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Category "British Columbia Politics"

9Aug

Committee recommends money for HandyDART, affordable transit fares in 2020 B.C. budget

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The HandyDART service made 1.3 million trips last year.


RICHARD LAM / PNG

Public transit could receive a boost in the next B.C. budget, if the provincial government heeds the advice of an all-party finance committee.

The select standing committee on finance and government, which conducted public consultations across B.C., released a report this week with more than 100 recommendations for the 2020 budget, including six for transit and transportation.

In the interest of making transit more accessible for people with disabilities, the committee said the province should increase funding to expand HandyDART, a door-to-door shared ride service.

“(The committee) acknowledged the importance of HandyDART for increasing accessibility and supporting inclusion,” the report said.

Beth McKellar, co-chair of the HandyDART Riders’ Alliance, said the recommendation is important because the service is in high demand and desperately needs more funding, despite Metro Vancouver’s regional transit authority having added more service.

HandyDART’s ridership has been on the rise for the past five years, and delivered 1.3 million trips in 2018.

“We’re just a wee tiny blip on the radar, but I’m pleased this all came out and I’m hoping that they do the right thing. I always have that little bit of hope,” McKellar said.

The committee made a similar recommendation for the 2019 budget, calling for “increased and sustained” funding for HandyDART services.

Although funding was allocated in the last budget to B.C. Transit to expand bus and HandyDART services in four communities over three years, Metro Vancouver was left out, to the dismay of advocates and the region’s mayors.

“It was good that the Island got it, that B.C. Transit got it, but we need it a lot more over here,” said McKellar.

In recent years, TransLink’s Mayors’ Council has argued that the province should help pay for HandyDART because the majority of trips are related to health services, such as dialysis, and said there should be a long-term, sustainable funding model for the service.

The committee also recommended that the province work with local governments and transit authorities “to explore new pricing mechanisms to help make public transit more accessible for youth and low-income families.”

“We think this is an excellent recommendation and we urge the government to follow through on it,” said Viveca Ellis, a community organizer for #AllOnBoard.

#AllOnBoard has advocated for free transit for all children and youth up to and including 18 years old, and a sliding-scale monthly pass system based on income for all transit systems in B.C.

“We know that affordability is an important part of our current government’s mandate, and as communities and many, many community members have brought forward to us transit is not affordable for many British Columbians,”

The Mayors’ Council has also discussed free transit for youths, but believes the province needs to be involved on the funding side to offset fare revenue losses. Victoria will offer free transit to all youths who live in the city in a pilot project starting in September.

On the transit side the committee also recommended working with public and private operators to address gaps in regional transportation services — particularly in rural and remote areas — and prioritizing faster deployment of electric buses in cities, including expensive charging infrastructure.

In the area of active transportation, the committee said the province should invest in walking and biking infrastructure, education and promotion, as well as eliminate provincial sales tax on electric bicycles.

In a statement the Ministry of Finance said it is “in the process of reviewing the report in detail and considers all proposals, including recommendations brought forward by this committee, during the yearly budget process.”

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6Jun

Vaughn Palmer: ‘Illogical’ suicide pact allegation lies behind B.C. legislature resignations

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VICTORIA — On the final day of the spring legislature session, Premier John Horgan paid tribute to Randy Ennis, who was retiring early from the upper echelons of the security staff.

It’s standard procedure for the premier to thank a departing public servant. Ennis had long served as deputy sergeant-at-arms and lately as acting sergeant-at-arms, with Gary Lenz placed on suspension.

But for Horgan, this one was personal because Ennis was a friend.

“Randy and I first met at the hockey rink over a cup of Tim Horton’s,” the premier told the house. “Our boys played hockey together, so we spent a lot of time complaining about the Canucks. We spent a lot of time talking about how we could make the world a better place.

“Randy is an outstanding individual,” Horgan continued. “I’m going to miss him terribly.”

There followed a display of applause from all sides of the house, albeit tinged with regret among those in the know.

Horgan claimed not to know why Ennis, who just turned 59, was leaving early.  But around the legislature, it was an open secret that Ennis was fed up with the regime of Speaker Darryl Plecas and his chief of staff, Alan Mullen.

Ennis had good reason to be incensed. Plecas had accused him of being party to a suicide pact involving an ailing member of the security staff.

The alleged suicide pact was one of 11 Plecas-authored allegations of misconduct that were examined and rejected by retired chief justice Beverley McLachlin. (She upheld four accusations against clerk of the legislature Craig James, leading to his forced retirement.)

Plecas claimed to have uncovered a plan by sergeant-at-arms Lenz and deputy Ennis to create a sheltered posting for an unnamed constable on the security staff who had a degenerative health condition.

“The Speaker also alleges that they created a plan whereby (the staffer) would commit suicide while he was still on staff so that his beneficiaries would receive insurance proceeds,” wrote McLachlin.

The former chief justice of the Supreme Court of Canada examined the documentation associated with the alleged plan and further evidence from the accusers, Plecas and Mullen, and the accused, Lenz and Ennis.

She concluded that “clearly Mr. Lenz and Mr. Ennis were deeply concerned over the future of the constable and wanted to find a way to help him.”

But she did not fault them for considering ways to allow the constable to work at home were his condition to deteriorate to the point where he could not carry a firearm as required by his position.

“Discussion of creating a new position so an employee can work from home does not appear on its face to be unreasonable, provided the proposed work would contribute to the business of the legislative assembly,” wrote McLachlin. “The discussions, according to Mr. Lenz and Mr. Ennis, related to whether (the staffer) could continue to do useful work without being able to carry a firearm. I accept this evidence.”

Nor did she accept the Plecas-Mullen version of events regarding the supposed suicide pact.

“The ‘plan’ that the Speaker says was being hatched proposed that (the staffer) would commit suicide while he was still employed and before his condition had deteriorated too far, in order to preserve his life insurance,” wrote McLachlin.

