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Posts Tagged "regulations"

26Jul

Daphne Bramham: Recovery homes’ dilemma: Trying to comply with regulations that have yet to be written

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After three years of operating two registered recovery houses, in January 2016 Cole Izsak found what he believed — and still believes — is the perfect place.

But before taking possession, the owner and executive-director of Back on Track Recovery applied to the provincial health ministry to essentially grandfather his operation and transfer the registration of one of his houses to the new site.

Because Back on Track has never had any substantiated complaints, he didn’t expect any problems and, a month later, shut the registered house and opened a four-plex now called The Fortress.

The next month, Izsak closed one of the two houses that were registered by the provincial government and moved to the new compound with internal, off-street parking at 9889-140th Street in Surrey.

He still wasn’t concerned when in May, the ministry said it was putting a hold on his application while both the province and Surrey were formulating new regulations.

Since then, it is rare that any of the 40 beds — two per bedroom in each of the five-bedroom houses — are empty.

While Back on Track continues to operate the one registered house, The Fortress remains unregistered, with only two of four business licenses that it needs.

For the last 2½ years, Surrey’s bylaw inspectors have been telling Izsak that unless all four houses at The Fortress get their provincial registry, the city can’t license the houses until the registration from the health ministry comes through, certifying that services offered meet its standards of care.

In mid-May, Back on Track and its residents were told that the licenses were being revoked and the four houses would have to close at the end of July. It has since been given a reprieve, pending a decision from the provincial registrar.

“If Mr. Izsak’s registration comes through, we’ll be prepared to do our own inspections for renewal or issuance of the licenses,” bylaw services manager Kim Marosevich said this week.

In late May, after Maggie Plett first spoke publicly about her son Zachary’s death at another Surrey recovery house called Step by Step, Addictions Minister Judy Darcy told News 1130, “We’re trying to make up for lost time over the past many, many years since the scandal started to break.

“But I would expect that we will have new, stronger regulations and enforcement in place by the end of the year.”

Throughout all of this, the government has paid Back on Track the $30.90 per diem that covers the cost of room, board and recovery services for each welfare recipient living there — a rate that has remained unchanged for 16 years.

Izsak doesn’t know why the ministry has yet to make a decision on his application. The mental health and addictions ministry has not yet responded to my questions about it.

On Tuesday, Izsak gave me a tour of the four neatly kept houses. He showed me the well-supplied pantry where residents are free to take whatever food they want and as much as they want. There is also an open-air gym and smoking lounge. Every room has a naloxone kit in case of an opioid overdose, and every few weeks, residents are given training on how to use them.

The half-dozen residents that I spoke to privately — including one who said he had been in at least 20 such facilities — said The Fortress is the best. They talked about feeling safe, well-cared for, and even loved.

Izsak makes no apology for not having more set programming in the houses.

“People who are coming off the street or out of prison are not going to surrender to eight hours of programs per day,” he said. “But what they will surrender to is coming to a place like this where they are fed well, have a clean bed, a TV, and programming from 9 a.m. until noon.”

He acknowledged that there are no certified counsellors or therapists working there. He devised a recovery program called MECCA based on his own experiences in recovery that is delivered by others who are in recovery.

Izsak also said he cannot afford to hire certified addictions counsellors and specialized therapists, as they do at recovery houses where monthly rates are anywhere from $3,000 to $9,000 a month.

Right now, registered facilities don’t require that, according to the registry’s website.

What’s required is that all staff and volunteers “must have the necessary knowledge, skills, abilities and training to perform their tasks and meet the health and safety of residents.”

Far from bridling at more regulations, Izsak has a long list of his own that he would like the province to enact to weed out bad operators.

It includes random site inspections, manager-on-duty logbooks documenting what happens every two hours from 10 a.m. until 10 p.m., and a requirement that all operators provide their expense receipts.

After three recent deaths in recovery houses, Izsak is now a man on a mission.

“I want to close operations that are bad so that I’m not treated almost like a criminal because they acted unscrupulously.”

Of course, he first needs to save his own.

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Twitter: @bramham_daphne


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9Jul

Taxi borders won’t change under B.C.’s new ride-hailing regulations

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Taxi cabs will keep their municipal boundaries even when ride-hailing is introduced in B.C. later this year.


Gerry Kahrmann / PNG

VICTORIA — Existing boundaries for taxis in most of B.C. won’t change with the introduction of ride-hailing later this year, according to the independent tribunal charged with making the decision.

The Passenger Transportation Board, which will set boundaries and fares for ride-hailing and taxis by next month, is not considering any large-scale changes to current taxi areas that are often based on regional or municipal borders.

