STANDING COMMITTEE ON ESTIMATES
COMITÉ PERMANENT DES BUDGETS DES DÉPENSES
Tuesday 26 October 2004 Mardi 26 octobre 2004
MINISTRY OF
CHILDREN
AND YOUTH SERVICES
The committee met at 1535 in room 151.
MINISTRY OF CHILDREN
AND YOUTH SERVICES
The Vice-Chair (Mr John O'Toole): I'd like to open the meeting of the standing committee on estimates and welcome the Honourable Marie Bountrogianni, Minister of Children and Youth Services. You have 30 minutes to address the committee, after which there will be 30 minutes for each of the opposition parties to respond. There's a total of seven and a half hours, as you're well aware. I welcome you and your staff, and look forward to your comments.
Just one administrative thing, when persons are first speaking, if they could identify themselves for Hansard and the record it would be much appreciated.
Hon Marie Bountrogianni (Minister of Children and Youth Services, Minister of Citizenship and Immigration): Mr Chair and members of the committee, thank you for inviting me today to present to you our vision for the new Ministry of Children and Youth Services. I thank you too for the opportunity to answer any questions you may have about the important and exciting work of this new ministry. I'm joined today by my Deputy Minister, Jessica Hill, and other senior ministry officials.
I'm confident that you will see that the people around me have done a remarkable job establishing the first new Ontario ministry in a generation, a challenging and often daunting task. I want to thank the many staff in the ministry who helped us get to where we are today. These are people deeply committed to bettering the lives of children and youth in Ontario, as are the thousands of Ontarians who provide services for children and their families across our province every day and the many more thousands of people who volunteer their time in an untold number of ways to help Ontario's young people live rich, full, promising lives.
The Vice-Chair: Mrs Bountrogianni, if I could just rudely interrupt and ask that if you have written comments that could be distributed among members of the committee, it would be appreciated. It's just much easier for them to make notes and follow up.
Hon Mrs Bountrogianni: OK. We'll arrange for that. There may not be enough copies now, but we will arrange for it.
The Vice-Chair: Thank you very much, Minister.
Hon Mrs Bountrogianni: Would you like me to wait until that happens?
The Vice-Chair: No, that's fine.
Hon Mrs Bountrogianni: I know that every member on every side of the Legislature faces important issues affecting children, youth and families every day, and I know that every one of you and your colleagues have many stories to tell of how we can do better for young people in your ridings. We must do better in Burlington, Kitchener, Ottawa, Bramalea, Ajax and Sarnia, and I know that children and youth inspire a sense of responsibility far greater than any party differences. That's the spirit in which I come before you today.
One of the first things that Dalton McGuinty did after being sworn in as Premier a year ago was establish the province's first Ministry of Children and Youth Services. Here's what he said at the time: "How we care for children is not only a reflection of our shared values, it is critical to the future social and economic success of our province.... Investments in ... children ... pay off with better learners, healthier children, more secure families and a more productive economy.... The time has come for us to invest in the services children need to become happy, healthy, productive adults."
In less than one year we have brought together, under one roof, programs from three separate ministries. The new ministry inherited programs for children and youth formerly in the Ministry of Community and Social Services, the Ministry of Health and Long-Term Care and the Ministry of Community Safety and Correctional Services. The result is that Ontario has a single ministry responsible for child care, services for children with special needs, early childhood development, children's mental health, child protection and youth justice.
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It makes sense. It's the same reason we have a Ministry of Health. There are dozens and dozens of individual programs, but they are managed in common because we have an overarching objective to provide quality health care. And so it is with children and youth. We have an ambitious vision and ideals for children and youth in this province, and the surest way to achieve those ideals is to ensure that the programs and services designed to meet them are managed thoughtfully and in concert with one another. I am well aware of the significance of the challenge but know that this government, this ministry and this minister will rise to that challenge. We are committed to developing an Ontario where all children and youth have the best opportunity to succeed and reach their full potential. We know that the journey to that kind of Ontario will take time. It will also take the energy of people working in communities across the province, and that is why I've spent a good part of the last year travelling around the province. I've met with many people who share a commitment to Ontario's children and youth: child care operators, child welfare workers, youth justice staff, children's mental health professionals, regional and municipal officials, and of course parents, children and youth.
Everywhere I went across the province, I asked the same questions: How can we serve our children and youth better? What barriers are in the way of delivering the best opportunities to our children? The response I heard was essentially the same from everyone. They told me that we need to bring it all together so that families can access the services they need and service providers can deliver integrated services. Time and again, I heard that children's services in this province have been too fragmented. I think that "frustration" captures the state of affairs that prevailed in children's services when I arrived here. As soon as I became minister I took stock of what we had. And what we had was a group of professionals and service providers very committed to providing quality services. Given the resources available to them, they have done an outstanding job. But the system that tied all of their individual efforts together was faltering; in fact, it was hardly a system at all.
First of all, there just weren't enough of those dedicated professionals to meet the needs. Inattention to the sector over recent years meant that wages and resources in the sector had not kept pace with other sectors. It's no surprise that many high-quality professionals left the children's service field, and the agencies that employed these individuals simply could not afford to keep them all, much less expand and hire badly needed new staff. So we had to get some new funds into the system fast to begin to rebuild its overall capacity. We did that, and I'll talk about some of the specific investment we made in a moment. But we had to do more.
We faced more challenges than simply staffing shortages and a lack of resources. We had a fragmented system. We had a system that saw parents of a child with special needs deal with multiple ministries to get the services they and their child needed. We had a system in which many children, youth and parents were not taking advantage of some very good programs because they didn't know they existed. In one of the public hearings -- this is in a rural area -- a mother told me that she was transporting her child for therapy one hour outside of where she lived for a year until she discovered there was a similar service 10 minutes away. That's important when you consider the communication aspect of this ministry. We had a system that at policy level was not maximizing its resources in one area to bring about benefits in another.
We've begun changing all of that. By combining children and youth services in a single ministry focused on the children and youth themselves, we can see and act on those linkages. We can make investments in children's mental health and know that they have an effect on reducing youth crime. We can make an investment in early years supports for parents and know that it will help reduce abuse and neglect, keeping children out of our children's aid societies.
I'd like to focus on what we've done in the first months of our new ministry. It's a long list, I'm proud to say, and you'll see that it addresses both of the challenges we faced. Our achievements have boosted funding and resources to begin to rebuild the capacity of our children's services, and they begin to tie all the services together in a web of interconnected programs all guided by the same common results we want to achieve for Ontario's children and youth.
I'll start with child care. We know that quality, affordable, accessible child care and early learning prepare our young people to arrive at school ready to learn. It's an investment that pays dividends for decades and decades, as children grow into productive contributors to Ontario's economy. It also pays dividends for families: Parents can work away from the home when their children are in a quality child care program. That's why I was proud to make two funding announcements earlier this year to boost child care services in Ontario.
In January, we invested $9.7 million into one-time capital projects. These were mainly health and safety projects like repairing roofs and heating equipment. This funding also enabled some operators to convert infant rooms to toddler rooms, as demand shifts. As well, as you're well aware, the federal legislation has changed with respect to parental leave, so that mothers now have, if they wish, up to a year to stay at home with their newborns, their babies. This has changed the demand in certain parts of the province for a bias toward toddler rooms as opposed to infant rooms.
But we were just getting started. This first investment helped shore up our existing supply of child care centres and spaces, and it helped prevent closures that might have resulted if some of these centres had not been able to make needed health and safety repairs. People in the child care community in Toronto told me it came in the nick of time. We certainly can't afford to lose any of our existing supply of child care spaces. We need to expand them.
In July, I announced that we are investing a further $58.2 million into child care. That kind of investment can create 4,000 new subsidized spaces across the province. In reality, 4,000 spaces will likely serve many more than 4,000 families, as many children only use a subsidized space part of the time: some only mornings, others only a few days a week.
These two investments represent the full federal transfers we received for child care, and we put every nickel of it where it was meant to go: into child care.
We know that families in rural Ontario have different needs than families in urban centres. That's why we've given municipalities significant flexibility in how they use the money to create new subsidized spaces. We expect them to provide new spaces for children from infants up to six years old. But we've also directed a portion of the funding specifically to create new subsidized spaces for preschool-aged children in child care centres in and around schools. Child care must prepare children for school, must be connected to the community and must be convenient for parents. When child care centres are in or near schools, they do all of that.
It's a start toward our Best Start strategy, a plan you'll be hearing about in the months to come. At its core, Best Start is about setting children on a positive trajectory from infancy and enabling them to transition smoothly into school, so we've set to work to rebuild the link between child care and education.
One of the very exciting announcements in this year's budget was that we would be increasing funding for children's mental health. It had been more than 10 years since that field had seen a substantial funding increase to its base budgets. As you may know, this is a matter at the heart of my life's work. As the chief psychologist of the Hamilton-Wentworth school board, I saw first-hand the anxieties of children as they sought to cope with their mental illness. I saw first-hand the courage of parents as they sought to come to terms with their children's struggles. I also saw the frustration of well-meaning teachers who simply did not have the background or the resources to help these children. I know all too well that these families need our support before their frustration yields to despair.
