through existing sources of comprehensive data and evidence. That includes, of course, the publicly available B.C. Coroners data, which is broken down in considerable detail, not just provincewide, but by gender, by where deaths occurred, by health authority, by health service delivery area and by township.

We also look, of course, very closely at B.C. emergency health service’s data, which is about ambulance calls. We look at the take-home Suboxone data; the data from supervised consumption sites and overdose prevention services, the utilization of those; the PharmaNet data on the uptake of opioid agonist therapy; and toxicology from various labs.

The office of the provincial health officer, under Dr. Bonnie Henry’s auspices, has established what’s called an unintended consequences working group in April 2020, which speaks directly, I think, to the question that the member asked. That’s really about identifying, monitoring and reporting on the unintended consequences of the public health measures that were implemented in response to the COVID-19 pandemic.

I know I don’t need to explain to the member the impact of COVID-19 on the disruption of the drug supply, what that means about extreme toxicity, what that means about social isolation, what that means about less people accessing harm reduction sites, emergency rooms and family practices, even.

One other piece that I want to mention that we are also working with health authorities on. Certainly, you know about the work that the First Nations Health Authority has done. It reports regularly on the impact on Indigenous people, which very much guides the work that we do together with the First Nations Health Authority about services and programs that are culturally safe, nation-based and community-driven.

We’ve also been working, for instance, with Fraser Health. Fraser Health recently did a report on the impact of the overdose crisis on the South Asian community. They did a particular study that was very interesting, very valuable information. If the member hasn’t seen it, we can certainly forward it to her. We’ve seen a significant increase in the number of men, especially, in the South Asian community affected by overdose.

[2:50 p.m.]

There’s an analysis there of things like not just the percentage of men, which I believe, in the case of the South Asian community, was about 98 percent as opposed to 80-20 for the population at large. Also, the age is generally lower — two-thirds under the age of 40. Most of these people are living in families with partners, many with kids. Very valuable information for work that we’re doing in partnership with Fraser Health helping to inform the work of the South Asian–specific services provided that we’ve been supporting.

Also, information that’s really valuable about the impact on different occupations. The building trades, for instance, trades and transport, account for a significant proportion of those people who are employed who are dying of overdose. So we’re working very closely. That data has helped to inform the work that we’re doing with the Construction Industry Rehab Plan, which is a partnership between construction employers and building trades unions that is really about preventing overdose, combatting stigma and connecting people to care in that sector.

S. Furstenau: I appreciate the response.

The minister also mentioned work with the First Nations Health Authority. As the minister knows, there has been a very significant spike in overdose deaths in Indigenous communities across B.C., as she points out, from the toxicity of the drugs.

Can the minister give some specific examples of the work that is being done to support Indigenous communities right now? In particular, I guess, with the remote communities, what precautions are being taken to ensure that there’s also protection from importing COVID into those communities in these efforts? If the minister could speak to those specifically.

[2:55 p.m.]

Hon. J. Darcy: Thank you to the member for her question. Our ministry works in very, very close partnership with the First Nations Health Authority, in a number of different areas, and has made some very significant investments. I think, probably, the biggest investments that our government has made in the field of mental health and addictions are focused on supporting Indigenous people.

Those include a shared investment with First Nations Health Authority of $40 million, which will be to rebuild and renovate six existing rural or remote Indigenous treatment centres, many of which have fallen into disrepair and disuse. We will be rebuilding or renovating six of those — rural and remote. There will be two new urban Indigenous treatment centres. We’re continuing to seek funding from the federal government in order to take that further.

We have also supported First Nations Health Authority with $23 million for land-based healing. I think the member knows very well that, for Indigenous people, a central focus for mental health and wellness is about reconnecting to land and culture and community and elders. So land-based healing initiatives is a significant funding envelope.

Again, it’s not us who determines what those are, where those are located or what the nature of them is, because we believe in self-determination. These are community-based and nation-driven programs.

The third area, which is 100 percent community-based, nation driven is a commitment of $30 million. This is a funding envelope that is far more flexible in its parameters than funding has been in the past.

It’s not expecting First Nations to fit into a box defined by government. It’s really about providing the resources to the First Nations and health authorities so that nations or groups of nations can — and certainly, there’s been encouragement of nations, especially smaller nations who live in close proximity to one another’s traditionally territories — come together for proposals that are nation-based, community-driven for mental health and wellness in their communities. That’s a $30 million funding envelope.

All of those relate, of course, to the overdose crisis. They are investments in supporting the building of that better, culturally safe system of mental health and addictions care for First Nations people.

In addition, there have been specific investments on overdose response that total $44 million. I’m happy to give the member their different time frames for different of these, but that’s sort of a Coles Notes version of it.

I would also mention that we’ve spoken about the counselling grants and rolling those out to community agencies. A third of the agencies that received the grants for no-cost or low-cost counselling were Indigenous agencies — one out of three. Then, when COVID-19 hit, we provided resources to stand those up virtually — those services and an additional 20 agencies that are very much about reaching people in rural and remote communities.

S. Furstenau: Those are helpful, all of those initiatives. I appreciate the recognition that it’s not just about treating at the end of the issue. It’s about finding ways to solve things earlier on.

[3:00 p.m.]

We’re going to move to safer supply, prescription drugs being made available. As we started out with the questions today in estimates, we appreciate, in Cowichan, the announcements that have come. I think it’s a good start. I think many communities around the province want to see a similar response. Can the minister tell us, to date, how many people across B.C. have benefited from the safe supply of prescription drugs?

Hon. J. Darcy: Thank you for the question.

The member used the term “safe supply,” and of course, people mean so many different things by that. So I’m going to, sort of, break down different types of access to safe prescription medication, which to my mind together make up the answer to this question.

Opioid agonist therapy. I usually call it medication-assisted treatment because people know what that means. The numbers of people on OAT have expanded by about 3,500 people. So that’s things like Suboxone, methadone, Kadian, and so on. Our program for injectable OAT has expanded from 304 people across six sites to 440 across eight sites. Access to tablet injectable OAT has expanded from 100 patients to 335 patients.

Then under the risk mitigation guidance. The overwhelming majority of people who are being prescribed medications under the risk mitigation guidelines that were introduced a couple of weeks after the pandemic was declared are accessing hydromorphone specifically, and there is an increase of 1,300 people who are now getting prescription hydromorphone in the province. That’s as of the end of June, I believe, those figures are for.

S. Furstenau: Thanks to the minister.

As we are acutely aware of how little time we have in estimates, we do send our questions ahead of time, although the next question I’m going to ask wasn’t sent ahead of time. We’re always hoping for as much efficiency as possible.

[3:05 p.m.]

One of the challenges that has been raised to me through my constituency office is the cost of prescription refills — that the prescriptions often tend to be very small amounts. I can understand that. However, the prescription refill costs can be a barrier for people. Can the minister speak to how people can address that barrier?

Hon. J. Darcy: On this issue, one of the components of the risk mitigation guidelines, which was enabled by exemptions from the federal controlled substances act, allowed for more flexibility around prescriptions. It allowed for longer carries, meaning longer prescriptions so that people didn’t have to go in every day. That’s specifically in order for people to be able to maintain physical distancing if they were expected to go to a pharmacy very regularly to get their medications.

It allowed for delivery. It allowed for longer carries, meaning longer prescriptions, and also provided for virtual prescribing. So still a health care provider that is able to prescribe had to do the prescribing, but it could be done virtually, all of which was to improve access and to keep people safe in the context of two public health emergencies.

If the member has specific instances about the issue of charges for prescription refills that have been a barrier to people accessing the risk mitigation guidance, I would ask her if she could please pass them on to my office so that we can follow up directly.

S. Furstenau: Thank you to the minister. We will absolutely do that through our constituency office.

My question on this line continues. Will the programs and the increases in numbers in the variety of safe supply approaches that the minister has outlined continue after the COVID-19 pandemic? If yes, are there going to be any expected changes to the program and the supply? Does the minister see, for example, the program continuing to expand to people who need it and also to other health regions?

Hon. J. Darcy: Thank you to the member.

On the risk mitigation guidance, initially, the federal government said that there would be a sunset clause. There was a sunset. They would expire as of the end of September. The federal Health Minister has indicated to us that they will be extended, which is very good news. That’s certainly something that we have advocated for.

I don’t think the member was in the room — maybe listening, though — for a discussion just previous about discussions that are ongoing. There was a question about a statement that Dr. Bonnie Henry had made about protocolization of access to medications under the risk mitigation guidelines.

[3:10 p.m.]

Basically, what Dr. Henry referred to by that was putting in place protocols that really are about building a multidisciplinary team in order to provide more holistic care. A multidisciplinary team, more wraparound care and also to use everybody in the team to the full scope of their practice. That, I know, is something that our government supports, something that I know the member supports — and looking at expanded roles within that team in order to expand access to medications. Those issues are under active discussion.

S. Furstenau: I’m taking from that that the minister sees this particular approach as one essential aspect to a wider array of approaches going forward, that it’s not something that would end when the pandemic crisis is over — which, hopefully, is sooner rather than later — but that it will continue after as part of the wider approach.