Plecas thereby insinuated that the new job was “false” — concocted for the purpose of preserving the staffer’s employment status long enough for him to kill himself.

“No one was able to explain the logic of this to me. The evidence I received was that if he was forced to go on disability status, his life insurance would have remained in place as long as he qualified for that status,” wrote McLachlin.

She instead preferred “the straightforward explanation of the incident” from Lenz and Ennis.

“They denied any talk of suicide and explained that the discussions were aimed at finding reasonable accommodation for (the staffer) by finding alternate duties when he reached the point that he could no longer use a firearm.”

She speculated, and not in a flattering way, why Plecas had gone as far as he did.

“The Speaker was deeply distrustful of Mr. Lenz, which may explain how he transformed fragments of an exploratory proposal from Mr. Lenz and Mr. Ennis into a bizarre go-forward plan involving (the staffer) committing suicide.”

She then cleared Lenz of the allegation of misconduct. She also cleared him of all the other Plecas accusations against him.

Lenz remains on suspension, pending the outcome of a police investigation.

So, Ennis was collateral damage to one of the more reckless and unproven allegations from Plecas.

Rough treatment for someone who deserved much better. Before coming to work at the legislature, Ennis served as a member of the Canadian Airborne Regiment, seeing duty as a peacekeeper in Bosnia, Cyprus and Haiti, and earning the military Order of Merit.

The supposed target of the non-existent suicide pact was collateral damage as well. He retired from his post on the security staff at the same time as Ennis.

Not that Plecas could be bothered to express regret over the damage done to reputations. Instead he’s been citing the shortcomings in the McLachlin report in public and bad mouthing it privately.

As for the premier, he could deliver a more sincere tribute to his departed friend by recognizing where Plecas has gone too far and by attempting to curb his excesses.

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1May

Daphne Bramham: Alcohol, not opioids, is Canada’s biggest drug problem

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Alcohol is so much a part of our culture that 80 per cent of Canadians drink. But each year, nearly 15,000 people die from alcohol related harms.


Canadian governments are addicted to the revenue from alcohol


DALE DE LA REY / AFP/Getty Images

With so much focus on illicit drugs and overdose deaths, it might seem that opioids are the biggest addictions problem. Far from it.

Alcohol kills many more people each year (14,800 in 2014), results in more hospitalizations annually than heart attacks and is one of the most expensive and intractable health problems.

While cannabis was legalized a year ago and B.C.’s chief medical health officer is pushing hard for decriminalization and ultimately legalization of all illicit drugs, two Canadian addictions research centres want tougher regulations to mitigate the costs and harms of alcohol use and addiction.

The Victoria-based Canadian Institute for Substance Use Research and the Toronto-based Centre for Addiction and Mental Health want a minimum price of $3.50 for a standard drink in a bar or restaurant and $1.75 for off-premise sales. They also want a national minimum drinking age of 19, which is a year higher than national minimum for cannabis. Those are just two of the recommendations in reports they released last month that look at federal, provincial and territorial alcohol policies.

The reports also calling for stricter guidelines for advertising, restrictions on manufacturers’ and retailers’ promotions on digital and social media platforms, and a federal excise tax based on alcohol content that would replace the GST.

Over the past decades, the researchers found an erosion of effective policies and regulations.

“Overall, alcohol policy in Canada has been largely neglected relative to emerging initiatives addressing tobacco control, responses to the opioid overdose crisis, and restrictions imposed on the new legal cannabis market,” their report on the provinces and territories says. In several jurisdictions — Ontario is the worst example — “customer convenience and choice are being given priority over health and safety concerns … the responsibility of governments to warn citizens of potential risks is largely absent.”

British Columbia got a bare pass at 50 per cent based on its potential to reduce alcohol-related harm, which is not good. But it’s still better than the national average of 43 per cent.

Alcohol-related harm was estimated at $14.6 billion in 2014, according the Canadian Centre on Substance Use. Productivity loss due to illness and premature death accounts for $7.1 billion. Direct health care costs add another $3.3 billion and $3.1 billion is spent on enforcement costs for this legal drug.

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Tobacco was second at $12 billion followed by opioids at $3.5 billion and cannabis at $2.8 billion. But the data predate the opioid overdose crisis and cannabis legalization.

Alcohol’s costs and harms reflect the fact that 80 per cent of Canadians drink. It’s not surprising. Culturally, we associate drinking with celebrations and good times. It’s We’re bombarded with images in movies, TV and ads of beautiful people drinking and having fun.

Scarcely a week goes by that there isn’t a “good news” story about research showing that a glass of red wine might be good for your heart or that yet another populist politician is campaigning on a promise to slash the price of beer.

Yet less was made of University of Washington’s Global Burden of Diseases Study last summer that found alcohol was the leading factor in 2.8 million premature deaths in 2016 and is so harmful that governments ought to be advising people to abstain completely.

One problem is that Canadian governments are addicted to the revenue from alcohol. Liquor sales and taxes provided $12.15 billion to federal and provincial governments in 2017/18 — $1.6 billion more than five years earlier, according to Statistics Canada.

Last year, liquor consumption rose in British Columbia, which already had the highest drinking rates in Canada. There were also record sales, which meant that in addition to tax revenue, the Liquor Distribution Branch provided $1.12 billion in earned revenue, up from $1.03 billion two years earlier.

Good for taxpayers? Not really. The reports by the substance-abuse centres recommends B.C. “reconsider the treatment of alcohol as an ordinary commodity: Alcohol should not be sold alongside food and other grocery items as this leads to greater harm.”

It’s based on research done last year by Tim Stockwell of the Canadian Institute for Substance Use Research. He and his researchers found that when access to alcohol is easier, more people die.