“As an administrative tribunal we’d have to discuss changes of boundaries and that would be very contentious and time-consuming and yet another delay in implementing ride-hailing,” board chair Catharine Reid said Tuesday. “And we don’t want a delay in implementing ride-hailing.

“The second reason is we don’t have good origin destination information. So if we try to change taxi boundaries, we don’t know if we’ll make things better or worse.”

Ride-hailing companies like Uber and Lyft can begin applying for licences in B.C. on Sept. 3, after the B.C. government announced Monday it has set the licensing and insurance regulations. Premier John Horgan has said ride-hailing could be in operation by the end of the year.

Drivers must have a class four commercial licence, and companies will be required to pay a $5,000 fee as well as a 30-cent-per-trip levy to improve accessibility services, under the government rules.

But the exact details on fares and boundaries are to be set by the Passenger Transportation Board, which is an independent tribunal.


The Uber app is displayed on an iPhone as taxi drivers wait for passengers at Vancouver International Airport, in Richmond, B.C., on Tuesday, March 7, 2017.

THE CANADIAN PRESS/Darryl Dyck

Reid and the board began public discussions on those issues with taxi companies in Prince Rupert on Tuesday. She said the rest of the taxi sector, as well as ride-hailing companies like Uber and Lyft will be consulted by the end of next week.

“The policy will be up sometime in August that will provide policy on boundaries, fleet size and rates,” she said.

Uber and Lyft have said they want to operate free of borders, to give their drivers flexibility on responding to demand for a ride anywhere.

The taxi sector is divided on the issue. Eliminating borders could solve problems like “deadheading” — where taxis from Vancouver, for example, take a passenger to Surrey but can’t pick up anyone on the return trip due to licensing restrictions. But removing borders could also devalue taxi licenses that hold value based on their scarcity in a certain area, causing significant financial losses for companies, drivers and those who’ve borrowed money to purchase or lease part shares in vehicle licenses.

The board has released two public discussion papers that lay out its options.

For the rest of the province outside of Metro Vancouver, it offers no options to change taxi boundaries. The report says ride-hailing companies could either follow the same borders, or be given larger regional or provincial areas in which to operate, depending on industry feedback.

In Metro Vancouver, three of the four options proposed would keep the existing municipal taxi boundaries for Vancouver, Surrey and elsewhere.

However, one option does propose opening up the Metro Vancouver region as a single area in which both ride-hailing vehicles and the traditional taxi sector could operate equally.

“It is not clear that taxis would want this approach as they are free to launch their own (ride-hailing) service and could also maintain the advantages of taxis that each has within their current operating area,” read the board report.

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An open metro region would give the public “faster and more reliable service, including at peak times,” reduce the numbers of trips refused and tackle the problem of deadheading, according to the report.

However, it would also result in “taxi service likely reduced for suburban areas,” wrote the board.

Taxi licenses would see a “large reduction” in value if ride-hailing was region-wide or provincewide, especially in the City of Vancouver, according to the report.

The B.C. Taxi Association, which attended consultations in Prince Rupert on Tuesday, said all boundaries should be removed for everyone.

“There’s no need for boundaries,” said president Mohan Kang. “If they have the ability to move around Metro Vancouver, so should we.”

The Vancouver Taxi Association, where taxi licenses hold the most value and its operators face the largest risk, could not be reached for comment.

The Passenger Transportation Board is also considering whether to limit the size of ride-hailing fleets, but its discussion papers note that no other governments do so and it would be impossible to set a defensible limit.

Fares are also up for consideration. The board notes no other governments impose maximum price limits on ride-hailing, despite concerns about surge pricing during peak demand. One option up for consideration is setting the minimum fare for an Uber or Lyft ride at the same rate as a taxi, or setting no minimum rate at all.

Uber and Lyft declined to comment. Both oppose B.C.’s class four commercial licence requirement and neither company so far has committed to opening in the province later this year.

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8Jul

Uber in B.C.? Regulations give ride-hailing service the green light

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The B.C. government says the Passenger Transportation Board will start accepting applications as of Sept. 3 in order to have the service in place this fall.

ICBC says it will offer a blanket, per kilometer insurance product and will only apply when a driver is offering the service. All other regulations will come into force on Sept. 16, which means ride-hailing is a go once the PTB approves applications.

PTB will need to consider appropriate operating areas, fleet sizes, and rates.

Other regulations announced via a government release include requiring drivers to have criminal and driver record checks. Those operating illegal services could be fined up to $100,000 a day. A 30-cent “per-trip” fee is also being added to help fund programs to increase accessibility.

The regulations released today come after a number of studies and consultations into the issue of ride-hailing.