I’m going to move to treatment and recovery spaces. Can the minister please let us know how many publicly funded treatment and recovery spaces there are in the province right now? How are they divided by health region and broken down by demographic?

[3:15 p.m.]

Hon. J. Darcy: I’m going to assume that the member is referring to beds as opposed to spaces, because there are also a number of treatment spaces provided on an outpatient basis, as opposed to residential treatment or supportive recovery.

Government does sort of a point-in-time count of beds. What I have is a bed survey from September, 2019, and there are some others that I will reference that are in addition to that. As of September, 2019, there were 3,027 health authority–funded, community substance use treatment beds in various locations. We have a chart that lays out where they are across the province.

That includes residential treatments, residential services, transitional services, withdrawal management, sobering and assessment, low barrier housing and supportive housing. There are also what we call surge beds, which were added as a result of the overdose crisis, and some more beds that were added in corrections that were part of the overdose response.

The total is 3,027 health authority–funded community substance use treatment beds and 38 treatment beds funded through PHSA. Those are very high acuity, for complex patients. That’s 38 funded through PHSA. They’re considered tier 4 and tier 5 because of their level of complexity. That’s a total 3,065. That’s as of last September.

What is not included in those figures is that we funded significant investment in Our Place Therapeutic Recovery Centre on the Island for an addition of 40 beds. They’re not health authority beds, but they are beds that receive significant public funding in order to be able to open that facility.

We have just recently announced, just last week, the funding for 50 to 70 new beds, residential treatment and supportive recovery, and we will be opening a youth treatment centre in Chilliwack very soon. It’s been delayed, first because of some soil issues and land issues and then, more recently, because of COVID, but it will be opening soon.

S. Furstenau: We’ve hit our 45 minutes. I’ll pass it back over to the member for North Vancouver–Seymour.

J. Thornthwaite: I’m recognizing that I don’t have very much time. I know now, from the House Leaders, that I do have a half an hour. So I’ll be going until 3:45.

My question is a follow-up, actually, from a question that I asked the Minister of Children and Families just before the March break. It was about the relationship between MCFD and Foundry on the North Shore. I asked specifically the question to the minister, and she was surprised that the relationship between Foundry on the North Shore and MCFD was not as cohesive as it should be.

I explained that it’s not a one-stop shop. In fact, I held up a diagram. I know I’m probably not allowed to do this, but that’s the diagram. It’s not a one-stop shop. There are varying degrees of where people have to go to get help. If a youth comes to Foundry on the North Shore with not concurrent disorders — in other words, not a substance use issue — and has mental health issues, then they are turned away. They’re turned away to go down the street to MCFD.

That I find disturbing, because apparently that has been going on for a lot of years, that Vancouver Coastal Health and MCFD are not very coordinated. I am wondering whether or not the minister will finally coordinate those two together so that it truly is a one-stop shop and that if somebody comes into Foundry, they’re not going to be sent away to MCFD, and then there’s another waiting lists for psychiatrists.

A good idea would be…. Why not have MCFD work out of the Foundry office? They do in other Foundrys.

Then the other question was about the child and youth mental health service framework that I talked to the Minister of Children and Families about. They talk about child and youth mental health. All MCFD — there’s not one word of Foundry in this. Obviously, there’s a disconnect between MCFD and Foundry from this document. So I asked that question as well to her, and she did not have an answer for that.

[3:20 p.m.]

Then I also asked the Minister of Education about the relationship between Foundry and the school district, and he actually directed me to the Minister of Health, who I will ask if I don’t have the answer from this minister.

It was my understanding that with the Minister of Mental Health and Addictions, the whole idea was to combine all of these issues, mental health and addictions, under one roof, one ministry. But it appears, after three years, that this is not the case. There appears to still be a lack of coordination between Vancouver Coastal Health and MCFD, at least in the North Shore, as well as, obviously, a disconnect with the school district. I guess my concern is…. I also read, on the record, a very sad story of a constituent of mine. Her child had fallen through the cracks because of this.

Again I’m going ask the same question, basically, that I asked the Minister of Children and Families as well as the Minister of Education: when are we going to get everybody together under one roof so that it truly is a one-stop shop and that it truly is seamless care for mental health and addictions, not just on the North Shore but provincewide?

[3:25 p.m.]

Hon. J. Darcy: Thank you to the member for the question.

The goal, certainly, of Foundry — as the member opposite knows — is to integrate service delivery. That doesn’t always mean that all of those service providers are in the same physical location. It’s really about creating pathways to services, pathways to care, and integrating those pathways.

As the member is probably aware, some Foundry youth centres have 35 to 40 partners. They can’t all be physically co-located. Foundries, depending on their physical capacity, have a number of them co-located. Regardless, they work very hard to integrate service delivery. I know that MCFD works closely with Foundry youth centres. I understand that they may not be physically co-located, but I also understand that their offices are very, very close by, which certainly would help to facilitate that integration.

[3:30 p.m.]

Yes, indeed, our ministry does work across government in order in order to expand our services and our programs for children and youth and for people of all ages. We will certainly be working with MCFD to ensure that you get a response to the questions that you raised with MCFD.

J. Thornthwaite: In the understanding of time, because I’m done at 3:45, I just want to make sure I get these questions in the record. If the minister does not want to answer them in person today, she could always write me a written response. I actually do have other questions that I will submit to the minister that I was unable to get to today, but these are the questions.

A constituent of my colleague in West Vancouver–Sea to Sky…. This woman had sent me — and I’ll send this letter to the minister for her — specifically this question about the waiting lists for psychoeducational and neuropsychological assessment. The average wait for such service is a minimum of one to two years. Privately, it is six months and costs in the tune of $2,000 to $5,000.

I also heard from many people on the North Shore, as well as provincewide, that it’s very difficult to get in to see a psychiatrist. The wait-lists are 18 months long, so even if you do get referred to MCFD out of the Foundry in the North Shore, as I mentioned before, the wait-list to see a psychiatrist is exorbitant.

I have a question to do with both the access to psychiatrists and psychoeducational and neuropsychological assessments. What is the minister doing to improve the time that people have to wait? In other words, reducing wait-lists or access to them. I know that there’s a problem with child psychiatrists. We don’t have enough of them.

I have a question on behalf of the member for Kamloops–South Thompson about Foundry. He was concerned that Kamloops was not one of the chosen cities for Foundry, and he’s very disappointed about that and wanted to know why that was.

Then the last question. If the minister could answer it today, and if not, I will take a written answer. This is on behalf of the member from Parksville. One of her constituents, who is a first responder and has been diagnosed with PTSD, was wondering if the minister would consider requiring mandatory trauma-informed practice at all mental health and addictions treatment providers in British Columbia because of the circumstances that she had to go through when there wasn’t trauma-informed care.

Those are my questions. If the minister would like to answer them in the time that I have, I’d very much appreciate that. But if not, I would be happy with a written response. I wanted to say thank you to the minister as well as her staff for allowing me and my colleagues to ask these questions on this very important file.

[3:35 p.m.]

Hon. J. Darcy: The member asked a number of questions there, and as she noted, we won’t have time to canvass all of them.

I wonder if she could share with us…. As she mentioned, there was correspondence that related to West Vancouver–Sea to Sky waits for psychoeducational assessments and the waits for psychiatrists. If she could share that with us, that would be very helpful so that we’re in a position to respond.

On Kamloops–South Thompson, your colleague who feels really badly that Kamloops didn’t get a Foundry centre, I’m sure the member can appreciate that there were dozens of communities — I think the number is more than 40 communities — that submitted applications for Foundry.

[3:40 p.m.]

I’m sure the member knows this, but just to reiterate — and please it pass on to the member for Kamloops–South Thompson — government does not make the selection. This is a process that is established independent of government.

They put out the expression of interest. They initially received over 40 applications. Sadly, there are eight new communities that are very happy, and there are many others that are waiting their turn, including Kamloops–South Thompson.

They began with about 40. They have two independent panels that evaluate them, narrow them down, develop their shortlists and then make their final determination. These are panels that include young people, families, caregivers, community agencies, subject-matter experts, existing Foundry facilities, people from Foundry central — really a large cross-section of people with experience in this sector. It’s really those panels, under the auspices of Foundry, that make the determination about where the next Foundry centres will be.

On the next question, which was related to PTSD…. It’s certainly an area that I’m very familiar with, having worked on this issue very, very closely with first responders, with ambulance paramedics but also with first responders.

We certainly believe that all of the care that is provided for people with mental health injuries or substance use issues should be trauma-informed care. That was really a foundational principle of A Pathway to Hope, which we released a year ago. It spoke to the need for practice guidelines for health authorities and MCFD for trauma-informed practice.

Staff in health authorities that work in this field, and staff in MCFD, are receiving training in trauma-informed care. We know that how somebody responds, if they are struggling with a mental health injury or an addiction, and how they perceive the care that they’re receiving makes an enormous difference to their care, to their recovery, to their healing.