Between 2003 and 2008, “a conservative estimate is that the rates of alcohol-related deaths increased by 3.25 per cent for each 20 per cent increase in stores density.”

Estimates have to be conservative because alcoholics’ fatalities are mistakenly counted as death from one of more than 200 other kinds of alcohol-related fatalities including car accidents, suicide, liver diseases, cancers, tuberculosis and heart disease.

What’s surprising is that more than a century after legalization, there are no federal or provincial policies aimed specifically at mitigating alcohol’s harms and costs.

The opioid crisis has been the catalyst for governments to finally think about addictions and drug-use policies and, it’s now impossible to ignore the slower moving crisis caused by alcohol abuse and addiction.

In the coming months, the B.C. health officer also plans to release an alcohol addictions report. The B.C. Centre on Substance Use recently developed guidelines for best practices in treating alcohol addiction, but the provincial government has yet to approve or release those.

Prohibition proved a failure. Yet, legalization and regulation are not panaceas either. Because even with more than 100 years of experience, there is still no jurisdiction in Canada or anywhere else that seems to have got it right.

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Twitter: @bramham_daphne


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2Apr

Eby’s bumpy, make-it-up-as-you-go-along ride on challenging ICBC file

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VICTORIA — Portrait of a cabinet minister making things up as he goes along:

Feb. 7: David Eby, wearing his cabinet minister for ICBC hat, reacts to news the government-owned auto insurance company missed its financial target for the first full year under the NDP.

ICBC forecast a loss of $684 million. Instead it will lose $1.18 billion, not much less than the $1.296 billon it lost in the financial year shared with the departed B.C. Liberal government.

Not to worry says Eby, still wedded to the belief that ICBC can be put on a break-even footing by 2020.

He’s already consulting with “stakeholders” on a new way to rein in legal and court costs: “The big one we’re concerned about are the cost of expert reports.”

Feb. 11: Eby, now wearing his attorney-general’s hat, signs a cabinet order rewriting the rules for court cases involving motor vehicle accident claims.

“We’re reforming the Supreme Court civil rules to limit the number of experts and expert reports allowed in certain cases,” he tells reporters.

The new limits are expected to deliver “in excess of $400 million” in savings for ICBC, starting that very day, which is when the new rules take effect.

Supreme Court rules are supposed to be vetted by a committee of lawyers and judges, jointly appointed by Chief Justice Christopher Hinkson and the attorney-general.

How involved was the committee in these changes?

Eby cites “discussions” with “a multi-stakeholder group” and “ministry staff.” But he never says whether these changes were approved in advance by the rules committee or to what extent the committee was even consulted.

Later that day the Trial Lawyers Association comes out and says what Eby won’t say, namely that the attorney-general pushed through the rule changes unilaterally.

“He is doing so despite a protest from the independent rules committee,” reports Ian Mulgrew in The Vancouver Sun.

Feb. 27: It has taken more than two weeks, but the attorney-general finally admits the trial lawyers were correct about the rule changes.

“I would like to clarify the process that was followed in relation to these changes,” reads the statement put out by his office.

He goes on to say the rules committee was “engaged” before the changes were announced. And it did offer “feedback,” which Eby claims to “very much appreciated.”

However: “The rules committee did not recommend these changes and was not asked to approve these changes. These changes were a decision made by government.”

Meaning government in the person of David Eby, an attorney-general who gets to preside over a unilateral rewrite of the court rules to suit the minister for ICBC, who is, of course, one and the same.

And lest there be any doubt on the part of the committee or anyone else, “government will continue its work on additional changes to the rules of court,” says Eby.

March 25: Eby announces via press release that he is pulling back on two provisions in the edict on the use of experts.

The new limits won’t apply to cases scheduled to go to court before the end of this calendar year. Litigants who incurred costs for experts before the Feb. 11 change of rules will be permitted to recover those costs.

All in the name of fairness and avoiding “unintended consequences” according to a followup statement from the ministry of the Attorney-General.

As for the financial consequences for ICBC, the ministry estimates the pullback will knock some $20 million off the projected savings of $400 million.

March 29: Another day, another amendment to the regulations regarding ICBC claims. There’s now more leeway for claimants to recover medical, rehabilitation, disability and other costs, including funeral expenses and death benefits.

“The new (60-day) limit gives people a reasonable amount of time to submit their receipts while ensuring ICBC receives the information it needs to accurately assess the severity of claims, provide additional supports to injured people as needed and better forecast future costs,” says the statement from Eby’s ministry.

This just two days before the new claims and litigation regime takes effect.

April 1: “The key for me is we’ve got to make it to April 1,” said Eby back in February, referring to the date he set last year for the big changeover on ICBC claims.

Those changes, limiting payouts for injuries, steering claims to arbitration and capping costs for ones that go to court, were expected to save $1 billion, even without the added limits on use of experts.

Now the big day is here and the trial lawyers mark the occasion by confirming they will challenge the new regime on constitutional grounds.

All of which recalls something else Eby said back when he was announcing the new limits on the use of experts and predicting savings of $400 million or more.

“The reality is that it will depend very much on the reception of the courts and the approach of lawyers to this,” he said.

“Our hope is that the bench and the bar support the intent of these rules, understand why we’re doing this, and that we do realize these savings.”

Against those hopes, there is Eby’s record, including a lack of consultations, arbitrary rule-making, and changes at the last minute.

Not the approach that most cabinet ministers would choose if they needed co-operation from the bar and bench to make the numbers work.

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26Mar

Legislative committee gives advice on ride-hailing regulations

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Ride-hailing companies like Uber and Lyft should not be limited by geographic boundaries or caps on fleet sizes, and drivers should be allowed to work with Class-5 licences, according to a provincial legislative committee.

In November, the provincial government introduced legislation that will allow ride-hailing companies to operate in B.C., likely by late this year.

