The House met at 1:32 p.m.

[The Speaker in the chair.]

Orders of the Day

Hon. Ravi Kahlon: I want to first remind the House, on behalf of the House Leader, that the House will be adjourning at 6:15 today. I think it’s understood, but I just wanted to make sure I did the reminder.

In the main chamber here, I call Committee of Supply on the Ministry of Health.

[1:35 p.m.]

The House in Committee, Section B.

The committee met at 1:36 p.m.

[Lorne Doerkson in the chair.]

Committee of Supply

Estimates: Ministry of Health

The Chair: Well, good afternoon, Members. We are going to call this chamber back to order. We are going to introduce the Committee of Supply for Section B, where we’re going to contemplate the estimates of the Ministry of Health.

We’ll acknowledge the Minister of Health to move the vote.

Hon. Josie Osborne: Hello, everybody.

On Vote 32: ministry operations, $34,996,928,000.

The Chair: Thank you very much, Minister.

Now we will turn to the minister for some opening remarks.

Hon. Josie Osborne: I’ll begin with a few general opening comments, and then we can get into this.

First of all, I just want to say that I’m grateful to be here, of course, on the territory of the lək̓ʷəŋən-speaking peoples, the SXIMEȽEȽ and Songhees First Nations.

I want to begin by first recognizing and thanking all British Columbians who provide and support health care services throughout the entire province. These past few years have been very challenging, and I sincerely appreciate — I think everyone sincerely appreciates — the work that they have done and continue to do for British Columbia.

Here, of course, we’re in it for a few days to discuss the Ministry of Health estimates. Joining me today on my right here is Tiffany Ma, who is the acting Deputy Minister of Health. I have a number of support staff who are with me and will be coming in and out of the chamber as needed over the next few days.

Health care is a top priority, of course, for government, and we will continue to make significant investments to support the public health system in British Columbia. Budget 2025 increases health’s budget by $4.903 billion over the next three years. The Ministry of Health’s base budget funding is $35.1 billion for fiscal ’25-26, $35.9 billion for fiscal ’26-27 and $36.9 billion for fiscal ’27-28.

This funding is focused on the services that people need, hiring more health care workers, increasing access to primary care, providing care to seniors, providing more surgeries and continued expansion and building of hospitals to support our growing and aging population.

Some of the highlights…. Some of the different buckets of funding include, under the demand for health services, $2.9 billion over the next three years to support this growing demand due to a growing and aging population, the cost pressures being experienced for supplies and equipment and services that are delivered under MSP, Medical Services Plan.

Under primary care, $442.8 million over three years to meet the primary care demand across the province and continue progress on connecting British Columbians to family doctors and nurse practitioners.

[1:40 p.m.]

Under mental health, addictions and treatment services, $500 million, over three years, to sustain mental health, addictions treatment and recovery services. These investments will continue to support the ongoing operations of over 3,600 treatment and recovery beds at over 300 health authority and community care facilities.

People with concurrent mental health and addiction challenges, including secure and dignified care for people under the Mental Health Act, as well as secure treatment within the B.C. Corrections system, are supported by this budget.

This budget also supports $68 million in this fiscal and next to support access to in vitro fertilization, and starting July 2, the publicly funded IVF program will provide access to one-time funding of up to $19,000 for eligible British Columbia residents.

Implementing a publicly funded IVF program will bring B.C. in line with other Canadian jurisdictions. It’ll help reduce some of the financial barriers that people and families experience, address gaps in health care services that are experienced by women and trans and non-binary people.

Capital investments of over $15.5 billion are projected over the next three years to help continue to deliver the infrastructure that’s needed to help strengthen our public health care system, and that includes funding to support the construction of a new acute care tower at the University Hospital of Northern B.C., a new Surrey hospital and B.C. cancer centre, new long-term-care facilities in Chilliwack, Kelowna and Squamish, cancer care facilities in Nanaimo and Kamloops. I know that these were the subject of some of the estimates that the Minister of Infrastructure has just completed.

Then under the shared recovery wage mandate, there is just over $657 million over three years to fund compensation increases related to the various collective agreements in the health sector. The annual funding allocation of $219.052 million this year will include just over $106 million for nurses, almost $56 million for cost-of-living adjustments for unionized employees and almost $3 million for HEABC community health bargaining associations.

I want to recognize and welcome my opposition critic for mental health and addictions, and I know that the other critics will be joining in the coming hours and days.

This is the fourth ministry that I’ve had the privilege of doing estimates in. It’s been an interesting journey to see the different ways that estimates are approached. I find this to be a really productive, collaborative, constructive dialogue. That is the attitude that I will always take. I will do my best to answer the questions that are put forward to me and work with the members opposite in getting them the answers that they are looking for, and I look forward to the dialogue we’re about to undertake.

Claire Rattée: I appreciate that. Obviously, as the critic for mental health and addictions, I’m going to be focusing mostly on mental health and addictions stuff. My colleagues will handle some of the other Health-related things, but I’m grateful for the opportunity. I’m grateful to work with the minister on this and get some answers to some of the questions that we have.

I’m going to start out with a few general questions. Budget 2025 outlines $1.14 billion in spending on mental health and addictions care, ’25-26, and there’s $500 million that is allocated specifically to mental health and addictions over the next three years.

I’m wondering if the minister can table how that funding will be broken down and where it will be spent. Specifically, how much of that $500 million is actually going to new programs? The budget currently states that the funding over the fiscal plan will support and sustain addictions treatment and recovery programs established through previous budgets.

I’m curious if there’s funding that’s actually going towards new programs, new facilities, if that can be broken down, please.

[1:45 p.m.]

Hon. Josie Osborne: Thank you for the question around how the $500 million in the fiscal plan for mental health and addictions breaks down into what is sustaining certain services and what services are new.

I’m going to talk about nine particular areas, and I will say that it’s not entirely exhaustive, but it’s very close. I’m going to talk about those areas where funding is being sustained, those areas where it’s being sustained and new together and then those areas where it’s all new programming.

I’ll start off with youth substance use services. Over the fiscal plan, there’s $70 million allocated to sustain existing services. I’m going to talk about the Road to Recovery program that exists at St. Paul’s right now. Over the fiscal plan, there is $47.416 million to sustain that.

There is also $65.710 million to begin expansion of the Road to Recovery program throughout the province to other health authorities. Together, there is money to sustain and to add, especially in the North, Indigenous treatment, recovery and aftercare, in the amount of $102 million.

[1:50 p.m.]

There is, to sustain and, again, add, particularly in the North, funding for aftercare regional community clinicians in the amount of $15.752 million.

There is new funding in the amount of $61.512 million for integrated child and youth teams. There is new funding to expand Foundry in the amount of $61 million. There is new funding in the amount of $34.608 million for HCAP mental health expansion, so bringing more skilled workers. There is new funding for recovery community centres expansion in the amount of $10.936 million.

Claire Rattée: On that vein, I’m just curious if the minister could tell me, with the expansion of the Road to Recovery program, which jurisdictions specifically are being planned for that to be rolled out to right now?

Hon. Josie Osborne: I’ll begin just by describing a little bit more about Road to Recovery and then directly answer the member’s question and, first of all, start out by explaining just how important it is. I know the member understands this very well — that when people who are living with addiction reach out for help, they need services there for them regardless of where they live.

Road to Recovery has been operating in Vancouver since October 2023. It’s a model of care that is changing the way that people access addiction services, and it’s making it easier for people to access the right care for their needs. I had the opportunity to tour the Road to Recovery facility at St. Paul’s Hospital and see for myself just how important it is to see that seamless continuum and for care providers to be able to meet people where they’re at when they come in and ask for this help.

In Vancouver, 60 of 95 new substance use beds have been implemented, and more than 2,137 people have been supported in their access to a withdrawal management bed between the opening in October 2023 and in November 2024. As we have said several times, we are very committed to expanding the Road to Recovery model in every health region.

To answer the member’s question, the intention is to expand to all health authorities. In the North, however, just because of the sheer geography of the Northern Health region, the focus will be on the northwest region to begin with.

This expansion is going to include the implementation of a same-day access to clinical assessment through what’s called Access Central, and that will be in every health region, up to 100 new substance use beds over three years and new and expanded outpatient services. Access Central is expected to open in each of these regions this year.

[1:55 p.m.]

Claire Rattée: Just going back to the previous question, could you outline how much funding is going towards specifically treatment and recovery beds — that’s new funding for treatment and recovery beds —and services in this budget?

The Chair: Just a quick reminder to ask your questions through the Chair, Member. Thank you.

Hon. Ravi Kahlon: Can I seek leave to make a quick introduction?

Leave granted.

Introductions by Members

Hon. Ravi Kahlon: We have students here right now from Island Discovery Learning Community school, many of them from Burnaby South, some from West Vancouver–Sea to Sky.

We want to welcome all of you to be here today, to be part of the deliberations. What you’re seeing is a debate about health care and how our investments in health care are going out to communities.

The opposition gets to ask any question they want about health care, and the minister and the team will try to answer them. This is part of what happens here in this building. I hope you enjoy this, and welcome to the building.

The Chair: Welcome to everybody joining us this afternoon.

[2:00 p.m.]

Debate Continued

Hon. Josie Osborne: I’m going to take the opportunity just to explain a little bit how past budgets have worked in developing and implementing an increased number of treatment and recovery beds. Note, too, that substance use beds include but are not limited to withdrawal management, or what we also call detox; supportive recovery; treatment; and transitional beds. Of course, that is one portion of the service continuum: to support people who are experiencing substance use issues.