We know there’s more that needs to be done. I’m sure there are improvements that need to happen. This trauma-informed practice is not integrated universally yet. We’re certainly moving in that direction, and that is the mandate now for health authorities and MCFD.

I do want to also flag for the member that our government did introduce changes to WorkSafe legislation so that mental health injuries could be the subject of presumptive disability claims. That was something new. Initially, it applied strictly to first responders and people who work in corrections. So that certainly covered ambulance paramedics. It has since been expanded to cover other occupational groups like nurses and care aides.

Certainly, based on what we’ve just been through and what we’re still living through with COVID-19 in nursing homes…. We know that the staff who work there are principally care aides. Not surprisingly, some have experienced, and probably many more will be dealing with, mental health injuries as a result.

Under active consideration, literally as we speak, is the issue, which has been raised with us by first responders and by other people who work in health care, about the importance of not viewing a mental health injury as just a single point in time.

There is presently, under WorkSafe legislation, a time limit of a year on submitting claims after an injury has occurred, but in the case of a mental health injury, those things are often cumulative. So the issue of point in time…. “Sorry. A year is up. You can’t file a claim anymore.” It’s important to re-evaluate that, and that is under active reconsideration.

[3:45 p.m.]

I believe that concludes our time. I would like to take the opportunity to thank the member opposite for all of her questions today. There are times that we disagree and have some, sometimes, difficult exchanges. I certainly want to recognize her commitment and her passion for issues related to mental health and substance use and her advocacy in that area.

I want to give enormous thanks to all of the people out there on the front lines who give their all every single day, under incredibly difficult circumstances, to support people who are living with mental health and addictions care.

I want to pay a special tribute to the people from my ministry who are in the room with me here today or who are connected virtually. I could not be more blessed but to work with an amazing team led by Deputy Minister Neilane Mayhew, in the Ministry of Mental Health and Addictions — a small but mighty team who are doing amazing, amazing work. I thank them so much for what they do 365 days a year and today, in particular, for their work in preparing for estimates.

Vote 36: ministry operations, $9,712,000 — approved.

The Chair: Thank you very much, Members.

We will now take a short recess to prepare for our next piece of work.

The committee recessed from 3:46 p.m. to 4:03 p.m.

[S. Malcolmson in the chair.]

ESTIMATES: MINISTRY OF
CHILDREN AND FAMILY DEVELOPMENT

(continued)

The Chair: Good afternoon, committee. We are carrying on with the work of budget estimates, but this is a little bit outside the ordinary pattern. By agreement of all the parties, in accordance with order of the House on July 15, 2020, we are now going to proceed with additional questioning of the Ministry of Children and Family Development.

Members of the public who have been with us for the weeks that we’ve been reviewing budget estimates will remember that we had finished that section, but by agreement of all parties, we are returning to further questions. Questions will be posed to the Minister of State for Child Care as well as to the Deputy Minister of Children and Family Development. A reminder to the committee that pursuant to the order of the House, questions must relate to ministry expenditures in relation to COVID-19 expenditures.

Thanks to all of you for your service to the public, being here this afternoon.

I’ll now recognize Minister Chen, our Minister of State for Child Care, for any opening comments.

Hon. K. Chen: I am very pleased to be able to open this special discussion on the Ministry of Children and Family Development’s response to COVID-19. I want to start by thanking ADM Christine Massey, who is here supporting; our executive director, Aleksandra; and also our DM, Allison Bond, who will be responding to other MCFD questions later; and all the MCFD staff for their incredible work and support during this very challenging time.

I would like to start by highlighting some of the work that we’ve done, in terms of supporting child care and early learning, including child care professionals, providers and parents throughout the pandemic.

[4:05 p.m.]

Of course, some of the key items we’ve done, starting with the support and the work that we’ve been doing, working closely with public health authorities, public health officer Dr. Bonnie Henry, Ministry of Health, BCCDC, to ensure that child care can safely operate during the pandemic and during this very unprecedented time….

We’ve published, for example, a public health guidance on child care settings and also a lot of frequently asked questions for parents, providers, early childhood educators to ensure that child care can continue during the pandemic, as a lot of parents, especially front-line and essential services workers, need the support of child care.

We, for example, have also procured and delivered hand sanitizers to a lot of the facilities that are receiving our operating fund and even set up a direct supply line for child care operators in need of cleaning supplies. Also, to reassure and support child care providers and parents, we have had phone conferences and even an online town hall with public health officials and experts to discuss health and safety concerns and also how child care can safely operate during the pandemic.

Of course, I think one of the key highlights and investments we’ve done is the temporary emergency funding that we think…. Within not even two weeks’ time after the declaration of the state of emergency in B.C., we rolled out emergency funding to support child care providers starting April 1 until August 31, 2020.

This has really significantly helped providers who are open to serve essential services workers, to be able to work on the front lines, with their child care needs and also supporting providers that are closed to be able to come back in service when they’re ready to. The program has been a huge success, with an intake of about 90 percent of providers starting this program and using the support.

We are also directing some of the funding to make sure we support early childhood educators. In addition to that, we have a B.C. temporary inclusion fund that is helping child care providers to create inclusive spaces for essential workers’ children who may require extra support. This is important to ensure children who require extra support are being looked after during this pandemic.

We have also worked with…. Thanks to the Attorney General’s office, we ensured that child care operators were protected and cannot be sued or held liable for damages caused by exposure to COVID-19, which is also making sure that child care providers are being supported and can safely operate during this pandemic.

We’ve continued to communicate with providers and parents through newsletters. We have a COVID-19 child care response site that has clear information about all the programs. We have a dedicated team, and thanks again to a lot of dedicated ministry staff for working long hours to make sure questions are being responded to during the pandemic. There are a lot of emergency situations where we are able to support providers and parents with during this difficult time.

We also have an online matching program, which has been a huge success, that has done over 5,700 referrals to ensure front-line workers, especially — but the majority of them are actually health care workers — are able to find child care services during this challenging time.

We ensure that parents will continue to get the benefits that they normally are entitled to, including the fee reduction program, affordable child care benefit. We’ve made adjustments, making sure that we can continue to support those programs.

Also, we are supporting early childhood educators. We made sure that they can continue to keep their licence. We made things more flexible for them to renew their licence. We are also, like I mentioned earlier…. To ensure that temporary emergency funding can also benefit early childhood educators and staff at child care centres, we continued with our enhancement to the wage enhancement program with additional dollars to support early childhood educators. We know that this is really a unique situation and an unprecedented time, but we’re committed.

A lot of things have changed during this pandemic, but our commitment to child care and to support and create an inclusive, affordable child care system for all families in B.C. has not changed.

L. Throness: I realize that estimates are over formally, so I appreciate the minister’s courtesy in appearing today. I sent a letter a couple of days ago to the minister’s office with some more statistical questions. So if we don’t get to them today — and I doubt we will because our time is really attenuated — I hope the minister will send me a written reply.

[4:10 p.m.]

I’ve constructed some questions in categories and from the viewpoint of parents and providers and ECEs and others. I would like to start with the category of things that parents want to know. Speaking as a parent, I would ask the first question: will my little boy be safe if I send him back to my old child care on September 1?

Hon. K. Chen: Child care has been safely operating during the pandemic, and we’ve been working very closely with public health on the health and safety of child care settings. I would direct the member opposite to ask more detailed questions to the Ministry of Health. But child care has been safely operating during the pandemic.

The Chair: To the opposition critic, if you are intending to pass questions to any other members of your caucus, it’s ideal if you coordinate that amongst yourselves so that I’m not choosing multiple hands. I’ll otherwise expect that it’s you who’s going be leading on this.

L. Throness: Okay. The second question is: has the minister consulted with Dr. Henry and the CDC on safety? Has she received advice from them? Has Dr. Henry and the CDC approved a plan for reopening?

Hon. K. Chen: Yes. Absolutely. We’ve been working with public health, including Dr. Henry’s office, very closely during the pandemic, and all the information, I hope the member opposite would know, is published on the website.

L. Throness: Where is the government’s plan to keep my children safe? I’d like to read it.

[4:15 p.m.]

Hon. K. Chen: As I’ve mentioned, we have been working very closely with public health, and public health has ensured that child care can safely operate during the pandemic, and they have been. Child care centres have been open. Many centres have been open during the pandemic. They’ve been safely operating.

We have information, all online, for parents and for providers with a lot of resources, guidance, suggestions and also ideas to ensure child care can safely run and we can keep our children and staff safe and healthy in child care settings.

L. Throness: What preparations has government made for the eventuality of a second wave? If there’s a second wave of the coronavirus, then are things going to close down again? What preparations has the government made?

Hon. K. Chen: We have always been responding very quickly to adapt to the changing situation. Again, it’s a very unique time. We continue to make sure we can respond to any emergencies, and we have been doing that. We’ll continue to work very closely with Dr. Henry’s office, with public health, to ensure that we can respond quickly.