The nine-member, all-party select standing committee on Crown corporations was asked to look at four specific areas of regulation: boundaries, vehicle supply, fare and price regimes, and driver’s licence requirements.

On Tuesday, it released 11 recommendations after hearing from 15 witnesses and receiving 47 written submissions from municipalities, regional districts, First Nations, taxi associations, disability advocacy organizations and ride-hailing companies.

“I do hope that now government will see fit to keep the recommendations and get real ride-hailing in place and on the road in British Columbia,” said Surrey South Liberal MLA Stephanie Cadieux, who was the committee’s deputy chair.

Currently, taxi companies are limited by operating boundaries, which are set when a taxi licence is granted. They dictate where a taxi can pick up passengers, which can lead to deadheading — return trips without passengers — and ride refusals.

The committee said boundaries should not be imposed for ride-hailing companies. Instead, they considered other options to manage the distribution of vehicles, such as geofencing to redistribute supply and per-trip or per-kilometre fees to deal with congestion, if necessary.

Fleet sizes for ride-hailing companies should not be capped, the committee said, however it did not agree on other mechanisms to deal with supply and demand.

In the interest of safety and reducing emissions, the committee recommended that vehicles used for ride-hailing be no more than 10 years old.

On pricing, the committee said there should be a minimum per-trip price that is not less than the cost of public transit. A regular adult fare for someone who does not have a Compass card is $2.95 for one zone, and $5.70 for three zones.

They also agreed that the cost of a trip should be the same for an handicap-accessible vehicle and non-accessible vehicle.

Companies should be required to disclose the price for a trip on their apps before the customer orders a ride, and data should be monitored to see if a base rate or cap on surge pricing should be implemented. These recommendations were in a 2018 committee report.

The committee was not unanimous in its views on driver licensing, but a majority of members voted for a Class-5 licence requirement, rather than a Class-4. A Class-5 licence is what most drivers in B.C. hold.

“Members expressed uncertainty over whether the Class-4 licensing process actually produces safer drivers,” the report states.

They emphasized that driver rating systems could help identify safe drivers, and said driving record checks and medical exams could be required.

The committee also recommended that ride-hailing companies be required to provide data to the province for monitoring purposes, and that the province make that information available “to the broadest extent possible while maintaining privacy.”

It was recommended that the province review the regulations in 2023.

Committee member and B.C. Green spokesperson for transportation, MLA Adam Olsen, said the government now has the tools to make ride-hailing a reality.

“Ride-hailing will make transportation services more accessible for British Columbians, and the recommendations brought forward by our committee ensure that there would be a regulatory environment that promotes overall safety and a fair playing field,” said Olsen. “I hope government will implement these recommendations, which are informed by other jurisdictions.”

Ridesharing Now for B.C., a coalition advocating in favour of ride-hailing, urged the province to adopt the recommendations and move forward.

“Today’s report marks a major milestone in bringing ride-sharing to the province by the fall of 2019, as promised by the government,” said spokesperson Ian Tostenson. “It is time to get ride-sharing on the road by implementing the key recommendations and finalizing ride-sharing auto-insurance.”

To bridge the gap until ride-hailing is allowed in the province, a local company has started Kater, a ride-hailing app that will begin beta testing on Saturday.

People who have registered on the company’s website and been chosen to take part in the trial will be able to download the company’s app and order rides from Vancouver to anywhere in B.C. Kater will begin with a small number of vehicles and scale up to 140 within a few weeks.

The company will use Vancouver Taxi Association licences to operate and will be expected to abide by the existing rules — which include requiring a Class-4 licence, TaxiHost Pro certificate, and chauffeur-for-hire permit, and charging taxi rates — but use a typical ride-hailing app that takes payment and allows users to track their rides and rate drivers.

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18Mar

Rob Shaw: NDP government ‘reviewing’ a basic human right for girls

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VICTORIA — Annie Ohana was in her classroom at L.A. Matheson high school in Surrey last week, when an all-too-common scene played out. A young woman ducked into her room after the final bell rang and quietly asked: “Ms. Ohana, do you have a tampon or pad?”

“Teachers at schools and counsellors, especially as women, we do often keep a little stash of products,” said Ohana.

So Ohana, the Aboriginal department head at the school, gladly reached into her own supply to help out. It made the difference between the student being able to stay at school for her extracurricular activities, or having to leave.

“She was volunteering for something, but instead of going home because of her period, she was able to ask me,” said Ohana. “I was able to provide it, but that’s my own money …  the system should provide it. In this case I was there, but what if I was gone?”

It’s a question increasingly being asked by teachers, parents, students and advocates in hundreds of schools across the province. Why is there no provincial funding to provide free tampons and pads for female students in school washrooms?

Instead, B.C. has a patchwork system that varies from school to school and often results in embarrassment and shame for female students.

Some districts put coin-operated dispensers in women’s bathrooms (requiring girls to have exact change to get a pad or tampon while bleeding and in need). Others schools have literally nothing. In some cases, like in Burnaby North Secondary, students have taken it upon themselves to organize free baskets of products in washrooms because nobody else will do it for them.

Some schools do offer free tampons or pads — but only if the student interrupts her teacher in class, asks to be excused in front of all her classmates, walks to the office, waits in the queue at the front desk and then asks the (possibly male) receptionist in front of everyone else sitting in that office if she can please have a tampon thank-you-very-much. You couldn’t create a more cumbersome and humiliating system if you tried.


L.A. Matheson teacher Annie Ohana.

Mark van Manen /

PNG

Some girls can’t afford to buy their own products. And there’s cultural and social stigmas around menstruation that can leave young women, at a difficult time in their life, isolated from family and friends. It’s even more difficult if the student is transgender. The very least the education system could do is offer them a discreet, free, and easy way to get a tampon or pad from every school washroom, without having to ask.

