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Posts Tagged "targets"

23Aug

Daphne Bramham: B.C. addictions minister targets province’s ‘wild, wild West’ recovery houses

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B.C. Addictions Minister Judy Darcy has no illusions about the current state of British Columbia’s recovery houses and the risk that the bad ones pose to anyone seeking safe, quality care.

Nor is she alone when she calls it “the wild, wild West.”

Anyone able to build a website and rent a house can operate a so-called recovery house. Like a game of whack-a-mole, even when inspectors try to shut down the worst ones, they spring up somewhere else.

That said, the regulations they’re supposed to enforce are so vaguely worded that it’s easier for bylaw inspectors to shut places down for garbage infractions than for failure to provide the most basic of services like food and a clean bed to people desperate for help.

Even the most deplorable ones have never been taken to court by the province, let alone fined or convicted which makes the penalties of up to $10,000 moot.

It’s taken two years, but this week Darcy — along with Health Minister Adrian Dix and Social Development Minister Shane Simpson — took the first steps toward bringing some order to the chaos and overturning years of neglect.

In two separate announcements, what they’re offering is both the stick of tighter regulations and enforcement as well as the carrot of more money for operations and training staff.

The carrots announced Friday include $4,000 grants available immediately to registered and licensed recovery home operators to offset the costs of training for staff before tougher regulations come into force on Dec. 1.

On Oct. 1, the per-diem rate paid for the treatment of people on social assistance will be raised after more than a decade without an increase. Recovery houses on the provincial registry will get a 17-per-cent increase to $35.90, while recovery houses licensed by the regional health authorities will jump to $45 from $40.

The sticks are new regulations that for the first time require things like qualified staff, which common sense should have dictated years ago as essential. Recovery houses will have to provide detailed information about what programs and services they offer. Again, this seems a no-brainer, as does requiring operators to develop personal service plans for each resident and support them as they transition out of residential care.

As for enforcement, the “incremental, remedial approach” to complaints has been scrapped and replaced with the power to take immediate action rather than waiting for a month and giving written notice to the operators.

Darcy is also among the first to admit that much, much more needs to be done to rein in bad operators whose purported treatment houses are flophouses and to provide addicts and their families with the resources they need to discern the good from the bad.

More than most, the minister knows the toll that poor funding and lack of regulation is taking both on addicts who seek help and on their loved ones. She’s haunted by meetings she’s had with the loved ones of those who have died in care and those who couldn’t get the services they needed.

“It’s the most difficult thing that I have to do and, of course, it moves me to my core,” she said in an interview following the announcement. “People say, ‘Do you ever get used to it?’ Of course I don’t. If you ever get used to it, you’re doing the wrong job.

“But I try and take that to drive me and to drive our government to do more and to move quickly and act on all fronts and having said that, there’s a lot to do. There’s really, really a lot to do.”

Among those she’s met are the two mothers of men who died within days of each other in December under deplorable conditions in two provincially registered recovery houses run by Step By Step.


B.C. Minister of Mental Health and Addictions Judy Darcy shares a laugh with Scott Kolodychuk, operations manager of Surrey’s Trilogy House One recovery home where Friday’s news conference was held.

Mike Bell /

PNG

It was four to six hours before 22-year-old Zach Plett’s body was found after he overdosed and died. On Christmas Eve, a 35-year-old man died at a different Step by Step house. It was two days before his body was found by other residents.

Two years before those men died, the provincial registrar had received dozens of complaints and issued dozens of non-compliances orders. Both houses remained on the registry until this summer when owner/operator Debbie Johnson voluntarily closed them.

After years of relentless advocacy Susan Sanderson, executive director of Realistic Recovery Society, was happy to host the ministers’ Friday announcement at one of its houses. She wants to believe Darcy that these are just first steps since the per-diem rate is still short of the $40 she and others lobbied for and remains a small fraction of what people who aren’t on welfare are charged — charges that can run up to $350 a day.

Having taken these long overdue and much-needed initial steps, maybe Darcy and her colleagues can take another logical next step to support working people getting access recovery who — without access to employee benefit plans — can’t afford the cost of treatment.

They shouldn’t have to wait until they’re destitute to get care, any more than someone on welfare should be deprived of help.

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27Feb

BC auditor general says urban ambulance response times below targets

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VICTORIA — Auditor general Carol Bellringer says emergency ambulance response times in British Columbia’s urban areas are well below their time targets.