In past budgets…. Each budget kind of layers on more investment into the implementation of new beds. Since 2017, we’ve added more than 750 new publicly funded adult and substance use treatment beds. That brings us to a total, as of March 2025, of 3,778 publicly funded substance use beds.

For example, in Budget 2021, there was a commitment to over 160 treatment and recovery beds. There has been funding provided to the Canadian Mental Health Association for over 200 beds. Budget 2023 committed to adding 375 new substance use beds over three years.

Then, specifically to the member’s question, I spoke about the Road to Recovery expansion and the $65.710 million that will be invested in the Road to Recovery expansion and 100 new beds there. As well, the Indigenous treatment, recovery and aftercare portion of $102 million in the coming three years over the fiscal plan will see additional beds asked there.

What I don’t have that the member has asked for is a specific breakdown of how much money that is for the beds versus other services that are being sustained, but that’s something I’d be happy to take on notice and can return and provide more detail to the member later.

Claire Rattée: In the vein of treatment and detox and recovery beds, does the ministry have a plan to ensure that continuum of care, moving forward, so that people aren’t accessing withdrawal management or detox services and then not being able to immediately go into recovery? Is that the purpose of expanding the Road to Recovery program — so that we can ensure that there is a continuum of care there?

I think we’re all very aware of the issues and dangers around people going to detox and then not being able to access those follow-up services. So is that something that’s going to be focused on, moving forward?

[2:05 p.m.]

Hon. Josie Osborne: To begin with, the member and the description of the aim and objective of the ministry and government is very accurate: providing a seamless system of care for people, where the gaps that she rightly points out begin to be filled and people are not lost through this.

I’m going to take a moment to talk a little bit about the previous state of affairs and what we are able to do through a program like Road to Recovery. Then I’m also going to speak about different services and programs that are being provided to people that are not specific to Road to Recovery but are attempting to do just this, build this seamless system of care for people.

First of all, we know that having multiple programs with different entry points makes it difficult for people to know where to access care. What the Road to Recovery model does is provide a single front door in every region as it builds out to other health authorities, and that’s provided through Access Central. So it’s a single place where people are able to get that immediate medical or clinical triage, if you will, to determine what the best place for them to enter that care is.

I just want to state how the existing Road to Recovery centre in Vancouver is functioning. I mentioned that it had opened in October 2023.

[2:10 p.m.]

Between October 2023 and November 2024, through this Access Central, they received 22,619 calls, and they supported 2,137 people into a withdrawal management or detox bed, with a median wait time of just one day for those people who are prioritized as urgent. Again, part of the point of Access Central is to do that triaging, determine who is most urgent and how to connect them with care.

Before, as I was saying, there was limited access to this kind of clinical assessment, and so that could result in clients being directed to the wrong service for the needs that they have. But Access Central changes that by providing that same-day clinical assessment and routing a person to the right place.

In the way that things have been, it has often been that access to service is based on a first-come, first-served basis and not on need or risk. Again, through Road to Recovery, individuals are matched to services that are based on their unique needs identified through that clinical assessment and that medical triage.

Clients in the past and still today are put on multiple wait-lists for services that result in longer wait times, and it makes it confusing for people. Road to Recovery changes this by having one wait-list for bed-based withdrawal management and stabilization that’s managed by this Access Central care team.

People have experienced too often, and the member rightly points this out, a fragmented care journey that results in the gaps in care, and it can create risk for clients. In Road to Recovery, there are health authority teams that ensure consistent and proactive connection across that continuum of care.

In the past, I would say, there has just not been enough dedicated long-term support. And part of what we’re talking about here today is the amount of funding that is being invested in this kind of support. And Road to Recovery brings in new aftercare and recovery supports across the province.

Not everybody will access bed-based treatment. And there are recovery community centres that perform really important functions for people. Right now, we have what is known as The Junction. There are three of them in British Columbia. This fiscal plan includes expanding that, so that we have at least one Junction or recovery centre like this in every single health authority to begin with.

As well, we’ve been working with communities in the establishment of therapeutic recovery communities. This is treatment and a place for people to live while they’re undergoing this treatment and stabilizing their lives and having access to the wraparound supports that they need.

Just a couple of weeks ago, of course, the New Roads Therapeutic Recovery Community opened, providing spaces for 20 women, specifically focused on the barriers and issues that women face. Just last week in Prince George, 25 beds were opened at a therapeutic recovery community.

These are places where people may stay for over a year. They could stay for up to two years. They have access to not only the clinical supports they need but the counselling and mental health supports, other life skills training and services that people need to not only undertake that healing journey themselves but become stabilized and be at a place where they can truly move out and integrate again into community in a way where they are sustained and are able to build lives again.

And then finally, when people leave detox or any kind of treatment centres, the opioid treatment access line is available seven days a week. That connects people with a doctor for same-day services, same-day prescriptions, and it routes them back to their health authority for a continuity of care.

Again, I’ve talked a lot about Road to Recovery and also three other kinds of services intended to do just what the member is mentioning around filling in those gaps of care and creating that seamless continuum. I’ll always acknowledge there’s more work to do, and that’s why this budget puts more funding into that, and we’ll continue to do that work.

Claire Rattée: One-day wait time for detox facilities is great and all, but that still doesn’t really address the issue of how long the wait time is for treatment.

[2:15 p.m.]

I’m wondering if the minister can provide what the current wait times are for people that are accessing treatment and recovery services, so that we can understand what that gap actually is and how long people are having to wait in between to be able to access those services.

I would like to add something to that question, if that’s okay. Could we also see that broken down by health authority, please?

Hon. Josie Osborne: Thanks for the question.

I’m going to talk about the way data are collected. I’m going to answer the member’s question, or part of the member’s question, and then explain the rest that we’ll have to bring in a little bit later.

First of all, health authorities are required to report quarterly to the Ministry of Health on available data about the number of clients that are served and the wait times for bed-based treatment and recovery services. From these data, B.C. is actually the first Canadian jurisdiction to publicly report wait times for bed-based services. And these are also included in the Ministry’s annual service plan.

Wait times are complex data to collect, and they are difficult to interpret accurately sometimes because they can be defined differently across different regions and service types, and they can be impacted by a wide range of factors. So that might include a person’s personal readiness to start treatment, the travel time to services and the family and child care and work commitments that people have.

[2:20 p.m.]

In 2023-24, the last full year of data that we have, the average wait time for health authority–funded substance use treatment and recovery beds was 31 days. That surpassed the target, which was 32 days.

I just want to acknowledge right now that that’s too long, and we know that. We’re going to continue to work very closely with health authorities and other partners to monitor and improve this kind of access.

We really need to strengthen the data to support system planning and ensure the health and safety of people who are receiving these services. Again, I want to remark on the fact that we are the first jurisdiction in Canada to be collecting and publicly reporting these data. What this has enabled us to do is have a closer understanding of the unique numbers of clients that are using these services and the utilization rates of these beds.

This is important because back in 2021-22, for example, overall, 62.9 percent of beds were being used, but having these data and knowing better about which are empty and how people can be matched into beds has led to an increase in utilization rates two years later, in fiscal ’23-24, of 74.4 percent.

Increasing the utilization of these beds means being able to serve more people. In 2021-2022, there were 3,195 unique clients, and that has increased over two years by more than 1,100 people, so almost a third, to 4,685. Again, this is trending in the right direction. There’s definitely more work to do.

The member also asked specifically about a breakdown by health authority. I can’t provide that right now, but we’re going to work in the background, and I’ll bring it later today or tomorrow.

Claire Rattée: Can I get a commitment from the ministry on what they believe is an acceptable number of days of a wait time for treatment? What is the goal here that we are looking to actually get to?

[2:25 p.m.]

Hon. Josie Osborne: I think we all would like to see a system of services and supports where people are not waiting to access what’s right for them. What’s really important is to do that work to match people’s needs to the services that are there and the services that we’re continuing to build.

That’s why Access Central, a feature of the Road to Recovery system, is so important, to be able to medically assess and triage clients so that those people who most urgently need bed-based care, for example, can have access to it and can have access to it very quickly.

Also remember that where people are at in their lives will sometimes impact the wait that they may experience. There is, for example, people’s personal readiness to start treatment, where they live in the province, and the time that it may take to access those services — to travel to them, the family, child care and work commitments that they have.

Again, this is about matching the right services to people where they’re at and ensuring that those people…. There are so many people who do not need bed-based treatment services but can really benefit and be effectively cared for on an outpatient basis, which would not have the wait time that would be associated with bed-based care.

I had mentioned, in the last question we canvassed, the wait times that currently exist, and I acknowledge that those are too long. That’s why we’re doing the work to continue to build more bed-based treatment, with over 750 new beds that have been implemented since 2017. We’ve talked also today about the investments into continuing to expand those beds.

Claire Rattée: You know, we recognize that in the last year the wait time has come down about half a day, and at this rate it would take us 60 years to be on par with Alberta’s model of same-day access. I’m going to move on, but that’s incredibly frustrating.

[2:30 p.m.]

Recognizing that the Minister of Housing is present in the chamber right now and that the junction model was referenced earlier, I’m wondering if the ministry could respond on the lack of wraparound supports currently within B.C. Housing and how we’re looking at building that out.

Which ministry is actually responsible for the funding for that? Is it the Ministry of Health, or is it the Ministry of Housing?

