STANDING COMMITTEE ON FINANCE AND ECONOMIC AFFAIRS
COMITÉ PERMANENT DES FINANCES ET DES AFFAIRES ÉCONOMIQUES
Wednesday 26 January 2011 Mercredi 26 janvier 2011
The committee met at 0902 in the Travelodge Hotel Airlane, Thunder Bay.
The Chair (Mr. Pat Hoy): The Standing Committee on Finance and Economic Affairs will now come to order. The committee is pleased to be in Thunder Bay today.
ONTARIO FOREST INDUSTRIES ASSOCIATION
The Chair (Mr. Pat Hoy): I would call forward our first presentation, the Ontario Forest Industries Association, please. Good morning. You have 10 minutes for your presentation. The questioning will come, in this round, from the official opposition. I’d just ask you to state your name for our recording Hansard.
Ms. Jamie Lim: Good morning. My name is Jamie Lim.
Members of the standing committee, Ontario’s forest sector plays a pivotal role in our province’s new local green economy. Ontario’s world-class forestry standards, combined with the integrated nature of Ontario’s forest sector, provide an incredible opportunity.
A critical component of that opportunity is the need for certainty. With the right public policy and continued government actions in key areas, Ontario can maintain existing investments, attract new entrants, and sustain and grow Ontario jobs.
Over the past five years, the provincial government has implemented numerous competitive measures that have been instrumental in making Ontario a more competitive jurisdiction for our sector. However, these critical measures only address half of the equation. Over the past several years, our sector has continued to witness the development and implementation of damaging provincial policy—policy that increases costs, reduces the forest land base and creates uncertainty. The good work that the province has done via its competitive restoration measures desperately needs to be complemented by the right public policy. Business runs on certainty, and that certainty cannot be achieved in Ontario without practical provincial policy.
Let me explain why an investment in today’s forest sector is a wise venture.
Despite recent economic hardships, our sector remains an integral part of Ontario’s economic well-being. The companies left standing are the survivors, the winners, the ones that will take Ontario to the next level. Ontario’s forest sector still supports 200,000 direct and indirect jobs in over 260 Ontario communities, with wages and salaries calculated at $2.7 billion, approximately $14 billion in sales, billions more in related activity, $4 billion in exports, and $2.3 billion in taxes to all three orders of government.
Two more reasons why an investment in Ontario’s forest sector is a win-win for government and hard-working families: local and global markets. Ontario currently consumes more wood products than it produces. Do we want to produce these products in Ontario, supply good-paying jobs and provide support to our rural and northern communities? Or do we want to forego these benefits and import wood products from other jurisdictions? I think we would all agree: We want Ontario jobs.
Consider this one local opportunity: The GTA home builders purchase approximately $800 million of lumber annually to frame homes, and it’s estimated that 70% of that lumber right now comes from outside of Ontario. This represents an opportunity of $500 million for Ontario’s lumber sector alone.
That’s not the only real Ontario opportunity. The anticipated changes to Ontario’s building code, which will allow buildings to six stories from the current four, will also create a mid-rise construction market for Ontario wood products. In 2009, BC changed their building code. As a result, there are more than 50 projects underway in the mid-rise sector. Changing Ontario’s building code will create new economic opportunity and new jobs. As highlighted on the back three pages of OFIA’s pre-budget booklet, the opportunity for wood use in mid-rise buildings in Ontario is substantial. Like BC, the Ontario government has an opportunity to lead the way. When we use local, renewable forest products, we all win. Markets outside of Ontario will also return. As the North American market recovers, Ontario’s forest sector is poised not only to take advantage of that recovery, but also to expand its share of the existing markets due to the pine beetle challenges that presently face western Canada’s wood supply.
Lastly, global demand for forest products is expected to rise and will favour those jurisdictions with first-class forest management practices. Ontario is that jurisdiction.
These are just a few of the opportunities that make a commitment to Ontario’s forest sector a smart commitment, an investment in our future, and that commitment can start with the permanent protection of Ontario’s industrial fibre, which will ensure Ontario remains well-positioned to capitalize on our domestic opportunities and secure our future as a renewable fibre basket for the world.
But despite the anticipated recovery of global markets and the desire to put Ontario’s wood back to work, our sector continues to face numerous significant made-in-Ontario challenges. The continuous loss of industrial wood fibre through untested public policy, uncompetitive electricity rates, and the government red tape have all contributed to the creation of uncertainty and an uncompetitive business environment. Over the past two years, OFIA has witnessed a series of arbitrary land withdrawals and set-asides that have not been supported by any credible scientific evidence or economic impact analysis.
It’s not too late. We can turn this around. Ontario’s forest sector has an opportunity to become the envy of the world. Let us begin by addressing the following key recommendations in nine areas:
(1) Government’s January 13th announcement on tenure reform was a positive development. OFIA requests the government to complete its provincial wood supply competition and accelerate the movement towards enhanced co-ops.
(2) OFIA requests that the government permanently protect a minimum of 26 million cubic metres of sustainable industrial fibre. The continued erosion of Ontario’s fibre basket threatens our northern and rural future. Also, conduct socio-economic impact assessments on all legislation, regulations and policies that could reduce the provincial fibre supply. This is critical. Government must keep its promise and implement a long-term regulation which recognizes the Crown Forest Sustainability Act and forest management plans as equivalent processes to the Endangered Species Act. This would fulfill a written promise made to our sector by the Minister of Natural Resources in May 2007.
(3) The forest sector needs to be governed by one ministry, not two.
(4) Government must ensure that it does not develop or implement any policies related to the biomass/bioenergy sector that will jeopardize existing facilities.
(5) OFIA requests government maintain all existing competitive measures and initiatives that have been put in place since 2005. As well, we ask that you modify the implementation of the roads program by providing more flexibility and consider funding for forest management plans and annual work schedules.
(6) OFIA requests government maintain the crown dues rate for poplar and birch at a rate no greater than $1.07 a cubic metre for the next three years.
(7) OFIA supports the concerns of the Ontario Chamber of Commerce and recommends that the WSIB reverse its decision to increase premiums and freeze rates at a current level. We also ask that they seriously consider the advantages of creating a competitive market for WSIB.
(8) OFIA recommends that the government continue to support the Ministry of the Environment in modernizing its approval system. We also request again that economic impact assessments on all new decisions be made and that sufficient resources be allocated to MOE for developing a pulp and paper sector technical standard.
(9) For industrial electricity rates, OFIA’s booklet outlines changes to both the class A consumers in the global adjustment program and the northern industrial electricity rate program. Also, the development of long-term special electricity rates for economic development such as occurs in New York state right now must be considered for Ontario. Ontario also needs to develop more tools to provide the forest industry with a long-term, industry-wide, all-in delivered price of $45.
In conclusion, Ontario can no longer afford the slow erosion of Ontario’s fibre basket and the associated uncertainty. Ontario has great potential. Through collaboration and the right government policy, we can maximize the full potential of Ontario’s forest sector. With practical public policy, Ontario’s renewable forest sector can maintain and grow Ontario jobs. Let’s begin.
The Chair (Mr. Pat Hoy): Thank you. The questioning will go to the official opposition. Mr. Miller.
Mr. Norm Miller: Thank you very much for your presentation this morning. I guess my first question has to do with relatively recent news, the latest Environmental Bill of Rights consultation piece on the caribou conservation plan, the habitat regulation that is in the news and has just recently been posted. Will that help protect jobs in the north?
Ms. Jamie Lim: I think you’re referring to the fact that on Monday, government posted a consultation piece on the EBR that explained what their approach was going to be to a caribou habitat regulation for Ontario. In that posting, they say they are going to do town hall meetings and consultation. That’s all fine. It’s a little late, but that’s better late than never.
The problem is that the plan that they’ve put forward is building our future with the habitat reg using the caribou conservation plan, the CCP. About 18 months ago, when the CCP was put in place, industry and mayors all provided feedback to government with concerns about the CCP, about fibre loss. We asked for economic analysis to be conducted on the caribou conservation plan. All of that was ignored. None of our concerns were addressed. Economic analysis on the CCP was not done. Now, if this new consultation piece is suggesting they are bringing this forward in an attempt to protect jobs in northern Ontario and prevent any further loss of jobs, we can tell you that that will not happen, because the implementation of the CCP, just in its first six months, has already reduced the fibre basket.
Everyone clearly understands that when you remove wood, you’re removing economic opportunity; you’re removing jobs. Minister Gravelle, in November 2009, clearly stated, when he was unveiling the wood competition process, that Ontario can sustainably harvest 26 million cubic metres of fibre a year. Why would we want to shrink that? Every time you shrink that, you shrink my economic opportunities in my hometown of Timmins, Ontario. You shrink the economic opportunities of the city that we’re in right now. It doesn’t make sense. It’s sustainable, and it’s renewable. We have to protect it permanently.
We certainly welcome these town hall meetings. I would hope that everybody will get out and let their voices be heard.
Mr. Norm Miller: But they’re not going to protect jobs in the north.
Ms. Jamie Lim: Well, if it’s going to be premised on a CCP that’s already removing 15% to 20% of the fibre basket in some areas—
Mr. Norm Miller: There are less jobs available.
Ms. Jamie Lim: —you can’t protect jobs. Those are lost jobs.
Mr. Norm Miller: And this is connected with the Endangered Species Act. When the act was brought in—I mean, I was involved with the process. Did Minister Ramsay and the Premier not promise that the Crown Forest Sustainability Act, which does protect endangered species, would take precedence over the Endangered Species Act?
Ms. Jamie Lim: Yes. When the Endangered Species Act was put out for consultation, many of the community leaders who are here this morning formed a coalition, the Ontario Forestry Coalition, and we specifically made recommendations to government on the proposed Endangered Species Act. Our recommendations were a total of about 60 words, because the 60 words that we put in were going to make the Endangered Species Act implementable.
What you have today is a flawed piece of legislation that has already had to introduce 200 exemptions in only—what?—two years. When you have to put in 200 exemptions, obviously something’s not working.
Minister Ramsay at the time recognized that the Crown Forest Sustainability Act and our forest management plans already provide for species at risk. So in an effort to not duplicate process, because Ontario is supposed to be open for business, and create more work and more costs, Minister Ramsay made a promise to us in writing, in May 2007, that the forest sector would be “exempted”; that’s the legal word because it’s section 55 of the Endangered Species Act, from the act, using our Crown Forest Sustainability Act and forest management plans.
I believe that there were many people in June 2007 who voted in favour of the Endangered Species Act because they truly believed that the forest sector was not going to all of a sudden be bombarded with duplicate process and that we were going to receive recognition for the Crown Forest Sustainability Act. It didn’t happen. We spent six months in the fall of 2007, after the election, working on the language for that exemption. Then, in April, environmental groups got wind of it, pulled the rug out from under us and put an end to it.
Mr. Norm Miller: Thank you very much for your presentation.
Ms. Jamie Lim: You’re welcome.
The Chair (Mr. Pat Hoy): Thank you for your presentation.
Ms. Jamie Lim: And I will add that I’ve left with you the calendars for the Wood WORKS! gala this year. Those are Ontario woodwork projects that are buildings built right here in our province. Architects, engineers, contractors all get it that using wood tackles climate change, that it’s a renewable resource, and that the more Ontario products you use, the more Ontario jobs you make.
Thank you, ladies and gentlemen.
The Chair (Mr. Pat Hoy): Now I call on the Northwestern Ontario Municipal Association to come forward, please. Good morning. You have 10 minutes for your presentation. There could be up to five minutes of questioning. This round, it’ll be from the NDP, Mr. Tabuns. And if you would identify yourselves, gentlemen, before we begin.
Mr. David Canfield: Thank you and good morning. My name is Dave Canfield. I’m the mayor of the city of Kenora and the executive vice-president of the Northwestern Ontario Municipal Association. With me I have Iain Angus, one of the vice-presidents of NOMA and a city councillor in Thunder Bay. Ron Nelson, the president of NOMA, gives his regrets, as he is out of the province on other business today.
Our time allotment does not allow us to present all the issues that challenge northwestern Ontario, so we’ve chosen to focus on a few key concerns. We recognize that the province of Ontario is still dealing with difficult economic times. Our municipalities are also facing extreme challenges with population declines, industrial closures, increasing social costs and declining tax revenues. That makes it exceedingly difficult to maintain the services that people need and want.
First, I’ll talk about the Ontario municipal partnership fund. We appreciate the outcome of the provincial-municipal financial review negotiations in 2008 and the 100% uploading of Ontario disability support and Ontario drug benefits, as well as the ongoing uploading of Ontario Works benefits to be completed by 2018. However, municipalities across the northwest continue to struggle to make ends meet due to the rising costs of social housing, land ambulance services and policing. It is absolutely essential that the current OMPF and the mitigation fund remain in place for northern municipalities. We again request an increase of $75 per household in the northern communities grant, which is currently at $235 per household, to help municipalities bear the burden of their lower and declining assessment base, as is unfortunately the case in the vast majority of our communities.
I’ll touch now on non-emergent patient transportation. As noted, land ambulance costs are on the rise. A significant portion of these costs relates to non-emergent patient transportation, which continues to be increasingly frustrating and expensive for our members. Municipalities direct and fund emergency services (EMS) to provide emergency services that align with police and fire services. At this time, the EMS in northwestern Ontario performs two types of patient calls: emergency and non-emergency. In both cases, patients are transported by paramedics using an ambulance. However, EMS are designed, mandated and funded to provide emergency assessment, treatment and transportation services only. Due to a lack of alternatives for non-emergent services, communities outside the city of Thunder Bay are using EMS to perform non-emergent transports.
An example of a non-emergent transport would include transferring a patient who is in no immediate distress but needs expanded treatment from the hospital in Marathon to the Thunder Bay Regional Health Sciences Centre, a three-hour trip one way. So EMS is called to provide a taxi service to this patient to get him or her from point A to point B.
The problem is that each time a non-emergent transfer request is filled, there is a compromise of the ability of the EMS to provide emergency services. In many of the smaller and rural communities, there is only one ambulance at any given time. As such, when paramedics are dispatched for a non-emergency call, there is no backup ambulance available when a 911 call comes in.
The provision of non-emergent transportation by EMS is not only highly inefficient and ineffective, but also unreliable, causing frustrations on all sides. In some of our communities, as much as 50% of their emergency service funds are being used to provide non-emergent transfers. This is unacceptable and unaffordable.
The solution to this problem is a separate infrastructure, similar to those in southern Ontario, which would focus on non-emergent transportation. The current system, where EMS funds intended for emergency services are being used to provide non-emergency transportation, is not in the best interest of either the patient or the taxpayer. This concern must be addressed by the province, as our municipalities can’t afford to continue to provide non-emergent transportation services through the EMS. It is not the responsibility of the municipal sector to provide non-emergency health transportation services. It is the responsibility of the province of Ontario.
The northern growth plan and long-term energy plan: Community leaders across the northwest continue to wait with anticipation for the release of the growth plan for northern Ontario. I would remind you that this plan will need sufficient budgetary resources for implementation. Without financial support, it could very well end up on the shelf, as have so many other studies and plans over the last 25 years. Ontario cannot afford to let that happen, and we will be counting on all parties to work together to make sure that the effort and energy spent in developing the Grow North plan will not be in vain.
Unfortunately, due to the delays of the province in responding to the economic downturn in northwestern Ontario, we have lost and continue to lose many of our skilled tradespeople to the western provinces of Manitoba, Saskatchewan and Alberta. We are extremely concerned that without quick action, these resources may be lost permanently as their families settle into new communities. Skilled workers will be essential to the growth of the northwest, and the province must do all it can to ensure these workers return to their homes and their home communities.
An important part of the northern growth plan relates to energy. The government recently released its long-term energy plan, which outlines the 20-year plan for energy infrastructure across the province. The plan’s foreword indicates that maintaining a clean, modern and reliable electricity system for all Ontarians is the government’s number one priority.
NOMA agrees with that statement. We recognize that in order for our economy to grow, and in particular for the many mining developments across this region, we must have a clean, modern and reliable electricity system in the northwest. However, we would also add that such a system must be affordable, for without competitive energy prices, industry will look elsewhere to set up shop, taking the jobs and tax revenue with them.
With such a strong statement of inclusivity at the outset, it was extremely disheartening to realize that the majority of the northwest’s energy system garnered hardly more than a passing mention, and that a large portion of the region—the Far North—was only referenced in a document that is supposed to set the course for Ontario energy development for the next 20 years. It is incumbent upon all parties to recognize that a long-term plan such as this must not just list minor improvements to the system that is now in place, but must provide a vision for the comprehensive system that will be needed to power our economy, in all parts of the province, over the next two decades.
While we recognize that currently the Ontario Power Authority was only given the responsibility to plan for lines that are 230 kV or higher, we might point out that it is an extremely short-sighted and ineffective planning structure that ignores most of northwestern Ontario, which is serviced entirely by 115 kV lines, and it makes it impossible for a truly comprehensive plan for the entire province to be developed.
The transmission system in northwestern Ontario is woefully inadequate and would not be tolerated in populated areas of southern Ontario. I will repeat: The transmission system in northwestern Ontario is woefully inadequate and would not be tolerated in populated areas of southern Ontario. Those deficiencies must be addressed as a public good and funded by the Ontario taxpayer in general. The taxpayers in northwestern Ontario continue to pay the nuclear debt, but we have had no need for that power. Our priority is to bring the northwest system up to a level playing field, to ensure the development of our resources and to connect our First Nations communities to the grid.
Infrastructure, roads and bridges: One final topic this morning is also vital but expensive, and that is infrastructure within our communities. Many of the roads and bridges that were downloaded by the province to municipalities in the late 1990s require significant maintenance, repair or, in most cases, replacement. The costs for these needs are extremely high and are not affordable in rural and northern communities with a low population and a shrinking tax base.
We thank the current government for recognizing the infrastructure challenges faced across the province and for the much-needed support we received through the ReNew Ontario program, the infrastructure stimulus program and the RInC program. However, we know that this is and will continue to be an ongoing problem that requires predictable, long-term and sustainable funding rather than short-term grant programs. We highlight the federal gas tax program as one of those that have got it right by providing much-needed, sustained, year-over-year funding to municipalities for infrastructure needs but requires limited administrative effort by municipal staff.
On behalf of all the organized municipalities in northwestern Ontario, I want to thank you for taking the time to hear some of our concerns, and we look forward to the question-and-answer period.
I do want to wrap up with one of my own analogies here. I started in municipal politics in 1992. I took a four-year break and actually went out west, to Manitoba and Saskatchewan, working. They happened to be open for business. We have a lot of tradespeople out there, who I’ve met, from right across this province and this country.
For many years, we’ve told provincial government of all stripes that a made-in-Toronto policy does not work for northwestern Ontario. Governments have agreed that one size doesn’t fit all, but yet as policies come forward, they continue to be made in Toronto. Our economy is in turmoil; our population has declined for the past two censuses. Is the government now ready to listen to policies for the north that are made in the north?
Another analogy: If a toilet plugs in Queen’s Park, I’m sure you don’t call an electrician, so when the economy of northwestern Ontario is in trouble, you just might want to think outside of Queen’s Park for your answers.
The Chair (Mr. Pat Hoy): Thank you, and we’ll go to the NDP and Mr. Tabuns.
Mr. Peter Tabuns: David, Iain, thank you very much for coming in this morning and giving us that presentation.
Could you enlarge a bit on exactly what investments are needed in northwestern Ontario so that the grid will meet your needs over the next few decades?
Mr. Iain Angus: Thank you, Mr. Tabuns, Mr. Chairman, members of committee.
We know that there are a number of fairly significant mining ventures that are going to be a reality within the next three to eight years. The Ring of Fire is the one that most of you know about, but there are a number of other projects in the Atikokan area, the Rainy River area, Red Lake, Ear Falls and north of Lake Nipigon. All of those require significant amounts of energy in locations where the current set of wires is not adequate to provide the capacity that’s needed.
In addition, we have a number of communities that are served by what’s called a radial line. It’s a single set of wires that connects community A to community B. There is no redundancy. So in the last month or so, we’ve had major outages of five, six, seven hours in these communities, where they have no power. Not only does the mine shut down, but the homes are without heat because there’s no natural gas. So it’s a very severe situation, and as Mayor Canfield pointed out in his presentation, that would not be tolerated in southern Ontario but it’s a fact of life up here.
So we need enhancement of the existing distribution system. We have less of a need for a transmission system, which is the 230 kV line. Our existing 230 kV line is a line that allows power to go from Manitoba to southern Ontario and really does nothing for this region.
We need public investments. It’s a public good, as we see it, that is required by the province of Ontario to ensure that the economic development the north needs badly can happen, and the province will be paid back. The taxes generated from these new mines, from our forest industry, which will come back—it may not come back in the form that it was 10 years ago but it will come back with new value added, new dimensional lumber, perhaps some expansion of pulp and paper, but that remains to be seen.
We need investments to make sure that we’re able to respond in a timely manner to those who are prepared to invest in the future of northwestern Ontario.
Mr. Peter Tabuns: Given the problems you face today and the prospects you have industrially in the future, was there any consultation with northwestern Ontario before the long-term energy plan was put forward?
Mr. Iain Angus: I want to go back to the first integrated power system planning process, where there was absolutely no consultation whatsoever in that. The OPA came out with a plan that was designed for southern Ontario, and then they just decided to apply the same philosophy or calculations to the northwest. We intervened, as NOMA, NOACC—the Northern Ontario Associated Chambers of Commerce—and the cities of Thunder Bay and Atikokan and pointed that out to them. The energy board agreed and said, “You’ve got to look at the regions.” Then the hearings were suspended. We now have a new Ontario long-term energy plan, which will be followed up by a new integrated power system plan.
The only consultation was two meetings with the Minister of Energy last summer where we outlined our concerns. Even though we had been a key player at the Ontario Energy Board and were known to the OPA, Hydro One and the Ministry of Energy as the go-to organization—this is the energy task force under Common Voice Northwest, of which NOMA is a key part—no one contacted us to say, “Okay, what do you think the problems are in the northwest? What do you think the solutions are?”
We have participated in the environmental registry over the supply-mix directive. The city of Thunder Bay, the energy task force and NOMA indicated very clearly what the deficits are within our region and strongly said to the government and the regulatory agencies, “You need to have in your 20-year plan a way in which to deal with all of these.”
We know that they can’t be fixed overnight. We know that it takes a lot of dollars to do it, but we think the long-term return on that investment will be significant for the province of Ontario. We would like to be talked to.
The Chair (Mr. Pat Hoy): Thank you for your presentation this morning.
For the committee, our 9:30 presenter has cancelled. Is the Student Union of Confederation College here?
STUDENT UNION OF
The Chair (Mr. Pat Hoy): Good morning. You have up to 10 minutes for your presentation. There could be up to five minutes of questioning. In this case, it will come from the government. I’d ask you to state your name for our recording Hansard and then you can begin.
Mr. Ryan West: My name is Ryan West. I’m the president of the student union here at Confederation College. I’m here today to represent my students, 3,400 who are full-time students on campus, as well as a member of the College Student Alliance, representing 135,000 students throughout the province of Ontario.
I would like to thank the committee for taking the time to listen to the student union’s concerns today, as well as the CSA’s, so on their behalf, thank you very much.
Higher education is a cornerstone of the social and economic well-being of our province. As Ontario emerges from the present economic downturn, it is of the utmost importance for the provincial government to focus its efforts on implementing measures to continue strengthening Ontario’s post-secondary education system.