L. Throness: Have there been any COVID cases among children or adults in daycares in B.C.?

Hon. K. Chen: Not that I’m aware of. But I think the member opposite should really direct his questions to public health.

L. Throness: Will all providers reopen on September 1? Are there providers that won’t reopen? Can the government give some idea as to how many providers will reopen on September 1? Will everybody be open?

Hon. K. Chen: I hope the critic would know that the child care sector in B.C. is very unique. We have smaller providers, large providers and family providers that all operate under very different circumstances, with different staffing situations, different needs and different concerns. A small child care provider, a family child care provider, may have concerns about their family members, if they have elderly parents living with them.

We have always made sure child care providers have the decision and the options to decide whether they’re closed or open. Our temporary emergency funding is providing support for both open and closed providers. We’re actually the only province in Canada that is providing support to centres that are closed so they can come back and reopen their service when they’re ready.

We will continue to do that. We’ll have to wait until September to know the actual numbers, but providers have been coming back in service throughout the past few weeks, and our temporary emergency funding continues to be there to support until the end of the summer.

[4:20 p.m.]

I just want to read a thank-you that I got from a provider. This is Megan, who has shared with us…. She said: “We’re so thankful for the ministry and all the staff there for making this emergency funding happen. If it weren’t for our beautiful province, we would have been put out of business, like many others. This money has saved our lives. Thank you.”

L. Throness: Speaking again as a parent, will my child care centre be the same as it was pre-COVID? What changes in terms of physical structure or practice can I expect?

Hon. K. Chen: As I mentioned, all the public health guidelines and health and safety guidelines and suggestions are published on the website. We’ve been working very closely with public health and BCCDC in terms of how we can provide the best resources and information possible to parents.

There are some good ideas, such as making sure children are washing their hands regularly, staggering pickup and drop-off time with parents, a lot of regular cleaning of areas that children touch all the time and making sure they do more activities outdoors, especially with the summertime. The weather is so good.

There are great resources for parents online. We’ve done town halls. We’ve done information sessions to make sure we can get this information out.

As a parent myself, I know we all do our best to make the best decisions for our own family and for our own children. I hope the member opposite also understands that parents can make their own choices and decide what is the best for their family and their children. But we have been working closely with public health to ensure child care can safely operate in B.C.

L. Throness: I’ve been reading, of course, documents online and so on. It appears that it’s going to be status quo. It’s going to be pre-COVID. There will be some more cleaning, but basically, a child care centre will be the same. There are no social distancing requirements. Everything will be the same except for a bit more cleaning.

Is that wrong? What structural changes — permanent changes — will there be in child care as a result of COVID? Anything?

Hon. K. Chen: I would like to share, actually…. Just this morning I dropped off my son at a child care setting, and I’m seeing a lot of changes to the centre. For example, they do staggered pickup and drop-off times. Parents are no longer allowed to go into the centre anymore. We have to keep social distancing between parents. Also, when the staff are coming out to pick up the children, some of them are wearing PPE.

[4:25 p.m.]

There are a lot in child care that are really working and doing their best to make sure they follow public health safety guidelines and making sure that we adapt to the changes that we’re seeing in our community. If the member has some experience with young children, the member would know that, yes, it is not easy for children to keep social distancing. But I have seen child care settings that designed their play area in a way — making sure there are tables and chairs separated — so children can play in different areas and do their best to keep social distancing.

It is a really unique time, and children are adapting. Child care providers and centres are doing their best. Early childhood educators are doing their best to ensure health and safety. We have been, again, working with public health very closely. Public health’s decisions really are based on the science of COVID and kids. We trust our public health’s direction.

I would, again, encourage the member to redirect the health and safety questions to the Ministry of Health or public health.

L. Throness: I appreciate the minister bringing out an anecdote, but I’m talking about systemwide changes. I just want to point out that parents will bring back their children if they’re confident that they will be safe, but there’s no…. The Ministry of Health is bringing out a plan, for instance, for K to 12 on August 1. It’s going to be a plan that speaks to safety for all children, for all K to 12.

There’s no updated, specific plan that the minister is bringing forward. That doesn’t give parents, I don’t think, a lot of confidence. It doesn’t seem that there are a lot of new requirements from the ministry for any kind of change in structure or practice except perhaps for cleaning, and that doesn’t seem to be very confidence-instilling.

I want to move on to ask a question about cost. If I get a haircut now, I pay a little bit more. I’m wondering: will the cost of my child care be the same as it was pre-COVID, or will there be an extra COVID-related charge that’s allowed by the minister and the ministry, as there is now on so many things?

Hon. K. Chen: As the member opposite knows, our government has always been committed to investing in child care and making sure child care is more affordable. We’ve provided historical investments to bring down fees through the fee reduction program, through the affordable child care benefit program and also through the prototype sites and other measures so that many, many families are benefiting from affordable child care right now.

Currently we’re not seeing any significant changes when it comes to parent fees. The reason why we actually introduced the temporary emergency funding, part of it, was to make sure that child care providers can continue to operate during the pandemic with the drop of enrolment. But on the other hand, the temporary emergency funding has also ensured parents do not pay a fee to hold their spot and also ensured that providers have extra funding to pay for their operations so they do not need to increase fees. They can continue to operate just as usual.

The temporary emergency funding has provided big support to parents to ensure child care continues to stay as affordable as possible and make sure there are no significant fee increases.

[4:30 p.m.]

We also have our child care fee reduction program. We have a contract with providers so that if a provider wants to increase fees, they have to come to the ministry to provide really unique and unusual circumstances. Again, we’re not seeing any significant changes. We will continue to work hard to make sure we can work with providers to ensure child care fees are not being significantly impacted after this pandemic.

L. Throness: Now from the perspective of an essential service worker. I’m an essential service worker. Will my child, who has had a space for the past few months because of vacancies due to COVID, still have a space on September 1?

Hon. K. Chen: During this pandemic, we worked hard to make sure that parents can have access to child care. That’s why we have the online matching program that has successfully matched thousands of parents to be able to get child care service. We’ll continue to monitor that and see how things go as more parents are coming back to their regular service.

We would totally encourage parents to contact their local child care resource referral centres. We’ve been working very closely with them, and they’ve been of tremendous help when it comes to matching those services, to ensure essential service workers can get the service that they need. At the same time, we have not slowed down in terms of building child care spaces. The pandemic has not slowed us down at all.

We’ll have more news to come about our new spaces that we’re continuing to build during this pandemic. Hoping that more and more parents, after many years of not being able to find the services they need…. Our government’s Childcare B.C. plan is really focused on creating more opportunities for families for child care services.

L. Throness: The ministry sent out form letters to providers to respond to parents, and they sent out a form letter for essential workers. This is what the form letter says: “If you will require child care after August 31 and space is no longer available in our facility, we encourage you to fill out the form to request temporary emergency child care. This will give your information to our local CCRR, which will try and contact you.” And so on.

Is the best that an essential worker can hope for to get more temporary emergency care while they are on the front lines?

Hon. K. Chen: I think the member opposite would know that there has always been a shortage of child care spaces in this province, especially for many years. Child care and early learning is an area that was neglected by the member opposite’s previous government for many, many years.

[4:35 p.m.]

When we became government, we made sure we provided a significant and, actually, historical investment in early learning and child care. We have been accelerating the creation of spaces, investing in affordability and making sure early childhood educators also get the support to be able to support the child care needs of parents.

That is why, during this pandemic, we’ve worked very closely with local child care resource referral centres. We’re monitoring the situation very carefully, because some parents may not return to work due to their employment situations, or they may have different arrangements for their child care needs. They may have family decisions or family situations so that their children may not be returning to child care full-time or part-time. And we also have families that are looking for services, and we’ve been quite successful during the past few months to match those services.

The spaces are available to essential services workers that urgently need those spaces. We’ve had some really good success and good stories, and I really want to take the opportunity again to thank early childhood educators and local child care resource referral centres for working together to provide those services. We’ll continue to monitor it closely and see how the spaces situation turns out, but at the same time, we have not stopped creating spaces for British Columbian families when it comes to child care.

L. Throness: Maybe we can just move that on — this is a good segue — to future plans. Because of COVID, will the government be able to meet its commitment to parents to create 24,000 new and incremental child care spaces by March 31 of next year, or has that goal changed?

Hon. K. Chen: We’re very thankful to say that the pandemic has not slowed down our plan to accelerate the creation of child care spaces. We are continuing to create spaces during the pandemic, and we have more information to come very soon that we will definitely share with the member opposite. We’re on track. We have not changed our goals, and we’re happy to provide more information very soon.

L. Throness: The February budget contains some significant new spending for child care. Is the government still committed to the spending on child care, as it is laid out in the February budget?

Hon. K. Chen: I believe the member opposite’s question is not related to COVID expenditures, so we’ve already covered that in our previous estimates, and that should not be included in part of this special debate.

L. Throness: How has the government’s universal child care timeline been affected? Has that been put off by COVID? Is it still ten years?

Hon. K. Chen: I believe the member opposite’s question has already been covered during our previous estimates.