Earlier this year, a legislature committee issued recommendations including there be no boundaries or limits on how many ride-hailing vehicles are allowed on the road. The committee also suggested the minimum cost for ride-hailing needs to be more than the cost of taking transit.

Another recommendation – that drivers be required to hold a Class 5 license was previously rejected by the minister.

In June, a report from B.C.’s Passenger Transportation Board found there was a “public need and desire for ride hailing.”

In 2017, the NDP government commissioned Dan Hara to speak to the taxi industry and stakeholders about how to move forward.

Parties have fielded the issue as a political hot potato for years. The Liberals, in power for 16 years failed to introduce regulations and the NDP broke a promise to bring in ride sharing by the end of 2017. Observers and critics accuse politicians to bowing to the taxi lobby and refusing to alienate voters in key battlegrounds like Surrey.

An overview of the regulations provided by the government follows. Viewing this on our mobile beta site? Tap here for a compatible version.


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8Jul

Uber in B.C.? Ride-hailing companies, advocates worried regulations too restrictive

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Imagine working for a cab company, ending your shift late and not and then not being able to get a taxi to stop and take you home.

Christiana Virtue said that’s exactly what happened to her.

“I was off at three o’clock in the morning waiting for a cab and the cab drove past me multiple times,” she told CTV News.

She blamed the early morning hours and the location. The Victoria-area resident estimated over the past year, she’s probably had a cab not pick her up for various reasons about 10 or 15 times.

Like others, Virtue likes the idea of having the option to ride-share. It’s a reality that’s a step closer, as the province unveiled regulations Monday that companies will need to abide by. Yet something that wasn’t addressed in those new rules is what advocates say may be the biggest roadblock ahead.

“We are very concerned around the Class 4 licensing that will reduce the amount of the supply on the road, which is ultimately the problem and the challenge that we’ve been experiencing for so many years here in B.C.,” said Lyft Canada’s Managing Director, Aaron Zifkin.

Lyft insists the requirement for the commercial Class 4 licence and not the standard Class 5 most people have won’t mean more vehicles on the road.

B.C. Ridesharing Coalition’s Ian Tostenson told CTV the Class 4 requirement makes it easier for those already driving taxis?to make the switch — which doesn’t increase supply. He’s also worried the requirement will be too cumbersome and costly for moms and students who, in other jurisdictions, have signed up to drive.

“It could cost someone upwards of $1,000 and several months to get it and we’re concerned it’s the only place in North America, practically, that people are required to get it,” Tostenson added.

In a teleconference speaking on behalf of Transportation Minister Claire Trevena, who is ill, North Vancouver MLA Bowinn Ma said the Class 4 requirement was “non-negotiable.” Ma chaired an all-party legislature committee that recommended the standard Class 5 license.

Ma also noted the Passenger Transportation Board will start accepting ride-hailing applications as of Sept. 3 in order to have the service in place this fall. She added she believed the government had struck the right balance in terms of the existing taxi industry, passenger safety and choice.

Other regulations include requiring drivers to have criminal and driver record checks. Those operating illegal services could be fined up to $100,000 a day. A 30-cent “per-trip” fee is also being added to trips in non-accessible vehicles to help fund programs to increase accessibility. All companies will be charged an annual fee of $5,000 a year – an amount government officials said was “conservative” when compared to other jurisdictions.

The regulations announced today will come into force on Sept. 16, which means ride-hailing is a go once the PTB approves applications.

PTB will need to consider appropriate operating areas, fleet sizes, and rates. Consultations with ride-sharing companies and the taxi industry are expected to start Tuesday.

In a statement, Uber says it will review the information and “evaluate how they may impact our ability to provide British Columbians with the same ride-sharing experience they already enjoy in cities across North America…”

ICBC will offer a blanket, per kilometer insurance product that will only apply when a driver is offering the service. The rates will be detailed in an application expected July 19 and the BC Utilities Commission has been given until Aug. 8 to approve the new rates. In a technical briefing, staff said taxi insurance rates would be used as a benchmark to determine rates.

The regulations released today come after a number of studies and consultations into the issue of ride-hailing.

Earlier this year, a legislature committee issued recommendations including there be no boundaries or limits on how many ride-hailing vehicles are allowed on the road. The committee also suggested the minimum cost for ride-hailing needs to be more than the cost of taking transit.

That resulted in blowback from ride-sharing companies and organizations like MADD who argue there’s no evidence to support the claim Class 4 licenses lead to increased safety. Several other Canadian provinces allow drivers to use class 5 licenses.

Parties have fielded the issue as a political hot potato for years. The Liberals, in power for 16 years failed to introduce regulations and the NDP broke a promise to bring in ride sharing by the end of 2017. Observers and critics accuse politicians to bowing to the taxi lobby and refusing to alienate voters in key battlegrounds like Surrey.