Sadly, suicide is the cause of one quarter of all teenage deaths in our province. Failure to deal with children's mental health problems can lead to a path of adult mental illness, conflict with the law and homelessness. The Provincial Auditor reported last year: "Timely access to children's mental health services is often critical for ensuring the best possible outcomes...."
Underfunding of mental health services for children has had three serious consequences: overuse of more expensive health services; inappropriate use of services and facilities never meant for children with a mental illness; and worst of all, tragedy for the children in need.
Through my ministry, the government is providing $25 million more this year for children's mental health services, and an additional $13 million next year, bringing our additional investment to $38 million. That is an increase of more than 11%. More significantly, it is the first big boost to the children's mental health sector in 12 years.
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Right off the bat, we provided a 3% base funding increase to agencies that provide children's mental health services. That will allow some agencies to fill professional staff vacancies and help us serve more children. It will also provide some overdue wage increases to staff in this very difficult line of work.
That's a start, stabilizing the sector with some badly needed new funding. But building for the future means more than simply percentage increases. This summer we announced the creation of the new Centre of Excellence for Child and Youth Mental Health at the Children's Hospital of Eastern Ontario. This new centre is based on blending intervention, education, partnerships and evidence-based clinical research.
As we move forward with the children's mental health action plan, I have asked Dr Simon Davidson and a team at the centre of excellence to lead an important information process. Dr Davidson and his team will engage the broader community in ideas for standardization of care and best methods for delivery of care, education, treatment, training and prevention.
In March, I announced a new plan to help children with autism and their families. Since then, we have moved quickly to put meaningful new supports in place this fall. For now, let me summarize the improvements we have made for children with autism and their families. Our government is committed to providing a better future for Ontario's children with autism. To do that, we must provide supports that can benefit all children with autism, not only those at the most severe end of the spectrum.
We have implemented a wide range of new supports for families of children with autism, from a child's first assessment right through their school years. Teachers who have children with autism in their classrooms have access to 75 newly hired autism consultants to help them support these children in the classroom. That number will increase to roughly 150 as we complete the hiring over the coming months.
We've doubled the number of transition coordinators from 13 to 26, to help children move smoothly from preschool into school. More therapists and psychologists will be able to provide intensive behavioural intervention to 20% more preschool-age children with autism. So far, 24 more therapists have been hired, and many more will be hired as we complete the implementation. New guidelines will enable more children to be assessed sooner, so that they can take advantage of preschool supports.
The net effect is that we have taken a program that was very narrowly cast and made it broader. Rather than offering one limited type of service to one limited group of children with autism, we are providing a wide range of services that can allow us to support all children with autism in some way. Children with autism need to progress from clinical interventions to applied social settings, and that's what our program is designed to deliver.
Of course, there are many more children with special needs who need our help, and many of them are well served by Ontario's 19 children's treatment centres. These centres help provide the best possible physical, emotional and cognitive development for more than 35,000 youngsters with physical disabilities and special needs. CTCs offer everything from occupational therapy to speech and language pathology to physiotherapy. Yet despite the vital services they provide, funding for Ontario CTCs had not nearly kept pace with a growing demand for those services.
Interruption.
Hon Mrs Bountrogianni: Are we being called in for a vote or something?
The Vice-Chair: There's a 30-minute bell. In fact, it's a good time, you have about eight minutes left.
Hon Mrs Bountrogianni: I'm used to speaking more slowly now, ever since I took over the responsibility for Ontarians with disabilities, to let the ASL persons -- I'll quicken it up.
So we stepped in to help. We provided a 3% increase to the operating budgets of all CTCs. It's a start. We know that 3% doesn't eliminate the pressure, but it does reduce it. We're starting to turn things around.
We're also building for the future. In addition to the operating increase, we are providing capital investment of $24 million over four years to build or expand children's treatment centres in four cities. In Thunder Bay, the new funding means a new building for the George Jeffrey Children's Treatment Centre. The current one is outdated and too small to handle demand in the region. In Windsor, the Children's Rehabilitation Centre of Essex County will benefit from much-needed renovations and expansion. In London, the Thames Valley Children's Centre will expand to add a third floor.
In North Bay, I'm proud to say that the $7.4 million in funding there will create a new CTC in a region that badly needs one. The new Northern Shores treatment centre will serve Muskoka, Parry Sound and Nipissing. There had been promises in the past about establishing this children's treatment centre and lots of headlines with pictures of the Premier of the day, but never money to build and operate it. Now North Bay will have the CTC it needs.
That still leaves us with one region in the province without a CTC. The Simcoe York District Health Council has made a proposal to integrate rehab services for children and youth of Simcoe county and York region. My ministry officials have spoken with the people in Simcoe York, and together they are working toward a solution.
Despite this outstanding gap, we have brought greater stability to the children's rehab sector and we're making real investments that will put the sector on a strong footing for the future.
Child welfare is another area we're building for a sustainable future. This isn't easy. Child protection services, through our children's aid societies, represent the largest single item in the ministry's budget. It's a sad reminder of how great is the need for child protection. What's worse, the need is growing. To be honest, it's not entirely a bad thing, because part of that trend is that more abuse and neglect is being reported. That means we're doing a better job, as a province, of finding and helping kids who need it.
The costs continue to climb. Just this year we added $65 million to children's aid societies' operating budgets. We also provided more than $20 million to clear children's aid society deficits from 2002-03. These investments help ensure that needed services are there for kids in the near term.
But to make the system truly sustainable, we need to change the nature of the child welfare business. We are starting to build toward sustainability by working with the agencies to identify ways of containing legal and infrastructure costs. That's a start. Ultimately, we need to realign funding so that it focuses on the specific results we want to achieve: results like more children in permanent homes through adoption, results like preventing abuse and neglect before it starts so that children can remain with their families.
We have undertaken a wholesale review of the child welfare sector. We also established a child welfare secretariat, headed by the executive director of the Toronto Children's Aid Society. The secretariat is working closely with the sector to develop a reform package that would put child welfare services back on solid fiscal and structural footing so that we can continue to provide these badly needed services to children and youth at risk.
One group of youth at risk is those youth in conflict with the law. In youth crime, we have a dual responsibility: We must hold youth accountable for their actions, but we must also do it with a rehabilitative focus. In other words, we won't give in to them, but we won't give up on them either. We're transforming the youth justice system so that it can meet our dual objectives of holding youth accountable for their actions, on one hand, and putting them on a path to become productive, community-minded adults, on the other. If we really want to make our communities safer, we need to help troubled youth turn their lives around.
Youth in conflict with the law have unique needs. Meeting those needs means a dedicated youth justice system: not merely an extension of an adult system, but an independent, youth-oriented system. That transformation took some big steps this year as we closed the unsuitable Toronto Youth Assessment Centre, as well as two other youth facilities that were housed in adult institutions. We made a major capital commitment to build the new GTA youth centre, a state-of-the-art facility to meet the unique needs of youth.
In all, we've accomplished a great deal in our first months. We've brought greater stability for the agencies, professionals and staff who provide services to children and youth. We've begun an ambitious review of all the programs carried out by the ministry and all the programs supported by the ministry. That's a huge undertaking, but it needs to be done. It will lead to a better, more sustainable children's services system, one that is truly a system.
I appreciate the opportunity to report our progress to the members of this committee. I know you're going to ask me some tough questions, but I know that all of us here care deeply about what we're doing and care that what we're doing is right for Ontario's young people. For that reason, I welcome your help in doing my job as well as I possibly can.
With that, I'm happy to respond to the questions of the committee.
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The Vice-Chair: Thank you very much for that, Minister. I think the tradition has been that those are your opening remarks, and we'll proceed now with 30-minute rotations starting with the official opposition, followed by the NDP.
We'll also respect the bells. There is a vote at the end of 22 minutes and we'll recess. I'm just wondering if it's the wish of the committee, for continuity purposes, not to interrupt the line of questions and responses, if at some appropriate time -- I'll leave that to Mr Jackson -- we could just adjourn the committee with sufficient time for members to do what they must do to get to the vote at the end of a certain block of questions and then leave the remaining time for that party. Is that appropriate? Would that be the best way to handle it so we can change topics?
This would mean that if the opposition critic would like to stand down their time to do their opening remarks -- and I would make that offer to the NDP: You could be splitting your time. You wouldn't get a 30-minute statement and/or questions to the minister. If somebody wants to make an opening statement --
Mr Cameron Jackson (Burlington): We don't have a ruling yet?
The Vice-Chair: No, what I'm putting to the committee generally is that normally Mr Jackson would have 30 minutes. His 30 minutes is going to be interrupted in about 15 minutes, because we need a few minutes to get to the vote. So what I'm saying is that we could recess now and come back after the vote, which means we would be recessed for about 25 minutes.
Mr Wayne Arthurs (Pickering-Ajax-Uxbridge): Why don't we proceed, Mr Chairman? Rather than debate the time, why don't we proceed with Mr Jackson and determine whether he would like to do the 15 minutes or break at the end of a question? At least then we'll be using the time we have wisely.