Hon. Josie Osborne: I appreciate the question, because I know it can be confusing to understand sometimes which ministry is doing what and what they’re responsible for. So I’ll touch on that in a moment but say that one of the reasons why this is important is because it is so important to have that integrated approach across government. So the way Health and Housing, or Housing and Municipal Affairs now, need to work really closely together is an important way, and I think we’ll see more benefits for people who are experiencing homelessness, for example.

First of all, I’ll talk about supportive housing. Supportive housing, the building and the operation of that type of housing, is the responsibility of the Housing and Municipal Affairs Ministry. But Health’s budget supports the enhanced health services that are provided in those supportive housing units — the supports that are provided for people.

[2:35 p.m.]

We know, though, that there are some people who struggle with supportive housing and that the supports that are there are not adequately serving those people. That is why we’ve developed complex care housing which, more specifically, is providing services and supports to those people who are experiencing complex mental health and addictions or concurrent needs — those together — and they’re not getting their needs met in supportive housing.

So complex care housing, the funding for the housing itself and for the supports that are provided in that are entirely within Health’s budget.

I hope that helps clarify a little bit and then maybe will lead to some more questions from the member.

Claire Rattée: I would say that that was a question that I honestly expected a response on pretty quickly, and it took quite a bit of time to think through. That may be part of the reason why these services aren’t being delivered as efficiently as they should be, if there isn’t clarity about which ministry is in charge of what or which budget it’s coming out of.

But I’m going to move on here. This next question maybe would be a better one for the Premier, but I figured I would try asking it here. This current government champions mental health and addictions as being one of their top priorities, and year after year, we know that thousands of people in B.C. continue to die.

Under the late Premier Horgan, mental health and addictions was a priority. So I’m wondering, why did the Premier dissolve the Ministry of Mental Health and Addictions?

Specifically, in that vein as well, just for the sake of time, the Ministry of Mental Health and Addictions had 177 full-time-equivalents and spent $20.13 million out of their $40.75 million operating budget on salaries and benefits. I’m wondering, further to why that ministry was dissolved, did the 177 full-time-equivalents become absorbed into the Ministry of Health?

Hon. Josie Osborne: Our government took the decision to separate Mental Health and Addictions out in 2017, when we formed government, because Premier Horgan and the rest of the team recognized just how important it is to put a spotlight on mental health and addictions. By doing so, through two terms of government, we were able to spend the time on the policy work that’s required to build a continual and a seamless system of care for people. That’s work that we’ll continue doing.

But we know we need the whole system supporting mental health and addictions care. Mental health is health. That’s why it was important to bring it back into the Health Ministry and be able to be more effective and more efficient and work more quickly. That’s just what we’re achieving now.

Of the 177 employees, FTEs, that the member mentions, all of the program staff came over into the Health Ministry, but not all of the corporate services staff. They have gone on to do other things in government as well.

But with respect to the ongoing focus on mental health and addictions, I’d point out that almost half of my mandate letter are items related to mental health and addictions, and I think that continues to put a spotlight on the priority that this is for our government and I think for the entire House.

[2:40 p.m.]

Claire Rattée: I would just point out that, through that same logic of it being health care, it could also be absorbed under the Ministry of Housing. It affects so many other things, right? It’s affecting cost of living. It affects public safety.

So I think, to really put a focus on it…. Health is a very, very large umbrella, and I fear that maybe that’s part of the reason why my estimation is not receiving as much care as it should be right now and attention as it should be, because it’s such an all-encompassing file and it’s difficult to kind of put enough focus on that.

I’d like to move on to the government’s safe supply program. I would like to start with just asking: in this budget, specifically how much money is being allocated towards running and distributing that safe supply program? And how much was allocated in the previous year, so that we can see a comparison of the two, please.

Hon. Josie Osborne: As the member knows, the prescribed alternatives program began during the pandemic and was scaled up in relatively short order. The province annually allocates $8.87 million to support prescribed alternative programs and prescribing.

Claire Rattée: I’m going to assume from that response, then, that that’s the same year over year, $8.87 million I believe was said, and that there is no change to that amount.

On the topic of safe supply, I would like to know how long the government has been aware of the issue with the opioids from the safe supply program being diverted and trafficked and why there wasn’t, at some point, a decision to look into what the actual results are of that program, why we…. It should be an evidence-generating program. At what point do we look at this and go, “Okay, we need to start analyzing and collecting and reporting on these programs,” so that we can understand what the outcomes are and the rates of diversion?

[2:45 p.m.]

Hon. Josie Osborne: First of all, I want to start off with a little bit of a read into the record why we feel the prescribed alternatives program is an important part of the services that are provided, and to start off by saying that we’re deeply committed to saving lives and to getting people the treatment that they need, people who are suffering from addiction. The goal, of course, of the prescribed alternatives program is to separate people who are most at risk from dying by overdose from toxic street drugs and from predatory drug dealers.

The program helps to connect people to care, and that is incredibly important as well. The opposite of addiction is connection. Helping to connect people to that care and the relationships that they have with medical professionals who are required to prescribe these medications is an important part of the system. And it’s been proven that prescribed alternatives do save lives.

It’s one part of the work that we’re doing to address the toxic drug crisis. And we’ve canvassed already…. We’ve been talking about treatment and recovery services, for example, but also the early interventions, the prevention and education that’s needed, the aftercare, the supportive housing, other social determinants of health, as we’re canvassing in these estimates.

We have to make sure that these are medications that are being used by the person for whom they are intended. The Premier has been very clear. He’s been very clear to me about concerns on diversion and ensuring that, again, these medications are getting to the very people that they’re intended for.

[2:50 p.m.]

Tackling diversion into the wrong hands is a key part of my mandate letter as well. We’ve been monitoring and mitigating the risk of diversion since the inception of the program, and I want to list out some of the tools that are used and have been used to do that.

First of all, clinicians are equipped with tools to monitor and address diversion, so they do use urine drug screens and witnessed dosing. The province has funded the B.C. Centre on Substance Use to develop and maintain protocols for prescribed alternative medications, and that includes very comprehensive direction to clinicians to address diversion. The regulatory colleges have the authority to audit and sanction practitioners that prescribe and dispense controlled substances, and that’s to ensure safe, legal and ethical prescribing practices.

Of course, the province has announced more efforts to mitigate diversion, and that includes extending, for example, the provincial evaluation of the implementation of prescribed alternatives, monitoring new instances of opioid use disorder and fatal overdose and then establishing a diverted prescribed alternatives working group.

It’s the role of law enforcement to intercept and disrupt the flow of illicit drugs, and of course, that includes prescription opioids. I know that the estimates for the Public Safety and Solicitor General Ministry are yet to take place, and I’m sure that some of this will be canvassed there as well.

I want to assure the member just how seriously we take concerns about diversion. It’s why we’ve been working since 2023 to strengthen the safeguards that are there. It’s why we made an announcement earlier this year around the need for witnessed consumption.

It is so important, of course, that there’s no tolerance for criminals who are going to exploit people, exploit the health care system and put people at risk. That’s why the Premier has given me such a strong mandate to be able to dig into this and to take action. That’s the work we’re doing.

I’m sure we’re going to canvass this with more questions. I’ll stop there for now.

Claire Rattée: Going back a little bit, I’m just going to be more specific on something because I think that the safe supply numbers that were disclosed by the minister earlier were a bit low.

It turns out that in 2022 and 2023, PharmaCare spent $14.22 million on prescribed alternative products, including opioids, stimulants and benzos, for over 7,600 beneficiaries. I am wondering if the minister could clarify the updated number for prescribed alternatives in this budget is accurate and has indeed decreased.

Hon. Josie Osborne: The number that I read into the record previously there, the $8.87 million, is around the program expenses of the prescribed alternatives program. I can say that in 2023-2024, in that fiscal, there was an additional expense for the medicines themselves, for the pharmaceuticals themselves, of $17.5 million. So that would be on top of the $8.89 million.

I hope that helps to clarify.

Claire Rattée: After the ministry’s own leaked presentation confirming that a significant amount of the ministry’s taxpayer-funded safe supply was being diverted into the hands of criminals and trafficked provincially, nationally and internationally, the Minister of Health announced that the government was ending unwitnessed safe supply. That was February 19.

[2:55 p.m.]

Now, more than a month later, no new guidance has been issued to practitioners, and the Premier’s taxpayer-funded drug trafficking is continuing unabated. Doctors who were reaching out for guidance to B.C. Centre on Substance Use were told: “There are still some fundamental questions pending that the government has not been able to answer. They still haven’t defined scope, timeline and other parameters.”

So my question to the minister is: when will the government clarify how it will end unwitnessed safe supply?

Hon. Josie Osborne: First of all, I’m going to give a little bit of an update on the trends that we’re seeing in the prescribed alternatives program and then talk specifically to the member’s question.

Hydromorphone, the most commonly prescribed drug under the prescribed alternative program…. The use of this peaked in March 2023, when there were 4,524 clients who were dispensed hydromorphone in that month. Since then, the number has steadily decreased.

On February 19, when I announced that all new prescribed alternative clients are to move to witnessed only, there were, at that time, 2,643 clients that were being dispensed hydromorphone under the PA program. So that’s a 42 percent decrease in the number of people receiving hydromorphone from that peak in March 2023.

The decline is attributed in part to growing concerns related to diversion, increased monitoring of the program and clinicians who are working with their patients, with their clients, to transition them to other medications when hydromorphone just wasn’t effective any longer in managing the withdrawal symptoms that people were experiencing, particularly with severe fentanyl addiction.

So again, since the announced change to the prescribed alternative program, there’s been a further 12 percent decrease in the number of people that are prescribed a prescribed alternative. As of March 17, 2025, there were 2,329 people dispensed a prescribed alternative.