Throughout the next 10 minutes I’m going to focus on two main areas: student affordability, the cost associated with obtaining a post-secondary education; and student transferability, the recognition of prior learning as well as transfer from institutions.
Before I go any further, I’d like to highlight the importance of strengthening our post-secondary sector. Research has linked post-secondary education to direct economic growth, labour force quality, innovation and high-tech activity. Graduates of PSE earn more than non-graduates, contribute more to society and support our province’s ability to remain globally competitive.
We recognize the fact that fiscal constraints will limit the government’s capacity to provide adequate financial resources to foster economic growth in the public sector. Nevertheless, as we approach a time of significant economic uncertainty and a future defined by people without jobs and jobs without people, it is in the government’s best interests to build on its successes and use higher education as one of the vehicles to achieve economic prosperity.
In February 2010, Dr. Miner published a report called People Without Jobs, Jobs Without People, which illustrated the challenge Ontario faces in the future. Dr. Miner further explained throughout his report that due to the emergence of the province’s knowledge economy, a greater number of Ontario’s populace will require higher education to acquire a desired career. Additionally, as the baby boomer population retires, the size of Ontario’s labour force will gradually lessen. I remind you to remember the number 1.8 million. That is the labour shortage Ontario will face by 2031. Furthermore, 77% of Ontario’s workforce will be required to have post-secondary education credentials by that point.
The College Student Alliance urges the provincial government to use this time as a time to integrate cost-effective and efficient measures that revolve around student affordability and transferability and ultimately increase access to post-secondary education for all of Ontario.
This year has been one of the most difficult years for students, as their dependence on financial aid has increased. The College Student Alliance, recognizing the government also faces similar challenges, believes the following three recommendations can be implemented with little cost to improve post-secondary education access, financial aid and student success: (1) re-evaluate the Ontario assistance program, known as OSAP, to determine areas of opportunity for cost-effective improvements and greater support for domestic as well as international students; (2) fulfill the 2007 election platform promise of enhancing targeted financial assistance for under-represented groups by eliminating the education tax credit; and (3) ensure tuition set aside for international students, which are derived from international student fees, are allocated for funds for work and study opportunities as well as college bursaries.
My next section is going over why OSAP should be reviewed. According to the Canadian Millennium Scholarship Foundation, 40% of students who exit the program prior to completion do so because of insufficient funds. Evidently, both the cost of post-secondary education and the associated costs of living for students have dramatically risen throughout Ontario. This should be reflected through OSAP distributions.
Ontario students accessing OSAP are allocated $34.72 daily for living allowance. This stipend is dedicated to transportation costs, shelter, food and miscellaneous items. It positions students $3,000 to $5,000 below the poverty line. Loan aid is capped at $12,354, yet in 2003, the average cost of living for a single post-secondary education student in Ontario was $14,512 per year.
Without significant support, students are forced to take part-time or full-time jobs to adequately cover the costs of post-secondary education. Unfortunately, government policy limits the ability of students to work and earn sufficient income to fund their post-secondary education. During a time of economic uncertainty and limited employment opportunities, OSAP must either provide students with the financial means to adequately cover the costs of studying and living, or the system must permit students to work without deductions in aid. Policy change to OSAP will not cost taxpayers and will promote employment throughout students’ years of study.
The Ontario government has spent more than $1 billion, representing the largest expenditure of non-repayable financial assistance that traditionally supports higher-income students and/or their families. In the 2007 election platform, the government promised to eliminate the tax credits and redistribute the funds to upfront grants. Ontario’s college and university students have not yet seen this promise come to fruition. The Canada Millennium Scholarship Foundation has noted that the average tax credit claimed per young person in the top income-earning quartile is twice that of the average tax credit available per student in the bottom quartile.
In 2009, only 6% of international students reported having received scholarships from their respective colleges. The College Student Alliance suggests that the government should ensure tuition set-aside funds for international students. These funds, derived from their student fees, should be allocated to employment opportunities and financial assistance. These can be measured and implemented at low cost, and Ontario’s knowledge economy will continue to benefit from their skills in Ontario.
Our second recommendation revolves around the credit transfer. First and foremost, I would like to acknowledge the Ontario government’s recent promise to integrate a credit transfer system over the next four years. We do applaud them for that effort. It has been a long time coming. We were all pleased to hear this. However, students of today still face the challenge of retaking courses and buying the same textbooks, costing them time and money. Following the implementation of this system, the cost benefit to students will amount to roughly $26,000 to $50,000 if 65% of student credits were to be accepted by a university. However, as of today, college and university students and graduates still do not receive proper recognition for prior learning. As a result, they are leaving the province to pursue further studies elsewhere, or else they enter the workforce. Ultimately, we are compromising many opportunities for students continuing to learn in Ontario.
Just some more facts: In the last eight years, the number of college students seeking university programs has doubled. Nearly 25% of college applicants have identified preparation for university as the major reason for applying to Ontario colleges. In credit transfers, an average annual benefit to Ontario’s economy over the next decade lies between $36 million and $61 million.
In summary, student affordability and transferability are two robust measures that could be utilized to improve the effectiveness and efficiency of our post-secondary education system and generate a return on investment for Ontario.
In closing, I thank you very much for spending the time today with me, and I look forward to your questions.
The Chair (Mr. Pat Hoy): Thank you. The questioning will come from the government. Ms. Pendergast.
Ms. Leeanna Pendergast: Thank you for being here this morning, and thank you for what you do in representing our post-secondary students.
I have a few questions—more of just a clarification. You have some interesting research; I’d like to get some references there as well.
I assure you that we hear what you’re saying. I have three teenage boys, and the first is going to post-secondary in the fall, so I particularly want to talk about where you stand on reducing parental contributions for your membership.
First we’ll talk about transferability since it’s in your summary as one of the two major focuses, and yes, you did reference that the government has announced that. We’re looking at ways to make that much more efficient, of course, for students in all areas. Have you had any discussions with your membership on how that might look, or any input or feedback that you could give to the government on that topic?
Mr. Ryan West: Over the past decade, the CSA has worked diligently to provide student feedback to governments around the importance of transferability among programs from college to college, college to university and university to university, because of the huge economic costs associated to those students for not recognizing prior learning.
As far as implementation, we have made submissions to the government. I believe we’ve already submitted one around the creation of change, which is part of the document I sent you. We have sent a number of submission pieces to the government over the past few years around improvements to post-secondary education, including possible ways of credit transfer. It’s very difficult, because we recognize that there are a lot of differences between the college and the university system. Working on an agreement is really going to be a true partnership between government groups, student focus groups, as well as the institutions themselves through their representing bodies.
Ms. Leeanna Pendergast: Excellent. Thank you.
We’re also hearing—we heard from the UWO and Windsor student alliances, as well as the colleges, St. Clair College, Western as well, and the University of Windsor. We’re hearing comments on the Ontario access grants, of course, that students prefer the money up front, and you made a comment about the education tax credit. Do you have that reference handy, what you gave on the education tax credit? There was an interesting reference—
Mr. Ryan West: I do.
Ms. Leeanna Pendergast: I can get that from you after.
What about reducing the parental contribution? Are you hearing that from your membership as a priority? I guess I could segue into that as well—
Mr. Ryan West: There are a number of concerns around OSAP. How much does that parental contribution factor into it—
Ms. Leeanna Pendergast: As an accessibility piece for all.
Mr. Ryan West: Yes, as an accessibility piece.
There are a number of issues. Also, with the changes to OSAP last year, students are able to earn $1,400 a semester, which is an increase of about $400 over the previous few years or decade. Along with that, the government also funds a program called the Ontario work-study program, which helps college and university students work on campus. It’s supplemented by the government, but through that program, they’re only able to earn $1,000 per semester. It doesn’t really make sense that we’re operating a program where you can only earn $1,000 when the levels of OSAP have been lifted to $1,400.
Ms. Leeanna Pendergast: That’s been a long-standing problem, hasn’t it?
Mr. Ryan West: What’s that?
Ms. Leeanna Pendergast: That’s been a long-standing problem, the earning $1,000?
Mr. Ryan West: Yes. I believe the cap for the Ontario work-study program has been the same probably since around 1980. It’s been a number of years, yes.
Ms. Leeanna Pendergast: Yes, I remember that.
Mr. Ryan West: With the change to, obviously, the levels of minimum wage—for students, I think it works out to about five or six hours per week. On average, students will probably work 12.
Ms. Leeanna Pendergast: One quick, last question before the Chair cuts me off. Staff training and support: Are you hearing about support? We’ve heard consistently the need for support for staff and training for staff. I mean, I’m a teacher. I have a B.Ed. I have training, and we’re hearing that they’d like to see that sort of support level for post-secondary staff as well.
Mr. Ryan West: I’ll answer this quickly. Yes, support for our staff is key as well, because it does help our students in the classroom and support student success as a whole. The same goes for faculty as well. That is something that I would say isn’t on the highest part of the college system in terms of our affordability piece.
Ms. Leeanna Pendergast: That’s my question, yes: Where does it fit with student affordability?
Mr. Ryan West: We’d like to see more changes to OSAP particularly, even if there was an increase to the operational grants given to colleges and universities. That might even allow for a possibility of a tuition freeze for a year or two, which would save millions of dollars for students throughout the province and help them pay off their debt quicker.
Ms. Leeanna Pendergast: Excellent. Thank you, Ryan, and again, thank you for everything that you’re doing on behalf of our students.
Mr. Ryan West: Thank you very much.
The Chair (Mr. Pat Hoy): Thank you for the presentation.
THUNDER BAY CHAMBER
The Chair (Mr. Pat Hoy): Now I call on the Thunder Bay Chamber of Commerce to come forward, please. Good morning, gentlemen. You have up to 10 minutes for your presentation. There could be five minutes of questioning. This time, it would come from the official opposition. I’d ask you to identify yourselves for our recording Hansard.
Mr. Harold Wilson: Mr. Chair, thank you. Harold Wilson and Dennis Buset. I’ll formally introduce us in our remarks.
The Chair (Mr. Pat Hoy): Very good.
Mr. Harold Wilson: Mr. Chair, members of the standing committee, thank you for once again holding pre-budget consultations here in northwestern Ontario. My name is Harold Wilson and I’m the president of the Thunder Bay Chamber of Commerce. I’m joined by Dennis Buset, director and past chair of the board. Our chamber represents over 1,000 members, covering all sectors of the local economy.
In addition, I’m also the chief operating officer of the Northwestern Ontario Associated Chambers of Commerce, which represents over 2,300 businesses who are members of chambers throughout our region.
We’re very pleased to make this formal presentation to the committee and to outline a number of areas that we believe should be considered in the crafting of the current budget and those to come for the next few years for the province of Ontario.
Firstly, the growing debt of this province is of great concern to the business community, especially when it does not appear that there are specific targets and a timetable to reduce our debt, estimated to have grown to $236.5 billion by March 31, 2011. This is significantly over the $157 billion as of March 31, 2007.
While much of the government’s statements recently have concentrated on the issue of the deficit, which has also grown substantially and must be addressed, there must be specific targets for debt reduction and a clear plan to meet those targets. It is understood that there are always fiscal issues that must be reasonably dealt with during times of economic downturns. However, there must be real debt reduction during times of expansion, and this has appeared a much more difficult undertaking for the province.
The chamber requests that a debt reduction timetable be presented with the next budget outlining what specific steps will be made above the plans for deficit reduction. A lack of commitment to addressing the debt issue impairs our province’s ability to prosper.
Like every budget, there needs to be an effort undertaken on both the revenue and the expenditures portions of the budget. We also understand that there is a significant difference between expenditures and investments and we request that this clear distinction be noted in preparing plans.
There are significant opportunities that would be very positive on the revenue side if we work strategically. Last year’s provincial budget outlined the economic opportunities of the Ring of Fire as one example. However, to achieve the benefits of this initiative and other resource development, the government will need to take a lead on strategic investments. There will be significant provincial support required to bring this project to fruition, especially around infrastructure. As we will want to maximize the economic impact of this mining development for our province, we should be encouraging value-added, including processing, wherever possible.
While it will be a business decision about where the processing and associated jobs will be located, it is critical that the province ensure that we are investing our resources wisely. The government must mandate that a proper accounting of all the costs borne by the taxpayers associated with the Ring of Fire is tracked and that when private sector decisions are made, the full amount we have invested is part of the payback calculation that must be included. We’re not dictating to the private sector but we are protecting our financial investment and encouraging strategic benefits. For example, the economic impact that is returned to Ontario would be deducted from the amount owing. The more direct the benefit, the lower the amount that need be paid back.
The Ring of Fire and Far North economic development also requires that benefits accrue directly to First Nations communities, and this effort should be targeted for investment in enhancing the capacity of First Nations to develop their economy. We suggest a focus on effective business supply chain development would yield significant long-term benefits throughout the region and province. The more goods and services that can be accessed close to the mining developments the better will be the benefits to the province and the progress of development.
Nishnawbe Aski Nation Grand Chief Stan Beardy has spoken about the incredible infrastructure challenges required to develop the resources of the Far North and to benefit their communities, especially around the Ring of Fire. It must also be addressed that the resource areas in our Far North require infrastructure corridors that are predominantly north-south, be it road, rail, telecommunications or electricity. The province’s efforts on protection, including current caribou preservation efforts, run east-west. Conflicts within the province’s government priorities for the Far North must be tackled head-on, otherwise the next 10 years will be characterized entirely by infrastructure planning and not by any infrastructure building.
There’s also a need to be proactive regarding the infrastructure needs of our municipalities to provide the base for business development that major resource sector investment requires. For example, surging gold mining communities such as Red Lake and Kirkland Lake have major current infrastructure challenges, especially around residential growth. We suggest commercial opportunities and needs are also a challenge. Greenstone will be next. The provincial ministries need to get involved quickly in providing the necessary support to municipalities to build, but not overbuild, to meet the needs. Cranking it up five years from now will not help, nor will expecting municipalities to have their required percentage ready. Municipalities live off the tax base; senior governments enjoy the resource revenue. Acknowledge this and provide the support needed to make these infrastructure investments in a timely, effective way.
Throughout the north the mantra should be to maximize value. Our chamber led the charge last year to the Ontario Chamber of Commerce, which unanimously supported our resolution that a minimum of 26 million cubic metres of wood annually be legislated as available for use by existing mills and new entrants. The provincial wood supply competition, kicked off in November 2009, was an example of how to make use of a resource that has been languishing. However, the plodding nature of the effort to work through the competition has been painful for all involved, including the province.
The wood supply competition could have been completed much earlier had the assessment criteria been transparent and tied to maximizing the value of the resource. A weighting of jobs, innovation, partnerships, new markets and products, financial viability and other criteria would have made the assessment and subsequent awarding of wood much easier and we would be in a better position as a province to be realizing the investments that would have come and the accompanying jobs and increased tax revenues.
Mr. Dennis Buset: While the government has taken steps to address and adjust current electricity pricing for industry, which has meant a marked improvement to the corporate bottom line, this is acknowledged as a short-term benefit. It does not encourage industrial investment and expansion, which is based on much longer time horizons. We are all aware that discussions related to processing chromite in Ontario are very much contingent upon energy costs. Energy pricing certainty for industrial and commercial investment must be a focus of the government in order to attract investment and encourage growth in our economy.
We also need the deficiencies in the existing transmission and distribution systems, articulated elsewhere by the Common Voice Northwest energy task force, including the failure of the proposed east-west tie line to connect Nipigon to Thunder Bay, to be clearly addressed within the 20-year plan under consideration by the province.
There is another suggestion concerning strategic support for investment development in northern Ontario that is fully within the purview of the province. Since the mid-1990s, the Ministry of Economic Development and Trade has not provided services or programs in northern Ontario. That role was picked up by the current Ministry of Northern Development, Mines and Forestry through its regional economic development branches. However, the shortcoming has been the delivery, as the current structure, one that removes direct responsibility for MEDT, has severely diluted their programs’ effectiveness. In order to ensure that the north benefits as much as the rest of the province from direct access to the programs and services of the main two-way instrument of government support for economic development and growth, we need to have a MEDT office back in the north. Northern municipalities, economic development officers and businesses would definitely benefit.
Specific improvement to the government’s financial instruments: There are a number of things that we’d like to address in this area. There is room to make improvements to existing programs that will result in greater investment and economic activity. Other provinces have recognized that enhancing research and development tax credits to supplement the federal scientific research and experimental development program, or SR&ED, is an effective way to encourage research dollars to be spent in their jurisdictions. Specifically, Saskatchewan and Manitoba have recently enhanced the attractiveness of their programs: credits of 15 and 20 cents on the dollar respectively, compared with Ontario’s current incentive of 10 cents on the dollar. Corporations in Quebec enjoy the highest rate of return on a dollar spent on R&D labour, at a combined federal and provincial rate of 82.5 cents for every dollar spent.
The Chair (Mr. Pat Hoy): You have about a minute left for your presentation.
Mr. Dennis Buset: Thank you.
A fully refundable innovation tax credit for small business would assure Ontario a place as the most attractive environment in Canada to perform scientific research and economic development.
Another concern for business is labour force development. The looming labour shortage has been well documented by the Canadian Chamber of Commerce in their research papers. One of the areas where the province of Ontario can help would be a measure to relieve the financial burden facing our youth as they strive to become skilled tradespeople. This could easily be accomplished by the province allowing, as qualifying expenditures from an RESP, safety apparel and the necessary tools purchased by students in pursuit of a career in a recognized trade.
Mr. Harold Wilson: Finally, we’d like to consider an important aspect of the expenditure side of the budget challenge. Regulatory ministries such as environment are coming up with new directives, foisting new initiatives upon us that will require infrastructure within municipalities—and therefore their taxpayers. The ministries should also be presenting compliance costs to government, not ignoring their impacts.
Moreover, employees of regulatory agencies, when faced with a reduction in activity from existing resource sectors, often go in search of additional targeted firms or increase their presence in existing operations, which our chamber members have seen in abundance. When business is faced with revenue shortfalls, we seek ways to trim our operations. Government has not sought a similar response, and the business community has been the recipient of their need to keep busy or get laid off. This is considerably different than the MEDT example cited above, which was about facilitating and supporting new investment.
We thank you for your attention to our presentation. We await any questions that you have.
The Chair (Mr. Pat Hoy): Thank you. The questioning will go to the official opposition. Mr. Ouellette.
Mr. Jerry J. Ouellette: Thank you very much for your presentation. You mentioned the Ring of Fire. More specifically, what benefit do you feel should come to the province from the Ring of Fire development, and how so?
Mr. Harold Wilson: There are many specific benefits that can come. I think a lot of the concentration, though, has been about, let’s just see the processing portion go. There are already a lot of economic impacts that are being felt here in the northwest—the exploration side, the development side. We have significant growth in a number of companies in Thunder Bay. One example is just in the issue of assay labs alone. There were over 260 people employed a year ago in that, and a lot of people in the community aren’t even aware of those impacts. We’ve seen growth in a number of the companies that serve that.
However, such things as the regulatory side and issues like the Far North Act have an immediate dampening effect. If it’s difficult to raise funds, if it’s difficult to raise money for exploration in the markets, be it Vancouver or Toronto, that goes right away to the ground. We feel that right now in our communities; it’s not felt on the bigger side. The province, I know, is looking at actual operating mines, which is farther along.
After exploration and development, you still need construction. Then, there’s the operation. The operation side might not come for five to 10 years. Then, after operating, there’s the issue about value-added processing and the rest. So there are significant economic benefits that are already accruing. We’re already feeling some concerns about that, and we have expressed them on numerous occasions. But we want to be able to see these things grow to fruition.
The last part, and we just touched on it, is that we have been doing—at our Thunder Bay Chamber of Commerce we’ve seen a lot of new membership from both First Nations-owned businesses as well as those associated with the mining industry. We see that as having significant opportunities for growth. If we can start to work to develop along that supply chain, working with companies that would be located in those First Nations communities to be able to be suppliers—it’s going to take some strategic moves, probably some things that aren’t being considered right now. All of those pieces, though, will yield many more dollars into the coffers of this province.
That other part we talked about a lot, because there will be significant economic impacts and great benefits. But we really need to track how much we’re going to be spending. The government is going to be asked to do a huge infrastructure investment in this. We have to make sure, as much as possible, as we’ve said, that we’re protecting that investment. The big issue right now in northwestern Ontario is where that value-added processing facility will be. Will it be in the northwest? Will it be in other locations? Will it be outside the province? Quite frankly, there would be a lot of costs associated with bringing that thing to fruition, and we need to make sure that those are going to be covered off to maximize the benefit to the province.
Mr. Jerry J. Ouellette: When you talk about the value-added process and potentially where it’s going to be located, what are some of the determining factors? I would think hydro would be one of the key ones.
Mr. Harold Wilson: The biggest determining factor, as far as I’m personally concerned, and we’ve had a lot of discussions on this, is energy. Issues about being able to do some energy rebates—that’s fine in the short term, as we’ve said, but it’s long-term energy costs. Right now, there are other jurisdictions right around us, and we know that’s already had an impact in Ontario and will continue to. When people are making investments about where they’re going to locate, anything that’s high-energy consumption is going to be first and foremost.
So we’re looking at other jurisdictions; we’re looking at other countries. That’s a huge determining factor. That’s why we need it seriously addressed now, especially from the industrial side. One can separate industrial and residential, but what are we doing to attract industry to Ontario?
Mr. Jerry J. Ouellette: You mentioned the Far North Act and the impact of that, potentially. I gathered from your statements that it negatively impacted—it deterred businesses from investing in the community. You stated about Vancouver and Toronto and that investments were being—
Mr. Harold Wilson: We’ve received feedback from such groups as the Ontario Prospectors Association and the northwest prospectors. Again, one of the great things about the early stages of development is that those monies are spent on the ground. It’s spent in communities like Greenstone. It’s spent up in Red Lake; it’s spent up in a lot of the northern communities. So anything that has a negative impact on whether or not they can develop in the future has an immediate impact, and that has been seen. That’s the feedback that we’ve received. Those are also the concerns expressed from a variety of companies that are already serving that. They’re saying that the expansions that they were looking to have over the near term have been dampened. We’ll see if that’ll come back. But any time there’s uncertainty about the longer-term vision for this province, it has an immediate impact on us.
Mr. Jerry J. Ouellette: I recall—
The Chair (Mr. Pat Hoy): Very short.
Mr. Jerry J. Ouellette: I recall when Ontario was leading in the mining sector around the world with some changes that came forward in a significant number of areas. I’ve also met with Grand Chief Beardy on this, and he’s looking forward to moving forward and developing First Nations communities. What aspects of the Far North Act do you think need to be corrected in order to move it forward, to remove that uncertainty?
Mr. Harold Wilson: Well, I think the First Nations are the main people that that should be discussed with. I know they have made their point very clear about that.
What we wanted to see are opportunities for development. Everybody does want to see planning. Nobody ever said we were against planning or the rest of that, but again, if one has made a case that they’re taking some 50% of the land base away, and they just won’t tell you which 50%, that obviously has an impact on the issue about uncertainty and an issue on being able to raise capital.
Mr. Jerry J. Ouellette: Thank you very much.
The Chair (Mr. Pat Hoy): Thank you for the presentation.
The Chair (Mr. Pat Hoy): I ask Literacy Northwest to come forward, please. Good morning. Your presentation can be up to 10 minutes; there may be five minutes of questioning coming from the NDP in the next round. I’d just ask you to state your name for the purposes of our recording Hansard.