[4:40 p.m.]

I’m open to the Chair’s direction in terms of how this special debate would include questions that are regarding our goal of universal child care and other items.

The Chair: For the special session, the agreement of the parties was that the questions must relate to ministry operations in regard to COVID-19-related expenditures. I’ll ask the member to contain his questions to that agreed-on subject area. Thank you.

L. Throness: Okay. Let’s move on to things that providers and early childhood educators would want to know about the COVID issue. If I’m a provider or ECE, given that children may be less susceptible to the virus but adults are more susceptible to it, will I be safe in my daycare after September 1?

Hon. K. Chen: As I’ve mentioned previously, we’ve been working very closely with public health on health and safety guidelines, and WorkSafeBC has also published health and safety guidelines for early childhood educators and workers in child care settings. I would direct, again, the member to ask the health and safety questions to the relevant ministries, but child care has been safely operating during the pandemic.

L. Throness: I’m a provider who doesn’t feel comfortable about opening on September 1, but my temporary emergency funding stops on September 1. Are there any options for me, or is the minister forcing providers to open or to lose their centre?

Hon. K. Chen: I want to emphasize that we have not forced any providers to open or close. It’s always been their choice during the pandemic, and it continues to be the providers’ choice to decide whether they want to open or close.

The purpose of the temporary emergency funding is to make sure that they can do either way. If they want to open, they have the support to keep their operations even while their enrolment is significantly dropped. If they are closed, we can still pay for the basic needs for their operation so they can come back to service when they can.

I would encourage all child care providers to look at health and safety guidelines as published by public health. There are a lot of details and information and a really good resource to support providers to ensure that they can safely operate and come back into operation in September. We’re also working closely, for example, with the education community when school gradually reopens.

Again, I would encourage providers to consult with public health, to look at public health and safety guidelines to have their peace of mind that they can come back in service in September.

[4:45 p.m.]

L. Throness: As a provider, will the minister help me to bear the cost of extra cleaning requirements due to COVID and anything else that the government may require of me? Will the minister help to deal with that?

Hon. K. Chen: As part of our temporary emergency funding, the provider has the choice to use the funding to support their extra costs, including cleaning supplies. That goes until the end of August.

The ministry has actually procured and delivered hand sanitizers to many facilities that are receiving our operating fund. Also, we have set up direct supply lines for child care operators in need of cleaning supplies.

L. Throness: So that assistance will be permanent, then, for cleaning supplies?

Hon. K. Chen: Our government has always been committed to supporting child care providers. As long as we can, we’ll definitely ensure that we can continue to provide those services to support child care providers and early childhood educators who work on the front line.

L. Throness: Because of the temporary emergency funding calculations, some providers had a surplus, and some had a shortage. I’m a provider who came up short financially this summer, despite receiving TEF funding of two times my average monthly CCOF payments, while other people had a big surplus. Will there be any extra help for me?

Hon. K. Chen: My understanding, and the feedback that we’ve been receiving from the child care sector, is that the temporary emergency funding has been a significant support to their operations, including those that are closed. Again, we are the only jurisdiction that is providing support to child care centres that are closed.

Of course, the critic would know that the child care sector in B.C. is very diverse. Centres operate in different ways and have different financial situations. The temporary emergency funding, from our understanding, has really covered up to an average of 75 percent of the operation of a centre that’s opened and also to 20 percent of operation of a centre that’s closed. It is quite significant to cover for the cost of a child care centre.

For example, some of the great feedback that we’ve received included Marsha, who owns a group child care centre. She said: “I want you and your team to know that in this time of pandemic, it was clear to me that when you stepped so quickly and so accurately, you truly understand the needs of our industry. Your strength, understanding and commitment to our needs and swift action and support gave us the confidence to persevere in a time of great uncertainty.”

[4:50 p.m.]

L. Throness: The government set out temporary emergency funding, and some people had a shortage, a severe shortage. I heard about that. Some people had quite a surplus, a significant surplus. How much in surplus funds is there in the system from temporary emergency funding?

Hon. K. Chen: I think it is important to note that the intent of the temporary emergency funding is to cover the anticipated loss in providers’ revenue because of the loss of ability to charge parent fees or due to the drop-off in enrolment, and also to ensure that parents don’t have to pay a fee to hold those spots and that child cares can continue with their operations.

As the critic, I hope the member opposite would know that the child care sector is very diverse. There are so many different ways of running a centre, different financial situations and different needs of the providers. It is really hard to anticipate and to predict how much surplus there is and then how the temporary emergency funding has created different results for providers.

That being said, I think the most important thing to remember is that the surplus is used to improve safety, accessibility and quality of child care spaces throughout this very uncertain time. What we’ll do is…. Later on we will provide a survey to providers to get information about how they’ve been using the surplus and more information about how the surplus situation has been.

L. Throness: Well, the minister will know that providers have been directed to use their surpluses for training for ECEs and different things like that. If I’m an ECE working for a provider who barely made it through COVID, and now those other providers who had a big surplus are spending it on training for their ECEs, how is this fair to all ECEs and all providers?

Hon. K. Chen: As I’ve mentioned, the child care sector is very diverse. As the critic would note, every centre has different types of operations and different needs. Some centres are owner-operated. There may not be any extra staff.

We want to make sure that we provide as much flexibility as possible and also that we respond as quickly as possible. I think our program does exactly that, to make sure that providers have more choices on decisions and in trying to find the best balance possible during this very unique time.

L. Throness: Exactly how much does the government estimate that it will spend on temporary emergency funding right through to September 1?

[4:55 p.m.]

Hon. K. Chen: We have been approved for funding of $253 million. We are happy to provide an update or the finals later.

L. Throness: I’m interested in how many spaces we may have lost during COVID. I wonder if the minister could give me two numbers: as of December 31, 2019 — or January 1, maybe, of this year — and today. How many CCOF-supported spaces did we have then, and how many do we have today, or in the latest period of record?

Hon. K. Chen: As this debate is limited to COVID expenditures, I would again like to respond to this question through other channels or at a later date. At the same time, I would like to do a time check with the Chair in terms of how many questions we have left, due to time limitations.

The Chair: Thank you, Minister. The length of questioning is not specified in the order from the House. Our understanding is that some questions would be going to the deputy minister as well as to the minister. Really, at this point, my understanding is that it is up to the members to work that out, unless anybody is privy to what the agreement amongst the House Leaders was.

At that point, I’ll encourage the member to carry on. Keep in mind that you’re also invited to ask the deputy minister some questions. That was specified in the order as well.

[5:00 p.m.]

L. Throness: It was my understanding that the MCFD minister was appearing today. Am I to understand, then, that the deputy is appearing in her place?

The Chair: That is what the order passed by the House says.

L. Throness: Okay. We had thought that the MCFD minister would appear for half an hour.

I just have one final question for the minister of state. Can the minister update us with regard to the analysis of the $10-a-day program, which was due in June? Has that been delayed by COVID? Has COVID delayed the continuance of the $10-a-day program? That’s my final question. Or will it go ahead as planned?

Hon. K. Chen: During the pandemic, we’ve continued funding and support through the prototype sites — that has not changed — and making sure that they’re stable and continue to serve children who are enrolled at the prototype site and also the centres that are part of the program.

In terms of the general questions about the survey and the result, I believe that’s, again, not related to COVID expenditures. We are more than happy to respond at a later date and through other channels.

L. Throness: Okay. I’d like to thank the minister of state for appearing today and move on to the deputy and put her on the hot seat for a few minutes.

Have there been any COVID cases among children in care? If so, how many, and what were the results of those cases?

The Chair: I recognize the deputy minister for the Ministry of Children and Family Development. I’ll encourage you to introduce yourself for the Hansard record as well.

A. Bond: My name is Allison Bond, the deputy minister of the Ministry of Children and Family Development. If I could just take a minute to extend my deepest gratitude for the staff at MCFD, the Delegated Aboriginal Agencies that work with us and our service delivery partners.

We were able to keep our offices open and services provided during this historic and unprecedented time. We’ve had many people in the ministry working hard to identify and implement the necessary emergency measures and changes to policy and practice to adapt. We’ve had a number of advocacy organizations, service providers and others working with us over the past many months so we could understand the impacts of this crisis and respond as best we could for the vulnerable people we serve. I want to express my appreciation for our front-line workers and MCFD, DAAs and the social services sector.

That being said, in response to the member’s question, I can say that we have no confirmation of any children in care that have had COVID-19. That might be captured in public health data, but we’re not aware.

L. Throness: That’s great news.

How has COVID impacted the expenses of the ministry? For example, were any additional funds provided to the ministry for COVID-19, or are the budget amounts still valid?

[5:05 p.m.]

A. Bond: Yes, we had some access approved to contingencies for pandemic response and economic recovery in the amount of $2.874 million to September 2020. That approved allocation was for children and youth with special needs to support the emergency relief support funding program and suspending monthly payments on special needs agreements.