That indicates, I think, that we see this work that’s being done with clinicians to adjust prescribing is already making an impact.

[3:00 p.m.]

We’re going to continue to work closely with prescribers to transition patients to witnessed consumption as soon as possible, but we need to ensure continuity of care, too. We are working with the B.C. Centre on Substance Use on specific guidance, and of course we want to get it right. That means engaging with a good number of physicians and care providers to provide feedback and review that guidance, and that will be forthcoming.

Claire Rattée: Since there is no distinction between safer supply opioids and generally prescribed opioids currently, will the minister immediately require that the safer supply opioids be chemically distinguishable from other prescribed opioids so that it will make it easier to be able to track and ensure that diversion is not happening?

Hon. Josie Osborne: In December 2024, 97 percent of all people who were prescribed opioids got it for other uses, largely pain management.

The member is asking about the use of chemical tracking or molecular markers that could be used to distinguish the medication. The trick here is that it requires pharmaceutical companies to go through the compliance process with Health Canada in order to be able to do that. They need to do that because they want to ensure that whatever is added would not alter the effect of the medication. Alberta has actually asked Health Canada to do this, and Health Canada was not amenable at that time.

I’m very interested in pursuing further discussion with the member opposite and continuing that kind of advocating to Health Canada. That’s obviously a conversation that will have to happen after the federal election.

[3:05 p.m.]

Claire Rattée: On the same vein, then, when we talk about OAT therapies and safer supply and all of that kind of stuff…. I would say that when we’re looking at issues of diversion, a very simple way to rectify that would be to look at only prescribing things such as methadone and Suboxone, evidence-based treatment that people are not trafficking or diverting.

When I’ve gone out and spoken with people that are on the streets, that are addicts, that are accessing these programs, I’ve been told time and time again, when they’re getting fentanyl patches, they’re taking them home and cooking them. We know that this is not effective, and we know that nobody is diverting methadone or suboxone. So will the government commit to changing their model when it comes to their safer supply program and looking just at evidence-based treatment, OAT, therapies like that, rather than giving out fentanyl patches?

Hon. Josie Osborne: First of all, prescribed alternatives are still an important part of the continuum of care for people. A lot of people who are on OAT are co-prescribed pharmaceutical alternatives. It’s necessary given the toxicity of the drug supply and the changing nature of it and the amount of fentanyl, for example, where OAT medications are first-line drugs that are just not meeting the needs of everybody.

Prescribed alternatives together with OAT give a clinician the opportunity to work with their patient or client to titrate them over time to OAT and do it in a way that is safe for those people. None of this, the prescribed alternatives program, is at the expense of OAT.

The work that we’re going to continue to do with the nurse prescribing, for example, for expanding access to OAT and iOAT is going to continue.

I want to thank the member for the question and ask the Chair if we could take a 20-minute recess, please — fifteen maybe, but I just want to hedge my bets.

The Chair: Members, the minister did warn me that she had an engagement that could not be moved this afternoon. Apologies for that, but I will grant a 15-minute recess, and we will return at 25 after.

The committee recessed from 3:10 p.m. to 3:27 p.m.

[Lorne Doerkson in the chair.]

The Chair: Good afternoon, Members. We’ll welcome you back into order, where we are contemplating the estimates of the Ministry of Health.

Claire Rattée: I’d like to talk a little bit about the B.C. Coroners Service now. Between 2019 and 2023, 16 youth deaths involved hydromorphone, with fentanyl detected in 12 of those cases. These numbers raise the question of whether diverted safer supply drugs played a role in these fatalities.

The B.C. Coroners Service has repeatedly claimed that prescribed safer supply drugs do not contribute to overdose deaths, but without tracking whether overdose victims were enrolled in the program, this claim lacks verification.

Why did the B.C. Coroners Service change its terminology and exclude prescription drug poisoning deaths from public overdose data? Will the minister direct the Coroners Service to release the number of prescription drug poisoning deaths immediately?

[Mable Elmore in the chair.]

[3:30 p.m. - 3:35 p.m.]

Hon. Josie Osborne: Thank you to the member for the question. Apologies for a little delay there, but we want to make sure that we have the right staff. I want to be able to give the member a thoughtful and accurate answer.

First of all, I want to clarify that the B.C. Coroners Service has not changed the way they report on drug deaths, that deaths related to prescription opioids were not removed from the public data. They weren’t hidden out under prescription drug poisoning or any other label.

The Coroners Service originally shared that if a death were to occur when an identified safer supply substance was determined to be the sole contributor to a death and the decedent had a recent prescription for that safer supply substance, then it would fall under the prescription drug poisoning category, and those are deaths that are reported to the Coroners Service.

So they did not change the language, but the report was previously titled Illicit Drug Deaths in B.C., and sometime in early 2023, they changed the title to Unregulated Drug Deaths in B.C. The coroner also reports on deaths that are due to prescribed drugs, i.e., people who pass away from medications that they are prescribed and, typically, older people who take more pain medication than they should have.

I just want to pause here again and reflect on just how serious and important this topic is. The loss of any human being, any person, whether it’s to prescribed pain medications or to the illicit drug supply, is a loss that’s felt by people and families and communities across the province. Particularly, the death of a young person is something that is always hard to hear about and just unimaginable for many of us to even contemplate happening to ourselves.

I think it’s important, as we have this conversation, that we just…. I know that the member feels strongly this way too and understands very, very well just how serious this is.

Claire Rattée: A report by the B.C. Coroners Service on December 31, 2022, was published to summarize the drugs detected among suspected illicit drug toxicity deaths. The report states that deaths were excluded if there were no illicit substances identified or the death was suspected to be due to intentional self-harm.

Can the minister please explain what this quote from the Coroners Service means?

Hon. Josie Osborne: This report is very specific, focused on people who tragically die from illicit substance use. I just want to note, too, that the coroner falls under the responsibility of the Public Safety and Solicitor General Ministry, and so these questions might be better appropriately directed there, when those estimates take place.

Claire Rattée: Yeah, I can bring that up in different estimates then, if that’s the case.

Sorry. Give me a moment here.

Okay, we’re going to go back to some more safer supply stuff then. Safe supply was introduced by this government and expanded in July 2021, designed to save lives, and it has been nothing short of a catastrophic failure, with thousands dying annually to drug overdoses in this province.

[3:40 p.m.]

The question that this government has been hiding is how much is spent annually on safe supply. We talked earlier about how PharmaCare spent $14.22 million on prescribed alternatives, including opioids, stimulants and benzodiazepines, in 2022-23, for over 7,600 beneficiaries.

I’m wondering if the minister will again break down year by year how much money has been spent on safe supply and if there is a way to be able to pull out of those numbers what specifically is getting spent on OAT therapies and what is getting spent on the prescribed alternatives side of things so that I can understand the difference between the two and what the exact numbers are.

Hon. Josie Osborne: All right, so I have a bunch of numbers here. First of all, as I spoke to earlier, the programmatic costs — I’m going to cite one year, 2023-2024 — of the prescribed alternatives program, as I previously stated, are $8.9 million. The programmatic costs around OAT are $90 million over three years. So we could average that at $30 million a year, compared to the $8.9 for prescribed alternatives.

Now, specifically, the PharmaCare expenditure in that same year…. I’m going to first list out the prescribed alternative drugs. First of all, under opioids, it is $16.2 million; benzodiazepines, $100,000; and stimulants, $1.2 million, for the total of $17.5 million that I referred to earlier.

Under OAT: methadone, $44.6 million; buprenorphine and naloxone, $13.5 million; slow-release oral morphine, $32.4 million; and extended-release buprenorphine, $12.7 million.

Claire Rattée: Out of that, how much is being spent or allocated towards intramuscular Suboxone, since we obviously know that that is one drug that definitely can’t be diverted and is certainly going to be one of the safest options, because it is an intramuscular shot? I’m just curious if we can get numbers on, specifically, how much was allocated for that, please.

[3:45 p.m.]

Hon. Josie Osborne: The specific amount is the $12.7 million that I previously cited for extended release buprenorphine. That’s the Sublocade that the member is referring to.

Claire Rattée: In the leaked document that came out of the Ministry of Health saying that there was significant diversion, I’m wondering if the minister would be able to define “significant” and give us specifics on what the numbers were.

[3:50 p.m.]

Hon. Josie Osborne: Thank you to the member for the question.

Specifically around the use of the word “significant,” I think a challenge with the word “significant” is that it can have a very subjective application. And while “significant” has a specific statistical meaning, in this case the data that RCMP may have are not public. They are part of the investigations that are undergoing and so they are confidential with the police.

It doesn’t change the fact that diversion to any unintended recipient of prescribed alternatives is an issue and one that we take very seriously. It’s why we are doing the work that we are to ensure that the safeguards are in place in the changes that I announced in February, for example.

It’s why we have the special investigation unit and that close working relationship between the Ministry of Health and the PSSG. It’s why we stood up the diverted prescribed alternatives working group, who work with the RCMP and the Vancouver and Victoria police departments to share information, address communication gaps, ensure accurate data collection, prepare the educational materials for police — part of which were the subject of the presentation that we’re talking about, where the word “significant” appeared — and ensure that they have coordinated and consistent, clear communications.

I hope that answers the member’s question as best that I can.

Claire Rattée: Further to that, I would just ask, is the ministry providing funding to any organizations that are studying drug legalization currently?

[3:55 p.m.]