An overview of the regulations provided by the government follows. Viewing this on our mobile beta site? Tap here for a compatible version.


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26May

Daphne Bramham: Tougher new regulations promise more agony for chronic pain-sufferers

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One in five Canadians lives with chronic pain, but the cries of an estimated 800,000 British Columbians are not only being ignored, their suffering is being exacerbated by regulators limiting their access to both drugs and treatment.

First, in a move unprecedented in North America, the B.C. College of Physicians and Surgeons imposed mandatory opioid and narcotic prescription limits on doctors in 2016 in an attempt to avoid creating additional addicts and having more prescription drugs sold on the street.

Physicians who don’t comply can be fined up to $100,000 or have their licences revoked.

Now, the college is setting tough regulations for physicians administering pain-management injections.

“I’m enraged,” says Kate Mills, a 33-year-old, palliative care nurse who has been on disability leave for the past 18 months. “People like me are living in chronic, intractable pain and being ignored by doctors who are either too scared or too callous to care.”

She has an uncommon, congenital condition that causes chronic inflammation near her sacroiliac joint and in her lower back, which pushes down on her nerves causing “exquisite pain” down her leg.

Her first doctor essentially fired her, refusing to treat the pain. The next one prescribed Oxycodone to help Mills through until she was able to receive a steroid injection at a clinic, which kept the pain in check for several months.

But by the time the injection’s effects were wearing off, her GP went on extended medical leave. The locum assigned to Mills refused to prescribe her any medication and told her to go to an emergency room where she was given a prescription.

After numerous ER visits, Mills finally found a doctor two weeks ago who is willing to provide medication for her between injections. But he agreed only after Mills signed a contract agreeing that she won’t sell the drugs, will only go to one pharmacy and take the drugs only as prescribed.

She is lucky, though. Her pain management clinic will likely meet the college’s new standards that were developed by an advisory panel over the past three years out of concern about patient safety.

“Increasingly,” the college says on its website, “Procedural pain management is being provided in private clinics and physician offices, but without much guidance on appropriate credentials, settings, techniques and equipment.”

The new regulations would require physicians’ offices or clinics to become accredited facilities with standards on par with ambulatory surgery centres.

That means having tens of thousands of dollars’ worth of equipment including resuscitation carts, high-resolution ultrasound, automated external defibrillators and electronic cardiograms with printout capability.

The college acknowledges that “patients do not require continuous ECG monitoring. However, the cardiac monitoring equipment must be available in the event a patient has an unintended reaction to the procedure.”

The disruption for patients will be huge, according to Dr. Helene Bertrand, a general practitioner, pain researcher and clinical instructor at UBC’s medical school.

She estimates that up to 80 per cent of the offices and clinics where the injections are currently being done won’t measure up and already wait times are up to 18 months.

When the new requirements come into force, Bertrand predicts patients will be waiting anywhere from four to seven years for treatment.

Bertrand herself will have to quit doing prolotherapy, which she has done for the past 18 years on everything from shoulders to necks to spine to ankles. That’s despite the fact she’s never been sued, never had a complaint filed with the college and has published, peer-reviewed research that revealed an 89 per cent success rate among 211 patients in her study group.

(Prolotherapy involves injecting a sugar solution close to injured or painful joints causing inflammation. That inflammation increases the blood supply and deposits collagen on tendons and ligaments helping to repair them.)

The college will not grandfather general practitioners already doing injection therapies. Instead it will restrict general practitioners to knees, ankles and shoulders. All other joint injections must be done by anesthetists or pain specialists.

For Joan Bellamy, that’s a huge step backward.

She’s suffered from chronic pain since 1983 and “undergone the gamut of medical approaches, often with excessive waits: hospital OP (outpatient), pharmacology, neurology, orthopedics, spinal, physiatry and private.”

Since 2000, she’s had multiple injections that have made a difference. But her doctor doesn’t meet the new qualifications.

“I am afraid that without her expertise … that pain will become an intolerable burden, and any search for treatment will result in inconceivable wait times and will debilitate me,” Bellamy wrote in a letter to the college and copied to me.

The near future for pain-sufferers looks grim with most physicians able to offer them little more than over-the-counter painkillers.

Ironically at a time when the provincial medical health officer and others are lobbying hard to have all drugs legalized so that addicts have access to a safe supply, chronic pain-sufferers are being marginalized. For them, it’s more difficult than ever to get what they need.

It’s forcing many of them facing a lifetime of exquisite and unbearable pain to at least contemplate one of two deadly choices: Buy potentially fentanyl-laced street drugs; or worse, ask for medically assisted dying.

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Twitter.com/Bramham_daphne

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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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