In addition to that, we had specific access to contingencies for youth and young adults at $4.715 million to maintain care arrangements for youth aging out of care or aging out of independent living arrangements or youth agreements, as well as $3.156 million, accessed again from contingencies, the pandemic response, to cover the costs of the temporary changes to agreements with young adults. Everything else that we did, we did within our budget.

L. Throness: That adds up to about $10 million, which isn’t very much. The temporary emergency fund was $253 million. That’s a lot of money. Where did that come from?

A. Bond: I believe that the member opposite is referring to the temporary emergency funding for child care. That was also through the contingency vote, pandemic response and economic recovery.

L. Throness: Are those all the contingency funds that were accessed then — 253 plus the three categories that the deputy mentioned? Or are there more? What were the total contingency funds that were accessed across the total ministry? That’s what I’m asking.

A. Bond: What we can give you today is what we were approved in principle to access. What we actually accessed is information that we would have for you at a later date.

L. Throness: Obviously, during the COVID period, some parents drew their children home and were no longer getting different programs from the ministry. The ministry was saving on those programs, and it was spending on contingencies. On balance, did the ministry lose money or save money through the COVID period?

A. Bond: Information about the actual expenditures, both for COVID and overall for the ministry, would be available through the public accounts next year. So we wouldn’t have that information available for you today.

L. Throness: I certainly hope that the ministry has that information, because on a month-by-month basis, I know that detailed dollar-by-dollar spending is tracked, and it better be tracked by the ministry. In any case, I’ll move on.

According to a cabinet directive last September, there were savings targets identified for MCFD in travel, new hiring, discretionary spending, and so on. Is there a new mandate for savings targets this fiscal year due to COVID? If so, could the deputy describe the target amount and what actions are being taken to reduce any expenditures?

A. Bond: I believe the debate is about the COVID expenditures. So if the member opposite is asking if there were any COVID-related savings required, the answer is no. What we have access to is additional funding through contingencies for certain program areas. But in terms of the actual operations, no, there have been no directives to save money associated with COVID-19.

[5:10 p.m.]

L. Throness: I’m wondering if COVID impacted the number of foster homes that were available for offering care and if any foster parents fell ill from COVID.

A. Bond: As the member opposite is aware, we regularly lose and gain foster homes. We don’t have any indication as to whether or not any of the losses or gains over the course of the last few months are a result specifically of COVID-19, and unfortunately, I don’t have a specific number for the member opposite at this time.

I would say that the ministry worked extremely hard with our foster parents to ensure that there were plans in place should any of our foster parents, unhappily, get COVID-19. The plans were intended to ensure that there would be a safe place for the child to go should that happen and, of course, that we would make sure that the foster parent was getting the care that they needed.

L. Throness: I’m wondering about caseload assumptions. Caseload assumptions are built into the budget, and those can change, perhaps as a result of a situation like COVID.

Have caseload assumptions changed in any way, perhaps with respect to the number of children in care? Might we have more children in care, for instance? How is the government anticipating change?

A. Bond: As we always do, as the member opposite is aware, we’re very closely monitoring the caseload and the demands on the ministry and ensuring that we’re adapting as much as possible. Obviously, we would be looking to see whether any changes happened over the course of the past few months going forward.

We’ll continue to do that work, and we’re continuing to apply the same strategies we’ve applied over the last few years, which is to make every effort to keep children with their biological families, and if that’s not possible, with relatives and other close family members. None of those strategies have changed. The ministry is continuing on the same track that it did before.

L. Throness: Did any contracted care residential facilities close as a result of COVID? If so, how many? How long were they closed? Are they still closed? What happened to the children in care? Could the deputy elaborate?

A. Bond: We’re not aware of any closures of contracted residential agencies as a result of COVID-19.

L. Throness: What sort of permanent policy changes will be made with regard to children in care and MCFD staff as a result of COVID?

[5:15 p.m.]

A. Bond: We’re looking very closely, obviously, at any of the lessons from COVID-19. As we’re still in the middle of the pandemic and we continue to adapt both our practices and our policies to the pandemic, inclusive of how our staff work and what tools they have available to them….

That’s work that’s ongoing right now, and of course, it’s responsible of us to continue to review the policies and practices. We’re doing that now, and we’ll continue to do that over the course of the pandemic.

L. Throness: You know, that’s just an extremely general and non-specific answer. Can the deputy give me one, two, three specific changes that have been made as a result of COVID?

A. Bond: Thank you for the question.

We made a number of changes over the course of the pandemic. As the member opposite may be aware, we made changes to how visitation occurs. We provided significantly more technology to families who were unable to physically see the children that might be in care or with other family members. For those, technology and virtual visits have really changed the dynamic and provided, in fact, in some cases, even more visitation than there was before. So that’s something that we’re looking at.

We’re also looking at, obviously, and doing an analysis of the changes we made for youth and some of the efforts we’ve made around youth, but as those are currently funded through the pandemic funding, that’s not available to us to extend past the date that it was already identified.

We’re looking very closely as well at the children and youth with special needs program to determine whether or not there are any other changes that we need to make there. There were a number of issues raised by families around how we communicate with the families, and we’ve made significant improvements around communications. We obviously have a long way to go there, and we’ll continue to make those changes.

Those are some of the examples. In terms of permanent changes, though, we have to do evaluations of some of the successes that we’ve had. We have to do evaluations as to whether or not those things continue to be relevant post-pandemic. Of course, given that we’re currently in the pandemic, it’s not available to us to complete that evaluation, but obviously we’re taking the time and making the effort to do that evaluation.

L. Throness: I received, during this COVID period, many complaints from parents who have children with special needs. They consider that the temporary funding of $225 a month for three months, depending on the need of the child and the intensity of the need, you might say, was hugely inadequate. Some of them even considered surrendering their children to the ministry to put them into care.

How was that $225 a month chosen? That seems to me to be a very small number in the face of some extremely severe needs. For instance, why wouldn’t it have been tailored to the need of the child?

[5:20 p.m.]

A. Bond: We were working very, very quickly to find a funding amount that we felt would meet as many of the needs as we could in the pandemic and balance off those needs with available funding. So we chose an amount that correlated to many of the supports and services that might be available.

L. Throness: Would the government consider extending that temporary emergency funding in case there are people who cannot find providers? The re-entry is uneven and difficult. Has the ministry considered extending that on a compassionate basis?

A. Bond: After June 30, 2020…. A final round of the short-term emergency relief support funding is available between July and September 30, aiming to support twice as many eligible families.

We’ve also got flexible parameters regarding autism funding and the temporary suspension on maintenance payments for children on special needs agreements. That will remain through to August 31, and the flexible use of respite funding will continue to families until March 31, 2021.

We’ll continue to evaluate all of these measures against where we’re at around the pandemic.

L. Throness: Have any of the key service plan targets of the ministry changed due to COVID-19? Have they been changed?

A. Bond: The service plan and the direction of the ministry remain unchanged.

L. Throness: Will the government consider adding a statistical overview of what happened during the COVID crisis to the performance management portal so that parents and others can have a detailed examination of what happened to the child care system during the COVID period?

A. Bond: The portal will be updated and continue to be updated, as it always is. That will show and reflect the changing caseload. You can see changes in the caseload based on COVID-19, because it’ll be a time series. Perhaps that would help, in terms of the question associated with the member opposite.

[5:25 p.m.]

There’s lots of information on how the ministry has responded to COVID-19 on our COVID-19 page, accessible through the Internet site. In fact, we’ve made information available there that we’ve never made available before in the interests of transparency. In terms of other data the member might be interested in, we would encourage the member opposite to submit those requests through regular channels, and we’ll see what we can do.

L. Throness: I’m wondering if the ministry has made specific plans, ministrywide, for a second wave. I didn’t catch, from the minister of state, that any particular plans have been made for child care, and I’m wondering if there is a broader initiative to account for the contingency of a second wave.

A. Bond: The ministry, like every other ministry, has looked at what happened through phases 1, 2 and now 3 of the pandemic. We now have a plan that says: “Here’s what we do in phase 1, phase 2, phase 3 and phase 4.” That’s consistent with government planning overall. Our service providers have also done similar plans, as have the Delegated Aboriginal Agencies.

L. Throness: I’m wondering about stakeholders today. Which major stakeholders have reported the most significant impacts from COVID-19, and how has the ministry attempted to mitigate them?

A. Bond: I would say all of the stakeholders that we deal with regularly have identified significant impacts associated with COVID-19. The way the ministry has managed that is to work very closely with our stakeholders and our service providers and our Delegated Aboriginal Agencies.

We’ve increased ongoing communication. We have regular contact, on a weekly basis, with most of our stakeholders, if not more frequently. We’ve held town halls. We have made more information available on our COVID-19 site than we normally do. We’re going to continue to do that work.

I don’t know that I can say that any one stakeholder was affected more greatly than another. This is a significant impact across all of the vulnerable sector. We have continued to work in partnership with service providers and other ministries to try to ensure that we’re meeting the needs of the children, youth and families that are affected.