Mr Jackson: First of all, it's the custom to not interrupt either a minister or the prescribed time frames of the half-hour intervals. That's the custom. I'm not comfortable having it all busted up. I do have a point of order to the Chair that I'd like to raise, but I'd be more comfortable starting when we're not being interfered with, with bells and our whips coming in and out of the room telling us to get upstairs. That's my opinion. I'd like to present my --
The Vice-Chair: Do you want a point of order right now?
Mr Jackson: I'm not sure it's a point of order, but more a point of privilege: I had asked for one of the agencies of the new ministry to send a representative. Both the NDP and I had made a request that a representative of the Child and Family Services Review Board be in attendance. Is that individual available?
Ms Jessica Hill: We understood that the request was made of a number of individuals, for some of whom we've suggested replacements because these --
Mr Jackson: Jessica, let me interrupt you and keep this simple. I asked for a rep of the Child and Family Services Review Board. The request was made to me as the Chair, I passed it on to the minister. There should be a chair, a vice-chair and several other individuals. But it is perfectly within the mandate of this committee to, short of a subpoena, have a board or commission present here. When I was energy critic, I had the head of the Ontario Energy Board come. It was a difficult session, but it respects the fact that they're a transfer agency of your government and that you have lay people in charge of them, and it has been the custom for them to come forward. Is there no one left in the province managing the Child and Family Services Review Board?
Ms Hill: There are, I believe, 12 active members of the board. We have not --
Mr Jackson: Is Mr Adams still --
Ms Hill: He is still the chair.
Mr Jackson: Fine, and the vice-chair is?
Ms Hill: I'm not sure who the vice-chair is. Just a minute.
Mr Jackson: Who decided their attendance wasn't necessary?
Ms Hill: I think, Mr Jackson, we thought for the purposes of the first day we did provide a number of names before you. If you would like Mr Adams particularly to appear, we can certainly approach him.
Mr Jackson: The custom is, out of courtesy, to advise him. Has he been advised his attendance has been requested?
Ms Hill: I'm not sure, actually; I'll have to determine that.
Mr Jackson: All right. Perhaps we could get back on track. I put the request in as the Chair. It wasn't my specific request; it was a request from a specific member who wishes to sub into the committee.
It's not our intention to hold these people up for three days and make them sit here. The idea of contacting them is to determine their availability so we can say, "For this one hour, would that person be available?" Then we would ask our questions during that hour and that would be the end of it. It's not our intention to have him sit here for three days, even though he gets paid a per diem. He may not be offended by that.
Ms Hill: We will convey that to him, Mr Jackson.
Mr Jackson: That's the process, so I appreciate that.
Ms Hill: I don't think it was actually clear whether he would be able to be here for that length of time --
Mr Jackson: Well, that's why you have a vice-chair.
Mr Ernie Parsons (Prince Edward-Hastings): On a point of order --
The Vice-Chair: Are you speaking to the point of order that is before us?
Mr Parsons: On that same point of order, I would look for some direction from the clerk, if he could check into it. This is an independent review board, and I'm not sure of the appropriateness of political interference in what is to be a stand-alone review. I wonder if we could check on the appropriateness as to whether there is a requirement to come, because I believe they should be independent and not part of the political process.
Mr Jackson: Which is why all three political parties are able to interview them. But they are a transfer agency, and under the act, I can assure you, in my six years as chairman of this committee, we have had a considerable number of agencies come forward, but we'll get a ruling.
Mr Parsons: I would just ask for a ruling.
Mr Jackson: It was important to you in opposition; I suspect it will be just as important to you in government.
The Vice-Chair: There it is. We're going to recess until after the vote.
The committee recessed from 1606 to 1627.
The Vice-Chair: The standing committee on estimates will reconvene. The Chair recognizes the member of the opposition, Mr Jackson.
Mr Jackson: Thank you, Mr Chairman. First of all, let me congratulate the minister on her appointment as the minister responsible for children and youth in our province. I certainly support the policy position that integrating services is important in our province, and long overdue.
In my almost 20 years here, I've had occasion to sit in opposition for 10 years discussing children's services as an advocate and recall very vividly the Children First document that laid out some rather significant challenges. If we were ever to sit down quietly and go over that document, we'd find out that about a third of it has been implemented, about a third is being considered and about a third seems to not make it on to the table.
I just want to say that I'd like to include myself as one of those individuals who, first of all, supports the public policy direction. I also would like to say for the record that I think your background eminently qualifies you to be the minister. I'm sincere when I say that I would be very happy if you could stay in the ministry for four years -- or three years, as would be the case, by your own hand -- because of your background and your understanding of these issues. I think we're fortunate, in a non-partisan sense, if we can move forward on issues of agreement when the critics -- in this case both your critics -- and the minister have a background in the area. We should be able to talk a similar language many times and understand what the real challenges are.
Having said that, obviously there are issues that we'll want to raise, and I would like to use a considerable amount of my time to probe deeper into what your short- and long-term plans are. Having been a member of privy council, for me the real issue will be the political will of the government as determined through the actions of the minister at that table, and subsequently the kinds of funding and policy initiatives the government will take.
You inherited various ministry pieces that you've referred to; some had undergone some degree of reform and some have not. To be fair, we need to acknowledge that some of the things that were initiated were a pretty important attempt, and we need to measure during the time in estimates to determine the will of the government to proceed with those reforms or the will of the government to change direction. Clearly, after one year we're able to see which ministries and ministers are moving in different directions. We really have not seen that as yet, and it may be too early, given that you're constructing your new ministry and you're integrating your personnel. Almost all of them, when I review the list, are well know to us in social services and should be able to work together quite well because they have a considerable amount of experience and they have the institutional memory.
Mr Chairman, so you don't have to interrupt, we have a 29-minute bell. I'm quite comfortable to continue. We can't predict these things. As long as we watch the clock, my time should expire just before we're called to the House. So if everyone is comfortable, I'd like to proceed and start moving through these estimates.
Minister, there will be questions that I would like to present for the record, and I would like to have as many responses as possible. At one point, I will reading questions into the record for your staff to respond to in detail, and I will want to ask general policy direction questions of where you're going.
If I might just begin, I understand -- again, a little bit of committee business -- you had notified me as Chair that you and your deputy were called to Ottawa for next Monday and Tuesday and therefore would be unable to attend. Given that both you and your deputy could not be here, we couldn't yield to a PA because that would be too large a deficiency, so we will be able to work on Wednesday with the issues around daycare.
I did want to raise some issues with daycare, but it may be more appropriate -- unless you're prepared in your rebuttal summary comments before today's end to discuss with us the agenda that the federal government has presented. We know there are substantive new dollars coming from the federal government as a result of federal government initiatives. We, as a province, welcome those. We recognize, for example, that we received 58.266 million more new dollars from the federal government. In your statements you had indicated that your enhancements were around $50 million. Perhaps you might address later exactly where those dollars were flowed and how: whether it was to change the eligibility for capital or whatever. Could you help us with that breakdown a little bit better?
We applaud the existence of new dollars, but it's fair for us to track just how much of that is new federal money and how much of that is new provincial money. If you do have elements of the agenda, I think what's of concern to us with the FPT meeting with Minister Dryden will be what conditions the federal government may put on those dollars coming to Ontario. Although the range of options is a lot less with daycare than it is with, say, hospital funding, which your health minister is struggling with -- the federal government is putting too many conditions on it -- I think this committee would be vitally interested in knowing, as will the public, what your position might be going into these FPT meetings, your first, to deal with this new money and the larger framework for a national strategy.
Generally, national strategies, as you know, Minister, put Ontario in an awkward position, because invariably -- and I can't think of any, but in the social health field, Ontario generally is a leader in terms of availability, access and the basic guidelines. So there are some concerns when the federal government designs programs and funding conditions that are more for those have-not provinces that need to have their outcomes prescribed by a federal framework. Ontario doesn't really need that. We have the critical mass of people and funding to provide some of the best programs on most of these fronts.
The second area I was hoping to explore and will explore in rather great detail is children's mental health organizations. I do wish to correct the record: This is not the only increase they've had in 12 years. In fact, your ministry provided a 1% staffing enhancement in 2000 and 1.5% in 2001. That was across the sector for staff retention, an issue which I know was near and dear to your heart. It was near and dear to your heart by your own occupational choices as a young woman. When you graduated with your degree, you saw the wisdom of earning $10,000 or $15,000 more by going to work for a school board instead of working in the --
Interjection.
Mr Jackson: It is true --
Interjection.
Mr Jackson: Under no circumstances am I impugning your motive. In fact, I consider that you're a minister who doesn't need any explanation as to how wage-gapping has occurred. But in children's mental health services, this has become very severe when a first-year psychology graduate is able to make close to $70,000 at a school board and yet our children's mental health programs can barely make it, paying $48,000 a year.
Why I raise that is that there are about four reasons for it. Maybe if we have time, we can get into a discussion about what the net effect of bump funding is when it's across the board, much in the way we did with pay equity and so on, without targeting classifications of workers who were lowest paid. There are other significant issues about where we migrate our programs based on the ability to pay salaries.