Bellringer says in an audit on emergency health services that missed response times in cities is significant because urban areas account for 86 per cent of B.C.’s life-threatening 911 calls.

Her report says when emergency response-time targets are not met, patients may not be receiving care when they need it.

The audit, for the period running April 2016 to December 2017, says ambulances in urban areas reached their nine-minute response time target on 50 per cent of life-threatening calls, while responses in rural and remote areas achieved and exceeded the time targets.

The report says B.C. Emergency Health Services has recently added more staff and introduced a new dispatch process, but data from 2018 indicates only a slight improvement in urban response times on calls to 51 per cent.

Bellringer’s report also calls for better co-ordination between ambulance services and fire departments, which often dispatch firefighters to emergency calls.


People walk past ambulances in the Emergency bay at St. Paul’s Hospital in Vancouver, B.C

Gerry Kahrmann /

PNG


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6Feb

Believe it or snot: Nasal mucous transplant study targets bad sinuses

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Dr. Amin Javer, with study subject Maggie Bernet, shows how photodynamic therapy — a blue-light treatment that sterilizes the nasal cavity as it kills bacterial and viruses — works as part of the broader nasal mucous transplant study at St. Paul’s Hospital.


Dr. Amin Javer, with study subject Maggie Bernet, shows how photodynamic therapy — a blue-light treatment that sterilizes the nasal cavity as it kills bacterial and viruses — works as part of the broader nasal mucous transplant study at St. Paul’s Hospital.


NICK PROCAYLO / PNG

There’s healthy snot, then there’s the other kind. And now those with good nasal mucous will be donating their slimy stuff to relatives suffering from chronically inflamed sinuses in a novel transplantation study at St. Paul’s Hospital.

Study leader Dr. Amin Javer said in an interview the inspiration for the chronic rhinosinusitis (CRS) study is the success of fecal transplants for inflammatory bowel diseases and colitis caused by Clostridium difficile (C-diff). A member of his research team — epidemiologist Amee Manges — has been involved in several human microbiome studies related to the higher risk of hospitalized patients getting potentially deadly C-diff infections.

Just like what happens in bowel disorders, good microorganisms in the sinus (microbiome) are disrupted and outnumbered by slimy groups of damaging bacterial and/or viral micro-organisms. Antibiotic therapy is not only often useless but often more damaging since antibiotics cut a wide swath, taking down good bacteria along with the bad.

The chronic sinus condition is common; it is said to affect up to 12 per cent of the North American population.

Indeed, the hospital clinic gets 6,000 outpatient visits a year, many of whom are patients with the chronic sinus condition.

Ethics approval for the St. Paul’s Hospital Sino Nasal Microbiota Transplant (SNMT) study, as it is called, has been granted by the hospital and the University of B.C. But Javer is waiting for final approval from Health Canada, which he expects to get next month.

The study aims to answer whether transplants are both beneficial and safe in patients with the chronic condition. The working hypothesis is that inflammation, mucous discharge and recurring infections will indeed be improved by renewing and replenishing the sinus microbiome with healthy snot from donors.

What would recovery look like? No more constant coughing, no more blocked nasal passages, no more dripping from their noses, no more headaches, sinus infections, fatigue and poor sleep, among many other symptoms.

A patient getting photodynamic therapy with a blue light that sterilizes sinuses by killing bacterial and viral germs. (Photo: Handout)


A patient getting photodynamic therapy with a blue light that sterilizes sinuses by killing bacterial and viral germs. (Photo: Handout)

Handout

Potential donors are now being screened and patients enrolled in the non-transplant arm of the study. Those patients will receive only photodynamic therapy — a blue-light treatment that sterilizes the nasal cavity as it kills all bacteria and viruses. While two-thirds of patients who get such treatment reportedly improve, the effect is short term. Just like antibiotics, it doesn’t distinguish between beneficial germs and bad ones, so a small number of patients actually get worse.

A second group in the study will be randomized to phototherapy plus the transplant while a third will get only the transplant. About 200 participants will be enrolled in the study.

Former nurse Pat Taylor is one of the participants in the trial. She’s been randomized to the branch of patients receiving only blue-light therapy. The Victoria resident said most people have no idea how life-altering and disabling chronic sinusitis is.

“It is financially, physically and emotionally debilitating with a poor quality of life. Many health professionals know little or nothing about CRS, so many people go undiagnosed,” she said, adding that patients often bounce around between specialists like respirologists and allergists, often to no avail.