Hon. Josie Osborne: I’m aware that there are a number of ways that drug use research is funded in British Columbia, for example by the CIHR, federal institutions.

The province of British Columbia does provide funding to the Michael Smith Foundation, B.C.’s health research agency. We are checking to see if there are any details on any particulars around addictions research, for example, there.

If the member wants to provide any…. Like, if there’s a specific entity or example that she’s particularly thinking of, that might be helpful.

Claire Rattée: No, there’s nothing specific. I just figured that the ministry would likely know if they were funding any groups like that.

I am also curious if there are any community action initiative grants or any other grants through the Ministry of Health right now that are going towards organizations that are calling to defund the police or to abolish the Controlled Drugs and Substances Act. If this is something that the minister isn’t able to get me right now, I would be happy to get a list of those groups through an email at a later time.

[4:00 p.m.]

Hon. Josie Osborne: I will be happy to provide a full list to the member about the initiatives that are funded through the CAA program. For example, I’ll just touch on a couple here.

The hope initiative based in Grand Forks, for example, that was provided with $60,000 in fiscal ’24-25 towards the work that they’re doing to collaborate with community partners to offer peer support and safety, focus on providing Indigenous harm reduction and cultural training, distribution of supplies, Indigenous art therapy — work that they’re doing to support peers and continue to develop a peer network.

Specifically on the provincial peer network, because I think I understand a little bit of where the member is driving through talking about the community action initiative and the funding that’s provided to the different groups, the role of people with lived or living experience and including them in substance use policy and design is incredibly important.

That’s why we fund capacity-building activities through the provincial peer network or PPN. It’s a provincewide network of 24 different groups, and we fund them through the community action initiative. They have three areas of focus around supporting the work of local organizations, ensuring equitable representation of people who use drugs across B.C. and collaborating with partners.

Some of these groups provide low-barrier access to life-saving services, and that includes things like episodic overdose prevention services or OPS. They do drug checking. They help to connect people to care, like treatment and recovery.

Now specifically, I want to address the two groups DULF and KISS, as we call them, that in October 2023 were expelled from the provincial peer network for operating compassion clubs. The government-funded PPN, the network groups, were provided a letter that very clearly stated the province requires any provincially funded organization to operate legally and that any alleged illicit or criminal activities would not be tolerated.

I do acknowledge, too, that the provincial peer network groups, they have other sources of funding that they may use for other things, but we have agreements through the community action initiative that are very specific around what work is being funded by provincial funding.

[4:05 p.m.]

Elenore Sturko: I thank my colleague from Skeena for giving me just a couple of minutes.

I just want to ask you a couple of questions and maybe make a couple of comments for the record on the topic of the CAI grants, specifically with what the minister was discussing about the Drug User Liberation Front.

I think it’s important that we are clear that the government of British Columbia, under this Premier and even the previous Premier, knew that unlawful activity was taking place before 2023 at the Drug User Liberation Front. That was because the Vancouver Area Network of Drug Users presented at the Select Standing Committee on Health for the overdose crisis and let them know what they were going to do. They told this government. In fact, the Deputy Premier was chair of that committee.

After a member of VANDU had told them that they weren’t even comfortable calling what they were doing safe supply…. After all, the drugs that they were purchasing were from the dark web, from the very gangs and cartels that this government should be fighting, the ones who are not only supplying and trafficking but manufacturing deadly fentanyl that has killed 50,000 Canadians.

This government has given over half a million dollars of taxpayer money into the hands of the Drug User Liberation Front who then, in a presentation that they made in Australia, admitted to laundering money. They said there’s a lot of laundry, taxpayer-funded money going directly into the dark web to be used to buy illicit substances, then to pass on to members of the Vancouver Area Network of Drug Users, including people in their own study that were classified as people who would traffic drugs.

The study, the research that was done on this compassion club…. The government says that they expelled the Drug User Liberation Front. They expelled them from the ability to receive CAI grants. The took away their funding, and yet they have continued to use the information that was garnered by this unlawful activity.

My colleague from Skeena had asked: “Is there any research going on that would be looking at the legalization of drugs?” In fact, the B.C. Centre on Substance Use had participated, the former director of research setting up, with the two now-accused drug traffickers from DULF, the structure of that research. The public health officer of British Columbia cited that research in her most recent report to the province of British Columbia, advocating towards non-prescriber models, advocating for things like having these compassion clubs, advocating for things like putting hard drugs in retail settings.

I find it just mind-blowing to hear this government talk almost sanctimoniously about the way they’ve expelled DULF. Not going to fund. Yet we know that there continue to be multiple organizations that receive government funding who not only advocate for the legalization of drugs; they’re anti-police. They’re calling for the defunding of police, and there seems to be very little oversight.

Given the history of this government in supporting unlawful activity that they knew about, what assurance can the minister give British Columbians with the 2025 budget that their hard-earned tax dollars aren’t being squandered and given into the hands of people who would provide profits and commodities and suffering to people through illicit drug trafficking?

[4:10 p.m. - 4:15 p.m.]

Hon. Josie Osborne: To begin, I want to just reiterate some of what I said in the previous answer around the valuable work of organizations that involve people with lived and living experience in substance use and addictions issues and the value of those voices and the work that they do.

We’ve been discussing particular organizations, and we’ve also been discussing the community action initiative and the work that they do in the funding they provide to groups. The member has asked, essentially, how government ensures that the dollars are going to the services that an organization is contracted for. I want to talk about the CAI programs and how the organizations have specific funding agreements and how there are the checks and balances that the CAI must monitor.

If groups receiving funding are not living up to the clauses, the agreements that they’ve signed, then there are consequences. For example, if an organization is late or fails to submit reporting, the funding stops until such a report is submitted, to ensure that the funds are being used the way that they are intended to be used.

Again, coming back to…. We were speaking about two specific groups before and the fact that they were expelled from the Provincial Peer Network for the work they were doing in operating compassion clubs. To be very clear, this government has never supported procuring and distributing illicit drugs in that manner. That is a fundamental on this.

Further, the member has raised some questions around, for example, the B.C. Centre on Substance Use. I think that sometimes the way we speak…. We can blur the lines of, for example, a person who is employed by one organization and then ceases that employment and begins working somewhere else. We can blur some lines in some of the independent research that is done that must be kept as independent research, and we can continue to learn from that.

I do want to take a moment to reflect on the B.C. Centre on Substance Use and the work that they do as a research and clinical organization to support evidence-based addiction medicine care here in B.C. The funding that the province provided to them last year in the fiscal was $4.64 million, and that is to support activities specifically that are aligned with provincial priorities, so around education and training.

The work they do leading several key addiction medicine education activities across disciplines, academic institutions and health authorities. The work they do with the provincial opioid addiction treatment support program, for physicians and nurse practitioners and registered psychiatric nurses, and the interdisciplinary addiction medicine fellowship program.

[4:20 p.m.]

The work they do in clinical care guidance, developing and helping to implement evidence-based clinical practice guidelines, the treatment pathways and the best-practice support documents that clinicians depend on, on the treatment of substance use disorders and opioid use disorder, alcohol use disorder, etc., and developing protocols and practice resources that are related to emerging substance use topics, things like prescribed alternatives and benzodiazepine use.

The work they do around research, and particularly here, the work they’ve done on program evaluations, on Road to Recovery, for example — they’re a valued partner. The province funds them for specific programs like I’ve just outlined, and we’ll continue to view them as a valued partner in this work.

Claire Rattée: We’ve spoken about it a little bit. We already know that through the community action initiative grants, the Drug User Liberation Front was provided with half a million dollars previously. I understand that that funding is no longer in place, but I know that the Coalition of Peers Dismantling the Drug War was awarded $180,000 of taxpayer money in 2024.

This is an organization that has a fairly similar agenda, as stated on their website and things like that — defunding all police services, repealing the Controlled Drugs and Substances Act. I’m curious if they are still receiving funding.

I also am curious if the ministry believes that it’s acceptable that regardless of the specific funding agreements that they might have with these groups…. Should taxpayer money be supporting groups that support such dangerous ideology? It doesn’t matter if there is a specific funding agreement for them to do specific work. That’s still supporting a group that supports dangerous ideology. I’m curious if that means that that’s the direction that this ministry wants to take us in, if taxpayer money is funding groups that support that.

[4:25 p.m.]

Hon. Josie Osborne: Thank you to the member for the question.

Specifically on the Coalition of Peers Dismantling the Drug War, in 2024-2025 they received $60,000 for a specific service: to provide outreach and extreme weather response, like cooling towels and water, clothing and blankets, etc., for people. They also deliver after-hours episodic OPS services as well.

I understand the question the member is asking. She’s asking around whether it’s appropriate for government to be funding an organization like this, and I want to be really clear on a few things.

First of all, working with organizations that directly involve the experience of people with lived and living experience on drug use is incredibly important in this work. It’s always going to be important to hear those perspectives and have those voices at the table as part of the solutions that we are hopefully all trying to collaboratively develop to address the toxic drug crisis.

It’s important to recognize that harm reduction is an important part of the continuum of care, and those are the services that we are funding with this group. The people who lead the service or the organization, are we going to agree with all of their perspectives? No. We don’t agree with all of the perspectives in this room. We don’t agree with all the perspectives that are put out on the front lawn of the legislature, and that’s part of the beautiful part, I think, of democracy in society, that we involve and engage these people.

What is also important is that we continue with evidence-based policy design. That is the work that we are doing, and we’re going to continue to do that.