The other issue, of course, is the one I raised with you in the House about the residential treatment centres for hard-to-serve youth and the fact that under a previous government, again receiving the advice of the same civil servants who are in the room with us today, we provided that bump funding -- staffing funding -- to that sector under that program, but we're not providing it under this program, and therefore the gap widens. That is of particular concern to me because, like yourself and my colleague from Sudbury, we are painfully aware of how gaps actually widened, and that action by government actually widens the gulf. I know that's not an intended outcome; it's just a fact of what happens.
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So during our question-and-answer period I'm going to want to pursue issues about the degree to which you, as a minister, are satisfied that you are providing adequate funding to these homes since, by your own omission, if I asked you, "Do you regulate these homes?" your answer would be yes; "Do you set their rate?" the answer would be yes; "Do you provide direct funding in some circumstances?" the answer would be yes.
To take a public policy position based on the advice of your bureaucrats today that these groups of residential centres are unworthy of the bump funding, I think, puts them in a compromised situation. For the record, they are not all commercial operations; there are many that are not-for-profit and many that are charitable, with a charitable board, and they are struggling. They do not get the additional assistance for health and safety retrofits, something we provided to private nursing home operators, private daycare operators, to a whole series of private facilities providing health services to vulnerable people. Yet, for some reason we have isolated this group uniquely. Again, I spent all my time on social policy and I cannot remember when we have done this to a specific group of care workers and their environment.
If you're satisfied, as the minister, that there are no health and safety issues and no children-at-risk issues involved, then that should be on the record. But I know there have been facilities where we've had staff murdered. I'm thinking back about 15 years ago to one in Barrie, particularly, when that occurred at a home such as this, with staff assisting children in transition from corrections facilities. Now fully within your mandate, this is the kind of residence we're talking about.
Limited training, access to training dollars -- that's all part of that environment when we say to them, as the government, that they are second-class facilities or their workers aren't worthy even though they have the same graduating certificate. The only difference is that you were able to get hired by a school board and they just didn't get that; they weren't that fortunate. They went and found work where they found it. They are considered probably the pre-eminent training facility for most facilities and then they take them and go on to other facilities that are the recipients of your bump fund. I think you're aware of that.
So there's unfairness and extraordinary staff turnover, which is never healthy for any system. These are all endemic to a system that isn't treated fairly. When I raise the concerns from the Ontario Association of Residences Treating Youth facilities in our province, I do so with the knowledge that we don't wish to, in any way, communicate to them that we think less of the importance of the care that occurs there.
That, in turn, is going to bring up a whole series of questions when we deal with children's aid societies and their deficits and their reliance on residential treatment. I was surprised. I did not know this statistic, but only about 7% of the clients served by children's mental health programs are children who are under the direct supervision of the CAS, and clearly 93% of them are families in crisis. I was surprised at such a low number.
Then, when we consider the rather high number of children who are placed in these homes and their cost, it raises questions about the analysis your ministry has done with respect to the size of these deficits and what is the primary reason for the deficits and the potential solutions.
Again, to be fair, these were reforms undertaken by our government. Through consultation, there was general agreement. We were trying to shift the paradigm. But to go from $560 million in 1999 to $1.08 billion in five years has to be of concern to everybody.
We budgeted, and you paid for, the $20 million in last year's deficits. But I'm hearing numbers as high as $85 million to $90 million projected for this year. I'm hearing anecdotal stories about CASs that are being told to lay off front-line staff. I'm not saying who, because no one wants to say. It's just what we're being told. You don't know if it's a regional office or where it's coming from. I know it isn't coming directly from the minister's office, because you know better.
Anyway, the point I'm trying to raise is that we need to spend a fair bit of time in these, because the CASs consume almost half at the rate they're going.
It's interesting -- if I can get political for 60 seconds -- that we've applied a standard to our hospitals that we're not prepared to apply to our CASs. As a child advocate, I'm glad you didn't get roped in on the same strategy. By the same token, it raises some questions about where we're going with the formula.
I wanted to raise an issue which I raised with you privately -- and I won't get into the circumstances; they are extremely difficult to talk about -- involving children receiving treatment for sexual abuse. The issue for me was triggered by unsupervised access. I have raised questions about why we have a two-tier supervised access program in our province. I've asked legislative research to do a research paper for me. They have, in turn, provided me with some very interesting information about how the various provinces in Canada are dealing with this.
It strikes me that to have a codified, legislated system available to families in conflict over a marital breakup -- we have all the supports in place. They're housed, there are guidelines, there is legislation, there's everything. Yet children who are at risk of sexual and physical abuse by a parent who wishes to gain access and who is involved with a CAS -- we really don't have the kind of legislated framework, nobody has really taken ownership of the program. We've sort of left our CASs out there to provide it with loosely defined guidelines. To me, that's risky.
It was risky, in my opinion, for the Latimer family. There is now a coroner's inquest occurring with Kevin Latimer's case, which I raised. It will, in time, reveal to us certain deficiencies. Clearly, as I've stated in the Legislature, there will be opportunities to examine just what happened. In my view, part of the process was the differentiation in supervised access. Kevin has a little brother, and I'm very concerned about the little brother now being subjected to a system that we haven't changed yet.
I'll leave that, but if you do have time, I would like to explore that a little further with you. I know it involves discussions with the Attorney General. Surely, supervised access -- and I was here in this room tabling the amendments to create it for the first time when we were doing the Family Law Reform Act about 15 or 18 years ago -- was to protect the children. So it may be rooted in one piece of legislation, but it's absent in another, which brings me to the Child and Family Services Act.
As you know, Minister, one of the concerns we have and have always had is that children aren't persons in our province, because they're really not deemed as such under the Child and Family Services Act, not in the pure constitutional sense of the Charter of Rights and Freedoms. In fact, the state determines so much of their outcomes by regulation. I'm interested in rights legislation for children, and I suspect you are very much so as well.
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If we have time, I'd like to discuss with you why, for example, when we transported services in 1979 in this province from health over to Comsoc, we transported program responsibility but we didn't necessarily pull over much of the legislative framework and protection that exists under various other acts under the Ministry of Health. Children's mental health, in my view, falls in that category. Former minister Keith Norton was the architect of that move, and at the time it was considered an extremely wise move, a more sensitive move, to take it out of psychiatric hospitals and sanatoriums, which you and I are both familiar with, having lived on Hamilton mountain.
However, to this day we still don't provide guarantees for children to have access to mental health services. Surely we should be looking for a vehicle with which we're able to do that. If we're prepared to do that, then we can create the kind of environment that protects young children from the mental cruelty and torment they go through, which I feel is just as important as their protection from physical cruelty. Until such time as we can stabilize their legal rights, we're going to have programs that don't interface directly because they're not required by a court.
In my view, the benchmarks for the performance of your ministry will be the pulled together, comprehensive and integrated policy framework for children's services, which has never really been done effectively in our country. Secondly, that necessitates the review of legislation that will enshrine in this province, with its heritage of being the first to recognize women's rights, the first with a Human Rights Code and the first with disability legislation, which both you and I are familiar with, but also to deal with children's rights, which are less than adequate for a child's protection, especially in children's mental health.
I'm anxious to hear from you, Minister, about the framework in which you're going to be working in order to move these benchmarks along. I'm familiar with many of the areas that your ministry staff and some stakeholders are currently engaged in. What I'm looking for is to take the microscope up and determine how we're going to integrate these parts more directly and to arrive at conclusions that are in the best interests of the child rather than the best interests of the largest recipients of funding in the province. I'll simply use as the example that I understand you've responded to the children's mental health organizations in our province that you would not be able to address some of their concerns until such time as you've reined in the deficits -- I'm paraphrasing -- of the CASs. In my view, that's very awkward by virtue of the fact that I'm not convinced you're going to be able to --
Hon Mrs Bountrogianni: That's not exactly what I said.
Mr Jackson: I'm paraphrasing, but that's why you've got a rebuttal, so you can clarify it. I don't have the exact quote; I'm just replaying the impression that stakeholders have. But 3% bump funding isn't dealing with the waiting lists in children's mental health organizations, given that 93% of the caseload they're dealing with is community-based, where the school boards have given up and said, "We can't handle this," where they're self-mutilating or we don't have enough residential homes as an important therapeutic venture for these children. So they're left in children's mental health centres in order to receive care. By bump funding 3% to retain staff, you're not creating more service units, as you well know, and that is always the challenge when you do bump funding. You're not expanding program access.
Minister, when we get into more detailed questioning, these are areas I would like you to cover off in more detail.
I know my colleague is going to raise concerns about autism and the autism funding. I don't think anything is served by starting talk about broken promises. What's important is that I'd rather stay focused on your decision to drive resources to school boards, which are an expensive alternative to other treatment forums and modalities. I'd really like to know why you make that conscious decision. I think I know, but I sometimes try and put myself: "If I were the minister, what would I be doing?"
I would have liked to look at the option of expanding the age cohort for a period and being a little more innovative with Early Years funding and/or work with school boards, which never come to the table to assist social services unless there are dollars, and then as soon as the door is open and they're told there are dollars, they get the lion's share because they have the better benefits, the better package, the whole nine yards. I can say that, having been a school board trustee for 10 years.