Ms. Annemarie Wesolowski: Good morning. My name is Annemarie Wesolowski. On behalf of the Literacy Northwest board of directors and the 17 literacy and basic skills delivery agencies in the region and their learners, I’d like to thank you, Mr. Chairman and standing committee members, for allowing me to present to you today.
In 2009, to bolster the province’s economic recovery and to support the transition to a fully integrated employment and training system, the Ontario budget initiative invested an additional $90 million over two years for literacy and essential skills training. While this funding comes to an end on March 31, 2011, the adult literacy field and the more than 60,000 adult learners across Ontario who are accessing literacy and essential skills upgrading in Ontario would very much like to thank the government for the benefits that this investment has provided them.
I hope to impress upon you the need for sustaining increased investment by sharing with you some of the key outcomes that literacy agencies and learners have achieved in the Literacy Northwest region through to September 2010, as well as sharing with you some of the identified issues and concerns that agencies and learners alike have expressed with regard to the future decline in funding, particularly during this time when there’s an increased need for services. The information I’m about to share with you has been gathered and compiled as a result of an annual literacy services planning cycle that takes place in all the regions throughout the province.
Through to the end of 2009-10, 100% of delivery agencies reported expanding services to include more daytime, evening, online and/or year-round access to literacy services. In addition, 100% of delivery agencies also upgraded their program space and/or added new program delivery locations to accommodate more learners, to provide an atmosphere that’s more conducive to learning and/or to be more accessible and visible to the communities they serve. On average, through the increased funding, agencies were funded to increase the number of learners they serve by 32%. The actual number of learners served increased by 66%. Agencies also increased their contact hours by 14.5%.
In the Literacy Northwest region, 353,074 contact hours were delivered to serve 2,882 learners. Of the 1,732 learners that exited the program at the end of 2010, 53% completed their upgrading goals, 27% were employed, and 24% moved on to further education and training opportunities. The return on investment is just beginning to kick in.
Some of the key issues and concerns that were expressed were:
—Initiatives that were undertaken through the increased funding to enhance agency capacity to respond to community needs and to the Ministry of Training, Colleges and Universities’ service priorities will be drastically diminished if funding is now decreased.
—Recent investments in marketing and outreach have resulted in increased community awareness and greater expectations of access to services; service capacity must be maintained in order to achieve maximum return on the investment and to retain community confidence and program credibility.
—The phenomenal success of the e-Channel projects—and through the additional funding, the e-Channel projects were allowed to accelerate their growth in terms of development of program and curriculum. The project is distance literacy and basic skills delivery via a Centra platform—a synchronous, they call it. It’s a live platform format. It clearly demonstrates the need for this type of delivery option, particularly in the north, where the population is spread out and we have very many remote communities. As such, the e-Channel project status needs to be changed to program status, with firm funding transfer dates to allow for effective planning, consistent access to programming and stable staffing to ensure quality service delivery and growth.
—Skill shortages need to be addressed now. I know you’ve heard this many times, and of course, that’s been confirmed through many current forecasts and numerous reports that are available, such as the Dr. Rick Miner report, People Without Jobs, Jobs Without People. Literacy and essential skills upgrading is an integral component of rebuilding Ontario’s economy and workforce, and if funded adequately, Ontario will reap a healthy return on its investment. The literacy and basic skills program is vital to achieving the Open Ontario plan to strengthen the province’s economy and create more jobs. Long-term, stable investment is needed to achieve these results.
While literacy and basic skills agencies are clearly accountable to the Ministry of Training, Colleges and Universities, they are also accountable to their learners and to the communities they serve. They’re the folks who are on the ground. As such, the field hopes to work in collaboration with the Ministry of Training, Colleges and Universities, the other learning ministries—the Ministry of Education, the Ministry of Citizenship and Immigration, the Ministry of Culture—and key literacy stakeholders to develop a strategy for stable, long-term funding for literacy and essential skills training—funding that invests in people’s lives; that provides all segments of our population with the opportunity to contribute to and benefit from the multitude of new and diverse economic opportunities that are emerging throughout the province, in particular, across the Far North; funding that responds to the labour market needs of today and tomorrow.
As reported in the Ontario news on December 2, 2010, in regards to ending stimulus funding, the Minister of Infrastructure, Bob Chiarelli, said, “Some projects need a little extra time … it would not make sense to build the four walls and not the roof. We need to keep pushing forward on these projects, to create needed jobs in our communities today, and lasting legacies that will improve the quality of life for Ontario families for years to come.”
I would suggest that the same could be said for the two-year budget initiative funding for literacy and essential skills training, which came after more than a decade of flatlined funding and diminishing services. Agency capacity has now been strengthened and services expanded in response to growing needs as a result of that additional funding. Now is not the time to return to inadequate funding levels. It would be just like building the four walls and not the roof.
I’d like to take a minute and share three testimonials from learners in our region. One testimonial: “The staff” at my agency “are patient, knowledgeable and positive instructors that make the atmosphere of learning less suffocating and more like an endless stairway, which you can climb and keep climbing. My instructor was always eager to help, even if it wasn’t needed, and if I win the lottery I’ll keep this program free in Canada. As an aboriginal, I’m happy to say this program and its staff are the most amazing people I’ve met during the educating years of my life. This program is the last beacon of light for some, so let’s keep it blinking.”
From an apprentice: “I enjoy coming to class and having someone help me in any questions that I have with math or trade materials. A great course to help prepare for the trades exam.”
Finally, from two of our learners from the remote communities: “We enjoyed the social contacts in academic upgrading and the teachers were knowledgeable and extremely helpful. The academic upgrading program and the dedication of the staff helped us reach our post-secondary goals.”
Once again, thank you for providing me with the opportunity to present to you and to share information with you that I hope will inform your funding recommendations.
The Chair (Mr. Pat Hoy): Thank you. We’ll go to Mr. Tabuns of the NDP.
Mr. Peter Tabuns: Thank you very much for coming in today. Also, thank you for the work you do. I think it is of great consequence.
Could you tell us a bit about where you draw your students from? Are these people who are employed, unemployed, on social assistance, if you can categorize where the bulk of them come from? And where do they want to go with the literacy training they get from you?
Ms. Annemarie Wesolowski: It’s truly a mix, the makeup of the adult learners who access literacy programs. The bulk of them would be not employed.
Of those who are not employed, some would be on social assistance of various different forms, whether it’s Ontario Works or the Ontario disability support program. Others are homemakers and/or they have other means of support. A small percentage of the learners who access programs—now, I’m just speaking on behalf of northwestern Ontario and not the province as a whole.
Mr. Peter Tabuns: I understand that.
Ms. Annemarie Wesolowski: There are a few, a smaller percentage of individuals, who are employed. However, over the past year and a half, that percentage has increased—although small, it has increased—as a result of a number of the agencies throughout the region being able to now offer evening classes and/or more flexible learning opportunities. It’s also been reported that the number of employed learners has also grown as a result of the distance delivery format that’s now available. So it’s accessible anywhere, anytime, 24/7.
Mr. Peter Tabuns: They come to you. They want to learn. What do they expect to use their literacy skills doing once they’ve completed your courses?
Ms. Annemarie Wesolowski: For the majority of learners accessing programs in the northwest, their primary goal is to access further education and training. So they’re accessing literacy upgrading services so that they can improve current levels of skills or learn new skills that will allow them to access that next step of training, whether it’s a post-secondary program at the college and/or the university, whether it’s to get into an apprenticeship program and/or whether to get into entry-level jobs or positions.
We have a percentage of learners who are accessing programs for employment reasons, so it’s either to improve their current employment situation by learning new skills that are a requirement of that or to be able to move into different employment positions. Quite often it’s with the same employer, but perhaps there’s an opportunity or there have been opportunities in the past to be able to move up and they haven’t been able to take advantage of that because they haven’t received the skills training needed to be successful in doing that.
Mr. Peter Tabuns: Okay. I don’t have further questions. Thank you.
The Chair (Mr. Pat Hoy): And thank you for your presentation.
THUNDER BAY HEALTH COALITION
The Chair (Mr. Pat Hoy): Now I’d ask the Thunder Bay Health Coalition to come forward, please. Good morning. You have 10 minutes for your presentation. There could be up to five minutes of questioning, coming from the government in this case. I ask you to state your names for our recording Hansard.
Ms. Sara Williamson: Sara Williamson.
Ms. Barbara Maki: Barbara Maki.
The Chair (Mr. Pat Hoy): Go ahead.
Ms. Sara Williamson: Good morning. I’m Sara Williamson, and this is Barb Maki. We’re co-chairs of the Thunder Bay Health Coalition. We welcome the opportunity to speak with the Standing Committee on Finance and Economic Affairs about the future direction of our provincial economy and health care.
The Thunder Bay Health Coalition’s goals are to ensure that the Canada Health Act is maintained and to expand medicare to areas in long-term care, home care and pharmacare. We host forums, monitor health care issues and work in conjunction with various groups to bring about improvements to the health care system. We’re non-partisan and we’re affiliated with the Ontario Health Coalition.
In Thunder Bay and surrounding areas, times are difficult. People depend on the health care system more than ever. We have many strengths and weaknesses in northwestern Ontario. We’re a huge land mass, as you know, and a small population. We’ve got high unemployment; high rates of diabetes, high blood pressure and arthritis; the highest rates of mental health visits to the emergency department; high suicide rates; and so on. But we like it here, and the citizens want a budget that pays for public health care and supports equity of care.
The public health care model is sustainable. Health care privatization solutions are not solutions. The mantra to privatize comes from self-serving organizations like TD Economics, which is linked to investments in P3 hospitals and private health insurance. The Ontario government should not rely on the analysis of TD Economics that attempts to doom public health care.
The real solution is to better distribute Ontario’s gross domestic product, the wealth of Ontario, and restore balance between government revenue and meeting human needs. Giving big tax cuts and exemptions to corporations and wealthy individuals was a mistake. Now Ontario is dead last among the provinces for per person spending on all programs and services, which includes health care. It’s no wonder that health care looks like it takes up a large proportion of the provincial budget. It’s easy to appear as a big fish when the spending pond keeps getting smaller.
Ms. Barbara Maki: The situation in the Thunder Bay area: Our coalition acknowledges the fact that our area has seen positive movement specific to health care in our region. We do, though, have several issues that concern us regionally.
The lack of catastrophic drug coverage is harsh in our community, where cancer is so prevalent. LifeLabs now does tests for the general public that was work formerly done at the Thunder Bay Regional Hospital. The service was discontinued because the Ministry of Health and Long-Term Care funding structure did not remunerate hospitals for these costs, but did pay private, for-profit labs. So instead of expanding lab work and gaining revenue, Thunder Bay Regional had to change business lines to the lab.
The continual gridlock, which is about 99% of the time here at our regional hospital, is ongoing, with alternate-level-of-care clients—those are the ALC clients—occupying beds that are designated for acute care clients. This is something that has been especially problematic in our area, with the hospital being closed to the region. This can result in delays for clients who require care and can certainly result in negative patient outcomes. In September 2010, the Thunder Bay Regional Health Sciences Centre saw at least 25 patients on stretchers in hallways and in the alcoves. In the emergency department, it can take a day to be admitted.
In October 2010, surgeries were cancelled and the number of alternate-level-of-care-bed patients hit an all-time high of 87; 43 of the latter were long-term-care clients waiting for placement in long-term-care facilities.
The long-term-care home wait-list gives preference to patients in the alternate-level-of-care beds. This leaves families struggling to organize 24/7 care at home for a family member who also really needs to be cared for in a long-term-care home.
Bit by bit, there are improvements in the systems—efficiencies, perhaps; partnerships; funding to add capacity—but in all of northwestern Ontario, only Thunder Bay Health Sciences Centre can provide moderate-surge-capacity critical care services, which are level 3 services, while a second site six hours from Thunder Bay can provide level 2 services. If there were a moderate or major surge event, which would be like a mine explosion, a large airliner crash or a deadly flu, our capacity for transportation of critically ill patients and the deployment of skilled health workers is very limited.
Community hospitals are many hours apart here, as we have geographical constraints. ALC patients would have to be bumped out, but we really don’t have anywhere to put these clients.
Delays in provincial funding for St. Joseph’s Care Group to build the new mental health wing, supportive housing and a long-term-care complex are having a ripple effect of further backlogging health care wait-lists. Because of the shortage of long-term-care beds, some seniors in the community end up in retirement homes. These are not regulated to provide nursing care and can cost individuals thousands of dollars every month. The new retirement home act does nothing to protect tenants.
And the story gets worse. Our long-term-care beds lack adequate care standards and the dedicated funding to provide for heavier-care residents who have been moved out of mental health facilities and hospitals. Patients who move out of hospitals to their own homes face rationed home care, which can be inadequate unless the family is able to assume a substantial burden of care. Respite care for full-time caregivers is almost nonexistent, and yet home care agencies are busy providing care in homes across the city to households that can afford to pay. It is actually a two-tiered system.
At a forum here in Thunder Bay specific to a minimum care standard for direct care/hands-on care in long-term-care homes, the message was very clear that means must be found to have sufficient appropriately trained front-line staff in the homes. Managers hoped that measuring residents’ needs with the resident assessment instrument, the RAI, would convince the government that more well-trained staff were absolutely necessary. However, a front-line health care worker observed that at work sites with insufficient staff, there isn’t time to do these RAIs thoroughly. As a consequence, data incorrectly reflects a lower level of need for these clients, and thus evidence for more funding is lost.
Ms. Sara Williamson: Hospitals are being strangled. Health care budget constraints have fallen heavily on hospitals. The provincial government has funded hospitals at less than the rate of inflation for three years consecutively, forcing hospitals to restructure and patch their services with one-time-only pilot funding. Our acute care hospital has been balancing the budget by not filling staff vacancies. Last May, the outgoing chair of our acute care hospital predicted that they will have to cut some services in the future, with the result that patients won’t get some of the types of care that they need when they need it, and the care may not be in their town.
We have a lot of recommendations:
—Cancel the corporate tax cuts, eliminate the employer health tax loopholes, and move Ontario’s health care funding into line with the rest of the country.
—For medically necessary services in all settings, whether they’re in the hospital or in the community, including ambulance services, home care, long-term care, mental health care, palliative care, restorative care—whatever—provide timely core funding that’s sensitive to real costs. A zero formula is just unrealistic.
—Restore hospital funding to meet, at minimum, hospital inflation and stop service cuts.
—Reinstate and fund a measurable long-term-care home minimum standard of care of 3.5 hours per resident per day.
—Examine and curb excessive administration and executive costs in health care.
—Stop the increasing privatization of health care, especially in home care and long-term care, where millions of dollars end up as profits for shareholders instead of back into our system.
—Cancel competitive bidding—don’t just freeze it; cancel it—and cancel pay-for-performance hospital funding and the P3s.
—Provide catastrophic drug coverage within a federal framework. The government is congratulated for at least starting to put this thing forward in 2008 and offering to cover 50%, but keep working on it, because we need a good pharmacare plan.
—Address the social determinants of health: economic equity through good jobs, income support, social housing, inclusive community supports and education.
I think the good news is that it’s sustainable; public health care is sustainable. We just have to use our fiscal capacity to do it.
The Chair (Mr. Pat Hoy): Very well. Thank you. The questioning will go to the government. Ms. Pendergast.
Ms. Leeanna Pendergast: Thank you, Sara and Barb, for being here. We appreciate your presentation.
Actually, Sara, you left off right where I wanted to begin, so it’s a beautiful segue: the idea of sustainability. Health care in the province is sustainable. On page 3, thank you for your comments that the model is sustainable. It’s certainly about a fine balance, and that’s why we need your input, specifically your input in the north and your specific needs. I’m from the southwest. Kitchener–Conestoga is my riding, so it’s wonderful to be here—thank you for hosting us—but it is a different situation that we have in the south than you have here in the beautiful north. It’s so beautiful we may never leave. We love it here.
Ms. Barbara Maki: Do stay.
Ms. Leeanna Pendergast: On page 4, Barb, you talked about the human cost. Your coalition acknowledged that you have seen positive movement specific to health, and we thank you for that. But I want to reassure you that we do hear the rest of your specific local concerns, and that’s very helpful, your input in that area.
Moving right to your recommendations, which would be number 5: “Reinstate and fund a measurable long-term-care home minimum standard” of 3.5 hours. I work closely with the long-term-care homes in my riding as well. I’m wondering if you have any studies or if your coalition has done any research into this for cost measures, what this would look like in terms of cost.
Ms. Sara Williamson: We had the figure at the last budget round, so I’m not sure what it is this year.
Ms. Barbara Maki: If you look at the Ontario coalition web page, there are a number of studies that will give you the numbers, I would suspect, for that.
Ms. Leeanna Pendergast: Okay. I’m going to jump right to the last one, number 10: “Address the social determinants of health”—absolutely. That’s a huge recommendation that you have there. We’re talking about being proactive and preventive—absolutely the way to go, rather than being reactive and focusing on hospitals and ERs. Again, any further—
Ms. Sara Williamson: Excuse me, but it’s not an either/or, because—
Ms. Leeanna Pendergast: No, absolutely.
Ms. Sara Williamson: —we have to look after people. But if we’re building for the future too, we’ve got to put that in place.
Ms. Leeanna Pendergast: Absolutely, so addressing those social determinants. Has your group had any discussions or any more feedback or input that you could give us in terms of how that might look?
Ms. Sara Williamson: Well, like you said, it’s huge. We’re supporting the initiatives and the suggestions that others have in that area. I think that, for instance, Poverty Free Thunder Bay will be presenting later, and they will have some things to say about income support. And the labour council will undoubtedly be talking about good jobs. Some of our other community services are going to be talking about some of the community supports that are needed if we’re going to have a healthy community.
Ms. Leeanna Pendergast: Excellent—and, of course, the involvement of all those different ministries in those areas.
Thank you again for the work that you do on behalf of the Thunder Bay Health Coalition. Thank you for your presentation today.
The Chair (Mr. Pat Hoy): Thank you.
NISHNAWBE ASKI NATION
The Chair (Mr. Pat Hoy): I call on Nishnawbe Aski Nation to come forward, please. Good morning. You have up to 10 minutes for your presentation. There could be five minutes of questioning, and in this case it will come from the official opposition. If you’d just state your name for our recording, then you can begin.
Grand Chief Stan Beardy: Good morning. My name is Stan Beardy, Grand Chief, Nishnawbe Aski Nation. I represent NAN territory: two thirds of Ontario, 55 million hectares, 210,000 square miles, and roughly 45,000 people that live both on- and off-reserve.
I’m indeed very pleased to have this opportunity to speak to you today, as it is important to recognize that although First Nations are a federal government responsibility and we made treaty with the crown, Nishnawbe Aski communities live in Ontario and we are part of Ontario.
We have always maintained our position that when we made treaty, we never gave up the title to the land, nor did we give up the right to govern ourselves. We never gave up the right to be self-determining or to be self-sufficient.
Of the 49 NAN communities in the north, north of the 50th parallel, over half are remote—that is, fly-in only; there is no road access—and all of which live in poverty and are forced to deal with the day-to-day struggles which directly affect and impact the safety and well-being of the members of those communities.
To continue to provide a high quality of life and stimulate the economy for both Ontario and Canada, there are three elements of infrastructure that must be addressed: transportation within my territory, energy and communications.
There must be an adequate transportation system in place, meaning all-weather roads. An investment in this would help alleviate the high cost of transporting essential goods to our communities. Currently, we are forced to pay expensive prices through air transportation and only get to use the winter road system for three weeks to bring in our bulk goods and our fuel supplies.
Secondly, having a reliable source of energy is essential to ensure the long-term sustainability of the north. This can be accomplished through grid line systems and site development.
Third, there must be continued investment in telecommunications, which we are currently doing through our northwest Ontario broadband expansion initiative. Telecommunications is vital to ensure that our youth have access to everything that the World Wide Web has to offer and are able to access online services such as teleheath, tele-education and e-commerce.
We would like to see commitments for proper housing within our communities and also steps to address our water issues, as some communities are faced with contaminated water. There must be infrastructure programs established on-reserve to begin to address some of these issues, which will inevitably improve the quality of life among Nishnawbe Aski people.
Policing is another major issue that needs to be addressed. Not only are there not enough officers to meet the needs of my people, but the accommodations they are forced to live in and the detachments they are forced to work out of are unacceptable. Many of the detachments in the north are falling apart. Because policing is both the federal and provincial governments’ concern and responsibility, the government of Ontario must live up to its end of the bargain and take steps to improve policing in the north.
We are a territory rich in many ways. We practise our culture and our traditions and maintain our traditional languages of Cree, Oji-Cree and Ojibway. Our territory is also rich in natural resources: the trees, minerals and wildlife which we work to protect and, at the same time, hope to benefit from what they have to provide.
As you know, there are many opportunities that lie ahead regarding economic development in the Far North. Specifically, I’m referring to the Ring of Fire, which falls in the traditional territory of Matawa First Nations, one of the tribal councils with the Nishnawbe Aski Nation. There is tremendous potential for everyone, including First Nations, industry and government, to benefit from any economic spinoffs that may be derived from mineral exploration in the Ring of Fire. This includes having access to training dollars in order to develop the skills of our members so that they have the opportunity to compete for and participate in jobs within our territory. It’s an opportunity that should be available to our young people so that they are not forced to leave their homes and communities to find work.
It’s important for Ontario to include First Nations in every aspect of activity on their traditional lands and to work with First Nations on agreements that would ensure resource revenue-sharing benefits for those communities once mining is up and running.
It is also important for there to be environmental accountability, to ensure that once it’s all said and done, our traditional lands will not be left in ruins. We want to continue to maintain pristine forests, as we have for thousands of years, and we need to ensure that others do the same. We will, after all, still be living there after the mining ends, forced to clean up the environmental damage that may have occurred.
We believe in land use planning, meaning that First Nations have the final say on how and when our traditional activity will be developed. We ought to ensure there is funding in place in order for our communities to be able to complete their land use plans, as no one knows how the land should be best used other than the people living on it.
In summary, Nishnawbe Aski Nation is looking for proper infrastructure in the areas of water and sewer, housing, roads, energy, communications and policing. We’re also looking for a commitment by the Ontario government for full inclusion of First Nations in all developments in our traditional territory and the ability to access training dollars to ensure that our young people are competing on the same playing field as others in Ontario when it comes to jobs within their home communities.
As you begin your deliberations on how next year’s provincial budget will be broken down, it’s important to keep First Nations at the forefront of your discussions. We are the fastest-growing population, yet continue to be left out of decision-making at the Ontario level.
Thank you for your time.
The Chair (Mr. Pat Hoy): Thank you, and the questioning will go to the official opposition. Mr. Miller.
Mr. Norm Miller: Thank you, Grand Chief Beardy, for your presentation this morning. You were kind enough, a number of years back, to take myself and our past leader on a tour of a couple of your communities, Fort Severn and Webequie, and it was very much appreciated. I know how much you are concerned about economic development for the communities in your area.
In your presentation you talked about some key infrastructure, one of the points being roads. Have you looked at what you would do first if you were going to start constructing roads? Have you got a plan for what makes sense to bring about economic development?
Grand Chief Stan Beardy: Yes. What we look at, as I mentioned in my opening comments and preamble, is that we never gave up the right to self-determination, self-sufficiency and governance. What we would do is, we hope to work with both levels of government to make sure there’s orderly development, that there’s some control of what happens in terms of traffic on those roads.