When we fund groups like this, the proper oversight and financial expenditure controls must be in place. That’s why collaborative service agreements are developed. That’s why reports are required from organizations. That’s why they are monitored. We ensure that the money is being spent on the services that they have legally signed a document to supply.

When they do not, and in the case we were talking about two organizations before, the funding is ended.

A letter was clearly sent to the community action initiative partners, and in this case the Provincial Peer Network partners, to ensure that they fully understand the obligations of the agreements that they sign. We’ll continue to do that work.

I think it’s important that we hear each other. That’s part of the dialogue that’s taking place here in the estimates debates. In listening to different perspectives, we are not always going to agree. I understand that, but I do think we are going to make better decisions for having these discussions and for being able to see through some of the noise that’s out there sometimes and understand that there are some organizations who are the only organization in these communities that are delivering services or the only organizations that are reaching certain parts, certain sectors, of our society and that it’s incumbent on us to do everything that we can to help those people.

We’ll continue to build out that seamless, that continuum of, care for people and continue to do this work.

Claire Rattée: If that’s the case and we need to fund groups that we may not always necessarily agree with, I would like to see if the minister could please break down for me how much funding the ministry is providing to faith-based centres, abstinence-based centres, church organizations that are out there doing this kind of outreach work, that are providing assistance to people that are struggling with addiction.

[4:30 p.m.]

Hon. Josie Osborne: Thank you to the member for the question.

Recovery looks different for every single person. For some, abstinence-based treatment and therapy approaches and recovery services work, and B.C. does fund abstinence-based treatment and recovery services.

I think it’s important to acknowledge in the use of evidence-based policy development how addictions medicine itself is evolving. For example, there are people who will require medically-assisted therapy, like opioid agonist treatments or therapy, for several to many years, some for a very, very long time. For those people, an abstinence-based approach may not work, and for others, it does.

It’s important, again, that we continue to invest and provide services and supports for people and do our very best to match those with where that person is at and what their recovery journey is going to look like, and so we’ll continue to do that work. I appreciate the question from the member.

Claire Rattée: I don’t think that specifically answers the question, respectfully. I’m looking to understand right now if the government is also helping to fund church organizations, for example, that are doing this kind of work. When I looked through the Peer Network, I didn’t see any groups like that on that list. I’m going to assume, then, that we don’t fund those, and that would mean, in my estimation, that we’re not always going to fund groups that we maybe don’t agree with ideologically.

SOLID Outreach is here on the Island, and it’s on the Provincial Peer Network. Why are their reports not public? It was mentioned earlier that they have to create these reports. I’m curious if the minister can provide those reports, the mandates and the funding breakdowns, as well as the other 23 agencies that are listed there.

[4:35 p.m. - 4:40 p.m.]

Hon. Josie Osborne: Just going back to the last question we were talking about. I think the member mistakenly assumed that because I didn’t list any specific organizations that may be faith-based, they’re not funded, but that would be an incorrect inference.

Again, although the Provincial Peer Network may not have faith-based organizations as part of their network, I can confirm that the province does provide funding to different faith-based organizations. The Salvation Army, I think, is a perfect example of that. They provide at least 40 treatment beds. Additionally, services are funded by the province to bed-based providers who provide services like AA, and one might argue that that is a faith-driven model of recovery.

The recovery journey for everybody looks different. Different kinds of programs will work differently for people. That’s why it’s important to ensure that there’s a range of services that are available for people and, again, why it’s important to continue to build out this system of care.

The member also asked around financial reporting and using SOLID Outreach, for example, as one particular group that would provide that reporting. Those financial controls and measures, of course, are a really important part of a funding relationship between the province and any organization delivering services that are funded through the Ministry of Health, for example.

The government has thousands and thousands of service agreements in place and doesn’t proactively post all of those. There is a disclosure mechanism, of course, that contracts above a certain amount are proactively disclosed.

Claire Rattée: Since the minister is not giving specifics, could she share with us the total amount in this budget for the Provincial Peer Network organizations and a breakdown of how much of this budget is being allocated to each organization?

Hon. Josie Osborne: In 2024-25, it was $1.7 million. We will send the member, by email, a specific list of all of the organizations and the breakdown of funding for them.

Claire Rattée: A recent study that was done March 25, 2025, found that decriminalization and safe supply in B.C. each led to an increase in opioid hospitalizations. Safer supply alone was associated with a 33 percent increase in opioid hospitalizations. With decriminalization included, that number was up 58 percent compared to pre–safer supply.

With this new information, will the minister finally commit to ending the safer supply program, just like they did with decriminalization, and admit that it was a failed experiment?

[4:45 p.m.]

Hon. Josie Osborne: The member refers to a paper that was published in an American scientific journal, a research paper that links safer supply and increased hospitalization due to overdose. I want to point out a few things around this paper, research that was done during the COVID-19 pandemic, and some of the study design failures in considering some key factors that are related to drug toxicity.

I know that some would characterize this as a new study, but I don’t think that would be an appropriate characterization. Our focus is always going to remain on using evidence to guide our policies and improve care, and ultimately, of course, the goal here is to save lives. We have heard concerns from health professionals and researchers and academics about the study design, particularly that it does not account for factors like increasing drug toxicity.

I point out that the illicit drugs in this province are quite different than they are in other jurisdictions that the paper refers to. In fact, over the past months, drug deaths are coming down in British Columbia and in some provinces, but they are rising in other provinces.

The authors of this study note that the rise in hospitalizations may actually reflect the success of decriminalization in encouraging people to seek help.

I would also point out that since the time that the study was done, several years ago, we have made significant changes to our prescribed alternatives and decriminalization programs. But we don’t make policy changes based on one study alone. It’s important to continue making evidence-based and informed decisions that are going to continue to achieve the best outcomes for all of those who are affected.

Claire Rattée: I have a simple follow-up, then. Why has the government not conducted its own study if this is an older report and we want to make sure that we’re making evidence-based choices? I would just wonder why we haven’t conducted our own study to try and clarify that.

[4:50 p.m.]

Hon. Josie Osborne: The province currently is undertaking an evaluation of the implementation of pharmaceutical alternatives to assess unintended impacts, for example, of the program, including diversion. The final evaluation report is slated for completion in March 2026.

Now, one might ask, why is it going to take until March 2026? And the reason why is because this program, decriminalization and prescribed alternatives, simply hasn’t been in place long enough to collect the data that are required for rigorous statistical analysis. In fact, that’s one of the faults in the journal article that we’re speaking about. It does take time to collect these data and to interpret them and provide the analysis that’s required to use the results to inform decisions.

Also, it’s important to note that this work must be done by independent researchers. That’s exactly the case here with the evaluation that the province is undertaking. We are aware that there are other research groups, and they are independently funded to do that work. So I think, as time marches on, we will see this kind of analysis be undertaken, and we’ll be able to use these results to guide better decisions.

Claire Rattée: Can I just ask, then, which independent group it is that is going to be performing this study?

Hon. Josie Osborne: It is the Canadian Institute for Substance Use Research, based at the University of Victoria.

Claire Rattée: Another study which conducted a cost analysis on the impact of poisoning in B.C. found that the average direct hospital cost per poisoning admission in 2016 was approximately $14,430. My question then is: how many of these poisoning admissions in B.C. are opioid-related, and what is the updated cost?

Hon. Josie Osborne: It would be helpful if the member could provide some specifics on the study, exactly where the study was published or what the study is.

Claire Rattée: We’re going to come back to that one. I just need to wait to find out.

In 2016, B.C. incurred about $67.2 million in direct hospital costs for poisoning-related admissions. Alberta’s annual hospitalization costs due to opioid-related utilization was $14 million in ’21-22.

Will the minister commit to reporting opioid-related utilization costs and provide the most updated data on the direct, indirect and total costs for poisoning-related admissions in B.C.?

[4:55 p.m.]

Hon. Josie Osborne: For this it would be helpful, again, if the member was able to share with us the specific data source or kind of the genesis of the question, and we could come back to this in the next day.

But I also wanted to say that parsing out hospital-related costs is a very complex thing to do. A person can be in the hospital for multiple reasons and so determining what costs are associated with what reason why they’re there — you know, for cancer or a broken leg or toxic overdose — that’s a challenging thing.

I think having the study that she is referring to and a little bit more information would be helpful to better answer that question.

Claire Rattée: It was a 2023 report by CMAJ, The impact of poisoning in B.C.: a cost analysis. That’s what I was referring to.

[5:00 p.m.]

In 2016, it was approximately $14,430. If the minister would prefer, we could come back to this tomorrow to give more time.

Interjection.

Claire Rattée: Okay.

Moving on, in 2016, BCEHS responded to 19,275 potential overdose or poisoning calls across B.C. In 2020, that number was up to 27,068. In 2024, BCEHS responded to 40,543 potential overdose or poisoning calls.

At this point, will the minister please acknowledge that the safer supply program is failing, if the numbers keep on increasing?

Hon. Josie Osborne: It would be incorrect to associate the prescribed alternatives program with the changes in calls, through BCEHS, for potential overdoses. The member cites figures going as far back as 2016, but the prescribed alternatives program didn’t begin until 2020.

[5:05 p.m.]

The increase in the number of calls is largely due to a highly toxic and unpredictable drug supply that is changing all the time. Obviously, I think we all know that the pandemic had a huge impact, too, on the toxic drug crisis.

The very purpose of the prescribed alternatives program is to separate people from that toxic, illicit drug supply. With a cautious ray of light and a bit of hope, we have seen deaths begin to decrease. We’re also seeing that the onset of opioid use disorder is decreasing. There are many different factors that are probably the cause for that. It’s difficult to say exactly which one and to what degree it has impacted that.