One in seven Canadian girls have missed school because they couldn’t get a tampon or pad during their period, according to a Procter & Gamble survey.

The issue was raised at the legislature by Green Leader Andrew Weaver during International Women’s Day. He based his question on a suggestion from one of his staff members, Stephanie Siddon.

Education Minister Rob Fleming responded by pointing to community grant programs that schools could try to tap, while offering to conduct more research into the issue.

It was an unimpressive display of leadership, said Weaver.

“There are some things that you just think about for 30 seconds and you realize, yeah that just makes sense,” said Weaver. “Here we are in 2019. You just do it. This falls into that. … “I would have thought he’d just have done it.”

Weaver’s own quick calculations — done in the middle of an interview using public pricing for hygiene products — pegged the rough cost at $200,000 a month for the education system, or $2.4 million a year to give more than 260,000 enrolled female students access to tampons and pads.

That amounts to a “rounding error” in the ministry’s $6.5-billion annual budget that should be acted upon without wasting time researching further, said Weaver.

New Westminster became one of the first school districts in Canada to fully fund feminine hygiene products when it voted last month to spend $10,000 of its own operating budget on dispensers and $7,000 annually to stock them with free supplies for women.

The issue is also on agendas for school trustees in Surrey, Greater Victoria, Cariboo-Chilcotin, Burnaby and Vancouver.

School districts are charging forward on their own, while the province lags behind.

The government could save time and effort by simply listening to advocates like Douglas College professor Selina Tribe, who has been clear, consistent and vocal about the issue for months.

Or Sussanne Skidmore, the secretary-treasurer of the B.C. Federation of Labour who is helping lead the United Way’s Period Promise campaign that sent a letter to Fleming on March 7 asking him to “take a leadership role in addressing period poverty in our province.”

“If there’s public policy around this, we can normalize it and make it no different than toilet paper,” Skidmore said. “It’s a human right.”

How frustrating it must be for socially progressive New Democrats to watch their government move so slowly on a clear-cut human rights issue like this.

“There are lots of leaders stepping up to say it can be done and it’s not that complicated,” said Skidmore.

Social Development Minister Shane Simpson is set to announce B.C.’s new poverty reduction strategy on Monday. There’s no good reason why this couldn’t be included.

Fleming said in statements last week that he’s “committed to supporting students around the province who need access to these products and I look forward to putting forward a plan soon.”

In the meantime, he said, “ministry staff are currently researching this further.”

Researching what exactly?

Is there some sort of cost-benefit ratio needed before the minister will sign off on funding access to hygiene products?

Is there a price to be put on the embarrassment faced in having to ask the office receptionist or school nurse (if the nursing office hasn’t already been eliminated due to cutbacks) for a tampon?

Is there a figure we can apply to how many days it’s acceptable for a female student to go home sick because they get their period in class and have nowhere to turn?

Does the ministry research the cost of toilet paper or soap?

For Ohana, who teaches social justice to her high school students, the issue is clear.

“To me, this is tied in to social justice,” she said. “At the end of the day, it’s a human right. It’s a human reality.

“There’s a shame element,” Ohana added. “If girls can feel they can be proud of their bodies, and part of that being menstruation, that’s going to impact their self-esteem and confidence.”

That’s worth the cost.

Free advice to the education minister: Just do it.

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28Feb

Daphne Bramham: First Nations’ solution to a modern, medical crisis

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Ending Canada’s opioid overdose crisis will likely require much more than sophisticated drug therapies. In fact, it might mean following the lead of First Nations health-care providers and transforming how we think about and deliver medical services.

First Nations people are dying of opioid overdoses at three times the rate of the general population. Hidden in that data are Canada’s most-neglected victims — Indigenous women.

Unlike in the general population where men comprise 80 per cent of the victims, Indigenous women are as likely to overdose or die as their brothers, fathers, husbands and sons.

They are eight times more likely to overdose than other women, and five times more likely to die from an overdose.

It’s not really surprising, says Dr. Evan Adams, the First Nations Health Authority’s chief medical health officer. The terrible numbers track other devastating indicators of how their health and longevity diverge from those of other Canadians.

“A lot of First Nations women who have substance-use disorders are exploited women. They are women who are victimized by the sex trade. They’re victimized by their partners,” said Adams, who worked for five years in Vancouver’s notorious Downtown Eastside, the epicentre of Canada’s opioid crisis.

What the opioid crisis highlights for him is the endemic problem of the western medical model, where people go passively to doctors’ offices and say, “Heal me.”


Dr. Evan Adams is the Chief Medical Officer for the First Nations Health Authority.

Jason Payne /

PNG

“Our (First Nations) model is that the doctor gives you a chance to get better. But, you make yourself better,” he said. “It’s your family that does most of the work of helping you get better, not that doctor who you visit for 15 minutes every week, if you’re lucky.”

Unlike in the western model, healing and wellness in the traditional Indigenous way involve mind, body and spirit. For First Nations men and women to achieve wellness, Adams said they require much more than medicine.

“They need healers who can do ceremony. Maybe they need love. They need justice.

“How can a woman recover from opioid use disorder when you won’t let her see her children? It’s disgusting,” he said.

The day Adams and I met, the FNHA offices were being “swept” by a group of elders carrying cedar boughs and candles using traditional ceremonies to restore the spirits of the people who work there.

“Some people would say an elder is less trained in opioids than an addictions physician,” Adams said. “But wouldn’t it be nice to have both?”

It’s not that FNHA rejects modern medicine. It continues to expand access to opioid agonist treatments such as methadone and Suboxone, which quell cravings, making it available at all FNHA nursing stations and at four of the nine FNHA-funded residential treatment centres. FNHA reimburses treatment fees charged by private clinics and has spent $2.4 million in grants to 55 communities for harm-reduction programs.

Yet, for Adams and his staff, drug therapies are only a small part of what he calls harm reduction’s suite of services.