I think what we’re looking at is that in our discussions with the industry, we know where the hot spots are and we want to be part of that development, to make sure that my people benefit. We understand that when we talk about transportation, it’s not so much for our people to access the south, it’s more to extract natural resources, and we want to be part of those discussions and that decision-making.
Mr. Norm Miller: You also mentioned, as one of the three, infrastructure—transportation was first, energy was second. Do you have some specific comments on energy? Obviously, for the development of the Ring of Fire and whether the processing happens in Ontario, energy cost is a factor. Do you have other thoughts about that?
Grand Chief Stan Beardy: Yes. We understand that to have viable economic activity within the Far North, there has to be a source of reliable energy. We have been at the table amongst ourselves for the last 10 years, along with industry, private sector and government, to talk about the energy needs in the Far North to continue to stimulate the economy. I think we’re at a stage now where we’re ready to implement those plans which we have been developing for the last 10 years.
Mr. Norm Miller: Okay. I know I have other questions, but Mr. Ouellette would like to ask some questions.
Mr. Jerry J. Ouellette: Thank you very much for your presentation. A question about the roads and the hot spots: I imagine it should be fairly close—if it’s not, Pickle Lake should be open fairly soon, the winter road, to access a lot of the communities.
When you mention that, and you mentioned in your presentation about policing, are you concerned—because I know when I talk to truck drivers who do a lot of the driving on the winter roads, there are a lot of concerns about how some of the goods get from one community and how sometimes they don’t make it through one community, depending on what they’re delivering. Are you concerned that that may cause problems later on, or is it that right now it’s the shortest route? Do you look at different routes, as opposed to the current ice roads, to access the communities and alleviate a lot of those hot spots that you mentioned?
Grand Chief Stan Beardy: It’s not so much those concerns as what happens in terms of the well-being and safety of my people at this point in time.
I guess my greatest concern here is that we have what we call NAPS police services. Our officers go to the same police college, the OPP police college in Orillia. They go through the same training. They have to pass the same standards and exams. But when they go in the field, if they happen to work for NAPS, the standards that they have to work under are substandard. There is inadequate resourcing to ensure that there are minimum standards that are acceptable in running a police service.
But in the short term, yes, we’re looking at where the roads are, just to make sure we deal with the flow of traffic into our communities. But in the long term, when you’re talking about all-weather roads, we have to make sure that the negative elements that come with that development are dealt with before they happen—preventive measures.
Mr. Jerry J. Ouellette: You mentioned federal responsibility. Do you have examples of partnerships where the provinces have been able to work together in different areas that we can look forward to?
Grand Chief Stan Beardy: Yes. I guess when I talk about infrastructure—although under the Constitution we are primarily a federal responsibility, we still live in the province of Ontario. One of the infrastructure programs that was in place in the early 1980s was a program under MNDM called retrofit to help bring clean running water to our homes. That’s what I’m requesting, that the government begin to look at a similar concept where there is a provincial infrastructure program on reserves to address the quality of life for our people, mainly in the area of water and sewer.
Mr. Jerry J. Ouellette: Meegwetch.
The Chair (Mr. Pat Hoy): Thank you for your presentation.
CANADIAN PARAPLEGIC ASSOCIATION ONTARIO, THUNDER BAY REGION
The Chair (Mr. Pat Hoy): I now call on the Canadian Paraplegic Association Ontario, Thunder Bay Region.
For the committee, someone was asking when checkout time was. I’m advised that it was 11 o’clock, but the hotel will hold it till noon for checkout.
With that public service announcement for our committee, we move to you, sir. You have 10 minutes for your presentation. There may be up to five minutes of questioning following that. If you’d just state your name before you begin for our recording.
Mr. Darren Lillington: My name is Darren Lillington. I’m the regional services coordinator for the Canadian Paraplegic Association Ontario, Thunder Bay Region.
First of all, let me thank you for this opportunity to speak to you about this important initiative and how it will impact the clients who are served by our organization. I know have 10 minutes, but I’ll try to move through this much quicker than that.
I’m here to present you today with a solution that would reduce the Ontario deficit and create a higher quality of service for individuals who require assistance with breathing. Many people in Ontario with spinal cord injuries and neuromuscular diseases need to use ventilators in order to breathe. A recent provincial survey showed that many of these Ontarians are presently residing in hospitals rather than in the community because adequate community supports are not presently in place. With the proper supports in place and following a best practice model developed in BC, these Ontarians can live successfully within the community, which would result in a much higher quality of life for them and reduce costs for the government.
Presently, because of a lack of adequate community supports, people who are medically stable but need a ventilator occupy intensive-care-unit and alternative-level-of-care beds unnecessarily, they don’t get the rehabilitation they require when they require it, and they remain in hospital, sometimes for years, awaiting discharge to the community. Those people who are discharged to the community are at constant risk of readmission to hospital because the supports that they need are not currently in place. Based on a report for the Ministry of Health and Long-Term Care, with these community supports in place, it could save the Ontario government a minimum of $5 million per year.
Just to bring some reality to this so that you can more fully understand this issue, I’d like to speak about one of our clients. Sarah, when she became 24/7 ventilator-dependent due to a rare muscular disorder, faced permanent institutionalization because she could not meet the discharge requirement of finding and training five attendants to be with her around the clock. With the help of her friends and family to provide the necessary care, she was able to return home. In order to relieve them of some of this responsibility, in 2005, she applied to the direct funding program in order to pay for her attendants. However, due to Ontario’s wait-list of over 400 individuals, this has not yet materialized.
Sarah noted that her husband and children are burdened with having to care for her when they return from work and school. Her attendant care hours through her local CCAC, or community care access centre, total only six hours a day. Due to this, she says that she lives in fear, especially in times of being alone, because the slightest thing gone wrong with her ventilator could risk her life. In addition, Sarah and her family cannot travel as she does not have attendants in place to take with her.
Sarah’s appeal to our health care system would be to give special attention to patients with respiratory supports in order that they may live independently and enjoy their families.
Just to give you a cost comparison of providing care for ventilator-dependent individuals, one day in an intensive care unit bed costs approximately $3,000 per day. One day in a rehab bed costs approximately $2,200 a day. One day in a long-term-care or alternate-level-of-care bed costs approximately $1,200 a day. Currently, most individuals who require ventilator supports are occupying one of these beds. However, with the proper community supports put in place, it would cost only $225 per day for these people to be able to live in the community.
In addition, given the reality up here of living in the north, and sometimes in remote communities, an individual requiring assistance with breathing would have to relocate to larger urban centres to receive the care that they require. This means leaving friends and family behind, who are often the backbone of support and also supplement provincial assistance programs. Furthermore, having to leave these important natural support networks can be very difficult and result in further physical and mental health issues, which translate to additional reliance on government-funded programs. For First Nations individuals who may be leaving their remote northern community for the first time, it may result in culture shock, and could be a very difficult adjustment.
What we are requesting is the resources to work with experts in Ontario to develop and implement a province-wide, community-based respiratory outreach program that is evidence-based and provides a higher quality of life for people who require assistance with breathing at significantly lower costs. According to Ministry of Health statistics, we can save the government a minimum of $5 million a year by developing this service and providing the ability for these Ontarians to live at home and in the community of their choice.
The Chair (Mr. Pat Hoy): Thank you for the presentation. We’ll now move to Mr. Tabuns of the NDP.
Mr. Peter Tabuns: Thank you very much for coming in this morning, and thank you for giving us that information.
We’ve heard similar presentations from groups allied to yours in other cities. You’re the first person to talk about the daily cost of $225. Can you break that down for me?
Mr. Darren Lillington: Essentially, the majority of that cost will go to the attendants who could come into the home. Or sometimes, it’s in what we call a supportive housing unit, so you’d have a barrier-free apartment, and then also 24-hour support care staff available. Essentially, the majority of that cost is just having the attendants in place. Then some of it would also be associated with the training that would be necessary to make sure that they can provide that care. In BC, what they have is a 24-hour on-call respirologist, and also a respiratory therapist, who can work with these clients to make sure that they can live independently in the community.
Mr. Peter Tabuns: So British Columbia already has a system in place that’s comparable to what you want to see in Ontario.
Mr. Darren Lillington: Yes.
Mr. Peter Tabuns: How long have they had it in place?
Mr. Darren Lillington: That’s a good question. I’m not sure exactly. Sorry.
Mr. Peter Tabuns: That’s all right. Don’t worry.
Have they seen the cost savings in British Columbia that you’ve noted here in your presentation?
Mr. Darren Lillington: As far as I know, they have. I haven’t been working as closely with the core group of experts that’s been looking at this, but I imagine yes, the cost savings could be actualized quite quickly by allowing—all the studies that I’ve looked at certainly say that living in the community is much less expensive than living in either the acute care or long-term-care beds.
Mr. Peter Tabuns: You’re asking, obviously, for Ontario to look at this approach overall, but you also talked about set-up money to do the studies and move this forward?
Mr. Darren Lillington: We’ve already done a lot of the groundwork. This team of experts has been looking at this for probably the last three or four years, so we’ve done a lot of the initial studies and necessary work to be able to implement it. Essentially, now it’s just a matter of starting to put the things in place that we would need to make it happen.
Mr. Peter Tabuns: Do you have a sense of the cost that we would be looking at in Ontario to actually get things moving in that direction?
Mr. Darren Lillington: No, I don’t have the expertise to actually tell you that, but certainly we could get you that information, a cost breakdown.
Mr. Peter Tabuns: If you could get that and provide it to the clerk so it could be circulated to the committee, we would appreciate that.
Mr. Darren Lillington: Absolutely.
Mr. Peter Tabuns: I don’t have further questions, but I do want to thank you.
Mr. Darren Lillington: Okay, thank you.
The Chair (Mr. Pat Hoy): And thank you for your submission.
The Chair (Mr. Pat Hoy): Now I call on Confederation College to come forward, please. Good morning. You have up to 10 minutes for your presentation. The questioning will come from the government in this case. We’d just ask you to state your name for our recording Hansard. I’ve been accustomed to giving people a one-minute warning. I noticed you took your watch off. Maybe you’re giving me a warning, are you?
Mr. Bob Backstrom: I’ve got a little bit of experience. I know I’ve got to watch it this time.
The Chair (Mr. Pat Hoy): Go ahead.
Mr. Bob Backstrom: Thank you. My name is Bob Backstrom, and I’m the vice-president of student and corporate services of Confederation College in Thunder Bay. Good morning, Chair, Mr. Pat Hoy, and members of the committee. Thank you for the opportunity to appear before you today for the 2011 pre-budget consultations.
Confederation College has eight satellite campuses in Kenora, Sioux Lookout, Dryden, Red Lake and Fort Frances to the west; and Geraldton, Wawa and Marathon to the east. We also deliver academic programming to approximately 40 small northern, rural and remote aboriginal reserves, making our area served the same size as Texas or France: approximately 550,000 square kilometres. Confederation College’s operating and capital budgets this year total approximately $100 million, with a regional annual economic impact—done by a consultant—of $800 million.
My main message to you today is that it is critical that the government remain focused on investing in education and the skills of people as a solution to many of the challenges we are facing. Investment in colleges is an excellent return on investment.
A college education is the best route out of poverty, and more under-represented groups turn to college to earn their post-secondary credential. Out of 3,187 total students, Confederation College had 446 students with disabilities, 950 first-generation students and 602 self-identified aboriginal students—and I say self-identified because in reality, it will be higher; many do not identify.
Our student services have expanded supports to ensure that our under-represented learners are successful. Our special needs and student success departments, as well as our Negahneewin College of Academic and Community Development, a college located in and throughout Confederation College, support our under-represented groups. Negahneewin College, which is a unique concept, has a board of directors of their own, representative of aboriginal communities.
Projects such as our summer transition program for prospective students with special needs, multi-year first-generation research projects funded by the Ministry of Training, Colleges and Universities, and our downtown Learning Café, which is a drop-in centre for mainly aboriginal students, have enabled us to deliver additional support and access for under-represented groups. We’ve actually seen people who have come into the Learning Café moving forward with a college education.
In addition, collaborative partnerships such as the Whitefeather Forest aboriginal skills employment partnerships, the Sioux Lookout area management board agreement, and the Two Feathers training initiative have enabled us to deliver upgrading and training to aboriginal communities throughout our region. I’d mention at this time the Ring of Fire and the chromite deposits up there, and we’re already having initial discussions with First Nations and companies involved as to how we can develop the workers that will make that possible and help the local communities benefit.
By 2020, 70% of jobs will require a post-secondary education. We also know that an estimated 40% of high school students do not go on to post-secondary education. It is estimated that 82% of aboriginal students do not go on to post-secondary education in Ontario. The aboriginal leaders recognize the importance of education to their children’s future. They need the support of the province and the college to overcome barriers to learning.
If you’ve read the report from Dr. Rick Miner titled People Without Jobs; Jobs Without People, there’s going to be a real mismatch between the people out there and the jobs, which will result in jobs going begging for someone to fill them while we have unskilled workers who just do not have the capabilities.
Ontario’s colleges recognize the fiscal challenges the government faces and we are doing our part to achieve savings. Each year, Confederation has reduced costs with such strategies as eliminating positions, establishing out-of-college partnerships in non-core work such as cafeteria, bookstore and cleaning, and participating in buying consortiums such as the Lakehead Purchasing Consortium, Ontario Education Collaborative Marketplace, and Ontario Buys.
Despite innovative partnerships, operational efficiency improvements and cost-cutting measures, each year Confederation College’s operating grants do not adequately fund our year-over-year increases to our full-time staff costs as mandated by our collective agreements and the recent enrolment growth of 22% over the past three years.
The ministry has recently announced that they will be discontinuing the recurring $12.9-million Ontario skills development flat rate or non-apprenticeship EI funding. For the upcoming 2011-12 fiscal year, this will result in a loss of operating grant of $894,600 for Confederation College, which will have to be found elsewhere, over and above the ongoing cost pressures. Some 40% of that grant goes to northern communities or northern colleges.
Investing in capital and equipment: College infrastructure needs to be reliable, safe, efficient and in compliance with Ontario’s building codes. Colleges are facing a significant deferred maintenance backlog. The estimated deferred maintenance backlog in the colleges is in the $550-million to $750-million range. The current level of annual provincial funding to the colleges is only $8.7 million. Confederation College has an estimated $18.4 million in deferred maintenance backlog. That is expected to grow to $19.9 million within the next two years.
Just as an indication, we get around $240,000 a year for maintenance, facility renewal, and we have a bridge on the property that is going to cost us $600,000 to repair. It’s rather hard to repair a bridge with $200,000, which they really don’t let you accumulate. We’ve also just found out that some of our pumps for the heating system, worth $400,000, have reached the end of their life. So these sorts of items, when they do crop up, just exceed the amount, and what you have to do is dip into operational funds, which hurts the academic side. It’s a no-win scenario for us.
A recent report of the Auditor General identified the deferred maintenance and recommended that the ministry work with colleges to tackle the deferred maintenance backlog. Colleges in Ontario are requesting $100 million for infrastructure renewal.
Credit transfer: Colleges believe that the recent credit transfer announcement is a good first step in ensuring that students can move from one institution to another, saving time and money for the system. Colleges have been advocating for a robust credit transfer system for several years, and we look forward to this system becoming operational as quickly as possible with MTCU support and backing. There must be strong pressure to change in order to overcome the status quo.
We’re very fortunate locally: We’ve had meetings with our university counterparts at a senior academic level, and they’ve talked about the need to move forward on this. The president of the local university and the president of our college have gone down to meet with the deputy minister and talk about what we can do to move this forward in northern Ontario. We’re being positive, but there’s still so much more. The day-to-day challenges of getting students to move forward on articulation agreements between the two organizations comes down to almost an instructor-by-instructor level, and that’s difficult. We need something overriding, something general.
Thank you very much for your attention and the opportunity to present.
The Chair (Mr. Pat Hoy): Thank you. We’ll go to the government and Ms. Pendergast.
Ms. Leeanna Pendergast: Thank you, Bob, for your presentation, and thank you for being here today. We’ve heard from colleges and from student alliances throughout the province so far; however, you bring a very unique perspective today that’s interesting and fascinating and, of course, something that we need to hear.
I’m going to work from the back forward, if that’s okay.
Mr. Bob Backstrom: Sure.
Ms. Leeanna Pendergast: That’s how I read a book, too. I always taught my students in high school as an English teacher to go to the end, start with the bottom line and then move backwards.
The credit transfer recognition, yes, the government is looking at that and has made an announcement. Do you see yourself playing a role in that or a part in the discussions? Where are you at now as a college on that?
Mr. Bob Backstrom: We’re hopeful that, because of the fact that we went down and talked about this before the announcement, some of the money they’ve announced will help. We wanted to do something in northern Ontario to help the colleges and the universities get together and develop a common approach across northern Ontario. We have actually asked for money to make that happen, and we’re hopeful that this money is part of that answer.
Ms. Leeanna Pendergast: Specifically for northern Ontario?
Mr. Bob Backstrom: We’re hoping there’s something in there that’s earmarked because we were front and centre. Apparently the Toronto area has approached with a similar request.
Ms. Leeanna Pendergast: Okay. We’ve heard the reference to Dr. Miner’s report, Jobs Without People. I’m from the southwest, in Kitchener–Waterloo. In Waterloo, we have a lot of jobs without people, so it is a concern.
I’m moving to the front of the report now, to the operating funding. I think you articulated quite nicely your fiscal challenges; for example, a bridge and pipes. You have unique challenges with eight campuses and 40 communities and reserves—is that right?
Mr. Bob Backstrom: Yes. If you think about it, most colleges, especially in southern Ontario, have their large main campus, or they have large centres of population. Our forte is to get out there and serve the small communities, and some of that we actually do through distance education. We can’t put infrastructure in every site, but what we can do is have one instructor in Sioux Lookout speaking through videoconferencing to 25 students across the north, and it works.
Ms. Leeanna Pendergast: It’s almost the opposite of what we do in my riding at Conestoga College, where we just focus on that one campus and building that campus.
I’m back to the beginning, where we began at your unique perspective: the under-represented groups that you talk about at the beginning. Can you tell us more about that? We’ve heard specifically from colleges and student alliances the request not only for upfront access grants but for support for staff and teachers. I’m looking through your under-represented groups; when you talk about the demographic of your students, then that would segue into the demographic that you would need for the training for support for staff, as well. Can you talk more about that in terms of the under-represented groups, please?
Mr. Bob Backstrom: We are in an area where I think you’re almost—we had the baby boom in the rest of Ontario, but the aboriginal community had their baby boom later. A high percentage of their population is under 25, and they’re looking—you know, when we had the baby boom, we built colleges and universities across Ontario. Now they’re coming in a little late, and they’re having to live within the existing structure. For some place like Thunder Bay, where they make up a high proportion—over 20% that were identified; I’d say 30% more likely—they’re coming in, and they’re wanting to change.
Their elders see this as their opportunity to move their children forward and get out of that circle they’re in right now. So they are really pushing it, and they want their children to come to school. They’re no different than anybody else in that regard. Everybody wants their kids to do the best they can. They feel it’s almost a social requirement to make a difference, so they’re doing that; they’re coming in.
The trouble with that is, when you get a student out of a typical high school in southern Ontario—well, one of our high schools, let’s say—they’re coming in with a certain background knowledge, a certain set of skills and time management and everything else. A lot of the aboriginal students don’t come in with that, and they have to learn in less-than-optimal circumstances in their high school environment, so they may not come in as well-qualified. It’s not that they don’t have the skills and the ability; it’s just that circumstances conspire against them, so they’re coming in and need more upgrading, more literacy or numeracy support, so we have to help them in that regard. A lot of them are coming from communities in northern Ontario, out of Thunder Bay, and it’s a culture shock to come here. We have to work with their elders to help them through that. We have to make sure the support is there in counselling and their traditional culture. All that is happening.
Everything you see with a normal student is multiplied, and the support in student services, with counsellors, upgrading and all the rest and teachers spending more time, is there. Now, it’s very rewarding to work with these people, their elders and their own support group, but it is challenging to do it on the budget we have for a typical student.
Ms. Leeanna Pendergast: That’s very helpful. Thank you, Bob, for what you do on behalf of Confederation College.
Mr. Bob Backstrom: Thank you very much.
The Chair (Mr. Pat Hoy): Thank you for the presentation.
Our next group has not arrived yet and we’re a bit ahead of schedule on the clock, so we’ll recess until they come or lunch, whichever should come first.
The committee recessed from 1111 to 1122.
CANADIAN DIABETES ASSOCIATION
The Chair (Mr. Pat Hoy): The Standing Committee on Finance and Economic Affairs will come to order once again. I call on the Canadian Diabetes Association to come forward.
Ms. Suzanne Sterling: Which one of these is the hot seat?
The Chair (Mr. Pat Hoy): Anywhere at all. Good morning. You have 10 minutes for your presentation. There could be up to five minutes of questioning. The questioning this time will come from the official opposition. I just ask you to state your name for our recording Hansard, and you can begin.
Ms. Suzanne Sterling: My name is Suzanne Sterling, and I’m the regional director for northwestern Ontario for the Canadian Diabetes Association. Good morning, and thank you for the opportunity to speak to you today.
Last September, the Canadian Diabetes Association released the Ontario diabetes cost model. That outlined the current and projected prevalence rates for diabetes and the financial costs of diabetes in Ontario. The findings of this model are shocking. There are approximately 1.2 million people in Ontario who have been diagnosed with diabetes. By 2020, we expect two million Ontarians to be diagnosed with the disease. This represents nearly 12% of the population and is a 63% increase from where we are right now.
A further 2.4 million Ontarians live with pre-diabetes. That’s a condition where your blood glucose level is a little bit higher than normal, but not quite high enough to be diagnosed with diabetes. It’s estimated that 50% of those folks will go on to develop type 2 diabetes. By 2020, we estimate that nearly 27% of the population of Ontario will be living with diabetes or pre-diabetes.
A recent report by the Centers for Disease Control estimated that one in three people in the US will be living with diabetes by 2050. Those numbers, we expect, are similar for Canada.
The numbers are staggering. The economic impact of diabetes on the Ontario health system and our economy is equally as staggering. Today, the cost of diabetes in Ontario is $4.9 billion. If no progress is made to curb these costs, the total will rise to $7 billion by 2020, and if, as projected by the Centers for Disease Control in the US, Canada were to have one in three living with diabetes by the year 2050, the cost associated with diabetes in Canada would be $54 billion annually.
It’s especially important to know that the pre-diabetes numbers are not mixed in with those. Those are strictly diabetes. One of our health care professionals in Thunder Bay describes pre-diabetes as having one foot in the door of diabetes and still being able to pull it back, so that’s why it’s so important to deal with the folks with pre-diabetes as well: There’s an opportunity to stop that.
It is clear that we have a diabetes epidemic in Ontario, and it’s getting worse. This epidemic poses not only a significant threat to millions of Canadians, but also threatens the sustainability of the health care system and our future economic prosperity. Our recommendations today are not just aimed at improving the health of Ontarians, but also the Ontario economy.
The Ontario Diabetes Cost Model shows that 80% of the diabetes-related costs are due to treating the complications associated with diabetes and not the treatment of diabetes itself. These serious and life-threatening complications include adult blindness, kidney failure, heart attack, stroke and limb amputation. Diabetes complications take a serious toll and impose a tremendous burden on those living with diabetes, their families and the health care system.
Canada has the third-highest mortality rate due to diabetes among its peer countries: 6,000 Canadians die each month from diabetes or diabetes-related complications. To give you a little bit of perspective, that’s equivalent to the entire population of Sault Ste. Marie, Ontario, dying each year. If we are to address the economic impact and the burden of diabetes, we need to focus on keeping those living with diabetes healthy so that they can at least delay or prevent the onset of complications.