It is an expensive way to go, and that doesn't necessarily mean they're not doing their job. It's that many of us, I'm sure all of us, have many cases that have built up in our files over years of kids who, having reached their sixth birthday, are left to the vagaries of the IPRC system and the politics, frankly, of the IPRC system in our school boards. But now the dollars aren't even coming to the table where we're case-managing these cases. These dollars are going directly to school boards. I'm pleased to hear --
The Vice-Chair: You have one minute, Mr Jackson.
Mr Jackson: One minute? Then we have the privilege of voting.
Hon Mrs Bountrogianni: I can clarify that later.
Mr Jackson: We're going to get into that. Let me simply say that there are several more areas of issues I wish to raise, but I look forward to working with you as the minister.
I know many of your staff from the years I was working in social policy, but I really want to support you to get more money at cabinet, because that's what this is about, and for you to be supported in your reforms of the system that will cause more seamless delivery, more case-managed, child-centred -- all those things we've read about in every report I've kept in my library from Children First all the way through. I would like to really see some progress made. A lot has been done to date; more can be done. I'm pleased you're the minister who can do it.
The Vice-Chair: Thank you very much. We stand recessed until after the vote.
The committee recessed from 1657 to 1704.
The Vice-Chair: This committee is now back in session. I welcome comments from the third party. Ms Martel, you have 30 minutes or a part thereof.
Ms Shelley Martel (Nickel Belt): I'll probably break a little before so that people can go and have a vote.
I'm going to do a combination of two things, both questions and comments, in the 30-minute rotation.
The Vice-Chair: It's your 30 minutes.
Ms Martel: Minister, thank you for being here this afternoon, and thank you to the staff who are here to support these estimates and this process. I don't think it will come as a surprise to you that I am going to focus my first round on the autism file. I have some questions and some comments through that process.
Where I want to begin has to be on the issue that I find most important with respect to this file, and that is the matter of IBI treatment for children over the age of six. It was interesting that on page 34 -- I don't think you had a chance to read it into the record -- you had a quote from Premier McGuinty, on the very last page, saying, "If we want kids to aim higher, we must give them strong support sooner."
I'd like to start with another comment made by Premier McGuinty during the election campaign to Nancy Morrison, whose son Sean has autism and who just, in the last two months, got off a waiting list and started to get treatment. He said very clearly during the election campaign to a mom who had a child with autism: "I also believe that the lack of government-funded IBI treatment for autistic children over six is unfair and discriminatory. The Ontario Liberals support extending treatment beyond the age of six."
That was the position before the election and during the election. After the election, the position changed. I have to tell you that I don't understand this position, so I think I'd like to begin the line of questioning around that very issue. What was it after the election that changed that would essentially have you in the position of continuing a discriminatory policy that was started by the former government?
Hon Mrs Bountrogianni: Thank you for the question, and I know the honourable member really cares deeply about these kids and this file. I want to assure all of you that so do I.
This was stated before the election. I can answer part of the question. Some of your question begs another answer, which has to do with a legal case that I cannot comment on. However, I can tell you how we did our plan, how we got our plan going. I can't comment on the IBI over six because it has legal ramifications. I can tell you why we did what we did, if that helps.
Ms Martel: I'm not sure. You can give me an answer, and then I'll probably pursue it from there.
Hon Mrs Bountrogianni: OK. I inherited a very difficult file on this issue. It's not a file that I was totally unaware of from a professional perspective, if not from a political perspective.
There were a couple of things. First of all, we wanted to get the best advice on what to do for all children with autism at all aspects of the spectrum: those who are severe, those who are moderate, those who are mild, those who are not necessarily diagnosed with firm autistic disorder.
We wanted to help all those kids, so we had a series of consultations with experts from the field. Some of them were people who were working with the former government and some were not. We had a combination of experts. Their direction was not -- it was actually not directive. It wasn't, "Don't do this," or, "Don't do A, B or C." Basically, I said to them, "If you were to design a very good program, the best possible program for children with autism, both before they go to school and after they go to school, how would you design it?" Based on those experts and that advice, we have a document. They gave me recommendations and I adopted them.
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Yes, there was a major infusion of money: $10 million for the under age six, which we hope will reach 20% more children for IBI, as well as $30 million for after age six, which, to clarify a point Mr Jackson brought up, is not going directly to the school boards. We felt very strongly, based on my own past experience and what the experts told us, that you lose control over a service sometimes if you give it away. We wanted control over the service for a number of reasons, and that's why the regional programs run this service. Children with autism require consistency and, quite often in the school system, for various reasons, children with autism lose their EA or change teachers, and that takes them back years sometimes, as far as their development. We felt that to have consistency of assistance we needed to have the same people in the school board. So we are actually controlling those monies and those consultants; it's not money to the school board.
The experts also said that we don't have a research chair in Ontario or, indeed, in Canada to study better treatments, to study why there is at least a perceived increase in the incidence of autism. Is it because we're better able to diagnose it, or is it because we truly do have more kids with this? It seems like we have more. We also have a research chair, which should be in place by September 2005.
We also have some concerns over the lack of regulation of IBI therapists. Those who are within the programs we supervise are properly supervised and we don't have concerns over them. But there are those, the freelancers, whom we do have concerns over. They have a two-week training period. Some of them have very good backgrounds and do very good work, we're sure, but there is no regulation; there is no consistency. We felt that two weeks of training is not enough, especially if you're not supervised, so we have also instituted, as part of our new funding, one-year certificates at the community college level, which we believe is a much more comprehensive way of educating people who work with some of our extremely vulnerable kids.
I can't talk specifically about anything that is in any way related to lawsuits, Ms Martel, but that is how we got to this platform.
Ms Martel: I didn't ask you anything about lawsuits. I'm not going to pursue Deskin or Weinberg or any of the matters that are before the tribunal, or even the cases at the Human Rights Commission. What I'm trying to focus on is a very specific election promise that was made that I have to believe your government understood the implications of when you were making it.
You were in the Legislature when I brought in any number of families and a number of children with autism who were being cut off because they turned six or had been cut off because they turned six. You heard some of the comments made by two former ministers during the time I raised those questions, ministers who said, "We've heard from experts who say that this doesn't work after six," and on and on. I think, if I recall this correctly, you were as appalled by their answers as I was.
So I cannot, for the life of me, understand an answer -- and I listened carefully to what you said, which was, "After we were elected, we went and got the best advice for what to do with all children." That's fine. But before the election, you made a very specific commitment about what you were going to do for some of these children; specifically, those kids turning six who were getting their IBI arbitrarily cut off, not because they miraculously got cured at age six, but arbitrarily got cut off because that was all the program dollars allowed for, up to age six.
I have to ask you again -- this has nothing to do with the legal case; I'm not even looking at that -- what was it that changed before the election and after to so clearly allow you to essentially break a promise that was given, a promise that I have to believe you understood the implications of, as you were sitting there seeing me raise these cases? You raised some yourself. What changed? Is it money? Because I just can't see what else it was that would have led you to change from what was so clearly a matter of discrimination before the election to essentially accept and, if not promote, continue on with the same discrimination started by the Conservatives before you.
Hon Mrs Bountrogianni: I understand your concern and your questions. I can't add more to what I said earlier except that we did have significant funding increases to this program. We did consult with experts, and this was the best possible program that they recommended. We're actually quite proud of our program. I understand your concerns, but this is the program we chose.
Ms Martel: Are you prepared to table the document that was prepared for you by the experts?
Hon Mrs Bountrogianni: Yes, absolutely.
Ms Martel: Let me ask, in that regard, do you have any advice from any experts that would suggest to you that IBI after the age of six does not improve the likelihood of children with autism doing well, actually maybe managing in school, keeping them out of a group home, allowing them to contribute later on? Do you have any information from any expert, any study that would show that IBI after age six is not worthy of consideration?
Hon Mrs Bountrogianni: We sometimes talk about IBI as if it's the only way to help a child with autism. For many children, IBI is totally inappropriate. What our experts have told us is that this is the best possible program for children to get IBI therapy when they're young, to learn these skills in a discrete fashion, one-to-one with an adult. But then they need to generalize those skills in a social setting, in a real world, in a world in which they will live. They will not live with someone one-on-one all their lives; that would be inappropriate.
That is the advice we received, and we acted on that advice. I'd be very happy to give you the recommendations.
Ms Martel: What if that advice is contrary to the recommendations being made to the very health care professionals who actually deal with the children? I raise the case of Cynthia and Bradley Boufford. I brought their son Jordan into the Legislature last year because he turned six and he got cut off under your government. His psychologist, the people he worked with in the IBI program he was involved in, said he would continue to benefit from IBI treatment -- not a general program of socialization but ongoing IBI treatment. What about that expertise and that advice from people who actually work with these children, who know that after age six they still need maybe a year, maybe 18 months of IBI before they're going to be able to deal with more general principles in a classroom setting, for example?