L. Throness: I’m wondering about performance. COVID may have impacted staff attendance. Maybe people are working from home or whatever. If you were to go through the performance measures of the ministry, what kinds of delays have been experienced, and changes, to the performance of the ministry as a result of COVID?

A. Bond: Again, I’m very proud, actually, to report that the front-line staff in the ministry really stepped up during the pandemic and noted their responsibility towards the children, youth and families they serve. We’ve seen no change in the available staff through the pandemic. We continue to see clients both virtually and in person.

Of course, we’ve had to adapt the how, how we deliver our services, based on provincial health officer guidelines. As those change, so, too, do our practices. We have continued to maintain a staff complement throughout the province so that the children, youth and families we serve get what they need.

[5:30 p.m.]

L. Throness: I’m wondering if the deputy has an idea of how many of her 5,000-odd staff worked from home during COVID and how many were in the office.

A. Bond: What we did was we tracked our front-line staff, primarily, in terms of who worked from home and who worked in the office. We were tracking regularly 30 percent in the office, which allowed us to maintain the office openings across the province. So we have 199 offices. Not all of those are front-line serving offices. But for any place where we actually had a service delivered out of that office, we had staff there to make sure that the office remained open.

Many of our back-office staff were able to do their work from home, so they weren’t in the offices.

L. Throness: Okay. Thank you to the deputy. I guess our time is pretty well up here. I’m going to introduce the member for Surrey–White Rock in a moment. I just have one final question that I didn’t get to ask the minister of state.

That is about the decision about the two times and seven times of CCOF funding for our child care providers. We got complaints that some providers who got the seven-time funding got too much. They, obviously, have a surplus, as the ministry has pointed out, and those who got two times got way too little.

Two providers, for instance, told me that they couldn’t pay the mortgage, based on their two-time CCOF provision. One said: “I’m going to have to rent out my space to a residential tenant and close my shop permanently because I just can’t make my mortgage, based on the little bit….” I think it was $600 a month that she was getting.

How did the ministry decide between the seven-time and the two-time CCOF payments?

A. Bond: Yeah. We were able to access data from child care providers that gave us information about the operating costs and enrolment figures. We could, therefore, look at what a typical facility might cost.

Of course, as the minister of state pointed out, there’s a huge diversity in the child care sector. So there might be outliers in that, as the member opposite points out. But it allowed us to provide very generous funding for most operators.

L. Throness: I just want to thank the deputy for filling in for the minister and for this opportunity. I’m going to hand it over now to the member for Surrey–White Rock. After that, I think the Greens are going to take over for the rest of our time today.

The Chair: I recognize the member for Surrey–White Rock and say how nice it is to see you here.

T. Redies: Thank you very much, Madam Chair. It’s very nice to see you as well.

I appreciate the opportunity to be able to ask a couple of questions on behalf of my families in White Rock–South Surrey who are living with children with autism. This has been a very, very difficult time. I’m sure the ministry appreciates it.

[5:35 p.m.]

With children not being able to go to school and not being able to access therapy…. In some cases, some of these families have children who are actually prone to violence. It’s a very, very sad situation. I know the deputy minister talked a little bit about, potentially, more flexible funding for autistic children and their families.

Specifically, I just wonder: if there is a second wave, is the plan to increase respite funding and funding for therapists and somehow look at ways to make those therapists available in a pandemic situation?

A. Bond: Yeah, we continue to work with our service providers so they can adapt their services.

We acknowledge, by the way…. I think it’s important, as the member opposite has done, to acknowledge the extraordinary pressures faced by families that have children and youth with special needs. They have had a substantial impact as a result of COVID-19. The suspension of in-class school instruction, for many of them, has had a significant impact: decreases in service accessibility, supply chain delays, the financial burdens that many of them are facing, practical dilemmas about working with home with some of these children — as the member opposite has identified, some of whom can have real challenges at home. This is something that we looked at very quickly as a ministry.

As we move through the pandemic and information becomes clearer about how services and supports can be provided safely to these families, we’re continuing to provide that information out to our service providers. We also know that they are receiving guidance from their regulatory colleges, and that’s helping them to adapt their services and supports. We also are aware there’s an increased use of virtual services — again, with guidance from the regulatory colleges.

Then, as the member opposite has asked, yeah, we’re going to continue to look at the impacts of COVID-19 on those families and those significant impacts and stresses on those families. That’s obviously something that we’re paying very close attention to.

T. Redies: Thank you for the answer, Deputy Minister. I appreciate the fact that you understand the situation, but I guess my specific question was: is there going to be more funding for respite? That is what families are asking me. They’re saying this is what they need.

[5:40 p.m.]

A. Bond: That’s precisely why we extended the emergency relief support funding to September 30. That was aimed to support twice as many eligible families and also continued to allow for the flexible use of existing funding.

As we know, a number of the existing supports that would normally be accessed by the families aren’t available. The increased flexibility has enabled families to find ways to provide support, respite and services in ways that they couldn’t do before under their autism funding. We’ll continue to look at ways to adapt our services, supports and our funding mechanisms to help families as much as we can.

T. Redies: Thank you, Deputy Minister, for the question. Maybe I’ll just be a little more specific. I know that you’ve extended the respite funding to September, but there’s a very good possibility that we could have a second wave of issue with COVID-19, and then these families again go into lockdown with no ability to access the therapists and the respite that they need.

If we do go into a second wave, is the ministry planning to extend that further to cover that period that we’re in, potentially, another lockdown?

A. Bond: What I can tell you is that right now we have approval to access from Vote 52 contingencies — the pandemic response and economic recovery — in the way that I’ve described; that is, until September 30 for that temporary emergency funding. We have no extension of that. We have to continue to analyze the impacts of COVID-19, and should we, as the member opposite has identified, move to a different phase, we would look at that again.

T. Redies: Okay, thank you for that, Deputy Minister. I think it’s really important that we, again, keep on top of this as much as possible.

My second line of questioning is around the residential placements for children with severe autism and other challenges, which mean that they can’t stay at home with their families. There seems to be a shortage of these residential placements and a shortage of, maybe, some of the real support — therapists, etc. — around them. I’ve got, I guess, three questions.

The first question is: is there a plan to increase the number of residential placements? My second question is: what’s the criteria for determining where the child gets placed? Is the criteria based on a child-centric modus operandi; i.e., it’s based on the best interests of the child? And finally, in terms of the process, how much value does the ministry put on advice and recommendations from doctors and the behavioural consultants?

A. Bond: This particular debate is focused on COVID-19 expenditures. What I can tell the member opposite is that a lot of the information that is being requested is in our current service plan, and we’d be more than happy to have a separate conversation about how the ministry does placements at a different time.

T. Redies: Maybe just a comment. I have had conversations with your staff around this, and frankly, I’m still confused. Frankly, it’s not clear to me that the decisions that are being made are based on what the doctors and behavioural consultants are advising, in some of the cases that I’ve been involved in. So if somebody could explain that to me, and do it in a way that makes sense, I’d certainly appreciate it at some point in time.

[5:45 p.m.]

The Chair: Member, I think that offer has been extended.

I’ll just remind the members that the questions in this committee are related to COVID-19 expenditures of this ministry. I’ll ask members to contain their questions to that area.

I’m now looking for more speakers. I recognize the member for Cowichan Valley.

S. Furstenau: Thank you, Madam Chair. I appreciate having a few minutes here to just ask about some of the COVID-related questions. I apologize if any of this has been covered already. We’re multi-tasking here in our Third Party caucus.

To the deputy minister, can she let us know, starting with the impacts to families who have children in care, how much loss of visitation there was during the period of social isolation?

A. Bond: As a result of the provincial health officer’s guidelines during phase 1 of the pandemic, the ministry worked very, very closely with the provincial health officer to determine whether or not we needed to suspend in-person visits. That was a decision that was made on March 26 by the provincial director of child welfare, acknowledging, as well, that while there was a suspension of in-person visits, there would always have to be provision for exceptions. There always is when you’re dealing with vulnerable children and youth.

We continued to work with the provincial health officer to assess whether or not the suspension of in-person visits needed to continue. Ultimately, on June 30, that suspension was lifted, and there was modified guidance from the provincial health officer.

What I would say is that there was a period from March 26 to June 30 where, for some families, the in-person visits were suspended. Exceptions were always available to them, and we encouraged a conversation with the social workers to talk through those exemptions.

S. Furstenau: Can the deputy minister let us know now: is the visitation rate currently at what would be expected fully, or is there still any diminishment of visitations at this time?

A. Bond: I misspoke earlier. The in-person visitation suspension was ended on June 3. At that point, all in-person visits were continued. If, for any reason, there was a desire not to have those in-person visits continue, that had to actually be reported to the provincial director of child welfare. So to the member’s question, we are aware of fewer than ten in-person visits that were not able to be completed.

[5:50 p.m.]

S. Furstenau: One of the other issues that came up during phase 1 of the pandemic was families that were on track to being reunited with their children. That got delayed or deferred.

Can the deputy minister let us know…? Does she have a sense of how many cases there were in which deferment or delay of reunion happened? Have those been resolved at this time?