The Crosstown Clinic in downtown Vancouver.

JONATHAN HAYWARD /

THE CANADIAN PRESS

“Harm reduction is not just, ‘Let’s make sure you don’t overdose.’ It’s the whole person that you have to treat, not just this one aspect of the person that is craving opioids.”

To incorporate First Nations wisdom into other programs, FNHA created two peer coordinator jobs at the Crosstown Clinic in the Downtown Eastside. Its compassion inclusion initiative has engaged another 144 Indigenous people with lived experience across B.C., and its Indigenous wellness team has taught indigenous harm-reduction and wellness programs in 180 communities.

“Opioid use disorder is everyone’s business. It’s yours and it’s mine and it’s everyone around us. It’s not just the domain of physicians with 24 years of training,” he said. “Why can’t Grandma help, or a family member?”

What concerns Adams about the response to the opioid crisis that is heavily grounded in the medical model is that it could widen the gap between his people and mainstream Canadians.

Indigenous people don’t necessarily trust health providers who don’t look like them or where there is no acknowledgment of the historical trauma they have suffered and their unique experiences in the world.

That’s just one more reason why the FHNA, which is unique in Canada, is so adamant that it must transform the way health care is delivered to its people so that they are empowered to help in their own healing within their own circles of trusted friends, family and elders.

This current crisis is rooted in the western medical model. The seeds were sown by an aggressive marketing campaign by Purdue Pharma, which falsely promoted its Oxycodone as being non-addictive. What followed was an epidemic of opioid over-prescription by physicians and other health-care professionals that eventually created a demand for synthetic opioids on the black market.

With so many deaths and no end in sight, this might be the time for all of us to reconsider whether the best responses to this crisis ought to be done within a much broader context of healing and an expanded understanding of what wellness really means.

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20Feb

B.C. poverty reduction plan a mix of new and old programs, says minister

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Minister of Social Development Shane Simpson says a new poverty reduction plan, coming within two weeks, will be a mixture of new programs and items government has already announced.


CHAD HIPOLITO / THE CANADIAN PRESS

VICTORIA — B.C.’s new poverty reduction plan will include a mixture of fresh government programs as well as services that have already been announced, says the social development minister.

Shane Simpson said Wednesday that while no specific money was highlighted in Tuesday’s budget for poverty reduction, there are nonetheless several programs already in place and funded by other ministries that will count toward the plan when it is released in “a couple of weeks.”

The poverty reduction plan calls for a 25 per cent reduction in poverty, and a 50 per cent reduction in child poverty, within five years.

“There are a whole array of issues that will play into achieving those objectives,” said Simpson. “It’s child care, it’s minimum wage, it’s housing, it’s pieces that have gone before, it’s pieces that will come afterwards, it’s pieces that we’re not even sure of where they land like the basic income initiative that we’ll see in 2020.”

Tuesday’s budget did announce a $380-million annual new B.C. Child Opportunity Benefit program to give families up to $1,600 a year in financial support for a child — though the benefit doesn’t begin until October 2020. The budget added only $9 million for child care, though that was on top of $1 billion over three years announced last year that funds a mixture of subsidies (including virtually free care for a family with an income under $45,000) and 53 pilot sites for $10-a-day child care.

Simpson said it’s difficult to put a dollar figure on his plan because spending for the child benefit and child care programs are budgeted elsewhere. But he said the plan will incorporate the $100 in increases to the disability and social assistance rates dating back to 2017, as well as the $50 additional rate increase announced in Tuesday’s budget.

Social advocacy groups criticized the government for not providing more assistance for the poor in the budget, including the deeply poor. Simpson said he appreciated the work of the advocacy groups and “I’m looking forward to working with these groups and for them to continue to push us. That’s healthy.”

The poverty plan will also include new funding for rent banks, which Finance Minister Carole James has said will help prevent people from being evicted if they run into financial trouble due to illness, their job or life events. James’s ministry said Wednesday the government will be providing money to existing rent backs in communities across B.C. rather than creating and operating its own.

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19Feb

B.C. Budget 2019: Government offers only modest new spending

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VICTORIA — B.C.’s NDP government delivered a stand-pat budget Tuesday that offered little new spending on its priority housing and child care agendas, but did unveil modest funds for student loans and clean energy incentives.

Finance Minister Carole James tabled a $58-billion 2019/20 spending plan for the fiscal year starting April 1, with a $274 million surplus. There are no new tax increases beyond those already announced last year on high income earners, corporations, luxury homes and the carbon tax.

However, there is new small-scale spending, such as $31 million this year to eliminate interest rates on student loans — a move government estimates will save an average undergrad student with $11,200 in loans roughly $2,300 in interest.

“We were very pleased to see that coming in the budget,” said Noah Berson, chairperson of the Alliance of B.C. Students.

It applies to all existing student loans as well, effective immediately.

“The past government racked up surpluses simply for the case of surpluses while not investing in people,” said James. “We are looking for a balanced approach … while also making sure we invest in people who help build that strong economy.”

The budget offered only $9 million in new spending for child care in the coming year, which is on top of $1 billion announced in the last budget spread over three years.

The hold-the-line spending meant the current hybrid system of subsidies and 53 pilot locations for $10-a-day child care won’t be significantly expanded in the coming year, according to ministry officials. Nor was there any signal when full $10-a-day child care — a key NDP election promise from 2017 — may become a reality.

James said there’s still $366 million in child care funding occurring this year from her previous announcements, even if it was not re-announced in this budget.

“Lets remember the child care plan is phased in over time,” she said. “Over the next year you’ll see the minister and ministry doing evaluation of the prototype of $10-a-day and looking at how we expand those.”

Child care advocate Sharon Gregson said she still believes the government is on track by increasing funding incrementally every year despite not making a big deal of re-announcing it. She said she expects the pilot locations and subsidies to increase this year, even if government doesn’t.