Hon Mrs Bountrogianni: I know you're aware that I can't comment on any individual case. But I can tell you that I am actually very proud of our program. With the kind of resources, when it's all said and done -- right now, every school board has at least one consultant, but there are more. It takes time to train and hire people. Right now, every teacher does have access to someone over and above whatever resources they have in the school boards. Some school boards have excellent resources and are dealing very well with the situation, but unfortunately many school boards do not. So they have access to someone who can come in and give different types of problem-solving techniques with these children.
When I was the chief psychologist at the Hamilton board, even though I'm a psychologist and had lots of experience with all sorts of special needs, there were some children with autism I couldn't reach. Then we called in the PDD from Chedoke-McMaster. That's what they did full-time, so of course they had more expertise and more experience. They gave us advice, and we implemented that advice.
I understand your concern. I understand what was said before the election. But this is the program that we decided was in the best interests of these children.
Ms Martel: What do we do for those children who can't attend school, who can't access a public education because they need ongoing IBI, which is vastly different from a consultant providing advice to a teacher in a classroom? What do we say to those parents -- and I'm not asking you to name names: I'm doing this as a reference -- to the Bouffords, whose son is not in school, to the McKee family, whose son is not in school, to Norrah Whitney's son Lucas, who is not in school, and a whole host of others who are not in school because they need ongoing IBI to actually access education? What do we say to those families? Your program of consultants and transition coordinators does not speak to or deal with the needs that those children have, which is, specifically, ongoing IBI in order to actually access public education.
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Hon Mrs Bountrogianni: Again, as you recognize, I won't address any of the specific families, except to say that I disagree with the premise of what you're saying. I don't believe that any board has the right to say to any child, "You can't come in here because you do not have IBI." I don't think boards are saying that. I think that at worst, boards are saying, "We don't know how to deal with your child. We're having trouble dealing with your child." Every child has a right to be in school when they're six years and older, and every child has a right -- this right they obtained in 1980 under Bill Davis -- to be in school with proper supports. I disagree with your premise that the reason they're not in school is because they don't have IBI. There could be other reasons why they're not in school. I'm just as concerned as anyone else in this province when I hear a child doesn't have access to an education. That indeed is what, in my other ministry, the Accessibility for Ontarians with Disabilities Act is all about and will address in the future.
If you remember, I've included children with special needs, including learning disabilities, in my other ministry in that legislation. It's all about children being able to have what all children have. I do not believe -- I could be wrong, but I have not heard of any cases of a board saying, "Your child can't be here without an IBI therapist." I don't think that's occurred. If that has occurred, I would be just as concerned as you, because school boards do not have that right. Every child has a right to be in school; every child has a right to be educated. I've worked with some of the most difficult children you could ever imagine where, with the proper resources, with the proper consultation to teachers, parents and educational assistants, these children developed to the best of their potential.
Ms Martel: The issue is school boards saying to parents, "You can't be here with your IBI therapist. You can't come to school and have your child come and access education because you need an IBI therapist." Frankly, parents may have a right to have their children in school. Whether or not their child actually receives education is really a function of the supports they need to sustain them in school. It is absolutely wrong for school boards in this province to say to parents, "You can't have your IBI therapist in the classroom so that your child can learn."
I just want to read this into the record, because it says it better than I, from a parent in Mississauga who wrote to me:
"My five-year-old son Adam has been receiving provincially funded IBI for the last year and we have one more year to go. Don't try and fool me into believing that the school boards are interested in implementing anything close to IBI/ABA into the education system. Adam is currently forced to stay home from school every Monday and Tuesday afternoon to receive IBI because our provincially funded school system refuses to allow our provincially funded therapists into the classroom. The Peel Board of Education has no regard for how my son feels when his sister and brother go off to school every day and he doesn't get to. Even the classroom teacher is on our side and can't understand why Adam is forced to stay home. The Peel board ... will not ... discuss any ... options with us. Erinoak preschool autism services is providing our team of therapists, and I have been told that unless I make Adam available for 20 hours, they would discontinue his therapy."
I just have to add, because I've spoken to it, that the reason he has to go during the school day is because Erinoak has changed their hours of programming and he can no longer go after school. So their hours of operation now are essentially the school day, not after hours. He has clearly been told by the IBI regional provider that he has to go for additional hours, which they are thankful for, but he has to go for the additional hours during the school day. So now you have a situation where she has to take her child out of school because that's the only way she can access his IBI.
She's talking specifically about the consultants. Now the school boards say that he will be able to learn from a consultant dropping by and handing out a couple of brochures or making a couple of suggestions. "Where is the evidence that this kind of approach will be effective? If it were that easy, then Erinoak would be dropping by my house once a week or once a month with a few suggestions ... instead of making me spend 20 hours a week in my house" to provide IBI for my child.
"People have been selling off their cars and homes to fund IBI/ABA services for their children, and now our government is telling us that they are going to hire consultants to protect all that we have invested and all the hard work and sacrifices that we have made? Are we really supposed to believe that a consultant will be able to fill the role of qualified people in the classroom? Who will oversee and monitor my child's progress? It is my understanding that these consultants will not even be dealing directly with the child, so how are they supposed to make recommendations based on the `perceptions' of teachers and teaching assistants who are not qualified to identify and address the needs" of our children?
"Our classroom teacher would welcome the therapist into the class." Frankly, the principal has told her that as well; it's only the Peel board that says no. "The teaching assistant and the teacher would benefit tremendously from being involved `hands-on' with the therapist working in the classroom, not to mention the tremendous benefit to my son and other children."
Teachers and teaching assistants are not trained to even identify issues that kids with autism face. How are they expected to bring these issues to the attention of a consultant if they don't even know what they are?
"When is the last time you heard of doctors diagnosing and recommending treatment over the phone or through a third party?"
"This is a slap in the face to our children. Would the" school board "ever consider putting one wheelchair in the school for all to share? I think not."
I just want to say again, Minister, you can talk about a right to be in the school -- and I appreciate that; that is the legislation -- but there's a huge discrepancy between the right that children with autism have to attend school and the actual mechanism that allows them to do that.
For children who are mild or moderate on the spectrum, the opportunity to have a consultant or, as you call them, a transition coordinator, may work for some of those children who are in a position to be able to learn. We are leaving behind those children who after the age of six still need ongoing IBI. They cannot learn in a classroom without the support of their therapist. What they need will not be provided by a transition coordinator or a consultant. What do we do for children like Adam -- and I'm not saying respond specifically to his case, although I've sent it to your staff already -- and many others like him who are now out of school because their needs cannot be met in school?
Hon Mrs Bountrogianni: Again, I appreciate your reading a specific case into the record. I don't want to get into this kind of match with you, because I know you really care about these kids, but I also have testaments from parents who like our program, from educators who like our program, who think it's the right thing to do.
I have a woman whom I actually talked about in the Legislature, but I had to stop talking about her because she starting receiving threatening calls. She's a teacher. She has an eight-year-old son who has autism, and she believes this is absolutely the right way to go. She knows she will not be alive forever and her son will eventually have to be as independent as possible.
To say that IBI is the only way for these children to learn is completely wrong. We have educated and socialized children with autism for many years before IBI was even known. I have personal experiences and cases, from my career, of children who were very difficult, who, with a lot of effort from the school board and therapists, as well as parents, teachers, education assistants, workplace placements, fights within the school system between advocates and teachers -- all of that -- had a good prognosis.
To put all of our eggs in that one basket is simply wrong. For some children, even under the age of six, IBI doesn't work. What we have attempted to address with this strategy is the full spectrum; not just the serious cases, not just the kids under six, but the full spectrum, from the moment of diagnosis right to graduation from high school and beyond, quite frankly.
Ms Martel: Minister, I'm talking about children who have had IBI. I'm not talking in theory about kids where IBI didn't work. These are children who were part of the government program, who would have continued to be part of the government program, except the program discriminates against them and arbitrarily cuts them off at age six, regardless of whether the diagnosis and the prognosis is that they should continue. I am talking about children who have had a government program, who would have continued to benefit and can't because they arbitrarily got cut off.
I think their parents, the psychologists and the staff from the regional providers would know better than most about what their ongoing needs are. Those people have said clearly that their ongoing needs are to continue to have IBI treatment and to try and do that in the classroom, if at all possible, because then they will be able to get an education and they will be able to succeed.
I'm happy some educators like the program; probably the ones whose needs are being met. I'm talking about the kids who had their IBI cut off when it was proving to be most beneficial. What about them?
The Vice-Chair: Ms Martel, we have about four minutes to get up and vote. I'm just wondering if you could make it quick, because we should do it in a minute or we should wait until after the bell.
Hon Mrs Bountrogianni: I appreciate the questions. I really respect the compassion, the passion and the concern for these children that Ms Martel has. This is our strategy. I am very proud of our strategy. We are just beginning to implement it, and I ask her and the families she's talking about to give it a chance.
The Vice-Chair: I have one administrative issue. You mentioned, Minister, in your response to the autism question, the name of a report that you made reference to. Could you put that name on the record for Hansard and for research?
Hon Mrs Bountrogianni: I don't have the title here.