I also would note that, interestingly, BCEHS just released their figures for 2025, and the calls have come down slightly from 2024. Again, perhaps a note of very cautious optimism, but of course nothing will stop us from continuing to take all the actions that we are, to battle the toxic drug crisis.

Claire Rattée: I think that, sadly, part of the reason that those numbers are going down is actually because a lot of people have died that were using those drugs. That’s just the sad reality of it. I’m hopeful that we’re not seeing more people having an uptake in that, but I think that that’s got a lot to do with it, sadly.

I’m going to move on to opioid agonist treatment. The percentage of people on OAT who have been retained for 12 months has fallen to 43.8 percent in ’24-25. In 2020-2021, the peak baseline was 51.9 percent. Considering this budget mentions opioids a total of zero times, as retention rates for OAT have declined, what specific actions in this budget will target improved retention, especially in northern communities, where travel and access are greater barriers?

[5:10 p.m.]

Hon. Josie Osborne: Thank you to the member for the question around OAT retention specifically. Yes, it has plateaued, and that’s why we’ve been looking at a number of ways that people can access OAT, to ensure that it’s available to them.

The member cited some statistics and certainly noted that there has been a slight decrease in retention rates. In 2023-24, for example, the percentage of people on OAT who were retained for 12 months was 44.4 percent, which was a slight decrease from the previous year, where it was 44.9 percent.

There are barriers that people face in accessing and staying on OAT. They definitely span across the health system. They span across the province: barriers to treatment access, care systems that are fragmented — we canvassed this earlier today — stigma in aspects of OAT provision that limit people’s ability or willingness to continue engagement and treatment. Things like witnessing and frequent visits and unsuitable medications can be a factor in that.

This may be a bit ironic for the member, too, but I would say prescribed alternatives actually have been part of the answer because OAT is not holding everyone who has an opioid use disorder. The ability for a prescriber to work with somebody with both therapies and titrate over time is part of the answer for some people.

The member also talks specifically about some of the barriers and those people living in rural communities, for example. Two actions that I want to highlight that we’re taking are, first, back in November 2023, establishing a new certified practice for opioid use disorder, enabling registered nurses and registered psychiatric nurses to diagnose and treat opioid use disorder.

That includes, of course, opioid agonist treatment. This is particularly valuable in remote communities where there may not be a physician prescriber, so the ability for a registered nurse to undertake that is helpful for people.

Another tool is the opioid treatment access line — we’ve spoken a little bit about that earlier — and giving people…. Particularly where there may be barriers in terms of stigma or access, physically talking to somebody, being able to call a clinician on a toll-free line, a person who can prescribe OAT medication…. This is part of the Road to Recovery program, a central part of this, and ensuring that people have that access to the opioid treatment access line.

I understand the member’s, I’ll call it, frustration that we don’t see everything listed in the budget. The budget is a fairly high-level document, but there are tools and programs and services that are established in previous budgets that stay funded. While they may not be specifically mentioned in Budget ’25-26, we know how important those are, and that’s why they’re continuing to be funded.

[5:15 p.m.]

We talked about that at the beginning of this session of estimates debate, around the different new and sustained treatments and services and supports that people can access.

Claire Rattée: I would ask why in the service plan it uses outdated numbers of people with an opioid use disorder. It states that as of December 31, 2022, approximately 112,318 people have an opioid use disorder.

It’s strange because last year’s service plan had a number that was more updated. It stated there that as of November 2023, 104,765 people have an opioid use disorder. I’m just wondering why the minister provided dated figures, and will the minister provide us with an updated number of people in B.C. with an opioid use disorder?

Hon. Josie Osborne: I would respectfully ask through you, Chair, to the member if we could provide that information later or tomorrow. We’re just going to get the most up-to-date information for her.

Claire Rattée: I would ask then, does the ministry collect opioid agonist treatment retention data disaggregated by health authority or region, and what are the current retention rates in Northern Health compared to the provincial average?

[5:20 p.m.]

Hon. Josie Osborne: I have this data as a breakdown by health authority for fiscal ’23-24.

The retention rate in Fraser Health, 48 percent — I’m sorry, I only have it to a whole number, not a decimal point — Interior, 42 percent; Island Health, 42 percent; Northern Health, 31 percent; Vancouver Coastal, 45 percent; for all of B.C., 44 percent.

Claire Rattée: Well, I think that gives me the answer that I’ve been looking for as far as what’s going on for helping people in the North.

The decline seems to correlate with the introduction of safe supply. Has the minister completed any investigations or analysis to determine if there is a linkage there?

Hon. Josie Osborne: The retention rate for OAT has actually been declining for the past 10 years, which is well before the introduction of the pharmaceutical alternative program. This is largely ascribed to the fact that the nature of illicit drugs and the increasing toxicity has impacted the ability for people to stay on traditional OAT. It’s just not working for everybody.

Again, I’d point out what might be a bit of irony, but this is where the prescribed alternatives working together with OAT are the solution for some people — and the ability of care providers to work with their patients and clients to titrate over time and reduce. Clearly, that’s what we want to see as a part of a person’s recovery journey.

Again, I’ll just point to the work that is underway to evaluate the prescribed alternatives program, with an initial report expected in March 2026 that may provide further insight into this.

Claire Rattée: Has the minister considered transitioning the OAT therapies into just being extended-release formulas and injectable treatments, given what we do know about issues around diversion and, obviously, the inability for somebody to divert something that’s injectable? I’m curious if the minister has given consideration to transitioning that program in general.

[5:25 p.m.]

[Lorne Doerkson in the chair.]

Hon. Josie Osborne: I’ll begin by saying that the diversion of OAT has not been presented as a problem. The drug seizures that police are talking to us about are not about OAT medications. Methadone is witnessed. What we don’t want to do is inadvertently limit the options for people who are using OAT medications in a way that allows them to live their lives as normally as possible.

It would be counterintuitive, I would offer, to limit the type of OAT medications that are available for people. In fact, restricting them could indeed drive people out of the program altogether. The whole point of this, of course, is that we want to provide access to treatments and therapies that are working for people and help them in their recovery journey.

Claire Rattée: How many treatment and recovery beds are currently funded in Northern Health? If there are any, where are they located? Can the minister please provide a detailed list of each facility treatment bed in the health authority?

[5:30 p.m.]

Hon. Josie Osborne: Thank you to the member for the question about treatment beds in the Northern Health Authority.

I’ll read into the record the 120 treatment beds that are available, by facility. In Fort Nelson, at the Fort Nelson general hospital, there are two adult withdrawal management beds or detox beds.

In Fort St. John, at the Northern Centre of Hope operated by the Salvation Army, there are six adult supportive recovery beds.

In Haisla, the Gya’wa’tlaab Healing Centre Society, are five beds of adult supportive recovery beds.

In Hazelton, at the Wrinch Memorial Hospital, operated by the Northern Health Authority, there is one adult withdrawal management bed.

Kitimat General Hospital, operated by the Northern Health Authority, has one detox bed or adult withdrawal management bed.

In Masset, the Haida Gwaii Society for Community Peace operates three adult supportive recovery beds. Also in Masset, the Northern Haida Gwaii Hospital and Health Centre operates one withdrawal management bed.

In Prince George, the Association Advocating for Women and Children operates nine supportive recovery beds for adults. In Prince George, the B.C. New Hope Recovery Society operates six adult supportive recovery beds.

In Prince George also, the Carrier Sekani Family Services sobering centre operates ten sobering and assessment beds. Again in Prince George, the northern B.C. therapeutic community — just announced very recently — is now operating 25 adult supportive recovery beds.

Harmony House in Prince George, operated by the Phoenix Transition Society, operates four supportive recovery beds. The Phoenix Transition House also has ten adult supportive recovery beds, in Prince George as well. Ketso Yoh, operated by the Prince George Native Friendship Centre, operates 15 adult supportive recovery beds.

[5:35 p.m.]

The Prince George detox assessment unit, operated by Northern Health Authority, operates 20 adult withdrawal management beds. The Prince George youth detox centre, operated by the Northern Health Authority, has seven youth bed-based treatment beds and one youth withdrawal management bed.

St. Patrick’s House in Prince George, operated by the St. Patrick’s House Society, has two adult supportive recovery beds.

The 333 Trinity Men’s Recovery House in Prince Rupert has eight adult supportive recovery beds. The North Coast Transition Society in Prince Rupert has five adult supportive recovery beds. In Prince Rupert, the Prince Rupert Regional Hospital has one adult withdrawal management bed. Also in Prince Rupert, Trinity House has three adult supportive recovery beds.

In Queen Charlotte city, the northern authority operates one adult withdrawal management bed. Quesnel Bridges Supportive Housing operates four adult supportive recovery beds. The Quesnel Tillicum Society at the Native Friendship Centre has two adult supportive recovery beds. Bulkley Valley District Hospital, operated by Northern Health Authority in Smithers, has one adult withdrawal management bed.

In Terrace, the Ksan House Society has 11 adult supportive recovery beds. At Mills Memorial Hospital, newly opened, there are two adult withdrawal management beds. Goodacre Place, one adult supportive recovery bed, and Meltans Bridge…. Sorry, that one is blank, so I won’t list that one.

Claire Rattée: My question was around treatment and recovery beds, and I noticed there were quite a few mentions of withdrawal management beds in there. As I’ve stated previously, I think that it’s actually really inappropriate to have access to withdrawal management and not have access to treatment because we’ve seen what that does to people in many instances.