The brief that you’ve got, our brief to the committee, contains three recommendations. First, we need to refocus the Ontario diabetes strategy, with an emphasis on secondary prevention of diabetes complications. Second, we need to eliminate the gap in access to medications and supplies needed by people living with diabetes to self-manage their disease. Third, we need increased financial assistance and support for people living with diabetes so that they can afford to comply with the prescribed treatment therapies. Our brief to the committee expands on these recommendations. For the remainder of today’s presentation, I’ll focus my remarks on the last recommendation: increase the financial support for people living with diabetes.
The greatest challenge for people living with diabetes is the affordability of medications and devices that they need to effectively self-manage their disease. Nearly 60% of Ontarians with diabetes have indicated that they simply cannot afford to manage their diabetes. People with diabetes face three-times-higher out-of-pocket health care costs than the average Canadian. The average out-of-pocket cost for somebody living with diabetes is about $2,400, so it’s another $200 a month over and above what they need just to live.
While we commend the government for including people living with diabetes under the newly revised special diet allowance program, it does not include the folks with pre-diabetes. That’s important because we know pre-diabetes can be caught if they can manage their health. Some 50% of the people with pre-diabetes generally go on to develop type 2. We encourage the government to expand the criteria for this program and to extend the special diet allowance program to people living with pre-diabetes.
While Ontario has provided some newer medications in recent years, significant gaps remain. Ontario needs to close the gaps to ensure that all Ontarians living with diabetes have fair and equitable access to the medications, devices and supplies that they need to live effectively with diabetes. A program needs to be established to help people with diabetes who do not have access to the Ontario drug benefit program or third party health care coverage. At present, these individuals pay thousands of dollars out-of-pocket for prescription medications and supplies that they need simply to live. Coverage of the insulin pumps and supplies program needs to be expanded to include individuals living with type 2 diabetes who are on insulin. The program also needs to include coverage for continuous glucose monitors. That’s something that also goes in under the skin and will basically work in conjunction with an insulin pump to make sure that the blood glucose levels are kept in even closer check.
Given our limited resources, we need to target our diabetes programs and services to get the best return on our investment. For diabetes, the focus needs to be on helping those living with diabetes prevent or delay the complications associated with the disease. That is where our best return in terms of costs to the health care system, the overall economy and, most importantly, the health of Ontarians will be.
The Chair (Mr. Pat Hoy): Thank you. The questioning will go to the official opposition and Mr. Hillier.
Mr. Randy Hillier: Thank you for coming here today.
Going through your presentation and listening to what you had to say—it’s all geared toward people who have diabetes or who have been diagnosed with diabetes. We all know that if we talk to any family physician in the province, they are all telling us the same thing: that diabetes is the looming health care catastrophe that’s in front of us. But we also know that diabetes is often preventable. If one engages in a healthy, physically active lifestyle, the probability of having diabetes is greatly diminished.
I’m just wondering; I didn’t see anything in your recommendations about how we can prevent diabetes from coming along. Do you see any impediments that the government has put in place or any impediments in society that you believe should be removed to help people engage in a healthy, physically active lifestyle?
Ms. Suzanne Sterling: If you take a look at the brief on page 3, under recommendation number 1, our recommendation there is a broad-based healthy weights strategy and the population at risk for diabetes strategy. Those are two areas of focus for primary prevention.
Right now, what’s costing the health care economy the most are the secondary complications. Say if we provide an insulin pump so somebody can keep their blood glucose levels in check, it’s roughly a $6,000 to $7,000 outlay of cash immediately, but it’s a lot cheaper than a $75,000 amputation.
Mr. Randy Hillier: Absolutely. I’m looking back as a father and as somebody who has had four children go through our public education system. I see a fear in the diminishing of physical activities in our schools. Of course, we all know the broader, overarching problems of a stationary lifestyle, but I don’t see our schools doing much to encourage that physical activity—actually doing much to reduce physical activity.
What I was looking at were specific items. You were talking about a broad-based strategy, but there are no specific targets on how to achieve that. Do you have any recommendations on how we’re actually going to encourage people and incent people to be more physically active? Prevention is the key to this. Everything else is a band-aid afterwards.
Ms. Suzanne Sterling: In some cases, yes. Our biggest focus is on secondary prevention of complications. At a local level, we do things like being part of the Healthy Ontario group—because there are a number of different organizations all working on prevention.
As an association, our primary focus and our primary responsibility is for those dealing with diabetes. We certainly work in partnership, but as far as working under the Ontario diabetes strategy and what’s best for people with diabetes in Ontario, it’s focusing on the secondary prevention, because that’s where we see the biggest return on investment right now.
Mr. Randy Hillier: Thank you very much.
The Chair (Mr. Pat Hoy): Thank you for your presentation.
We are now recessed until 1 o’clock.
The committee recessed from 1135 to 1301.
CANADIAN HEARING SOCIETY, THUNDER BAY REGION
The Chair (Mr. Pat Hoy): The Standing Committee on Finance and Economic Affairs will now come to order. Our first presentation of the afternoon is the Canadian Hearing Society, Thunder Bay region. If you could come forward, please.
Good afternoon. You have 10 minutes for your presentation. There may be up to five minutes of questioning following that. I just ask you to state your names for the purposes of our recording Hansard.
Ms. Nancy Frost: Good afternoon. My name is Nancy Frost. I am the regional director of the Thunder Bay region of the Canadian Hearing Society, a non-profit agency that delivers services to two very distinct and separate groups, that being the culturally deaf, of whom I did have a representative who was going to attend but unfortunately is sick today. But I am fortunate to have with me Sharon Bjorklund, who represents our consumers who have various degrees of hearing loss, and for her access is reading a verbatim captioning of the spoken word, so you will see that I’m going to be looking to make sure that the captioning is keeping up with what is being said.
We are pleased to be here to advise the committee of the realities experienced by our consumer groups and to recommend strategic investments that will realize cost savings to the government, maximize value for taxpayer dollars and create a province that is fully accessible to our consumer groups and in which all citizens have equal opportunity, an ideal, although supported by laws, that is unfortunately not a reality to many.
Too often our consumers experience inappropriate assessments, misdiagnoses, improper institutionalizations, marginalization, victimization, unemployment, underemployment, denial of opportunities and refused access and accommodations, all of which result in costly errors and great cost to individuals, government and society as a whole.
The stories of our consumers and their situations are abundant and heartbreaking. For example:
—children developing severe or no language and learning delays and behavioural problems due to a lack of appropriate and accessible language, educational and mental health counselling services;
—adults with hearing loss losing their jobs, being unable to find other unemployment, becoming depressed and anxious and increasingly isolated from friends and families and having thoughts of suicide, with no help available as their communication access needs are deemed to be too costly and time- and labour-intensive;
—culturally deaf individuals being misdiagnosed, denied opportunities and equitable participation due to a lack of understanding of service providers as to their legal obligation, or their unwillingness to provide signed spoken-language interpretation services, or, in the case of those who are willing, not being able to do so due to the limited supply of qualified interpreters.
As a specialized service able to meet the linguistic, cultural and communication needs of our consumer groups, the Canadian Hearing Society is an excellent service option for our consumers and an excellent model as to what accessible service provision should look like. Our services do make a difference to our consumers, both directly and indirectly. Lives are changed and sometimes saved through the work we do.
What is required to continue and enhance our work and support the realization of a fully inclusive and accessible society is further investments by the government. In particular, and specific to our service delivery, as explained in greater detail in our corporate submission which you have, we ask for:
—$4.3 million to expand our mental health program to ensure appropriate assessments and diagnoses and prevent improper institutionalizations in prisons and psychiatric wards;
—$2 million to expand our staff resources and cover communication access costs, such as interpretation and captioning, specific to our diversion service in the justice system, to facilitate proper identification and prevent wrongful confinement and conviction;
—$2.6 million in additional employment services funding to enhance existing services and to add said service to regions such as ours where there are services not currently offered but yet they have high demand.
As an aside, in all of northwestern Ontario we have one full-time mental health counsellor and we have no employment counsellors.
The cost-benefit of these investments is huge. By providing culturally affirmative and linguistically accessible services such as our mental health counselling and employment services, the lives of 23% of the population that experience some degree of hearing loss, along with culturally deaf citizens, will be immeasurably improved. Institutionalization and incarceration, at great cost to the government and human life, will be avoided. Citizens will be fully aware and capable of managing their health care, and in their own home. Citizens will have equal opportunity to develop language and obtain an education and employment, all of which enhances one’s independence and contribution to the economy, thereby reducing the cost to the province.
Although currently the only open door for our consumers, we cannot, nor should we, do it alone. Our consumers deserve full accessibility; our consumers deserve options. We all can help in this regard. We, the Canadian Hearing Society, in partnership with our consumer groups, have the expertise to educate service providers as to how they can welcome, identify, provide and meet their varied accessibility accommodations.
The government can play a valuable role with providing dedicated accessibility funding to service providers, funding to support the development of more professional services such as sign language, spoken-language interpreters and real-time captionists, along with an expectation that service providers, actively and in partnership with consumers, plan and provide for full accessibility of their services and facilities.
Lastly, service providers can help by being open to, welcoming, respectful of and willing to identify and provide accessibility accommodations.
Too often our consumers are painted as the problem client or the problem patient. We must change this attitude. We must provide them with the same opportunities and treatment as all citizens deserve and as guaranteed under current legislation.
With government attention and funding, we can realize full accessibility for all Ontarians—a commitment unanimously supported by all parties—and, in the long run, realize cost savings to the government and maximize value for taxpayer dollars.
On behalf of the Canadian Hearing Society and our consumer groups, I thank you for this opportunity and now invite you to ask questions of myself and Sharon.
The Chair (Mr. Pat Hoy): Thank you. The questioning will go to Mr. Tabuns of the NDP.
Mr. Peter Tabuns: Good afternoon. Thank you very much for coming in. I hope that my words are translated on the captioning there as well.
First off, you’re suggesting concrete investments to make lives better for people. Is there an estimate of the costs to society now of the failure to provide those necessary services, in direct expenses and lost earning potential?
Ms. Nancy Frost: It’s an excellent question. I unfortunately don’t have specific dollar amounts, but if you consider every person improperly placed in psychiatric wards or in prisons, who is on social assistance, who is denied access to education or employment, it’s absolutely huge.
Mr. Peter Tabuns: You said that approximately 23% of the population has some kind of hearing deficit. What percentage of the population has no hearing whatsoever?
Ms. Nancy Frost: I don’t have those numbers, and when you ask no hearing, again, our consumers are very diverse. By no hearing, that can mean someone who’s culturally deaf, who is not a hearing person who can’t hear; they are a member of a cultural-linguistic minority group whose language is a signed language. Then there are individuals who really have profound hearing loss who are hearing people, such as Sharon.
Mr. Peter Tabuns: I understand that distinction, but of those who have I’ll just say severe hearing loss, what percentage of those people are unemployed or on social assistance?
Ms. Nancy Frost: If you look at the corporate, there are statistics in there, and they offer that 10% have significant hearing loss.
Mr. Peter Tabuns: Okay, 10% of the population as a whole.
Ms. Nancy Frost: Ten per cent of the population.
Mr. Peter Tabuns: Their source of income, then?
Ah, “Only 20.6% of deaf Canadians are fully employed,” which would mean that more than half are unemployed and receiving some sort of social assistance.
Ms. Nancy Frost: Correct.
Mr. Peter Tabuns: That’s a very large loss of earning potential and a very large number of people who are receiving some sort of social assistance or depending on their families.
Can you tell us how the investment that you’re asking be made in your services would affect the level of unemployment and the level of people on social assistance?
Ms. Nancy Frost: As I said, it’ll have a huge benefit by providing—just think of yourself. By not having the opportunity for an education, to work, to participate in your health care, it puts you in a volatile, marginalized situation, requiring the assistance of government and social assistance to survive, and being fully isolated from your community, your friends, your family. It’s devastating.
Mr. Peter Tabuns: I don’t have any further questions, Mr. Chair. Thank you very much for the presentation. I appreciated it a lot.
The Chair (Mr. Pat Hoy): Thank you for the presentation.
CITY OF KENORA
The Chair (Mr. Pat Hoy): Now I call on the city of Kenora to come forward, please. Welcome back. I think you know the process here, so if you’d just state your name again, you can begin.
Mr. David Canfield: Thank you, Mr. Chair. At least I could have changed my shirt or something, I guess, to have a different appearance. But thank you for the opportunity. I am Mayor David Canfield from the city of Kenora, filling in for myself this time.
The first statement here: The city of Kenora is here today, with many other municipalities—and I’m looking around and I’m wondering where they are. I think part of the problem is that if it wasn’t for NOMA, we wouldn’t even have known about this. When I was in politics before, I made presentations at different times to these committees. With technology today, I think with a simple push of a button on your computer, every municipality in northwestern Ontario could have known. Especially with this being an election year, and given the situation our economy is in, hopefully you’ll take that advice back so that everybody will have the opportunity to be here the next time.
We recognize there are many issues facing so many difficult stakeholders across the province, and the economic turmoil that the world has faced over the past few years has deeply affected the world in which we operate today. It is important, however, to recognize that northwestern Ontario was deeply impacted prior to the rest of the province, largely due to the crisis in the forest industry.
We brought with us today some key issues to speak on with the province as part of your pre-budget consultation process, and over the next few minutes I’ll briefly identify each issue and provide you with a recommendation for consideration in the provincial budget. We’re looking to the province to give serious consideration to each of these key issues and how you can work with the city of Kenora and northwestern Ontario municipalities—and all Ontario municipalities, as far as that goes—to strengthen the provincial-municipal partnership.
First, I’ll talk about roads and bridges and the deficit. Municipalities across the province have significant infrastructure deficits, one of the most significant portions of which relates to roads and bridges. The Auditor General’s report of 2009 noted that municipalities have responsibility for 80% of Ontario’s bridges, and Ontario municipalities own more infrastructure assets than any other order of government in the province. This report goes on to say that Ontario municipalities cannot make up the infrastructure deficit alone and must have long-term sustainable and predictable infrastructure funding programs from the federal and provincial governments. Kenora estimates its road and bridge infrastructure deficit alone is in excess of $4.5 million annually, and compounding. Kenora has 20 bridges, more than any community in northwestern Ontario, and impossible to maintain for the city of Kenora. In fact, we probably have more bridges than all the communities of northwestern Ontario put together.
The province must either reinstate a funding program towards major roads and bridges in municipalities to help offset the escalating infrastructure deficit, or take responsibility for these back. I would have to say that the bridges, especially for the city of Kenora and all of northwestern Ontario, have to be taken back by the government. It’s impossible; it will bankrupt us.
On economic development, Kenora’s economy has been deeply affected by the crisis in the forest industry. It’s been estimated that the impact to the Kenora economy related to just the Abitibi mill alone, which closed in 2005, is over $61 million. With a significant downturn in the forest industry sector, the tourist industry has assumed a greater role in Kenora’s local economy. Unfortunately, visitors from the US have decreased as a result of the strong Canadian dollar and of course the economic turmoil in the United States.
Tourism alone is not enough to account for the losses associated with the recent crisis in the forest industry. Kenora must continue to diversify its economy by attracting new business development. Municipalities in the north need a commitment for sustainable capital funding programs intended to stimulate economic development in the north.
In the forest industry, the city of Kenora is very supportive of the position and the work done by the Ontario Forest Industries Association. Key messages from the OFA are:
—protection of a minimum 26 million cubic metres in fibre for industrial use;
—commitment for socio-economic assessments prior to passing or changing legislation that could impact the forest sector, particularly with regard to endangered species—and I can’t emphasize that strongly enough, ladies and gentlemen;
—maintaining the competitive restoration measures, including road maintenance and construction funding, forest resource inventory funding, wood promotion funding, forest sector prosperity fund, the loan guarantee program and the northern pulp and paper electricity transition program;
—maintaining relief on stumpage dues for an additional three years while revisiting the rate structure on a permanent basis;
—amending the Ministry of the Environment approval process to fast-track low-risk projects. For the Kenora area forestry industry in particular, it is critical that the province implement a plan that will ensure the timely flow of fibre to the local mills, specifically with regard to harvesting in the Whiskey Jack and the Kenora forests;
—providing the required support to resolve the Grassy Narrows situation to ensure a secure, uninterrupted wood supply based on work done by Justice Iacobucci with Grassy Narrows First Nations. A local company, folks, has waited for eight years for a wood supply in Kenora; waiting eight years, the province of Ontario is not open for business.
The Kenora OMPF funding and the RSCM: Kenora has been unfairly penalized by the application of the rural and small communities measures with regard to the Ontario municipal partnership fund. The RSCM is a formula based on statistical information provided by Stats Canada. Most municipalities in the north are deemed to be too small to be statistically important and are not tracked by Stats Canada. For these municipalities, the RSCM assigned by the province is 100%, entitling them to 100% of various OMPF funding components.
Unfortunately for Kenora, we’re just large enough to be deemed interesting by Stats Canada. The end result for 2011 is that our annual funding entitlement under the OMPF program is about $2.8 million lower than it would be if entitlement were at 100%, a significant loss for a municipality so deeply affected by changes in the forest industry. Kenora has an RSCM currently at 51.4% and is the only municipality in the Kenora district with an RSCM of less than 100%. This makes absolutely no sense. But I will tell you, if the policies stay the same and our population keeps declining the way it has in the last four years, we’ll be under the 10,000 pretty soon.
The twinning of Highway 17: On May 15, 2009, Prime Minister Stephen Harper and Premier Dalton McGuinty announced the first stage of twinning Highway 17 commencing at the Manitoba border. Tourism will be a growth area for the future, and the twinning of the highway will make a real difference in providing access to northern Ontario as well as providing additional revenue to the city and to the province. We would like to urge the province to keep this important expansion moving forward to full completion as quickly as possible. A twinned highway will provide us with a powerful underpinning for our future growth, but it must happen sooner rather than later.
Let me tell you, a twinned highway from Kenora will go from Kenora basically to Banff. Spending the last couple of years in Manitoba and Saskatchewan, there’s a lot of money out there. That’s our future for our economy as far as tourism goes. The simple fact is the Americans aren’t coming the way they did before, and we have to start drawing people in from our own country. That’s huge revenue for the province of Ontario and a good way of rebuilding our economy.
The next thing I want to talk about is the drinking water quality management system. The tradition of the municipal drinking water licensing program represents a major change of focus in the management of the municipal drinking water system for most municipalities. The biggest challenge presented by the DWQMS is a requirement for infrastructure maintenance, rehabilitation and renewal. The expectation is that this requirement will be maintained on a user-fee basis, and the end user will bear the cost. Unfortunately, the additional burden may be more than people are willing to accept. It is critical that a committed, ongoing infrastructure funding program for water and sewer operations be established and made available to municipalities to ensure the ongoing successful implementation of these standards.
Land ambulance funding: Costs related to land ambulances were downloaded to municipalities in 1988 as part of the local service realignment. At that time, the province committed to revenue neutrality related to LSR and the community reinvestment fund, funding programs introduced to reconcile these costs and provide offset funding. When the CRF was replaced by the OMPF funding in 2005, land ambulance was removed from the funding calculation. The provincial-municipal fiscal service delivery review did not resolve the issue, and municipalities continue to bear costs related to this program. The land ambulance program delivery should be taken back directly by the province and, at a minimum, appropriate provincial funding must be established to offset the significant and escalating costs for program delivery.
The rent-scale issue: Since 1998 and the transfer of social housing to the property tax roll, taxpayers across the province have been subsidizing Ontario Works and the ODSP with social housing dollars. Under the provincial rules, tenants receiving OW and ODSP pay artificially low social housing rents, so property taxpayers end up subsidizing social assistance dollars with 100% social housing dollars, resulting in the province saving between 80% and 90% of related costs. This is known as the rent-scale issue. For example, in 2010, for a family of three living with a market rent of $900 per month, an additional $674 is paid for through the property tax roll if they reside in social housing as opposed to a private residence. The province should immediately raise the OW and ODSP rent scale for all social housing tenants to the maximum shelter amount for private housing.
In conclusion, we would like to thank you for your time and for coming to the northwest to allow the opportunity to participate in the pre-budget consultations. Northwestern Ontario needs your help. You are in a position to make a real difference to us here in northwestern Ontario. We look forward to your serious consideration of these issues and those that so many others have brought here today. Most importantly, we look towards partnerships in implementing the many recommendations contained within our presentation in the coming provincial budget.
I just want to give you some quick numbers here. I cut out part of my presentation; I think I’m going long in time.
Some of our numbers that we’ve lost with the closure of three mills in Kenora in and around 2005 and up to now include about 909 direct jobs. When I went over these numbers that were put together by people, these numbers are a little low. Working in the industry, I realize that they are not quite up to speed. They are not exaggerated, let me tell you.
The total employment loss with the indirect and induced job losses is 2,682 jobs, and the annual compensation in the loss of employment is $122.2 million. For a community of less than 15,000 people now, that’s a lot of money. So when we make these presentations, we’re very serious. There have to be some serious changes, and we hope that you’ll take these seriously and realize that if northwestern Ontario is to continue to exist, it’s not going to do it on its own; it is going to need some help. We can reinvent ourselves, and we are doing that in Kenora, but we need help from the government in order to sustain ourselves through this transition period. We don’t need the government to make the changes for us, but we need them to set up an environment and policies that are conducive to making change and bringing business into Kenora.
Let me tell you, living 30 miles from the Manitoba border, we’re looking at Manitoba businesses to build in Kenora, and in a lot of cases they don’t like what they see, but they love Kenora.
The Chair (Mr. Pat Hoy): Thank you. We’ll go to Mr. Delaney.
Mr. Bob Delaney: Thank you very much, Mayor Canfield. First of all, it’s a superb brief that you have accompanying it, and there’s nothing that’s unclear about your priorities and the way that you’ve organized your information.
I’m going to try, in our very brief five minutes, to explore three topics with three what I hope are focused questions, and let’s see if we can get through them.
The first one is tourism. Could you tell me what geographic markets, other than the traditional US, Manitoba and Saskatchewan markets, Kenora has considered for a focused marketing campaign to build tourism among new clients who haven’t yet experienced northwest Ontario?
Mr. David Canfield: Well, the sky’s the limit. We’ve had tourists from Japan; we’ve had tourists from probably almost every country around the world.
As far as marketing to these countries, it’s financially impossible for a city of our size. We’re much better to market to the local area. I mean, Minneapolis, Chicago, Wisconsin—the Midwest has been a huge market, as is Winnipeg. We’re basically cottage country for Winnipeggers. I see, and I think all of us see, the changes in western Canada, especially in Manitoba, Saskatchewan and Alberta, the opportunities that are there. The reality is, we’re closer to Banff than we are to Toronto, so where are we going to draw our tourists from? We’re probably going to draw them all the way from Banff. We’re the most beautiful destination between Niagara Falls and Banff. We come in third; I believe we’re first. We’ll argue that one on another day. But it’s better for us to look at those areas for drawing our tourism. We’d love to draw them from abroad, but we just don’t have the resources to do that. But if the province is willing to step forward, we would be willing to be a partner.
Mr. Bob Delaney: Fair enough. That’s what I was asking.
Let’s explore forestry a little bit. Would you describe the type of research Kenora and the surrounding municipalities have undertaken into the type of products and services, either existing or just emerging into the marketplace, or into non-traditional markets, that might be addressed by the forest resources of the northwest?