The Vice-Chair: We're going to recess, but if you could provide a copy of that report to the committee, it would be appreciated.
This committee stands recessed until after the vote.
The committee recessed from 1731 to 1737.
The Vice-Chair: The meeting is reconvened. Ms Martel has three minutes left, and then there will be 30 minutes for the minister to reply.
Ms Martel: I see that the date on that report is 2004, and the decision for the new program was announced at the end of March 2004. What I'm curious about at this point is, who was involved in the specific decision, then, about not providing service to children over six? That document is dated after that decision was made.
Hon Mrs Bountrogianni: I'm sorry; I'm misunderstanding the question.
Ms Martel: Who was involved in the very specific decision not to provide IBI to children after the age of six?
Hon Mrs Bountrogianni: The decision wasn't made in that manner, Ms Martel. The directive I gave my ministry as well was to find the best experts we could possibly find in the field to come up with a program for all children with autism. No specific decision was made at all about ages. This was the program that was best for all ages, from the diagnosis right through to high school.
Ms Martel: Did your party, during the election and before the election, do a costing of how much it would actually cost to provide IBI after age six?
Hon Mrs Bountrogianni: Not to my knowledge. I was not the critic in this area before the election.
Ms Martel: In terms of the cost to end the discrimination and provide services after age six, you wouldn't know whether or not your party actually had a figure in mind before you made that specific commitment to Ms Morrison?
Hon Mrs Bountrogianni: No, we didn't have costings out. I don't want to talk about any other cases, but I do know that the advice the Attorney General was given was that this could be precedent-setting and it should be government that's developing policy, not the courts. That was as specific as it got with respect to actual decisions.
My directive was, "What is the best program for all children with autism?" There was no specific direction about cutting off or not cutting off. It was, "This is the best program for children with autism."
Ms Martel: I appreciate your directive to your own staff, but you must have been aware of the promise your Premier made during the election.
The Vice-Chair: One minute, Ms Martel.
Ms Martel: Where was your directive to staff to follow that and actually implement it?
Hon Mrs Bountrogianni: I was aware of what was in that letter, but I was not the critic in the area. I'm not even sure if we had a costing of it before the election, quite honestly. I don't know. I honestly don't know.
The Vice-Chair: That ends this rotation. At this point in time, Minister, you have up to 30 minutes for right of reply. I'll leave that at your discretion, as there are really about 20 minutes before the House will be --
Hon Mrs Bountrogianni: Chair, do I have the 10 minutes at the beginning of the next session? Is that how it works?
The Vice-Chair: You have up to 30 minutes. If you'd care to forgo the additional 10 minutes after we've recessed for the day, it's up to you.
Hon Mrs Bountrogianni: Then do I lose those 10 minutes or do I get them back the next time?
The Vice-Chair: No.
Hon Mrs Bountrogianni: I lose it?
The Vice-Chair: No, you can use the 10 minutes at the next part of the total 7.5 hours.
Hon Mrs Bountrogianni: Again, I just want to thank the honourable members for the questions. With respect to Ms Martel's concern about this situation, I respect it; I really do. This was the strategy that we developed after a lot of consultation with experts, and I'm very proud of it.
Also, I want to bring people to the reality here. Again -- and I know this as a practitioner -- children don't necessarily fit into the slots that people think they fit into, and one therapy is not conducive for all children. So when I did address my ministry and the experts, I actually stayed out of the working group. I said, "I want you to give me an unbiased recommendation on how to run the program for children with autism in this province," and this was the strategy. We are getting copies of the report. It's called, Implementation: Working Group Report. If you don't already have copies, you will have copies of the report.
I'd like a few minutes to address some of Mr Jackson's questions as well. You asked about the $58 million, all federal money, and how it was spent. It was all spent on child care. It was spent on 4,000 child care spaces. There was also approximately $19 million of that money for capital repairs, because after not being funded for a decade, a lot of the child care centres -- 60 of them in fact -- were going to lose their licences if they didn't have repairs made. So we allowed that flexibility. Also, a portion of that money was to go to child care spaces in or around schools.
You asked, Mr Jackson, about integration of services. Our goal is to have our Best Start program announced in a couple of months' time. You will see that this is the beginning of Best Start, because we want to make a more seamless transition into the school system, and this was part of it.
You asked a little bit about our meeting next week. I think you've heard the Premier this week that Ontario needs to get its fair share. My position is my Premier's position on this: Ontario needs to get its fair share of child care dollars. We know there are four quads to the money that the federal government wants to give and that there probably will be strings attached, but quite honestly at this point, Mr Jackson, I don't know specifically what those strings are. I will have a better idea after Tuesday, so maybe on Wednesday -- if I do have a better idea after Monday or Tuesday, depending on how the FPT meeting goes, I'd certainly be happy, if it's appropriate, to discuss it with you. I have to say that my bias, obviously, as Minister of Children and Youth Services, is for that money to go for young children, for the education and care of young children. That is my bias. If there are strings, I hope those are the strings.
You asked a little bit about children's mental health and the discrepancy in salaries, which is why we gave that 3% right off. We know that's just a start, and we know there are discrepancies. When I was working in the field -- I was in a management position -- we routinely received resumés for the school board from people in children's aid, social workers in children's aid societies, psychologists and social workers and speech-language pathologists in mental health treatment centres. They liked the 10-month working schedule, they liked the salary, they liked the benefits. There is that discrepancy; you are absolutely right. The benefit of that was to the school system, to the detriment of the agencies. This is beginning to address that gap, and I know it's just a beginning.
You did mention that we did not increase services, that the 3% basically increases salaries and not services. We did give $12 million out to the communities, where community planning tables are set to develop guidelines to provide a continuum of mental health services. So this additional $12 million is for services, not for wages. We just established these a month ago, and we are receiving amazing recommendations on how communities can better integrate and provide more and better services with these monies. Again, that goes toward my longer-term plan -- and I know you appreciate that things can't happen overnight --
Mr Jackson: In fairness, it's planning --
Hon Mrs Bountrogianni: The $12 million will provide --
Mr Jackson: I get it, but it's not service units in the plan.
Hon Mrs Bountrogianni: The $12 million will provide more services. That was one of the criteria. But this is a beginning to a better integration of children's mental health services across the province. In some cities, they work amazingly well. They have good connections with the school board and good connections with the children's aid societies. In other parts of the province there are silos. In other parts of the province there is unnecessary competition, and actually unnecessary competition of expense to the government and to families, which I am going to address.
This is just the beginning, and the regional plans -- they were given some criteria: prevention and early identification, early intervention, intake and assessment, treatment and support, case management and service coordination, and crisis response. They were given target populations: children with social, emotional or behavioural problems; children and youth involved with child welfare; children and youth at risk of chronic, long-term mental health; children and youth with dual diagnoses; children at risk of suicide, which I am extremely concerned about; aboriginal children and youth; and, more specifically, fetal alcohol syndrome children. I know my colleague Ernie Parsons has a great deal of support for that.
It's basically to get people to work together. In the communities where all the mental health agencies, the children's aid societies, the boards of education, youth justice workers are all around the same table, the outcomes for children are better. It's quite simple. You know; you've probably dusted off 20 years of research studies that prove it. It's also common sense, and that is why we gave this $12 million.
Mr Jackson: Our government started it.
The Vice-Chair: Mr Jackson, it's the minister's time.
Hon Mrs Bountrogianni: Mr Jackson, I was in the sector and I know what your government did. I know a lot of governments have been grappling with this. I know I'm not the first to grapple with it. I do have the good fortune of having an actual ministry with an actual budget, so I'm hoping that will make a difference in better integrating what's out there. In some communities, it's actually tragic. It's not necessarily lack of resources but lack of coordination of resources. And in some communities it is lack of resources, quite frankly.
You mentioned the children's aid societies and the amazing increase in the costs. This happened over the last five years. We are also concerned about that. Let me clarify what I did say to the children's mental health. We paid off $80 million of deficits last year. All I said was that I don't have an infinite budget. I would like to get these costs under control so that I could give more money, not only to children's mental health but to all other aspects of my ministry, whether it's early childhood, adoption or youth justice. There are a lot of areas that are crying out for money. You know very well that children's mental health asked for $50 million and we only gave $25 million, which grows to $38 million next year. I'm very well aware of the gaps, and I'm very well aware that this was just a start, but we have to grapple with that.
More importantly for me -- or as importantly, I guess I should say, as a government member now -- is not only the expense but the fact that we're not doing the best we can for children and children's aid societies; we're not. There are 9,000 crown wards; 75% of those have access orders and 60% are never accessed. We have it in our plan for the spring. Our intent is to bring forward legislation to change the adoption laws of Ontario so that we can model some of the best practices across North America, where adoption rates increase and where children get what they really need and deserve, and that is a family.
1750
Again, you can dust off any research project from the last 20 or 30 years. It's that lack of intimacy, the lack of connection with a family, the lack of security and the lack of consistency that leads those very same children to go to children's mental health and then go out and move on to youth justice -- the crossover kids.