“They’ve got room within this funding envelope to do that,” said Gregson. “Now we want to make sure they are spending the money the right way.”

Housing affordability also held to its $7-billion spending plan over 10 years, with a $9 million increase in the budget for “incremental housing initiatives” and more homeless modular housing.

There was no sign of the $400 annual renters rebate promised by the NDP in the 2017 election, which is opposed by the NDP’s power-sharing partners, the B.C. Greens.

“It is something we’re working on with our Green colleagues,” said James. Government is creating a provincially backed rent bank for those who fall behind on their rent and need help to avoid eviction.

James announced a new “Child Opportunity Benefit” as a key new budget promise that would provide up to $1,600 a year for a child, through monthly deposits to families on an income-tested scale.

“We really want to make sure we have the opportunity for every child to thrive and provide more help to families in raising those children,” she said.

“So I’m very proud that budget 2019 introduces the child opportunity benefit. This really is a historic investment, and puts dollars in the pocket of middle class families.”

But the program does not actually start until October 2020 — meaning it is not even part of the coming fiscal year.

Related

Therefore, there’s no money set aside to fund the program in the coming year, and no cheques in the mail for almost 20 months. James said that’s because it takes a year’s notice for B.C. to get the Canada Revenue Agency to agree to help with the administration of the program.

James reiterated the elimination of Medical Services Plan premiums this year — which are replaced with an Employer Health Tax — combined with future credits like the child benefit could be considered in one of the largest middle-class tax breaks in provincial history.

The government’s ambitious plan to promote clean electricity use to hit its pollution-reduction targets, called CleanBC, received $902 million over three years in the budget.

The money will fund already-existing climate action tax credit cheques, as well extend for a year the current $6,000 point-of-sale rebate on electric vehicles, $2,000 to replace a fossil fuel burning furnace with an electric heat pump and $1,000 to upgrade windows and doors to be better insulated.

Some programs, such as electric vehicles subsidies, have been so popular in the past that they’ve run out of money and had to be topped up by government during the year, said James.

The government had set up expectations of a fully funded poverty reduction plan to be unveiled this year.

However, there was almost no mention of such a plan in the budget.

Instead, the budget outlined a $50 monthly increase to disability and income assistance levels — which advocates have already said are so low they need a major spike in order to provide a livable foundation for the poor.

“We know more needs to be done to make income and disability assistance more accessible,” said James.

“You’ll hear more about this as the poverty plan comes forward in the spring with more specifics.”

That disappointed advocates like the Canadian Centre for Policy Alternatives, which said the $50 monthly increase was insufficient.

“I think we could have done more,” said senior economist Iglika Ivanova. “I think we definitely have the fiscal capacity.”

She said she can see the outlines of a poverty reduction plan on the horizon, but that the new child benefit tax program won’t help as much as government claimed.

“No children and families on welfare will be lifted out of poverty by this child benefit,” she said. “It is not big enough.”

Other small-scale new spending initiatives in the budget include $74 million over three years for new mental health and addictions programs for children, and redirecting $297 million in gaming revenue to share with First Nations over three years.

James said there’s flexibility built into the budget for unanticipated spending, both in a $500 million forecast allowance as well as a $750 million contingency fund. There’s also $553 million set aside for bargaining mandates.

James said the provincial economy remains the healthiest in Canada, with forecasts of the Gross Domestic Product increased to 2.4 per cent in part due to the new Canada-United States-Mexico trade agreement.

“It’s a budget strong on the social side and quite weak on the economic development side,” said Jock Finlayson, executive vice-president of the B.C. Business Council. “It’s complacent. It says the relatively strong economy we’ve been operation on will continue. I’m not sure that’s necessarily true.”

Finlayson said James deserves credit for holding back on large spending initiatives and pressure within her party to spend big.

“The fiscal and economic projections I think are credible,” said Finlayson.

The Greater Vancouver Board of Trade gave the budget a “B-“ rating, calling it “a steady as we go budget” built on last year’s tax increases.

A cooling housing market is estimated to cut into property transfer tax revenue, lowing it from $2.2 billion to $1.9 billion. B.C. Housing starts are expected to drop almost 33 per cent by 2023, compared to the final year of the previous Liberal government.

However, the government does not necessarily think lower construction and sales will translate into lower prices for housing.

“The average home sale price in B.C. is expected to increase moderately over the forecast horizon,” read the budget.

James said she’s still pleased with what she sees.

“We’re finally starting to see some moderation,” she said of housing. “I’m cautiously optimistic.”

But she said the government wants more “moderation” in prices

“I don’t think we’re at that stage to say housing is affordable particularly in our metro centres,” she said.

Paul Kershaw, of Generation Squeeze, said the housing measures “were resting on last year’s laurels” but the government deserved credit for at least trying to influence the market.

Kershaw said he wished government would act on incentivizing municipalities to approve more density in communities that would allow for more purpose-built rental housing.

The government has already introduced a speculation tax as well as surcharges on homes valued at more than $3 million, as part of a 30-point plan James said needs more time.

The budget predicts a stunning turnaround at the Insurance Corp. of B.C., which Attorney General David Eby has called a “dumpster fire” financially and is on track to lose $1.18 billion this year. ICBC’s finances should reverse to only a $50 million loss in the coming year, after government institutes a new $5,500 cap on pain and suffering claims for minor injuries as well as other legal reforms, according to the budget. By 2020/21 ICBC is predicted to be back in the black.

“All of us and I as finance minister feel some frustration that these change didn’t occur early and we’re faced with this kind of fiscal challenge in our budget,” James said of ICBC.

Health care spending, the single largest item in the annual budget, is budgeted to rise almost $1 billion to $20.8 billion, or roughly 36 per cent of all government spending. Some of that is for expanded cancer services and improved access to drugs, though much appears to be the simple growth in the cost of delivering health care services.