A. Bond: We made no practice changes when it came to reunification of families. In fact, where a child had a plan for reunification with their family, we continued to work towards that plan. There have been no changes within the ministry and no guidance within the ministry that would delay any plan for moving ahead. There may have been other factors involved in that delay, should that have happened, but we’re not actually aware of any.

S. Furstenau: I’ll ask our constituency staff to flag a specific file on that. It did happen, it appears, in the Cowichan Valley riding.

Given that there’s a great deal of concern about future waves of COVID-19, can the deputy minister just speak to what kind of planning has happened in the ministry, around any kind of adapting and learning from this period that we have just come out of, to apply to future periods to ensure that there is as much connection and continuity of connection for children if we have subsequent waves of COVID?

A. Bond: I think the member opposite raises an approach that we’ve been taking in the ministry. That is to continue to understand the actions that we’ve taken — whether or not we’ve had positive impacts on the children, youth and families we serve; what vulnerabilities have come up through the pandemic; and how we might need to adjust those going forward.

We’ve been working hard at understanding the impact of our various emergency measures for youth who are aging out, for those young people who are on agreements with young adults, for the children and youth with special needs, as well as for the children and youth in care. I know that the provincial director of child welfare worked very closely with the provincial health officer around balancing the impacts of a lack of in-person visits — while virtual visits may have continued, there was a lack of in-person visits — and what that impact might be. We’re absolutely evaluating those impacts.

We are looking at what happens if we move to a different phase of the pandemic. We’re looking to see, on the measures we took, whether or not those were effective and, if we were to go to a different phase, whether or not we needed to reinstitute those. Hopefully we’ll be more responsive going forward in these unprecedented times, but yeah, evaluating the effectiveness of what we’ve done is absolutely a part of what we’re doing right now.

S. Furstenau: Further to that, the deputy minister speaks specifically to the agreements with youth but also to youth aging out of care. Supports were extended during the height of the pandemic.

Can the deputy minister just give us information about how long those supports will continue to be extended for? Again, what will be the plan for youth aging out of care if we get into another wave of this? Once you’ve got an extension of supports, how long will those extensions last for?

[5:55 p.m.]

A. Bond: We currently have approval for our emergency response measures under the contingencies, pandemic response and economic recovery, as the member opposite is probably aware.

The key emergency measures, as the member opposite identified, were originally available till June 30, now extended to September 30. That’s for those who were in the agreements with young adults program. The measures allow the youth currently living in foster care, contracted residential agencies or with relatives through the extended family program to stay where they are until September 30 without a loss of supports and services.

Youth nearing the end of an independent living agreement or youth agreement are able to continue receiving their monthly living expenses past their 19th birthday up until September 30, 2020. Those young adults between the ages of 19 and 27 enrolled in the AYA program — that’s the agreements with young adults program — are able to continue to receive financial support despite the school closures and other training program interruptions caused by the pandemic up till September 30. We also made a regulatory change that there would be no impact on the 48-month duration of the agreements with young adults program during the pause as a result of these closures and interruptions.

To the member’s question as to whether or not those might be extended again, based on whether or not the pandemic moves back to phase 1 or 2, that would be something we would have to analyze at that time. Right now our approvals for expenditures under pandemic response and economic recovery — that’s about 52 contingencies — are only available to September 30.

S. Furstenau: I just have to say that it’s quite something to get such rapid responses with such great detail. It’s different from our other experiences thus far in estimates, and I’m quite appreciating the speed with which the responses are coming back as well as the level of detail. I appreciate that from the deputy minister.

I’ll just end with one last question for my time here, and that is the services for families who are maybe getting support services, counselling services — all manner of support from MCFD — as part of family preservation. I expect that during phase 1, those were disrupted. If the deputy minister could speak to that a little bit, what are the efforts to ensure that families are getting access to support services through MCFD right now so that they can get the support they need?

A. Bond: I’m not sure if the member opposite was here during this part of the debate. We worked very hard to ensure that our offices were open. We continued to provide services, as did our delegated agencies.

We also worked very hard with our service providers. We knew that they needed to adapt their services to the pandemic. That meant that one of the things we did very early on was work to ensure that they received their full contract funding right through to the end of May while there was such a tremendous amount of uncertainty associated with the pandemic and the services that they provide.

Then we also worked closely with the service providers and the provincial health officer to determine how we could facilitate them to create plans in the child and family services sector to adapt their services and supports in accordance with phase 3 — and potentially, if we have to go back phases, doing that as well. We acknowledged the uncertainty with our service providers. We worked very closely with our service providers.

Again, it gives me an opportunity to extend a huge thanks to our front-line staff here in MCFD as well as all the back office staff that spent many extra hours trying to adapt our services, supports, policies and practices to adjust to the pandemic; our service providers who did the same; and our delegated Aboriginal agencies who also stayed open throughout the pandemic.

S. Furstenau: That’s my 15 minutes. I’ll pass it back to the official opposition critics for their questions. I appreciate the very rapid and detailed answers from the deputy minister. Thank you very much.

L. Throness: I’m pretty well out of questions, but I had some questions that I didn’t get to ask the minister of state. Could I go back to those questions?

[6:00 p.m.]

The Chair: I recommend that you address your questions to the deputy minister, and we can follow up if she’s not able to provide the information that you need.

L. Throness: Okay. I will see how long I can keep going here. We love to squeeze all the information we can out of the ministry.

How many child care providers did we lose during COVID?

A. Bond: We track closures, as the member opposite is aware. That being said, we don’t know whether any of those closures are a result of the pandemic. We also don’t know whether or not those operators might restart in September. That’s information we can provide to the member at a later date, once we get closer to the September date.

L. Throness: Given that the ministry tracks these things, is it different than prior years?

A. Bond: We are, of course, tracking the recipients of the temporary emergency funding for those who have remained closed, for whatever reason, during the pandemic, as well as those who are remaining open during the pandemic. In terms of those who might choose to permanently close post-pandemic, that obviously is not information we have right now. Therefore, we can’t really compare it to previous years. It’s not really comparable data.

What we can do, though, and what we will be doing is that analysis after September, when the conclusion of the temporary emergency funding occurs.

L. Throness: Anecdotally, we heard of providers…. For instance a provider in Vancouver had several locations. I think there were about 350 spots in total. She said that she had about a dozen kids in care.

Does the government have any kind of handle on how many children were actually in subsidized care throughout the COVID period? I’m talking not about enrolment but attendance.

[6:05 p.m.]

A. Bond: During the pandemic period, we paid providers, based on historical enrolments, through TEF, the temporary emergency funding. We’re not actually tracking enrolments or attendance, so I’m not able to provide the data that the member opposite is asking for.

L. Throness: I assume that there are people who spend their lives doing this planning and so on, thinking of future things. Does the government have any idea, or has it done any estimation, of how many providers will return and open who have not opened, and how many children will actually return to care? Do we have any estimate that the ministry has done?

The Chair: Member, I’m going to ask you to frame your question in the context of ministry expenditures and ministry operations related to COVID-19, please. Thanks.

L. Throness: Chair, how is this not related to COVID? I mean, come on.

The Chair: I’m encouraging you, again, to honour the wording of the agreement. I’ll read it again: ministry operations in regard to COVID-19–related expenditures. Thanks. Carry on.

L. Throness: Has the ministry spent any money on planning for future enrolment due to COVID?

A. Bond: Are we talking future enrolment in child care, Member? I’m seeing a yes nod.

Obviously, these are unprecedented times. It’s been a challenge for all of us to track and work with our service providers and our child care providers to ensure that we’re providing the best possible service that we can during the pandemic. We’ll continue to do that work.

We have to continue working with the provincial health officer on how we can safely operate during different phases of the pandemic and post-pandemic. We will continue to do that work. We know that the operators are doing everything they can themselves to plan for their businesses in order to ensure that they can provide those safe operations.

Yes, we’re going to continue to look at and track and monitor the data so that we can understand the impacts of the pandemic on our programs as we’re currently in phase 3. All we’re doing right now is gathering as much information as we possibly can, based on expenditures under the temporary emergency funding program, and through our CCFRI, in order to better understand the usage of child care.

L. Throness: What was the average amount paid to a centre that stayed open versus one that closed?

A. Bond: That’s not information that we have available right now, but we’re happy to follow up.

L. Throness: I have no more questions. I want to apologize to the Chair for my impatience. I have no more questions.

The Chair: Thank you, Member. Thank you for your work on this file.

I am going to recognize the Attorney General, who I believe has a motion ready to move.

Hon. D. Eby: I move the committee rise and report resolution and completion of the estimates of the Ministry of Mental Health and Addictions and, further, report completion of the questioning of the deputy minister, Ministry of Children and Family Development, regarding ministry operations with respect to COVID-19-related expenditures in accordance with the order of the House of July 15, 2020.

Motion approved.

The Chair: Thank you to the members. Thank you to the ministry staff and to the Clerk’s team.

This committee now stands adjourned.

The committee adjourned at 6:10 p.m.