But I’m curious, since this information is clearly readily available to the ministry, if we would be able to receive a copy of all of the treatment and recovery beds that are available throughout the province.

I would also like to see a breakdown of how many recovery beds are available in the northern region based on population comparatively to the rest of the province. What are those numbers? How many beds-to-people do we have in the northern region? If the minister could please make sure that we are provided with a copy of that, maybe by tomorrow if that would be something that we could do.

I will move on to the next question. How many youth substance use treatment beds currently exist within each health authority, and are they primarily treatment-focused or supportive recovery? I know that the minister mentioned a few youth substance use treatment beds there, but just in general, I’m looking for a breakdown throughout the province so that I have an understanding of how many there are in total.

[5:40 p.m.]

Hon. Josie Osborne: Across the province, there are 208 youth-based beds. That’s 110 that have been added since 2017. In Fraser Health, there are 34 beds. I won’t list as much detail as I did before. I’ll just quickly break this down to say: 20 bed-based treatment in Chilliwack, four supportive recovery in New West, four withdrawal management in Maple Ridge and six withdrawal management in Surrey. In Interior Health, there are 34 beds — five withdrawal in Kamloops, five bed-based treatment in Fort Steele, ten supportive recovery in Kelowna, four withdrawal management in Kelowna and ten supportive recovery in Kamloops.

In Island Health there are 31 youth-based beds, five withdrawal management in Victoria, nine supportive recovery here in Victoria as well, three withdrawal management and recovery in Nanaimo, four transitional services operated by the Tillicum Lelum Aboriginal Society that doesn’t have a specific location listed, five supportive recovery in Courtenay and five withdrawal management and supportive recovery in Campbell River.

Northern Health has eight beds. They are in Prince George, with seven bed-based treatment and one withdrawal management. Vancouver Coastal has 61 beds: 28 supportive bed-based treatment in Vancouver, withdrawal management in Vancouver, five treatment in another confidential location in Vancouver, eight bed-based treatment in Vancouver, eight supportive recovery in Vancouver, five treatment and seven treatment again in Vancouver.

The Provincial Health Services Authority further operates 30 beds. There are 18 treatment beds in Surrey. There are 12 treatment beds in South Surrey. The First Nations Health Authority operates ten beds at Williams Lake, and there are a further ten beds that are First Nations–led at the Orca Lelum Youth Wellness Centre in Lantzville.

Claire Rattée: I’m wondering if the minister also has the data on the utilization rates of those youth beds. I don’t need them broken down. Just overall, what are the utilization rates for those youth beds?

[5:45 p.m.]

Hon. Josie Osborne: A bit of information here, as per the member’s request. Provincially, as of September 2024, the average utilization rate is 33 percent for youth withdrawal management beds and 61 percent for treatment, supportive recovery and transitional beds. I don’t have those data broken down by health authority right now. Sorry for that.

I want to talk a little bit around some of the challenges of what can be perceived as underutilization of beds across the system of care and the dependency on referral volumes, on the geographic location, the specific client needs, the types of bed-based care and factors including release from custody or needing to arrange child care that can impact the utilization rate. Just to that, sometimes beds are held for a young person in preparation for them to begin treatment soon, but the bed is only counted as utilized from the start of service. So these are some of the factors that will impact the number.

I also want to comment on the fact that we know that it is really challenging for young people to leave their community and to leave the supports that can be around them there. They often don’t want to leave. That’s why it’s been so important to do everything that we can to expand non-bed-based substance use services for people.

That includes crisis supports, culturally safe wraparound services, better emergency room and hospital-based care, better or enhanced discharge planning and transitioning between acute care and community-based services, things like Foundry, preventative measures, increasing the access for youth to primary care, mental health counselling and other supports that way, integrated child and youth care teams, all things that we’re really proud to be continuing to invest in and expanding across the province.

Claire Rattée: Recently, the Representative for Children and Youth recommended to the Ministry of Children and Family Development the creation of youth-specific drug consumption sites. Is the Ministry of Health, in this budget, going to prioritize funding for safe consumption sites for youth over detox treatment and recovery centres? Will this minister state for the record that this government will or will not be going down this dangerous path of more enablement for our most vulnerable?

[5:50 p.m.]

Hon. Josie Osborne: There is no funding in this year’s budget for youth-specific safe consumption sites. Ergo, no emphasis on that at all. But what there is, is a commitment to continuing to build a system of care that works for youth, and that includes withdrawal management, treatment and recovery beds, for example. There is commitment for new funding for new Foundries for new integrated child and youth teams, and there are still youth beds that will be coming.

I think it’s important to note here too…. I just want to highlight the work that’s being done through Orca Lelum, an Indigenous-led program and site for youth. We know that the toxic drug crisis disproportionately impacts Indigenous peoples. We know that it disproportionately impacts Indigenous youth. The commitment that we have made to work collaboratively with First Nations and First Nations organizations around Indigenous-led solutions for children and for youth is a really important focus of government’s work.

Claire Rattée: I’m really happy to hear that it sounds like the focus is going to be around treatment and recovery, not safe consumption sites.

Further to that, I have a follow-up question: if the minister will state whether or not this government is going to allow overdose prevention sites in hospitals. I know that that’s been a topic of some debate, and I would like some clarity around whether or not overdose prevention sites will be allowed in hospitals.

[5:55 p.m.]

Hon. Josie Osborne: Before I answer the question, I misspoke earlier. I was listing sites in Northern Health, and I referred to Queen Charlotte city, and that was a mistake because that place has been renamed in the Haida language as Daajing Giids. So I want to apologize to the people who live in Daajing Giids — which is a beautiful place that I’ve had the privilege of visiting — and correct my mistake there.

With respect to designated overdose prevention services and locations, I want to begin by being perfectly clear that illicit drug use at hospitals is absolutely prohibited outside of designated OPS locations. This, of course, stems from the fact that the safety of staff and of patients and of visitors is of the utmost importance to us as government, to the health authorities. This is why we took the step of establishing a provincial policy that supersedes health authority policies, and it clarifies specifically that drug use in hospitals is not allowed outside of these designated OPS.

We do know, however, of course, that illicit drugs have become increasingly toxic and unpredictable. In that context, we know that OPS are critical for saving lives, and they are critical for connecting people to better supports and treatment, and they play an important function.

Also, I’ve spoken before in this House about how we are working to finalize minimum service standards for publicly funded both fixed and mobile OPS. That will support the consistency that we need to see, the quality, service accessibility and cultural safety at those sites.

The minimum service standards are under development right now. They do align with a recent recommendation that we had from the Office of the Auditor General, and once the standards are finalized, we’ll then work with health authorities and service providers on any implementation that is to occur.

Claire Rattée: Given the recent issues around increasing violence and attacks in hospitals and the safety of the staff there, I’m wondering if the minister could provide us with how much money in this budget is being allocated towards security measures in hospitals and how much has been allocated previously. Is there an increase in this year’s budget to increase the amount of security that is happening in hospitals?

[6:00 p.m.]

Hon. Josie Osborne: Thank you to the member for the question, raising the very serious issue of workplace safety, particularly in health care facilities.

It is incredibly unfortunate that it is more common in health care than in other industries, and ensuring that we are providing psychologically and physically safe places for physicians and nurses and other health care workers to work in is of utmost importance. That’s why we have been working together with health authorities, with the B.C. Nurses Union, for example, and taking action to build safer workplaces.

The member will know — I’ve spoken about it before — the creation of the relational security officer program. This initiative that was announced back in October 2022 and began being filled — these positions — in 2023…. There was a commitment to 320 net new relational security officer positions.

And I just want to take a moment to describe these positions, which are not just your regular security guards that you might see, like in a mall for example, but people who are trained specifically through trauma-informed practice, for example, and ensuring that these people have a very acute awareness of patients and their surroundings and how to anticipate and de-escalate and ultimately prevent aggression.

Again, this is based in trauma-informed practice and really integrates that knowledge of how people are affected by traumas that they have experienced into the procedures and practices and services that these relational security officers provide.

We expanded this model in spring 2024 and again in spring 2025. Specifically, back in 2023-24, we committed $40 million in the budget to support their relational security initiative. And for 2024 and 2025 and onwards, this commitment increased to $60 million annually. That includes, obviously, the salaries, for example, of these officers, but all the program area costs as well, including the infrastructure that they need, the violence prevention leads that have additionally been hired and the corporate support and training that takes place.

The sites for relational security officers were selected in consultation with the health authorities but also, really importantly, with the B.C. Nurses Union. It was really important to have their feedback and input into the sites where they would be installed. So today we have 781 full-time equivalents of these officers working at sites across British Columbia — 32 of them.

[6:05 p.m.]

Claire Rattée: I don’t know if I missed it there, but I didn’t actually hear what the increase in funding was going to be in the budget. I’m not sure if I missed it. I’m sorry, but if I could just hear exactly what the increase in funding is going to be in this budget for security measures.

Hon. Josie Osborne: This year’s budget remains the same as last year’s. It is $60 million.

With that, hon. Chair, I would move that the committee rise, report progress and ask leave to sit again.

Motion approved.

The committee rose at 6:05 p.m.

The House resumed at 6:06 p.m.

[The Speaker in the chair.]

Lorne Doerkson: Committee of Supply, Section B, reports progress on the estimates of the Ministry of Health and asks leave to sit again.

Leave granted.

Hon. Kelly Greene moved adjournment of the House.

Motion approved.

The Speaker: This House stands adjourned until 1:30 p.m. tomorrow.

The House adjourned at 6:06 p.m.