Mr. David Canfield: Absolutely. When I was mayor before, one of the things I had was a value-added committee. We realized that the forest industry was going to change in this country and in this province. I don’t think anybody is going to be building any more paper mills. The ones that are here hopefully will be sustainable and will continue to operate. We’re looking at reinventing ourselves in the forest industry.
We’re looking at basically a value-added cluster on one of the old sites, the old Abitibi mill site that was bulldozed. It’s a huge area. It’s an industrial park within itself. Hopefully with some investors from Manitoba, if we can convince them, you will probably see in the next four years at least half a dozen businesses.
Basically, what I mean by a “cluster” is, if we had one dimensional sawmill on that property, that would feed—and each business would feed the other businesses. All the residuals, the waste, would go into creating the energy that’s needed, both electrical and thermal, and there will be—my concept—house-in-a-box, premanufactured homes on this site; a pole peeling plant; probably some of the clean residuals, a pellet plant for biofuels. There will be a veneer plant. There will be, hopefully, at the end of the day, windows and doors. The sky’s the limit. We’re looking at every opportunity there is, but what we’re looking at is a cluster and turning that cluster into something that’s going to feed and basically sell our wares in this area.
Mr. Bob Delaney: Let’s see if we can get in the last question before we run out of time.
Priorities: From your perspective, both in politics and in industry, what existing program that serves the northwest right now should be the top priority for Ontario to either change or reform?
Mr. David Canfield: That’s a tough one. If it comes to funding, when I look at the OMPF funding, as I said, we’re basically owed $2.8 million. I’m not going to quit that, so get used to it. I’ll be back year after year if necessary until it’s righted.
I think what we need in northwestern Ontario and Kenora is a climate for business. I think we have to have a different relationship with northwestern Ontario municipalities and the government. It doesn’t matter who the government is. We have to work with whoever is in power, in a lot closer relationship, on having made-in-northwestern-Ontario solutions to rebuild our economy, because made-in-Toronto solutions don’t work. The proof is in the pudding, as I said this morning.
Mr. Bob Delaney: I’m from Mississauga, and we can tell you that from where we are, made-in-Toronto solutions don’t work.
I want to thank you very much for your time and for coming here.
The Chair (Mr. Pat Hoy): Thank you for your presentation.
POVERTY FREE THUNDER BAY
The Chair (Mr. Pat Hoy): Now I call on Poverty Free Thunder Bay to come forward, please. Good afternoon. You have 10 minutes for your presentation. There could be up to five minutes of questioning. In this round, it will go to the official opposition. I’d just ask you to identify yourselves for our Hansard recording.
Mr. Larry Brigham: Thank you, Mr. Hoy, and members of this committee of the Legislature. Welcome to northwestern Ontario and to Thunder Bay. We’re glad you’re here. My name is Larry Brigham, and I’m going to bring some general comments on huge monetary savings, increasing the quality of life for all and increasing the amount of money in the hands of those in need. That’s what my job is going to be. Terri-Lynne Carter is going to give you a perspective from an ODSP point of view, and Cindy Crowe will give you an aboriginal perspective.
First, Poverty Free Thunder Bay is a group of citizens and organizations that want all citizens of our community to enjoy an adequate, livable income. Poverty is not a partisan issue, and we congratulate all parties working together to establish the poverty reduction strategy for Ontario to eliminate hunger and provide affordable housing, adequate daycare, social justice, easy access to education and community support.
The cost of poverty—you’ve probably seen it before—is outlined in the Ontario Association of Food Banks’ November 2008 report, an analysis of the cost of poverty in this province. It’s a very important paper, and it shows that federal and provincial governments are losing $10.4 billion to $13.1 billion a year due to poverty, or between 10.8% and 17% of the provincial budget. Poverty costs every household in Ontario, in terms of real amounts of money, from $2,299 to $2,895 a year.
A few northern statistics for your information: 47% of the people using food banks in northwestern Ontario are under the age of 18; that’s higher than the national average of 33%. In the last three years, the use of food banks has increased 89% in northwestern Ontario. And 17,000 people or 15% of Thunder Bay residents live below the LICO rate, the low-income cut-off, spending more than 55% of their income on food, clothing and shelter. In Ontario, it’s 1.8 million people or 14% below the LICO.
In From the Margins is a recent report put out at the federal level by Art Eggleton and Hugh Segal. It’s a bold, well-thought-through plan that would address the issues of poverty and, at the same time, save Canada and the provinces billions of dollars. They are suggesting a guaranteed livable income for all Canadians administered through the Income Tax Act. This would put more money in the hands of the poor, and it would avoid huge, cumbersome bureaucratic mechanisms. When people are trusted to make good decisions, they generally make the best decisions for themselves. If they make a false claim, that could be handled through the Income Tax Act. It’s very clear; there’s accountability there.
Sadly, I want to tell you that I personally attended the Croll commission hearings back in 1969. Senator Croll came. It was in St. Lawrence Market in Toronto, and tremendous recommendations came out of that. He tried to get the guaranteed livable income implemented. That did not occur. He offered these sweeping changes. They would have been as sweeping as medicare was at the time medicare came to Canada. It would have saved billions of dollars over a period of time, but that was not done.
Now we have another opportunity to look at this. Many reports have followed which have suggested band-aid solutions. I remember Judge Thomson’s report. Some of you may remember that. Then there were Ed Broadbent’s recommendations that were supposed to have no child poverty in this country by 2000. Those are just band-aid solutions. Now Eggleton and Segal, after touring the country, are suggesting the Croll formula once more. They’ve listened, they’ve heard, and they see that there could be excessive savings here, an accessible living income for all Canadians.
I can’t say it more clearly than Hugh Segal states in the two attached documents I’ve given you from the Globe and Mail, so I’ll let you look at those. There is a suggestion that a green paper will be coming forward as the federal-provincial agreements are renegotiated around the social programs in three years’ time. Segal has said that if citizens were guaranteed living allowances for themselves and their families through the income tax system—and I’m not sure I’ve got these right, but it seems big to me—the cost to people in Canada would be $60 billion. That’s all to give everybody a livable income. At the same time, the Canadian people would save $160 billion. That’s a lot of money: $100 billion to be saved across Canada. This report that was brought forward has been approved by the Senate.
New research is also available to show that if poverty is dealt with effectively, everyone will have a better quality of life. The research is in from 23 well-developed countries. This document is found in a book called The Spirit Level, by two British epidemiologists, Pickett and Wilkinson. The book examines inequality of income distribution in the upper 20% and the lower 20% of these 23 countries, including Canada, and the spread of incomes. It’s compelling because all the positive social indicators in a society improve with the narrowing of this spread of incomes. We’ve seen a spreading of this spread of incomes, and we need to bring it down if we follow what they’re saying in this book. Sweden, Norway and Japan are good examples of countries that have narrow equity spread.
Here are a few things I’d like to encourage the committee to do:
—stay the course on the poverty reduction plan for right now and then be open to change;
—kick-start the economy with a security review, build guaranteed livable incomes for Ontarians and attach them to the Income Tax Act;
—develop a strategy and provide funding for disproportionately poor communities to effectively redress the structural and systemic poverty: communities with large aboriginal groups, single-parent groups and disabled people;
—provide increased affordable housing provision for those at risk: single parents, aboriginal and disabled people.
The Honourable Frances Lankin and Munir Sheikh, who are the two commissioners in the review of Ontario social assistance, could be encouraged to meet with the federal senators and review their findings. A thorough understanding of the research in Britain might be helpful. Canadians like incremental change, don’t we? And some sectors will strongly oppose a radical shift. However, as I said before, it was just such a radical shift that took place with the medicare system, which is respected in many parts of the world these days. A new social network of support with adequate living income will be less costly, and we’ll have more money in the hands of the people who need it. Other services are not going to be as badly affected as they are today. Health, corrections, education, policing: Those costs could come under better control if people had the money they needed in their hands.
Hopefully, these ideas will be considered because they are the right thing to do and because they will save taxpayers money. A sense of hope and opportunity for all citizens will be a cornerstone of a new Ontario social support fabric.
The Chair (Mr. Pat Hoy): We have about three minutes left.
Ms. Cindy Crowe: Remarks in Ojibway.
Standing Strong is my spiritual name and Caribou is my clan.
I’m an urban aboriginal person. As the elders like to say, I’m the urban Indian and they’re the bush Indians. I grew up in a home with two alcoholic parents. This was devastating, but it’s not uncommon for people who are even here in the city. It causes you to feel disconnected, or to have a feeling of not belonging.
You might have caught the story on Canada AM yesterday morning. There was a story about Attawapiskat. They were showing the family’s home and how it’s full of mould. A 2009 housing report for the Nishnawbe Aski Nation territory illustrated a housing backlog of 4,752 homes—this was in 2009. The projection for 2029 is a shortage of more than 12,000 homes. If you were to take care of the current housing backlog, you’re looking at $1.2 billion. If you looked at the projection for 2029, it’s more than $3 billion.
I have experienced poverty myself, along with my five children. We have been homeless and we have had to use food banks. It’s got to be the worst experience that a parent has to go through with their children. You don’t know what it’s like until you’ve actually experienced it. This trauma that my children and I experienced—it takes years of therapy to get over things like that.
One experience I remember of a local food bank here—the person was well-meaning, but she asked me why I ever let myself get to this extreme. I remember being so distraught when I left that I didn’t buckle my baby into her car seat, and she fell out when I turned the corner. That just goes to show you some of the experiences that we have, and these are real experiences.
A few statistics: I’m not going to do too many as we’re running out of time, but 39% of our aboriginal population has not completed high school, compared to the provincial aboriginal average of 30% and an overall Thunder Bay average of 25%; 33% of aboriginal men and 39% of aboriginal women 25 years and over had less than high school as their highest level of schooling; 41% of the aboriginal population in Thunder Bay lives in poverty—41%—compared to 27% elsewhere in the province; and approximately 25% of people in Canada suffer from mental illness. This statistic is much higher in the aboriginal population.
Again, speaking from personal experience, there are no services to access for anybody who has an emotional or mental illness. I suffered with it all of my life, and it wasn’t until I started achieving teachings through my culture that I was able to achieve balance, but you would not believe what I went through to get that. There were no treatment centres here to go to, there were no health centres to go to. I mean, we desperately need these services. There’s no welcoming centre for aboriginal people who are coming into the city, and we know we have more and more people migrating to Thunder Bay.
How much time do I have left?
The Chair (Mr. Pat Hoy): You’re two minutes over.
Ms. Cindy Crowe: Oh, I’m two minutes over? I’m sorry.
The Chair (Mr. Pat Hoy): So what I’m going to do is, I’ll ask the other individual to give some brief comments, and you’ll have to tell the others to practise before they come.
Ms. Terri-Lynne Carter: My story is not really unique: I’m on ODSP. I went to university. I come from a family where only one person worked at a time, so I had to put myself through university. I worked three jobs. And when I went off to university in southern Ontario I got very ill; I got Crohn’s disease. It was hard, because I had to apply for ODSP. It was a hard process, because the first time I went to apply for Ontario Works, I was turned down because I had $3,000 in the bank, so I had to apply again and I got it.
Living on Ontario Works is definitely hard. You get $540 and your rent is $600, and I lived in the cheapest area possible because I was a student. I tried to use a food bank, but I have a disease where you need specialized food. Most of the food that they give you at the food bank, I can’t eat. They didn’t give me enough money for rent but I couldn’t borrow money off my credit card, because that’s considered a cash advance—it’s like a loan—and my parents couldn’t give me money because then I’d have to declare it. So it’s very hard to live on this.
The system punishes people who want to be independent, productive members of society; those who don’t want a handout but need a hand up. You can’t save for the future. You can’t have relationships. You can’t have children, because you can’t pay for their expenses. It’s humiliating to fill out forms to receive the special diet allowance, and well-educated minds are not encouraged to contribute to society.
If I had sufficient money to live on, I could buy what I want instead of approaching the government, bowl in hand, saying, “Please, sir, can I have some more?” like a modern-day Oliver Twist.
The Chair (Mr. Pat Hoy): Thank you. We’ll go to questioning from the official opposition. Mr. Barrett.
Mr. Toby Barrett: Thank you, Chair. We’ve got a lot of ground to cover here.
I really appreciate the information from Hugh Segal and Mr. Croll. On the guaranteed annual income, I don’t think we’re there yet. I don’t think this government is there on that one, although as you’ve indicated, there’s—what?—$160 billion to play with.
Mr. Larry Brigham: Big money.
Mr. Toby Barrett: I hear what you’re saying as far as, obviously, a lot less bureaucracy and a lot less expense in that end of it, and eliminates the micromanagement that you would see through the Ontario disability support program. I think it is appropriate, given the times, to go back to ideas from the Depression, from the 1930s.
There’s this lack of trust, I suppose, and there’s this constant—every paycheque is monitored, and there’s recording and forms to fill out. I’m thinking more of, say, ODSP. We received a similar recommendation before this committee yesterday, in Windsor, to streamline the efforts with respect to monitoring, say, any employment income that people are able to add to government payments. Half of that gets yanked away. You can only have so much in the bank, which creates nothing for the future. So one proposal is that the government move to an annual review, based on the tax system. It would eliminate a lot of government jobs.
Any further thoughts on that?
Mr. Larry Brigham: I think the other thing it does is, if you see the scale there—it doesn’t show up too well on the documentation—it’s a graduated scale, which really encourages people to become more independent. The system right now does not do that. It does not encourage people. The system purports to be something that would try to get people off of welfare, but it really is not set up that way, whereas the system that Eggleton and Segal are suggesting—interesting; Liberal and PC—does that.
Mr. Toby Barrett: Just maybe to focus again on ODSP, there’s legislation that was put forward a year or so ago—I put it forward—to encourage more employment of recipients. I think only about 9% are working, and many people, like yourself, could be working more. Some of the hooks there: People would be allowed to keep the first $700 a month that they earn. They’d be allowed to keep more money in the bank: up to $12,000, and $20,000 for a family. Would that help out?
Ms. Terri-Lynne Carter: It would, but right now my problem is that I’m on Remicade, so my mum’s drug plan pays for that. If I go to work, I lose her drug plan.
Mr. Toby Barrett: Again, I think part of that is to eliminate some of these unfair practices, where you’re penalized for working, volunteering or helping out.
The last point: You mentioned Frances Lankin and Dr. Sheikh with a major review. I find this odd, because we just came out of the recommendations of the Social Assistance Review Advisory Council. They brought out their report in June. This committee, last year, formally made submissions, made recommendations to that review. Now we’ve got a review on top of a review, and it’s not going to come out until June 2012. What’s going on here? Did we get hoodwinked on this one?
Mr. Larry Brigham: There have been reports coming out for 40 years. They’re all patchwork, they’re all band-aid. They don’t deal with the real issue: having more confidence in people, giving them a right to make their own decisions, giving them the money to make their own decisions and helping them become independent. What we’re doing with our system right now is we’re increasing dependency and we’re not giving people enough money. The other way, we give them more money and we increase their independence. To me, having seen this back in 1970 and hearing it again, it’s refreshing, but it’s long overdue.
The Chair (Mr. Pat Hoy): Thank you for your presentation.
The Chair (Mr. Pat Hoy): Now I would ask Wesway to come forward, please. Good afternoon.
Ms. Carol Neff: Good afternoon.
The Chair (Mr. Pat Hoy): You have 10 minutes for your presentation. There could be up to five minutes of questioning following that. I’d ask you to identify yourself for our recording Hansard.
Ms. Carol Neff: Okay. My name is Carol Neff, and I just want to say many thanks for this opportunity. I believe you have a copy of my presentation.
What I wanted to tell you about a little bit was what Wesway does. We’re a local non-profit organization and we provide a flexible range of community-based respite care services for families who provide ongoing care for a family member who lives with them. The family member may be of any age and must have a disability or chronic health condition.
The ongoing care responsibilities for family members cause changes in the health status of the family caregivers. They frequently report high stress levels, exhaustion, depression, interpersonal conflict, loss of sleep and social isolation.
Respite provides families with short-term breaks. It’s a crucial support, enabling them to continue their role as caregivers. Our health system and our developmental services system would actually collapse if family caregivers didn’t make the sacrifice.
Wesway understands the difficult economic climate that we’re in right now, for sure. We also appreciate the impact on the provincial budget and the unique challenges the government faces, and as a not-for-profit organization, as a charity, we certainly understand restraint. But we also see community need and public policy opportunity. Government is very familiar with the challenges posed by the demographic shifts in health trends; namely, an aging population and a growing prevalence of chronic conditions and various disabilities.
The government also has demonstrated an understanding of the value and cost-efficiency of home and community-based support, particularly with the decision to maintain planned levels of funding in recent budgets, including the aging-at-home strategy when the economy was experiencing a severe downturn.
Respite helps reduce the need for more costly services, giving maximum benefit for public dollars invested. These challenging times require more than ever that funding for respite and other community services be preserved in the 2011 budget. In addition, we urge government to consider some strategic investments now to save money in the future.
There are some facts that I wanted to point out. First of all, nearly half of the people who are waiting for long-term-care beds don’t really need daily medical care. They could safely continue to live in the dignity of their own homes, if they had adequate community support services, at a much lower cost to the public. People end up in the emergency department or in hospital beds because the basic home and community care services they truly need are not available, and this alarming trend will be hugely exacerbated in the coming years with rapidly aging baby boomers, of which I am one.
Family caregivers provide about 80% of the care for seniors and people with disabilities. They are collapsing under the weight of their responsibilities, as they juggle careers and manage the care needs of aging parents. Some family caregivers are very elderly, with health issues of their own, and they steadfastly strive to continue to care for their frail spouses or their adult children with disabilities, yet community support services account for only about 1% of Ontario’s health care spending.
The province cannot afford to fund costly hospital stays as a solution; they don’t address the root of the problem. It’s absolutely imperative that we get upstream of the crisis by supporting individuals and their family caregivers in their own homes.
It’s crucial that we reform the focus of our health system toward prevention, allow more people to be supported at home, prevent family caregivers from burning out, avoid unnecessary hospitalizations and long-term care placements, and do so at a fraction of the cost. Investments in community support services free up hospital beds and unclog emergency rooms; they reduce the demand for chronic care beds, they shorten the wait-lists for long-term-care homes for those who truly do need that level of care, and they decrease long-stay hospitalizations. Costs are lower when care is provided in the community.
By addressing the true needs of seniors, the province can support them to continue living in dignity in their own home in the community for as long as possible, which is exactly where they want to be. This was the intent of the government’s aging-at-home strategy, and I believe it’s a brilliant tactical approach that must be upheld and reinforced and expanded.
I have two simple recommendations: One is to please sustain the aging-at-home strategy with base funding for the projects which have successfully proven their worth to the health system; and the second one is to build on that successful philosophy underlying the aging-at-home strategy to consider the needs of people under the age of 65 and their family caregivers. So we need a provincial strategy for adults with disabilities.
Investments made in the community now will strengthen families, maintain dignity and respect for frail seniors and people with disabilities, and will achieve clear cost savings in the long run. We must take action now to preserve the future of our health and community care system for our children, grandchildren and generations to come.
The Chair (Mr. Pat Hoy): Thank you. The questioning will go to Mr. Tabuns of the NDP.
Mr. Peter Tabuns: Thanks very much for that presentation. Thank you for coming in this afternoon. Of the clients you serve, what percentage are elderly couples where one person is looking after the other?
Ms. Carol Neff: The way we are funded, we actually serve different populations. If I look at the people we’re serving who are seniors, I would say probably at least half of them are elderly seniors caring for a spouse. The others would be adult children caring for their parents, by and large. So what we see quite often is a 92-year-old wife caring for her 94-year-old husband and really wanting to stay at home together. The 92-year-old wife may have her own health needs and need to attend her own medical appointments, but can’t leave her husband alone. Sometimes you end up having two crises supported because you don’t give that wife a break so that she can get out to attend her own therapy or whatever—those kinds of situations.
Mr. Peter Tabuns: Right.
Ms. Carol Neff: You’ll also see people who are in their 60s and 70s caring for their parents who are in their 90s, and again, they have health issues. On the flipside, we see parents who are in their 80s and 90s caring for their adult children. Caregiving has been a lifetime for them because their children have had a disability and continue to live at home with them. So there’s quite a number of caregiving scenarios.
Mr. Peter Tabuns: On average, how much respite care—and I’m sure it has to vary an awful lot—
Ms. Carol Neff: Sure.
Mr. Peter Tabuns: How many days per week or hours per week are you able, on average, to give to a household that is part of your operation?
Ms. Carol Neff: Typically, we would provide from maybe five to eight hours a week, on average, which isn’t a lot. Some families need more than that. Because we provide a flexible range of respite services, we can offer a weekend respite at one of our respite homes as well, so that would be a 48-hour block of time. People can mix and match how they use the service. Sometimes it’s a simple thing, like being able to get out to the drugstore to pick up your prescriptions, to be able to go and have a haircut. It’s some of those kinds of things. Or sometimes it’s a chance to be involved in the life of the community and sing in the church choir on a Thursday evening, or something like that. Those are the kinds of ways people use their respite. A lot of the seniors are using their respite in order to attend to their own medical needs.
Mr. Peter Tabuns: How did your agency come into existence?
Ms. Carol Neff: Actually, it’s interesting. We were probably one of the first respite care organizations in the province. Our history goes back to 1973. We originally began serving children with developmental disabilities. We actually came together—there was a group of people around someone’s kitchen table from a church group, Wesley United Church and Wayside United Church, so you can see where we got our name. We’re no longer affiliated with the church group, but we’ve grown and expanded beyond children with developmental disabilities to serve I guess what you would say are families who are caring for someone with an ongoing condition. We serve a lot of people who have Alzheimer’s disease now. That’s a really big area and a huge demand for our service.
Mr. Peter Tabuns: Okay. I don’t have any further questions. Thank you.
The Chair (Mr. Pat Hoy): Thank you for the presentation.
THUNDER BAY AND DISTRICT
The Chair (Mr. Pat Hoy): Now I’d ask the Thunder Bay and District Labour Council to come forward, please. Good afternoon.
Ms. Melanie Kelso: Good afternoon. I’m Melanie Kelso. I’m the president of the Thunder Bay and District Labour Council.
On behalf of the Thunder Bay and District Labour Council, we’d like to thank the Standing Committee on Finance and Economic Affairs for this opportunity to share our thoughts and concerns on the upcoming budget.
The Thunder Bay and District Labour Council has 10,000 members within Thunder Bay and district from a variety of unions that work in virtually every sector in our community. Given our size and the variety of our jobs and members, we’re aware of the changes of—I’m nervous. I’m really nervous.
The Chair (Mr. Pat Hoy): Don’t be nervous.
Mr. Peter Tabuns: We’re very friendly.
Ms. Melanie Kelso: I know you’re friendly.
Ms. Melanie Kelso: We’re all friendly.
Mr. Bob Delaney: Don’t believe him.
Ms. Melanie Kelso: You’re not friendly?
Mr. Bob Delaney: We are friendly.
Ms. Melanie Kelso: Oh, okay. There are a few main issues that I’d like to bring forward, and those are the economy and employment loss, poverty reduction, education and training, strikes, pensions, fairness and equity in public sector compensation, and health care.