Javer echoes her sentiments. “Chronic sinusitis has been shown by research to totally ruin the quality of life of patients. It’s a disease that creates so much emotional distress for people. I’ve got patients who tell me they’d rather be dead than endure all these symptoms. One patient from Prince George recently said to me that if I couldn’t fix him, he’d rather I killed him.”

Javer said he’s convinced a “sinus probiotic” is needed to repopulate unhealthy sinus cavities with healthy microbes. Without a beneficial probiotic, harmful pathogens find a way to return and multiply in the nasal cavity, ensuring the recurrence of the sinus disorder.

‘We think the transplants using healthy donor microbiome could drastically improve the long-term health of those with diseased sinuses,” he said, adding that a recently started study in Sweden is also exploring the use of sinus microbiome transplants. In that study, phototherapy is not being used and no data have yet been reported.

Javer said research has not yet pointed to the cause of the sinus disorder but it starts when something alters the environment in the nasal/sinus cavity.

“It can be a virus or a cold that starts this cascade of symptoms, and what’s worse is patients get antibiotics from their family doctors and the vast majority of them don’t need them,” said Javer. “Prescribing oral antibiotics when you aren’t sure they are needed can be the worst thing you can do because they can alter the microbiome.”

The $300,000 study is funded through private donations to a charitable foundation Javer established at St. Paul’s Hospital. The funds are earmarked for sinus disorders.

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7Jan

Alzheimer Awareness Months targets stigma around disease

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Lisa Glanville, left, is the daughter of and caregiver for her mother Ollie, who has dementia.


Arlen Redekop / PNG

One of the biggest stigmas around dementia is that you’re going to develop the disease if you grow old, according to seniors advocate Isobel Mackenzie.

For January’s Alzheimer Awareness Month, Mackenzie said the biggest stereotype she wants to break down is the belief that the majority of British Columbians 85 and older have dementia. They don’t.

“If you look at age 85 and over, 20 per cent do have a diagnosis of dementia — but four out of five don’t,” Mackenzie said Monday.

When it comes to nursing homes, most people might think that every resident has dementia or Alzheimer’s. In fact, about 35 per cent don’t and two-thirds have only mild cognitive impairment, she said.

Mackenzie said dementia is a spectrum. Someone who is diagnosed with dementia may be fully competent in some areas but not in others. In some cases, a person may never go on to develop full dementia.

“It’s a journey,” she said.

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In B.C. in 2018 about 70,000 people were living with dementia. By 2033, that’s expected to increase to almost 120,000.

Experts don’t believe the rate of dementia is changing. Instead, the numbers are increasing because there are more older people living longer than ever before.

The aim of this year’s Alzheimer Awareness Month is to eliminate the stigma around the disease by changing attitudes. Events culminate on Jan. 31 with a two-hour open house starting at 3 p.m. at the Alzheimer Society of B.C.’s Resource Centre, 301 — 828 West 8th Avenue, Vancouver.


Lisa Glanville and her mother Ollie enjoy a walk in the Vancouver sunshine.

Arlen Redekop /

PNG

One family dealing with the affects of dementia is that of Lisa Glanville and her mother Ollie, 82.

Glanville said her mother worked for years as the property manager of Vancouver apartment buildings she owned after her husband died. She also worked as a bartender at the Billy Bishop Legion in Kitsilano.

Glanville said she’s seen stigma directed against her mother when she went to an estate planner and explored options for nursing homes. She was told that it didn’t matter because her mother’s dementia meant she wouldn’t remember anything.

Glanville said the most challenging times for her was before her mother was officially diagnosed. When she found out that her grandfather died of Alzheimer’s, she wondered if her mother had it. Initially, her mother passed tests measuring her cognitive abilities.

But Glanville noticed that things were starting to go awry. One day, she discovered that her mother’s online accounts were locked because someone had unsuccessfully tried to access them.

On another occasion, her mother showed her a cup with five of her molars in it. She’d never told her daughter she had any problem with her teeth.

“I thought: ‘Whoa, what is going on here?’” Glanville said.

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The clincher was a visit to the dentist.

“The receptionist said to me after my mom went in. ‘Can I give you some advice?’. I said ‘sure.’ ’Have you got enduring power of attorney yet for her Alzheimer’s?’”

Since Glanville is an only child, her mother’s well being become her responsibility. As part of her efforts to seek help, she started attending monthly Alzheimer caregivers support group meetings at the Alzheimer Society of B.C.

“The validation is incredible,” she said.