Elementary and secondary school funding is budgeted to grow $197 million. The government says it has hired more than 4,000 teachers and restored $423 million in extra funding annually to the system after the Supreme Court of Canada decision on class size and composition.

An increase in capital spending for transportation, health, schools and other infrastructure will also grow the total provincial debt from $67.9 billion to more than $82 billion in 2021/22, an increase of almost 21 per cent.

Almost four cents of every dollar of revenue is set to be used to pay for interest on debt. James said the debt-to-GDP ratio on taxpayer-supported debt — a key metric credit agencies use when awarding B.C. a AAA credit rating — remains affordable at an estimated 15 per cent.

“British Columbia is thriving,” said James. “We have a balanced budget across the fiscal track. We’re the only province with a AAA credit rating …

but we will never have a truly prosperous province unless everyone in British Columbia can share in that prosperity.”

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13Feb

Inflated numbers on docs, nurse practitioners at urgent-care clinics

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The B.C. government’s throne speech contained misleading information about the number of doctors being hired for 10 urgent-care centres across the province.

“These new centres will come with 200 more family practice physicians, 200 nurse practitioners and 50 clinical pharmacists and other health-care providers,” the speech stated.

However, when questioned Wednesday about those inflated figures, the Ministry of Health acknowledged the speech “wrongly linked” 400 health professionals to the clinics, five of which have opened and five more that are slated to open by May.

Ministry of Health spokeswoman Kristy Anderson said that while “some” of those nurses and doctors will be working at urgent-care facilities, the rest will form part of the government’s overall objective for its primary-care strategy. She couldn’t provide the number of nurses and doctors working now, or in future, at urgent-care centres.

The five clinics that have opened so far are in downtown Vancouver, Surrey, Kamloops, Quesnel and Langford. The government will not reveal where the next five will be.

As of today, there are about 6,600 family doctors (also called primary-care physicians or general practitioners) licensed and actively working in B.C. That’s about 200 more than last year, so the throne speech implied that the government was grabbing almost every new doctor for urgent-care centres, an unlikely scenario.

Similarly, there are 500 practising nurse practitioners (NPs) in B.C. and only 54 new NPs in the province in all of 2018, so for the throne speech to state that 200 will work in urgent-care facilities is a stretch.

Anderson said the government aims to staff urgent-care clinics with doctors who’ve recently completed their two-year, postgraduate specialty medical training (residencies) in family medicine. Such doctors don’t yet have a “panel” of patients, so working in urgent-care centres gives them an instant pool of patients and a team around them, including nurse practitioners and medical mentors, she said.

There are about 170 doctors who complete their residencies in family medicine each year in B.C., so if every one of them were to be snapped up by urgent-care centres, there would be no doctors to take over the many practices of retiring doctors.

Urgent-care centres have been a stated priority for Adrian Dix since he was appointed health minister. Last spring, the government said urgent-primary-care centres would be a new medical-service model intended to take pressure off hospital emergency departments. They are also designed to provide ongoing primary care — or link patients to such doctors. They all offer extended hours, weekends and evenings.

Until Wednesday, when Postmedia News challenged the ministry on figures in the throne speech, the government has been unwilling to share information about the business models of the government-sponsored clinics, despite numerous repeated requests for such info going back to last October. Instead, each time a new clinic has opened, like the one in Premier John Horgan’s riding, a news release containing few specifics has been issued.

(Late Tuesday, the ministry offered a briefing by senior officials but stipulated that all information was background only.)

Liberal health critic Norm Letnick said he found the throne speech not only short on substance in the health arena, but also “thin everywhere else too.”

Dr. Eric Cadesky, president of Doctors of B.C., said his understanding is that physicians being hired for such clinics are being paid through salaries or contracts rather than billing on a fee-for-service model. The contract-payment model is appealing to doctors who don’t want overhead costs and businesses to run. In that sense they’re better for “work-life balances.”

It’s unclear if the government is handing money over to clinics directly or if they’re channelling money through health authorities. In a few cases initial setup costs were about $2 million and annual operating costs per year are said to be up to about $4 million.

“Hopefully, these clinics will achieve their stated goal of providing after-hours care to patients as well as ongoing care for patients who are unattached (without a family doctor),” Cadesky said.

There are pros and cons to the urgent-care model, he said. On the plus side, they have labs, pharmacies, other health-providers like nurses and imaging facilities. But Cadesky said the potential unintended consequence of such centres is that they could siphon doctors away from full-service, cradle-to-grave, primary care clinics.

“Some doctors may choose to start off with this kind of model. It’s seen as less stressful and less costly than running a business, but we still need doctors working in private practices across the province,” he said, referring to ever-increasing rents for medical clinics and staff costs.

Doctors of B.C. is presently engaged in talks with the government on a new contract and one of the priorities for doctors is more money to “sustain” the independent, medical-clinic model, Cadesky said: “With the high cost of living and sky-high rents, it’s becoming more and more difficult to operate medical practices and to recruit staff.”

Dr. Afshin Khazei, medical director of the recently opened Vancouver City Centre urgent-care clinic at 1290 Hornby St., said that 14 doctors are on staff, including family doctors and emergency room specialists, but some work only part-time. While the clinic expects to eventually see 36,000 patients a year, volume so far during the “soft opening” has been lower. Next month, however, renovations to the second and third floors will be complete. On those floors, patients can get connected to up to 40 family doctors with offices there.

“That’s important because there are 18,000 in the downtown area who don’t have a family doctor,” he said.

The extended hours of the clinic are proving to be hugely beneficial. On Tuesday night, the urgent-care clinic offered measles vaccinations after public-health clinics closed at 4 p.m.

“We vaccinated six infants and 13 adults in a few hours last night,” Khazei said.

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Twitter: @MedicineMatters


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