What I have done is set up a children's aid secretariat. We've seconded Bruce Rivers -- who, I believe, is still here -- the executive director of the Toronto Children's Aid Society, to review the children's aid societies to come up with recommendations on how to, with the children's aid societies, better give the services to children. This report will be due by the end of December. I'm very much looking forward to acting on the recommendations of Mr Rivers and his team.
I'm surprised that you actually had a statistic, Mr Jackson -- 7% of the mental health patients are children's aid kids and 93% are not. I actually have a lot of difficulty when I ask for data about children in children's aid societies, so we are also going to address that. We have spent so much money -- your government as well, over the last few years -- and yet we don't have any outcome data at all on how those kids are doing. I find that an insult not only to those families and children, but also to the taxpayers of the province, when you consider it has grown from $500 million to almost $1.2 billion.
So we need to have outcomes, and we will have outcomes. We're going to work toward that very aggressively so that whatever changes we make, we can actually measure and we can actually say, "OK, we're succeeding," or "No, we're not; we have to change," and be very honest and non-partisan about it: "We're not doing it right; we have to change" or "Yes, this is working, but this isn't working."
With respect to supervised access and sexually abused children, I will have to get back to you on that. That does cross over a couple of ministries. I can tell you that I'm just as concerned about these children because, again, as a therapist in this area, those are the children who are scarred the most for life, particularly if it's a parent who is doing the sexual abuse. I'm in total agreement with you: the sooner we can protect those children -- we need to do so.
I do understand that your bill has passed and is in --
Mr Jackson: It has been referred to committee.
Hon Mrs Bountrogianni: It's in committee now. I congratulate you for that and for your concern for those children. I knew of your reputation when you were with Big Brothers and Big Sisters, because I had a friend who worked with you. I know you care, and I thank you for that. We can do what we want legislatively and in the House -- we're politicians -- but if there is any help or assistance you can give me in a non-partisan way, aside from what we need to do as politicians, I'd most welcome it. I'd most welcome expertise of any kind, and yours especially. You have a lot of experience in this.
I think I addressed that the autism funding is not going directly to school boards. I want to talk a little more about that, not so much for children with autism, but the fact that the majority of the human rights complaints about education are about special-needs children and education. So we need to address that in a very systematic way. I am hoping that -- and we're re-evaluating this -- if this works out and if indeed the children have better outcomes as a result of experts coming to the schools, over and above what the school boards have, then I would like to explore other ways for other groups of children that are having difficulties in the school system.
My most frustrating times as chief psychologist were when children weren't allowed to go to school. I fought. My job was threatened to be taken away from me when I advocated for those kids, only to have apologies two years down the line from the very same people who threatened to fire me, because the kids were doing great with the proper support. So anything we can do to have those children in school with other children, learning to socialize and learning to the best of their potential, is something that I advocate.
You talked about the gap of the residential treatment centres and how the gap is widening with our past budget. I have met with the sector that you talked about and that you're concerned about, and I do know we need to address their pressures as well.
We are, in fact, reviewing a great deal of this new ministry, and I think that because it's a new ministry, now is the time to do that. Now is the time to say, "Before we put funding to something, let us see how it's working. Is there a discrepancy between the per diem rates? Why? Is the service they are providing the same, with respect to quality? If not, why not? Should we be funding them more? Should we be funding them at a standardized rate? Should we be taking geography into account a little bit more?" These are all things I have heard from my consultations across the province. We need to take a closer look at it.
But I'm very well aware of the excellent services that many of these agencies provide. I've met with them formally, but I have also met with them informally at events and so forth. I know they do good work. There isn't a bias against them. Simply, it was a limited budget. I was one of the fortunate ones who had more money put in my budget. This is where we felt the pressures were the greatest, and that's why we put the money where it was. I guess it's a difference in judgment there.
We haven't talked about youth justice at all, but I'm very excited to have phase 1 and phase 2. We've had a number of accomplishments in youth justice -- do I actually have almost 15 minutes?
The Vice-Chair: You actually have five minutes left.
Hon Mrs Bountrogianni: Oh, just five minutes?
The Vice-Chair: Today.
Hon Mrs Bountrogianni: OK.
The Vice-Chair: At 6 o'clock this committee will stand adjourned --
Interjection.
Hon Mrs Bountrogianni: I see 15 there, but I only have five?
The Vice-Chair: That vote will occur after 6 o'clock because it's a 30-minute bell.
Hon Mrs Bountrogianni: Oh, I see.
The Vice-Chair: You'll have your 10 minutes remaining tomorrow at the start of the session after routine proceedings.
Hon Mrs Bountrogianni: Then I'll save the youth justice piece for tomorrow. I'm sure I will have questions on it, if not from Ms Martel, maybe from someone subbing in or from Mr Jackson.
But I'm really proud that phase 1 and phase 2 are together under this ministry. I can be more specific tomorrow or next Wednesday, but the fact remains that many of our children who are in youth justice today are children we saw and either missed or didn't do justice to when they were young. They're children who are in our children's aid societies who were never adopted, or perhaps they were but the damage was done, unfortunately, or they're children in the mental health field who, for whatever reason, we could not reach. We've reached many over the decades and we've helped many -- I was in the profession, and I know we have -- together with government and within our organizations and within our families, quite frankly. But there are many more we obviously have not reached: otherwise, we wouldn't have the difficulties we have with some of our young people.
This is an opportunity under this new ministry to have prevention programs in place without going, quite frankly, through the major bureaucratic processes I've learned you have to go through when you cross ministries. Having said that, we have some initiatives for young people in place already, cross-ministerially, for prevention, as well as for addressing some of the youth justice issues.
I really look forward to talking about that, because I think that some of the greatest gains can be made in the prevention of kids going into the youth justice system, as well as helping those who are already there in a more productive way than perhaps we've done in the past.
I'd like to thank you -- you can put your hand up when my time's up. I'd like to thank all of you for your questions. Again, we do what we do in a partisan way because we are politicians, but if there's ever, in a non-partisan way, any assistance I can get to make this ministry better and to help kids in a better way in this province, I'd be very happy to hear it from all sectors of the House. Thank you.
Rob Adams will attend tomorrow at 3 pm. This is confirmed, Mr Jackson.
Mr Jackson: I'm sorry. We may have sounded overzealous. Generally, we negotiate the time frame with the person who requested his attendance, and that was Ms Churley.
Hon Mrs Bountrogianni: I'm sorry?
Mr Jackson: Ms Churley had specifically -- which is fine. It's not as rigid as that. It's just, when is he available? We want to be able to tell Mr Adams that we only need him for half an hour and then he can get on his way. I think it would be unfair to have him sit here from 3:00 till 6:00 if he only gets one question. We try and accommodate these individuals. Unlike staff who get paid to sit here, he doesn't.
Hon Mrs Bountrogianni: OK.
Mr Jackson: I'm not doing the Chair's job, but then again --
The Vice-Chair: Yes, thank you, Mr Jackson, I think you've clarified that.
Minister, thank you for making the commitment to have the CFSRB appear. To clarify, are you going to use the remaining 10 minutes of your response time tomorrow?
Hon Mrs Bountrogianni: I don't even know the rules. Is that OK?
The Vice-Chair: Yes. You have 10 minutes, and you can use those at the opening.
Hon Mrs Bountrogianni: What's an alternative, if I don't do it that way?
The Vice-Chair: That's it. You would lose it.
Hon Mrs Bountrogianni: OK. Then I'll use it.
The Vice-Chair: At that time, with the will of the committee, we'll go into rotations and start, after your remarks tomorrow, with Mr Jackson. We'll go to a 20-minute rotation for each of the three parties and then we'll do that consecutively for an hour each time.
This committee stands adjourned until after routine proceedings tomorrow, probably about 3:30.
The committee adjourned at 1800.
CONTENTS
Tuesday 26 October 2004
Ministry of Children and Youth
Services E-277
Hon Marie Bountrogianni, Minister of Children and Youth Services
Ms Jessica Hill, Deputy Minister
STANDING COMMITTEE ON ESTIMATES
Chair / Président
Mr Cameron Jackson (Burlington PC)
Vice-Chair / Vice-Président
Mr John O'Toole (Durham PC)
Mr Wayne Arthurs (Pickering-Ajax-Uxbridge L)
Ms Caroline Di Cocco (Sarnia-Lambton L)
Ms Andrea Horwath (Hamilton East / Hamilton-Est ND)
Mr Cameron Jackson (Burlington PC)
Mr Kuldip Kular (Bramalea-Gore-Malton-Springdale L)
Mr Phil McNeely (Ottawa-Orléans L)
Mr John Milloy (Kitchener Centre / Kitchener-Centre L)
Mr John O'Toole (Durham PC)
Mr Jim Wilson (Simcoe-Grey PC)
Substitutions / Membres remplaçants
Ms Judy Marsales (Hamilton West / Hamilton-Ouest L)
Ms Shelley Martel (Nickel Belt ND)
Mr Ernie Parsons (Prince Edward-Hastings L)
Mrs Maria Van Bommel (Lambton-Kent-Middlesex L)
Clerk / Greffier
Mr Trevor Day
Staff / Personnel
Mr David McIver, research
officer,
Research and Information Services