The outlook for people in Thunder Bay entering 2011 remains highly uncertain, as across the country. Almost 1.5 million people still remain out of work; it’s still very high in Thunder Bay. We keep hearing that Canada has fared the recession better than other countries, but evidence suggests otherwise. There has been little improvement in overall labour market conditions. The pace of economic recovery has slowed. The good news for Ontario is that 75% of our jobs since the last recession have been recovered; the bad news in this is that employment is still 25% below the pre-recession level.
Many of the new jobs that have been created are termed “precarious”; that is, contract work, part-time or temporary employment. The single most significant change in employment since the recession has been an increase in temporary work. A family can’t pay their mortgage or even feed their family on jobs like this. We need more full-time, secure jobs.
Reforming our labour laws on union certification would increase—the collective bargaining of trade unions has been found to bring more job security, benefits, better working conditions and a higher level of income for Ontarians. If workers want to join a union, they should be able to do so without employer interference and without rigid bureaucratic hoops that are imposed by restrictive legislation.
Poverty reduction: We still have a very high poverty rate. I believe it’s still very high in Thunder Bay. I believe that a lot of the numbers are hidden. In 2008, child poverty was 15.2%; this was based on the low-income measures after tax. That demonstrates 412,000 children and youth under the age of 18 were living below the poverty line, despite the introduction of Ontario’s poverty reduction strategy. It’s still too early to assess the impact of this strategy. There are even more families that are struggling to make ends meet and falling into poverty.
For education and training: Ontario needs to renew its infrastructure for workplace-based literacy and language upgrading. The budget needs to increase the funding for the Second Career program.
Child care both creates jobs and facilitates employment and education through early learning programs. Funding is needed in this budget. In Thunder Bay, there is not a daycare that is open after 10 p.m. There are many people who still work shifts, and they have no place to put their children. Many parents are paying $40 to $60 per day per child. That’s $10,000 to $15,000 per year per child for daycare. That means if you’re in a minimum wage job, all your money goes for child care.
I also believe that business, government and labour should get together and talk about the problems for debate and research and advice on public policies and initiatives that might lead to improvements in interrelations and important social and economic developments. The province must establish a labour market partners forum with a broad range of labour market issues that can be addressed.
In the past several years in Ontario, there have been some long strikes. We have just had one strike that was over eight weeks at our medical school. A lot of the long strikes that have happened in Ontario in the past year haven’t been helped when there have been replacement workers that have been able to come in. BC and Quebec have anti-scab legislation. That has reduced lengthy work stoppages, and we believe that a change like that in Ontario would be beneficial if we can reinstate that kind of legislation.
For pensions: Unfortunately, a lot of pensions and severance, if a company goes bankrupt, aren’t secured, and that’s all gone. The Canadian Labour Congress, the OFL and the labour council are saying that what we should be doing is upping the old age security, the guaranteed income and the Canada pension plan, and we should be replacing this with—that should go from 25% to 50% of the pensionable earnings. This would involve a premium of about 3% for each employee and employer, phased-in over a seven-year period. The Canada pension plan is very secure, and it would benefit everyone.
But instead, as you know, the finance minister, Jim Flaherty, backtracked from his position earlier that he had taken about upping CPP and having people go into pooled registered pension plans. I believe that this is what people should be able to do not only because it is voluntary, but because it’s shown that our public retirement plans are much better. This should be given serious consideration and support by both the provinces and the federal government. Millions of workers across Thunder Bay, Ontario and Canada would benefit, in our view, and would be willing to pay more to receive the better pension that would make our pension 50% of our wages rather than 25%, the pension that we get now. Right now, if you’re collecting old-age, you’re living below the poverty level. This would have people living at the poverty level after the seven years of increase.
The Chair (Mr. Pat Hoy): You have about a minute left.
Ms. Melanie Kelso: Okay. I didn’t think I was that long.
With health care, I think what’s important to Ontario is what kind of reforms are necessary or not necessary, and we need adequate funding for our public health care. The cuts that are affecting our hospitals are affecting us personally, and to have more for-profit health care is not the way to go. We should be having OHIP still, not for-profit services.
Thank you very much.
The Chair (Mr. Pat Hoy): Thank you. The questioning will go to the government. Ms. Pendergast.
Ms. Leeanna Pendergast: Thank you, Melanie, for being here and for your presentation. Thank you for the work that you do on behalf of Thunder Bay and District Labour Council and your 10,000 members, did you say?
Ms. Melanie Kelso: Yes.
Ms. Leeanna Pendergast: That’s outstanding.
You brought up a lot of issues—there’s a lot of information there—and it’s difficult, not having had a chance to go through the information. But I just want to comment on a couple of things that you talked about.
Your first topic was the economy and employment loss. Is that right?
Ms. Melanie Kelso: Yes.
Ms. Leeanna Pendergast: Okay. I just want to say we understand that and hear you loud and clear. On the bus on the way to Windsor from London, I was on the phone with the president of my local union for a factory in my riding that has just declared receivership, so I have 350 people out of work this week. It’s an ongoing problem. The question, of course, is sustainability, and I think at the end of your presentation you talked about that in health care and the idea that we have to find something sustainable.
You talked about poverty reduction and the high numbers in Thunder Bay. Fascinating, your comments on child poverty. I didn’t catch the numbers or anything, but children and youth under 18?
Ms. Melanie Kelso: Yes, and I believe those are Canadian numbers. That’s from Statistics Canada in 2008: 1.6 million, or 12.5% of the people in Ontario, live in poverty. The child poverty rate was 15.2%, based on the low-income measures after tax.
Ms. Leeanna Pendergast: Thank you. You talked about training as well as something that’s necessary and needed to get people back on their feet or to make the transition from one job to the next. You mentioned Second Career, which was expanded, but I’m hearing a need for more programs like that from you?
Ms. Melanie Kelso: Yes. A lot of the people who have been laid off have been working in forestry; some of it’s mining. There are no jobs for these people at this point in time. A lot of it as well—they haven’t received severance. For some of them, there’s a reduction in their pensions as well. They’re not getting what they were promised because their pensions were underfunded.
Ms. Leeanna Pendergast: I wanted to talk about pensions, too; you brought that up. But you did mention that daycare is not open after 10 p.m.?
Ms. Melanie Kelso: That’s right.
Ms. Leeanna Pendergast: It was an “aha” moment for me as a mom and as a teacher, because—is that usual, for daycares to be open after 10 p.m.?
Ms. Melanie Kelso: In larger cities you can get 24-hour care.
Ms. Leeanna Pendergast: And you’re saying that’s something that would be necessary or needed in the north.
Ms. Melanie Kelso: Yes, because not everyone has family they can rely on to take care of their children. I know that personally, with people I have worked with. So if you worked to 11 o’clock at night, what happens to your child between 10 and 11? Are they thrown out on the street? Or they just don’t go to that child care. And there is nothing. You also run a risk when you’re just getting anybody to come in.
Ms. Leeanna Pendergast: Absolutely.
Ms. Melanie Kelso: And those children are very much at risk when it’s not regulated.
Ms. Leeanna Pendergast: Thank you for your comments on pensions and pension reform. The government has just introduced and passed Bill 120 on pension reform, of course, looking at over two thirds of the recommendations from the Arthurs report. Minister Duncan, our provincial Minister of Finance, continues to call on the federal government and Minister Flaherty, as you pointed out, to urge them to continue to reform CPP. We appreciate your support in that area as well.
You talked about a labour market forum. Can you tell me more about that, working together? You talked about business, government and labour working together and forming something called the labour market forum. Do you have further information or could you direct us to learn more about that?
Ms. Melanie Kelso: Yes, and this is from the OFL. It’s the umbrella group for myself. It’s the Canadian Labour Congress and then it’s the Ontario Federation of Labour and then it’s the labour councils.
Ms. Leeanna Pendergast: Right.
Ms. Melanie Kelso: And it’s the Ontario Federation of Labour that is proposing that the province establish a permanent labour market forum. I do have—it is a document from the OFL and I believe the OFL will be in Toronto later on.
Ms. Leeanna Pendergast: It will be available, yes.
Ms. Melanie Kelso: You will get the information there with Sid Ryan.
Ms. Leeanna Pendergast: Perfect. Those are all my questions. Thank you again for being here and for your presentation.
Ms. Melanie Kelso: Thank you.
The Chair (Mr. Pat Hoy): Thank you for the presentation.
I’m advised that the Thunder Bay and District Injured Workers Support Group is not in the room yet, but I’m also asking. I’m also advised that the Persons United for Self-Help in Northwestern Ontario are not here yet.
FOR CHILDREN AND YOUTH
The Chair (Mr. Pat Hoy): But I do understand that the Provincial Advocate for Children and Youth is here and would present at this time, so if you want to come forward, that would be wonderful.
Mr. Irwin Elman: I was asking if I could get extra time, but no. Too bad.
The Chair (Mr. Pat Hoy): We expect them at any minute, but we do appreciate you accommodating the committee at this point.
You have 10 minutes for your presentation. The official opposition has an opportunity for up to five minutes of questioning. I would just ask you to identify yourselves for our recording Hansard.
Mr. Irwin Elman: Sure. I’m Irwin Elman. I’m the Provincial Advocate for Children and Youth.
Ms. Laura Arndt: My name is Laura Arndt. I’m the director of strategic development for the Office of the Provincial Advocate for Children and Youth.
Mr. Irwin Elman: Thank you very much for having us here. I’m very pleased to be here.
I want to touch on three different themes, if I can, in the short time I have with you: children’s mental health, support to aboriginal students, and youth transitioning from child welfare care.
When I was listening to Michael Kirby, Canada’s mental health commissioner, he said that children’s mental health is the orphan’s orphan within the health care system. A much greater investment in children’s mental health is needed if it is to shed that label. I’m asking the government of Ontario to make that investment in children and youth in the province.
Currently, about 5% of the $47-billion health care budget goes to mental health. I’m asking the government to commit to raising that at least to the national average of 7.2%, including equivalent increases in children’s mental health funding.
When I was thinking about an example from my office to give you about the problem in children’s mental health, I thought about a 14-year-old girl’s parents who phoned the office the other day. She had been an in-patient in a pediatric psychiatric unit and she was ready to leave. She had about five different mental health diagnoses, and she was ready to leave. But in her community, where she needed to go to be treated, the children’s mental health centre had a wait-list for six months, so she couldn’t be released. Her parents phoned our office, and once that call had been made, her parents were presented with a solution, which was to find a foster home bed for this child. The parents were told that this was the only option in their community where this child could receive the support treatment that she needed. She’s a 14-year-old child.
The parents accepted the offer, but I remember when they talked to our office they said, you know, if their child had had a broken leg and the parents were told, “Well, the only option for treatment is gall bladder surgery in your region,” nobody would have expected them to say, “Okay.” I think the message is that we can do better than that, as a province. We need to do better than that.
We know that 15% to 21% of children and youth are affected by a mental health disorder in the province. That translates to about 467,000 to 654,000 children. We know that more have a mental health problem at some time. I have more statistics, but I have 10 minutes.
I want to say that we also know, from the Legislature’s own Select Committee on Mental Health, the terrible strain that living with mental health puts on the people living with these issues, particularly children as well as the families. The committee articulated that well. In fact, over the past 25 years, there have been 20 reports in Ontario about reforming mental health, many of them saying the same things as even the recent—I call it the triple-R report, but the interministerial advisory committee report on mental health, which says a community-based service approach is really important—crucial—to be the cornerstone of a deinstitutionalized system. The problems are not new. It’s time to act.
What’s wonderful about this, I think, is that the reports, including the most recent ones, give elegant solutions to coordinating the services and creating the system that will meet the needs of that 14-year-old girl and others whom I spoke about.
So it is the time to act. The last report talked about a perfect storm brewing, where there’s political will, bureaucratic will and community will to do something, and templates and road maps ahead. My suggestion to this committee, if I can continue with that metaphor of the storm brewing, is to catch the wind and make a commitment, this budget, to do something, to signal to the province that this is important and we need to move ahead. I can’t say that more strongly.
I want to talk a little bit, being in Thunder Bay, about a call I had about a year and a half ago, close to when I started in this position. It came from Kenora. It was from a reporter, and he said that a young person who had come from a remote community and was going to school in Kenora had just thrown himself in front of a train. He wondered whether we in the south—because at that point, he considered our office in the south—cared about these young people. And of course we do, and I know the people in this room do.
Later on, very quickly after that, I learned there was an inquest to be held in Thunder Bay about a young man who was 15, who went to Dennis Franklin Cromarty school here in the city and ended up dead in McIntyre River, in the city. He was, I think, the fourth, and now there are five young men who have died in a similar way—in the river; in the city—all going to that school, and who came from remote communities and went to school here.
The office worked with a group of youth in this city, supported by the regional multicultural youth centre and NAN youth decade council—because that’s what we do: We work with young people to hear from their wisdom about what could be different. They produced a report called Reserved and Lost, and I chose to be here in Thunder Bay both to honour that young man and those young men who died here and the work of the First Nations young people out of the regional multicultural youth centre, the work they’ve done and continue to do to make sure that those young people did not die in vain.
The report recommends a number of things which I will suggest to the committee to consider. One of the most remarkable things about my work is that the young people I meet, whether they’re in care and they’ve gone through a childhood of sometimes unspeakable difficulties, or they’re young people living with really difficult special needs in hospitals, in rehab centres, to a person, when I ask them what they need, they talk about that, but they say they want to contribute. The young people in this city who are from remote communities want to contribute too. So it’s not surprising that the recommendations they made that I can deliver to the province—because there are others to other jurisdictions—talk about how they can be part of the solution.
They talk about developing and training more youth leaders who can plan, organize and deliver youth-to-youth activities that appeal to their peers and engage them in mass prevention-oriented activities like physical activities, healthy lifestyles and wellness. They want youth centres, in this city and others—in Kenora and others—where they can have safe spaces, where they can feel they belong, where they can have a voice.
They want targeted youth campaigns against alcohol and drug abuse. They want youth-friendly information to prevent alcohol and drug abuse. They want support for youth-led strategies to educate, communicate and raise awareness of the consequences of alcohol and drugs. And they want support in raising public awareness of the difficulties that young people in their situation have.
I wanted to put that on record. There’s a lot more that the province can do for First Nations children and youth, and needs to do, because it is a crisis. I wanted to make sure the words of these young people were heard here.
Finally, I want to speak to you about your children. They are crown wards who come into care through no fault of their own. I think you know this. Young people come into care with child welfare. They’re made crown wards because they were deemed in need of protection, they were deemed to be suffering from physical, sexual, emotional abuse or neglect. They come into care and they’re made crown wards and that makes them the province’s children. It means that the government of the day that’s elected is their parent. They are the children of everybody sitting around this table, including me, but there’s a special obligation for government members and, I believe, the Legislature. When you’re elected, I and other Ontarians elect you to parent these children. So they’re your children; I don’t think there’s any doubt about that.
The other thing that there’s no doubt about is that they’re not doing well. I could say that to you. The Ministry of Children and Youth Services says the same thing; it’s concerned. That goes from government to government. It’s not that they just started not doing well; they haven’t been doing well. Study after study says that. I could quote them.
The latest one, because I think it’s relevant to one of the goals about graduating high school, is that the graduation rate of a crown ward, your child, is 40% from secondary school. OACAS, the Ontario Association of Children’s Aid Societies, and the Ministry of Education did that study and released it just this year. The average in Ontario I think is 79%. These kids—your kids—are overrepresented in shelters, in youth justice centres. They’re not doing well.
But some, through courage and hard work and grace—sometimes I don’t know how they do it—manage to get through, struggle through. I remember a young man I met—because it’s my job to talk to young people—who said to me: “I’m 22 years old. I was in care since the age of six. I lived in a few homes until I moved to a foster home at age 10. They were wonderful. They told me that they loved me. I eventually told them I loved them too. When I was 18 years old, I learned that I would have to leave the home I was in. I did not realize. I was so hurt. I thought, ‘What kind of family would say that? I said “I love you” to them.’ I had to live on my own, and I never spoke to them again. I was so depressed, I’m not sure how I survived. But today I’m at Ryerson University, and I’m trying to study computer science. I can tell you, I don’t know how I’m going to make it.”
The first thing to remember is that that’s your child telling you that; it’s not just me. The second thing is that it doesn’t have to be that way. I’ve spent some time, because I know time’s a restraint, talking to ministries, deputy ministers and ministers—not just the people you’d think I’d talk to—the Minister of Transportation, the Minister of Government Services, saying, “They’re your kids.” Nobody debates that they’re your kids; nobody debates that they’re not doing well. What can you do without spending a dime that would help them? Because I know time is a restraint. You’d be surprised. There’s goodwill in those ministries—every ministry I’ve spoken to; I’ve spoken to 15 so far—and every minister.
Some, like the Ministry of Government Services, before we brought them together with child welfare already said, “Do you know what? We have a program for kids who drop out of schools, a co-op program. We can make some of those spots in that program for our kids, crown wards, if that is something that would be helpful. We can maybe think about waiving the cost of a birth certificate for crown wards or former crown wards.” It won’t cost a lot of money, if that might be helpful.
The Chair (Mr. Pat Hoy): We have about 30 seconds.
Mr. Irwin Elman: Oh, jeez—and I want to say that that goodwill is in the private sector, too. But if you don’t act in addition, that goodwill will be squandered.
What I’m asking you to do is to extend what’s called extended care and maintenance, a stipend to allow kids, at 18, to live on their own from child welfare until they’re 21. Extend that to 25 with set goals, like graduation from high school; like finding a supportive person, an adult in their life; like having all their status, having all their ID.
I’m asking you to support some of the recommendations in the expert panel on infertility and adoption, like subsidies for adoption, to parents considering adoption, so that permanent homes can be found.
I’m asking you to allow foster care rates to be extended for kids who want to stay in their foster home past 18 if they’re going to school. It’s not going to cost you a lot of money. It will make a huge difference to your children.
Finally, I want you to consider everybody coming to you, and I want the cabinet to consider in every decision that’s made, and I want bureaucracy at the deputy ministers’ council to consider with every decision, whether it’s from the Ministry of the Environment, the Minister of Agriculture or MCYS, “How can this decision benefit our kids?”—just the way you would when you go home and sit around your dinner table and decide if you’re going to buy a new car or move your house or get a new job. You always think about your kids. I want this government, any government, to do the same for the kids that they’re obligated to parent. Thank you.
The Chair (Mr. Pat Hoy): Thank you. The questioning goes to the official opposition. Mr. Miller.
Mr. Norm Miller: Thank you for your presentation. It looked like you were running out of time at the end there. You were talking about crown wards not doing well and a list of suggestions for how they could do better.
It seems like when kids hit 18, there’s a wall that they hit, I guess, where all of a sudden, they lose a lot of supports. That’s what I’m gathering from what you’re saying, without being an expert on it.
You talked a little bit more about that and what supports you think should be there. Instead of just right at 18, it sounds like you’re suggesting that supports should be there to a higher age or until they’ve achieved a secondary diploma or other targets.
Mr. Irwin Elman: I think that we need to have outcomes and expectations for what we want for our children—and I’m talking about crown wards. I think we should expect them to graduate from high school. We should expect that they have a permanent home rather than a placement. We should expect that they have permanent status in Canada—believe it or not, sometimes they leave with no status in Canada. We should expect that they have ID cards. We should expect that they have a source of income. We should expect that they have a connection to a caring adult or peer. Those are goals.
Your question about 18: The way the system works now, at 18, you’re no longer a crown ward, which means child welfare cannot pay a per diem to a foster home or a group home if they’re living there, so they must move. What happens is they stay on the books at children’s aid and they have a social worker who gives them a monthly stipend, usually below—well, it is below—the poverty level in whatever community they’re in, and they are expected to live on their own. At 21, regardless, you’re out.
I don’t say this—because child welfare isn’t very supportive of this, but these are the rules: You’re out and don’t phone home, thank you very much. You’re on your own. And nobody, particularly with the backgrounds that these young people have, can expect them to do well under those circumstances.
Your question is, “Do they need support after 18?” Yes, of course, and we need to do it in a systematic way. But the system needs to work just the way people have articulated it before, individually tailoring to each young person what makes sense for them, what they need; making sure they have a voice. So if they need to stay in that foster home or want to stay in that foster home because it’s their home, allow it to happen. It makes sense. It’s certainly a fiscally responsible thing to do, because the likelihood is that they will not be in our jails or our shelters or on OW. They’ll be in school, which is what we want for them. I’m not just making a moral argument, although I am making that too. It’s a common-sense, fiscally responsible argument.
Mr. Norm Miller: You also made a comment that I didn’t quite follow. You said that you could make improvements without spending a dime. Did I follow that correctly?
Mr. Irwin Elman: Well, they haven’t done it yet. What we’re asking ministries to do is to look at everything they do and see how what they’re doing can benefit their children or crown wards.
For instance, crown wards often don’t have access to first-time jobs, because we know you get a job by personal connections. Well, they don’t have those personal connections the same way that maybe children of people here sitting around the table do. But the government is their parent, so if the government has a program that provides jobs, why not cut a piece of that program for their very own children, the same way as, if we had our own business, we might let our children work in our business. By not spending more on that program—I wish they would—but just making that opportunity available to their children, they’re finding a way to support crown wards. There are many opportunities like that.
I know I don’t have time. You’re going to tell me I don’t have time so I’m not going to give you any more, but I could. But I want to make it clear that it’s really important, but not good enough. It’s a whole-government approach, but we need to make some legislative changes to make sure that goodwill is tapped into and can be used by the young people.
The Chair (Mr. Pat Hoy): Thank you for your presentation and accommodating us at this time. Thank you very much.
Is the Thunder Bay and District Injured Workers Support Group here? No?
PERSONS UNITED FOR SELF-HELP
IN NORTHWESTERN ONTARIO
The Chair (Mr. Pat Hoy): The Persons United for Self-Help in Northwestern Ontario; if you’d come forward, please?
Good afternoon. You have 10 minutes for your presentation. There could be up to five minutes of questioning after that, from the NDP in this case. If you’d just state your names, then you can begin.
Ms. Amy Vaillant: Okay. My name is Amy Vaillant and I’m the program coordinator at PUSH northwest.
Ms. Sarah Hampel: And I’m Sarah Hampel. I’m the regional communications coordinator, at PUSH northwest as well.
The Chair (Mr. Pat Hoy): Go ahead.
Ms. Amy Vaillant: First of all, I just wanted to apologize for the dating on my report; I’m still in 2010 for some reason. That is supposed to be today’s date.
I’m just going to give you a little bit of background on PUSH and what we are. We’re actually Persons United for Self-Help in Northwestern Ontario. We’re a non-profit charitable group. We were founded in 1989 and our mandate is to act as the collective voice of persons with all types of disabilities throughout northwestern Ontario. The region we serve covers from White River to the Manitoba border.
What we do is we advocate strongly for the removal of barriers to inclusion for people with all types of disabilities in our region. We also try to promote inclusion and equality for all citizens. It’s our mandate to address issues that we feel impact the quality of life for these people in our region.
What we wanted to speak on today—our big issue we’ve been working on for the past couple of years—is that there’s a lack of funding for home support care services in our province. Over the past couple of years, PUSH and its members have been working to address the fact that there are extensive waiting lists for service within our region. We’ve had group committee meetings with a number of local and regional service providers that provide home support care services, outreach care services, some of the groups that run the direct funding program in our region and other groups that provide supportive housing for people with disabilities.