Morgan Donahue, support and education coordinator at the Alzheimer Society of B.C.’s Vancouver Resource Centre, said she believes that there is a lot of shame associated with a diagnosis of dementia.

She said the stigma can even discourage people from getting a diagnosis or even telling people they have been diagnosed.

In a survey by the Alzheimer Society in 2018, one in five Canadians said they would feel ashamed or embarrassed if they had dementia; one in five admitted to using derogatory or stigmatizing language about dementia.

“I’ve heard so many family members say they wish their family member had cancer because there is so much more of an understanding and acceptance of cancer than this disease,” Donahue said.

An early diagnosis can mean the person is displaying few, if any, symptoms at first.

“This disease is often so invisible, as with other mental health challenges.”

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Alzheimer’s Awareness Month is aiming to address stigma around Alzheimer’s and dementia. 

Arlen Redekop /

PNG

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2Oct

Historic legislation sets targets, timelines to reduce poverty

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British Columbia’s first Poverty Reduction Strategy, guided by legislation introduced today, will lift thousands of people out of poverty, create more opportunities to break the cycle of poverty and make it easier for people to participate in their community.

The Poverty Reduction Strategy Act will define the scope of the strategy, which will be released in early 2019, and sets poverty reduction targets and timelines that government must meet.

“A strong province is built on a foundation of equity, inclusion and opportunity for everyone,” said Shane Simpson, Minister of Social Development and Poverty Reduction. “We know that poverty is a serious issue in our province. That was driven home throughout the consultation as thousands of people told us about the impossible challenges they face each day. Social issues have been ignored for too long and that is why we are committing this government, and future governments, to break the cycle of poverty and improve people’s lives.”

The legislation is shaped by the experiences, voices and hopes of more than 8,500 people who took part in a broad public engagement on poverty from November 2017 to March 2018. If passed, the legislation will:

  • Commit government to reduce B.C.’s overall poverty rate by 25% and child poverty rate by 50% in the next five years.
  • Establish an independent advisory committee that will represent the breadth and depth of personal and professional experiences of poverty in B.C. and advise the minister on matters relating to poverty reduction and prevention.
  • Require government to report annually on its progress to reduce poverty.
  • Require government to release its first poverty reduction strategy by March 31, 2019. The strategy must focus on the key issues faced by people living in poverty including housing, education, employment, income supports and social inclusion.

The commitment to a poverty reduction strategy, in addition to addressing liveable wages under B.C.’s new Fair Wages Commission and exploring basic income, is a component of the Confidence and Supply Agreement with the B.C. Green Party caucus. The work of the Fair Wages Commission and the basic income expert panel will inform future updates to the poverty reduction strategy. 

“It is our shared responsibility to make sure that everyone has the tools, resources and social supports they need to improve their lives,” said Mable Elmore, Parliamentary Secretary for Poverty Reduction. “Hundreds of thousands of people in our province experience poverty, and this kind of long-term government commitment is what is required to lift people up and achieve real progress.”

Quotes:

Adrienne Montani, provincial co-ordinator, First Call

“First Call’s Child Poverty Report Card shows one in five B.C. children live in poverty and we have called for a 50% reduction in B.C.’s child poverty rate since 2009. We are pleased that government has listened and has this target and timeline in legislation. Reaching this target will benefit the health and well-being of thousands of children and youth, and may well reduce the number of children coming into government care. Our coalition looks forward to working with government to deliver on this target and help more children, youth and families thrive.”

Dawn Hemingway, co-chair, Minister’s Poverty Reduction Advisory Forum –

“The only way to seriously tackle the complex issue of poverty reduction is to have a meaningful and ambitious strategy that enforces targets and deadlines. This legislation is a significant step forward in making poverty reduction a reality in British Columbia.” 

Quick Facts:

  • British Columbia is the only province in Canada without a poverty reduction strategy despite having the second-worst rate of poverty.  
  • Based on the latest statistics available, in 2016 approximately 557,000 people were living in poverty in B.C., including 99,000 children.
  • Between November 2017 and March 2018, government engaged in a provincewide consultation about how to reduce poverty and inequity and provide opportunities for people to be successful. Thousands of people participated in the consultation, more than half had lived experience.

Learn More:

To read the legislation:
https://www.leg.bc.ca/parliamentary-business/legislation-debates-proceedings/41st-parliament/3rd-session/bills/first-reading/gov39-1

Learn more about B.C.’s commitment to reduce poverty for the people of B.C.: https://engage.gov.bc.ca/bcpovertyreduction


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