We’ve also met with local health integration networks, the district social services administrative boards and other interest groups in our region just to do a little bit of research on what’s going on in our region. What they’ve told us is that there’s up to 400 people in northwestern Ontario, people with physical disabilities, who are on waiting lists to receive home support care. We felt that this was a huge issue for us. Some of the groups we’ve talked to have said that once an individual is placed on a waiting list, there can be a wait from between four and 10 years to receive home support services. We’ve deemed that a bit of a crisis for people with disabilities and we’re looking to try to develop some type of funding solutions that can address this issue.
Some of the programs we wanted to bring to your attention as ones that are very effective and that can hopefully reduce some health care costs are things like supported living units, which are accessible apartments with support care built into them; community outreach care; in-home care services; and the direct funding program.
Disability service providers that we’ve talked to have said that there has been no expansion funding for these programs in at least eight years in northwestern Ontario. In the meantime, people with physical disabilities are waiting in hospitals. Some of them are left to live with aging caregivers and they’re not receiving the services that they need to be independent, functioning, active members of the community. With a lack of care, sometimes if you’re left in the hospital or living with an aging parent who can’t meet all your needs, it exacerbates your problem. You can end up with people with bedsores, people in hospitals where nurses just don’t have time to customize their care to the level of care that they need. They’re inappropriately housed in long-term care. I’ve read statistics that up to 10% of the people who are living in long-term care could actually live in the community if they had proper community care.
We’re here to say to you that people want to go home. People want to live in their homes. They want to be actively involved in their community. They don’t need to be in the hospital. We are trying to advocate that there might be a shift in funding priorities as far as Ministry of Health programs.
We believe that there’s a bit of an imbalance between institutional funding and community care funding. Just for an example, in Thunder Bay there was a recent investment of about $100 million in projects like the centre of excellence for seniors, which is more of an institutional model, yet when we talked with the North West LHIN about expansion funding for home support for people under the age of 65, they told us that their plan goes to 2013 and we can’t expect to see any new funding up to at least 2013. It’s a bit of a concern for our group that the focus is more on institutional care when we believe that a more community-based model is more appropriate for people with disabilities and seniors as well. For a lot of our members it’s a serious concern. They’re living in fear of being institutionalized at a young age when their families can no longer meet their demands.
We wanted to give you a little bit of background on some of the people we have talked to, just a couple of key stories that we’ve heard in the past year alone. For example, in one case we spoke with, a 50-year-old woman who lived in Dryden had multiple sclerosis and she was living in the Dryden hospital. When she was ready for discharge, she couldn’t leave the hospital because there was nowhere for her to go. There was no accessible housing and there was no home support. She would even have been able to manage in her own home if she could just access some community care. Because she wasn’t able to access that, the hospital began to bill her $1,500 for every day she remained in the hospital. When she called our organization, her bill was up to something like $240,000. The stress of how she was going to pay for that started to make her condition even worse and she was very distraught at the thought of having to leaving Dryden because her children and her grandchildren were there.
What eventually resulted from this case was that the hospital essentially forced her to move into a seniors’ long-term-care facility. They way they did that is they offered to forgive her bill if she would move.
We think that’s a little outrageous. The cost of keeping her in the hospital was probably 10 times more than it would have been to fund her living at home, and the cost of her living in this facility is even higher than home care would have been.
Ms. Sarah Hampel: In another instance, a young person with a disability living with his family in Atikokan, Ontario, contacted our organization because he wanted to go to Confederation College here in Thunder Bay. Unfortunately, he had been waiting for over three years to access the support care services he would require to move away from his family and to attend the school. He was forced to place his education and future as a contributing member of society on hold because of the lack of service. His mother began facing health issues of her own because of the demands of his daily care. His issue cannot be solved by accessing support care funding such as the direct funding program, which would allow him to move freely while still accessing the care he requires.
Finally, we have spoken to a person living in Thunder Bay with muscular dystrophy. She has been on a waiting list for a support service living unit at one of our local agencies in Thunder Bay since 1996. Fortunately, she had the foresight to apply to the service at a young age because she was aware of the degenerative nature of her disability. She continues to reside in an inaccessible apartment with her spouse, who helps her with her daily care, but who also has health conditions that may impact his ability to care for her in the future.
In an interview with PUSH northwest, she stated that after 15 years on the waiting list she’s afraid that she’ll end up in an institution because the supports she has applied for will not be provided at the time.
We have heard time and time again that people with disabilities across northwestern Ontario are angry that the services they need to live are not being provided to them and that they are afraid for their futures and their families. The members of PUSH northwest are asking you as a committee to make the recommendation to fund home support services that can reduce the costs and demands to our health care system and change the quality of life for up to 4,000 people—individuals and families.
The recommendation that PUSH is making is that community care makes fiscal sense. From local and regional service providers, we have spoken with community support services for people with physical disabilities at maximum care levels, which are approximately $150 per day. For those with high-level brain injuries and those who require 24 hours of coverage, the cost can be up to approximately $350. Compared to the cost of an acute care bed at $1,200 to $1,500 per day, the savings are considerable.
In some reports it has been stated that up to 10% of people living in long-term-care facilities could remain in their homes with the proper home supports. The Ontario Community Support Association states that as of November 2010 there are approximately 4,000 people with disabilities on waiting lists to receive home support services across the province. Our regional members make up approximately 400, or 10% of that provincial waiting list. According to the OCSA, a shift in merely 0.1% of the provincial health care budget, or $16 million, from acute care to community home support services could reduce existing waiting lists by half. Details of the funding strategies are attached to our presentation for the standing committee’s review.
The Ministry of Health and the local health integration networks have recently begun to recognize that home support services can ease the costs of health care and free up resources at acute care hospitals, as demonstrated by some aging-at-home initiatives for seniors. Yet none of the same supports are being provided to individuals under the age of 65 who require the very same care. Home support funding should be home support funding for all regardless of age.
In closing, we are requesting the support of your committee to ensure that people with disabilities have the right to be independent and grow and develop in their own environment. People with disabilities need and want to be in their own homes and continue relationships with their spouses, family members and friends. With the proper funding for home support care, we can reduce pressures on the health care system and avoid family burnout. Health care spending can be reduced in a way that improves the quality of life for thousands of people with disabilities in our province.
People with disabilities must be able to dream of pursuing a higher education or obtaining their dream career. We are confident that with the implementation of the Accessibility for Ontarians with Disabilities Act in the coming years, our government is demonstrating a willingness to increase opportunities and quality of life for all citizens. We look forward to seeing these principles reflected in the budget decisions made by the finance minister.
Thank you for your time this afternoon. It’s been a pleasure to present to the Standing Committee on Finance and Economic Affairs.
The Chair (Mr. Pat Hoy): Thank you. We now move to Mr. Tabuns of the NDP—I looked the other way, though. Go ahead.
Mr. Peter Tabuns: No problem. Thank you, Mr. Chair.
Thank you both for coming and making the presentation today.
You present some numbers here in this document about the number of people—4,000 people in Ontario with physical disabilities waiting for attendant services, and you list where they are. Can you break it down, the number who are in hospital, ALC beds, or in long-term-care facilities?
Ms. Amy Vaillant: We can’t. Right now, PUSH is actually doing a research project to find out the regional numbers. We’ve talked with service providers, and they will tell us that they have 400 on their waiting list, but because people who require supportive housing are sometimes transient, we’ve tried to develop a process to track people—because sometimes they’re in a hospital and they are moved to long-term care or they go home to their families. So we’re not exactly sure what our regional numbers are specifically. We’ve been told 400 and we’ve started to do some research with some of the groups we’re involved with, but I couldn’t tell you specifically how many are in the hospitals and so on.
Mr. Peter Tabuns: So you have roughly 400 on your waiting lists?
Ms. Amy Vaillant: That involves some of the groups in Thunder Bay, such as the Handicap Action Group, Brain Injury Services, and Kenora Northwestern Independent Living Services, their wait-list in Rainy River. That also includes the number waiting for direct funding through the Independent Living Centre. So that makes up that 400 that we claim.
Mr. Peter Tabuns: No, that’s fair.
Of the people who are not in long-term-care facilities or in hospitals, how do families juggle? How do they actually manage to deal with this? How do the individuals actually manage to deal with this?
Ms. Amy Vaillant: They stress greatly. We’ve heard a lot from caregivers, single parents, grandparents even, people in their 60s who want to retire who have children in their 20s. And the children want to go. The guy who wanted to go to school wanted to leave. He did not want to live with his mother in Atikokan, but he did not have a choice. And her health was a concern as well.
Families are getting tired. They do need support. There’s not a lot of respite care available for people in the middle ages. Once you get out of childhood, the service level for people with disabilities drops considerably until you’ve reached senior age again. It’s families in the middle age that are suffering the most.
Mr. Peter Tabuns: How did your organization come into being?
Ms. Amy Vaillant: PUSH? We were a division of the Handicap Action Group in Thunder Bay. Are you familiar with that group?
Ms. Amy Vaillant: Okay. Back in the 1970s, there was a group of people with disabilities who decided that they needed service. There wasn’t housing for them, there wasn’t transit for them, there wasn’t home care for them, and they actually founded the Handicap Action Group in Thunder Bay, which now provides HAGI Transit, the parallel transit service. They provide supportive housing and they also provide a recreational facility for people with disabilities.
PUSH came to be the advocacy wing of HAGI and eventually separated because of funding interests. HAGI became more of a service provider, and it was our job to kind of push the ministry. PUSH actually separated from HAGI in about 1989.
Mr. Peter Tabuns: Okay. I don’t have any other questions. I appreciate the work you do and the presentation you’ve made.
Ms. Amy Vaillant: Thanks.
The Chair (Mr. Pat Hoy): And thank you.
ASSOCIATION OF ONTARIO MIDWIVES
The Chair (Mr. Pat Hoy): Now I’d ask the Association of Ontario Midwives to come forward, please. Good afternoon. You have 10 minutes for your presentation. There could be up to five minutes of questioning, and this time it will come from the government. If you’d just state your name—
Ms. Eileen Abbey: My name is Eileen Abbey.
The Chair (Mr. Pat Hoy): Go ahead.
Ms. Eileen Abbey: I am a registered midwife in Thunder Bay and a former board member of the Association of Ontario Midwives. I’m here today to talk about pilot funding for midwifery-led birth centres. I will begin with a brief overview of midwifery and then discuss how birth centres can provide cost savings and efficiencies for Ontario’s overburdened health care system.
With a proven safety record and high client satisfaction rates, midwives are experts at providing evidence-based, cost-effective care. Midwifery is an integrated part of Ontario’s maternity care system, with services fully funded by the Ministry of Health and Long-Term Care. Midwives care for women with low-risk pregnancies from the time of conception up until six weeks after the birth of their child. Currently, there are more than 520 registered midwives in this province who provide care to over 10% of Ontario’s pregnant women as well as their newborns. Some 20% of those clients give birth at home, the other 80% in hospital.
This is why I’m here today on behalf of the association: to talk about where babies are being born in Ontario. I’m going to talk about changes that could lead to more efficient use of health care dollars, greater patient satisfaction rates and better outcomes that lead to healthier moms and babies.
Birth is the leading reason for hospitalization of women in Ontario, yet there is no medical reason for the vast majority of healthy women to be hospitalized for labour and birth. The evidence simply isn’t there. In jurisdictions around the world such as the UK, the United States, Australia and closer to home in Quebec, women have the option of labouring and delivering in midwifery-led birth centres.
Birth centres are family-oriented sites where midwives provide comprehensive prenatal and postnatal care as well as labour care. They are community hubs with a focus on providing care within a health promotion model. This is the model of care that Ontario midwives currently practise. They are places where a woman feels safe and supported and where her caregivers know her name. Women can safely talk about what’s going on at home and have not only their physical needs met but also their social needs addressed as well. As sites that support optimal health for women and newborns, birth centres in Ontario would provide excellent, safe and cost-effective alternatives to hospital-based labour and delivery units.
We know that they would provide excellent safe care for two reasons. First, midwives have the best clinical outcomes in the province, regardless of birthplace. We get these outcomes in part because of the relationships we build with women. As midwives, we have the ultimate opportunity to make positive changes in women’s overall health during the prenatal period. This has an impact on the well-being of the whole family, which has positive implications for generations afterwards. Secondly, midwives are well integrated into the provincial maternity care system. With a proven safety record, seamless systems for transporting women in labour and hospital privileges, the model of midwifery care is already well-suited to practice in birth centre settings.
In addition to being safe, birth centres are also cost-effective, creating savings in two main ways. The first is by decreasing hospital admission rates. Birth centres redirect healthy women from hospitals to community-based care, presenting a significant cost savings without adversely affecting patient safety or satisfaction. But it’s not just in hospital budgets where the benefits will arise. At a time when concerns about pandemics and hospital-based infections are increasing, the importance of keeping healthy people out of hospital becomes more pressing. Birth centres help to keep healthy people healthy. Birth centres also create savings by decreasing obstetrical intervention rates.
Funding birth centres supports the spirit of the Excellent Care for All Act. This important piece of legislation will improve health outcomes and reduce spending through the application of evidence-based care. Birth centres staffed by midwives present precisely the kind of cost-effective, evidence-based care that this act is supporting.
Let’s take, for example, Caesarean sections. The rate of Caesarean sections has increased by almost a third in Ontario over the past 15 years. It is now at about 30%. There is broad consensus in Ontario that Ontario’s C-section rate is alarmingly high. This number is twice as high as the maximum recommended by the World Health Organization. We have a rate of nearly one in three women undergoing a Caesarean section in this province. It is not evidence-based care; it is not safe care.
Research has shown that increases in Caesarean section rates in North America have not improved overall outcomes. In fact, the increased rate of C-sections has been indexed to poor outcomes, such as increased risk of maternal mortality and morbidity.
It is not cost-effective care, either. A recent report from CIHI, the Canadian Institute for Health Information, indicates that Caesarean-section deliveries can cost hospitals twice as much in obstetric care for both mothers and babies. The total cost of a Caesarean section itself, plus the three to five days a woman spends in hospital, cycles into thousands of dollars. The daily bed rate is approximately $2,000 per day. What all of this means is that we currently pay a lot of money for bad outcomes.
Birth centres, on the other hand, promote births that are evidence-based while eliminating unnecessary interventions. Birth centres provide support to women that helps them have a safe and healthy birth. When women have the opportunity to access a birth centre, the rate of medically unnecessary interventions is reduced. This produces a significant cost-savings to the health care system without compromising either optimal or evidence-based care.
Because midwives are well integrated into the hospital system, those women who would need to have a Caesarean section for medical reasons or other needed medical interventions would still have access, as they do now.
Birth centres also make financial sense because they would be a valuable addition to the currently existing infrastructure that the province has already invested in. Last year, close to 500 midwives provided prenatal and postnatal care to approximately 14,000 women. They did so in 75 midwifery clinics from Kenora in the north to Windsor in the south, stretching across the whole province.
When birth centres are established in Ontario, they will take the existing provincial investment in midwives and clinic spaces and provide a significant benefit: a safe and healthy place where newborns can get the best possible start in life. The entire spectrum of maternity care needs would take place under the same roof. The continuity of care that midwives already provide would be enhanced because women would labour and deliver in the same familiar environment where they had received their prenatal care, further contributing to the excellent outcomes midwives have.
Because funding for the midwifery model of care is well-established, initial calculations undertaken by the Association of Ontario Midwives indicate that an investment of between $3 million to $4 million could support up to four pilot projects. The cost of establishing these four pilot sites would be recouped from the savings to the system that birth centres present by diverting women out of the hospital system and their potential to decrease costly and medically unnecessary interventions.
Birth centres are already a success in Quebec, and this summer, Winnipeg is going to open Manitoba’s first midwifery-led birth centre. At one midwifery practice in Gatineau, Quebec, 70% of clients plan for their birth to take place in the birth centre. Imagine how this frees up health care dollars.
In Ontario, midwives hear from women and their families that they want centres as an option in their maternity care. Ontario midwives believe it’s time women and their families are able to access birth centres. We look to the next provincial budget to support our campaign to listen to women, enhance their health care options and support the long-term sustainability of our health care system.
Throughout its history, regulated midwifery care has enjoyed support from all three political parties. You can all be proud of the contributions midwifery has made to maternal and newborn health care in Ontario. Today we are asking for your support again. We look forward to seeing funding for birth centres be taken up in the next provincial budget.
Thank you for this opportunity to speak. I would be happy to answer any questions that you may have. Questions that I cannot answer should be directed to Juana Berinstein. Her details are at the end of this presentation.
The Chair (Mr. Pat Hoy): Thank you. The questioning goes to the government and Ms. Pendergast.
Ms. Leeanna Pendergast: Thank you, Eileen, for being here today, and thank you for the work that you do on behalf of the Association of Ontario Midwives.
I just have a couple of points of clarification, as this is the first presentation we’ve heard on behalf of the Association of Ontario Midwives. You end by talking about funding for birth centres, and then I flip back to the first page where you’re talking about pilot funding for midwifery-led birth centres. So is that what we’re talking about? A pilot?
Ms. Eileen Abbey: Yes. I think, initially, we’re looking into setting up these four pilot projects.
Ms. Leeanna Pendergast: Is there a plan already being developed through your association?
Ms. Eileen Abbey: I’m not specifically privy to those details, but I’m pretty certain that the AOM are in the process of developing more specific plans. Juana Berinstein will be the one to have the specific details.
Ms. Leeanna Pendergast: That always helps, if we’re looking at cost-effectiveness—what exactly would be the cost associated with this request.
Ms. Eileen Abbey: They’ve looked at the cost calculations. They haven’t given me the specific details, but they presume that for the four, it will be between $3 million and $4 million.
Ms. Leeanna Pendergast: Between $3 million and $4 million for the four pilot sites?
Ms. Eileen Abbey: Yes.
Ms. Leeanna Pendergast: On your first page, you talk about greater patient satisfaction—of course, that’s a priority—and then a more efficient use of health care dollars; another priority, for sure. I’m going to go back to that point.
Then you talk about, on the top of page 3, the studies that the UK, the US, Australia—they have midwifery-led birth centres. Would the association have any further research about those?
Ms. Eileen Abbey: They have the references to what we’ve addressed in the presentation, so the statistics or the evidence are there. I haven’t read those. These are ones that they’ve presented.
Ms. Leeanna Pendergast: If they have something, it’s always helpful. We’re talking about informing the Minister of Finance—in the spring budget. So if we’re talking about a pilot, it’s good to know.
Further down on page 3, you talk about cost-effective alternatives. In the footnotes, the references are 1996, 2000 and then the American journal from 2003. I’m wondering if there’s anything more recent or more specific to Ontario.
Ms. Eileen Abbey: I’ll send that question to Juana and get her to contact you with that information. They have asked me to present this, and it was a fairly sudden request. They weren’t here in Thunder Bay. I can ask them to get that information.
Ms. Leeanna Pendergast: If there’s anything more recent—if we’re talking about a $3-million to $4-million request.
One last question. Just the model itself, in the pilot: How would that look, in terms of decreasing the ob-gyn intervention? Would it be in a model like a family health team, where there would be a relationship with obstetrics? How does that work?
Ms. Eileen Abbey: Where the pilot projects are situated would obviously be in response to the uniqueness of that community, and it wouldn’t be isolating obstetric care. Obviously, we would be part of a team to ensure that women are getting safe care, whether it’s for low-risk women or high-risk women, so it would be part of the whole health care package that women would have.
It would be a stand-alone clinic or birth centre, but there would be, obviously, opportunity to Medevac people out or transfer people out if they needed to be transferred, as currently happens in Quebec. There are processes by which either women are not suitable for delivering in birth centres, or something happens in their labour that requires their transfer to a more suitable site.
Ms. Leeanna Pendergast: Okay. We are talking about stand-alone, as you said, so it’s a significant initial capital investment?
Ms. Eileen Abbey: Yes, initially, but with the belief that excluding women from the potential for unnecessary intervention will ultimately be a saving throughout, not just financially but also for women’s and babies’ health.
Ms. Leeanna Pendergast: And of course, it supports the government’s alternative-level-of-care investments.
Ms. Eileen Abbey: Yes.
Ms. Leeanna Pendergast: Thank you very much. Thank you, Eileen, for your presentation. It was great.
The Chair (Mr. Pat Hoy): Thank you for your presentation.
By the way, I forgot: If you send any information, if you could send it to the clerk—she’ll give you the address—and then everyone on the committee can get that information.
Just so the committee is aware, we’ve tried to contact the 2:15 presentation and there’s no response. As you probably know, we ask people to come half an hour ahead. They’re quite late. We do have a shuttle bus ready for 3:45, so my estimation is that they’re not coming, but we did try to get a hold of them.
With that said, I’m going to adjourn.
The committee adjourned at 1511.
STANDING COMMITTEE ON FINANCE AND ECONOMIC AFFAIRS
Chair / Président
Mr. Pat Hoy (Chatham–Kent–Essex L)
Vice-Chair / Vice-Présidente
Mrs. Laura Albanese (York South–Weston / York-Sud–Weston L)
Mrs. Laura Albanese (York South–Weston / York-Sud–Weston L)
Mr. Toby Barrett (Haldimand–Norfolk PC)
Mr. Bob Delaney (Mississauga–Streetsville L)
Mr. Kevin Daniel Flynn (Oakville L)
Mr. Pat Hoy (Chatham–Kent–Essex L)
Mr. Norm Miller (Parry Sound–Muskoka PC)
Ms. Leeanna Pendergast (Kitchener–Conestoga L)
Mr. Charles Sousa (Mississauga South / Mississauga-Sud L)
Mr. Peter Tabuns (Toronto–Danforth ND)
Substitutions / Membres remplaçants
Mr. Randy Hillier (Lanark–Frontenac–Lennox and Addington PC)
Mr. Jerry J. Ouellette (Oshawa PC)
Mr. David Zimmer (Willowdale L)
Also taking part / Autres participants et participantes
Mr. Bill Mauro (Thunder Bay–Atikokan L)
Clerk / Greffière
Ms. Sylwia Przezdziecki
Staff / Personnel
Mr. Larry Johnston, research officer,
Legislative Research Service
Wednesday 26 January 2011
Pre-budget consultations F-371
Ontario Forest Industries Association F-371
Ms. Jamie Lim
Northwestern Ontario Municipal Association F-373
Mr. David Canfield
Mr. Iain Angus
Student Union of Confederation College F-376
Mr. Ryan West
Thunder Bay Chamber of Commerce F-378
Mr. Harold Wilson
Mr. Dennis Buset
Literacy Northwest F-381
Ms. Annemarie Wesolowski
Thunder Bay Health Coalition F-383
Ms. Sara Williamson
Ms. Barbara Maki
Nishnawbe Aski Nation F-385
Grand Chief Stan Beardy
Canadian Paraplegic Association Ontario, Thunder Bay Region F-387
Mr. Darren Lillington
Confederation College F-389
Mr. Bob Backstrom
Canadian Diabetes Association F-391
Ms. Suzanne Sterling
Canadian Hearing Society, Thunder Bay Region F-393
Ms. Nancy Frost
City of Kenora F-395
Mr. David Canfield
Poverty Free Thunder Bay F-398
Mr. Larry Brigham
Ms. Cindy Crowe
Ms. Terri-Lynne Carter
Ms. Carol Neff
Thunder Bay and District Labour Council F-402
Ms. Melanie Kelso
Provincial Advocate for Children and Youth F-404
Mr. Irwin Elman
Ms. Laura Arndt
Persons United for Self-Help in Northwestern Ontario F-407
Ms. Amy Vaillant
Ms. Sarah Hampel
Association of Ontario Midwives F-410
Ms. Eileen Abbey