Insite can't be allowed to close

Writing a column means finding some quiet time to let yourself think.

Which is how a morning walk this week in brilliant sunshine turned into a long and dark reflection on my readiness for civil disobedience if Ottawa tries to shut down Vancouver’s supervised injection site.

A few of my activist acquaintances have pointed out that I’m not much for actually showing up at a protest, even when it’s an issue I feel strongly about. I suspect they take that as an indicator that I’m a bit of an armchair quarterback (even though the truth is that I just think writing is the more effective protest tool for me).

Still, ever since I heard a retired medical health officer vow years ago at a Vancouver harm-reduction forum to chain himself to the door of Insite if that’s what it took to prevent its closure, I knew I felt the same way. Count me in for a blockade if it comes to that.

I have great faith in our court system to get past the unthinking politics of the moment. So my first hope is that the Supreme Court of Canada - which heard arguments on this issue Thursday - makes mincemeat of the federal government’s attempts to close down the quiet little clinic in the Downtown Eastside.

But if worse comes to worse, this is an issue that’s well worth going to battle for. Denying life-saving health services to people solely because you don’t like their illness is morality-based health care. No democratic, civilized country should be setting foot on that slippery slope.

Back in its early days, Insite was a bold experiment for Canada. Supervised injection sites were old news elsewhere in the world by the time Insite opened in 2003, but still an untested and controversial concept for Canadians to get their heads around. People understandably had many concerns at the time about what it would mean to open such a site.

But that was then. Now, we know absolutely that Insite saves lives. We know that it doesn’t increase drug use or public disorder, and that it helps people connect to services that can get them out of their addiction entirely. More than 800 people now access Insite in a typical day.

The federal government of a decade ago was extremely wary about allowing an exemption to the Criminal Code so that people addicted to illicit drugs could use them under the watchful eye of nurses at the clinic. Insite has endured intense scrutiny for eight years as a condition of being allowed to open.

The facility has passed every test. 

Some 30 peer-reviewed scientific studies have examined the impact of Insite. They all found that the clinic prevents overdose deaths, reduces the transmission of potentially fatal diseases, and helps people connect to treatment for their addiction.

Other researchers were tasked with gauging the harms Insite might be inadvertently causing. They didn’t find any.

So what’s the problem? There isn’t one. The current federal government simply believes - against all scientific evidence - that harm-reduction strategies encourage people to use drugs.

Never mind that nothing about being addicted is easy, and no amount of supervised injection sites will ever change that. Never mind that everybody wins if we get our heads out of the sand and actually provide services for a terrible, debilitating illness.

Crime drops. Health-care costs fall. Productivity rises. Police are free to return to the important work of catching criminals rather than wasting time busting people with addictions. Why would any government fight against such positive developments?

Court rulings tend to be based on narrow legal arguments, so it’s hard to predict whether the Supreme Court will come down on the side of all that’s right in this particular case. The federal government is arguing there will be “chaos” if Insite is allowed to remain open and provinces start making their own decisions around access to illicit drugs.

That sounds like one of those sweeping statements a government trots out to dress up a specious argument. The time for chaos is if Ottawa tries to close the facility.

I'm not a regular Margaret Wente reader (she's such a contrarian), but I caught her column in the Globe today and it led me to this great piece in the Guardian by George Monbiot. It's a eyes-wide-open look at the difficulty of getting past the heartfelt intents and declarations of the environmental movement and actually doing something. 

It's unbelievable and deeply embarrassing that our own federal government is trying to shut Insite down, based solely on an ideological viewpoint. The safe-injection site is a health service, and a very effective one. The case will be heard by the federal court on Thursday - here's hoping they've got more savvy and an open mind than our political leadership. 

Tasering incident brings many more layers to light

Update Oct. 18, 2011: More details from police on the tasering of an 11-year-old boy with severe developmental disability

All the world’s an onion. Peel back a layer on any issue and a dozen more await, each more intriguing than the one before.

An example: The Tasering of an 11-year-old boy in Prince George last month. I went digging around for information this week on that troubling incident, only to end up puzzling over how a company with a history of running bars and liquor stores ends up in the group-home business.

The lowdown on this particular case will ultimately come from B.C.’s Representative for Children and Youth, Mary Ellen Turpel-Lafond. Her office is reviewing the incident and other issues at B.C. group homes for children in care, and we’ll all know more when her analysis and two separate police reviews are complete.

But even a cursory look at the Prince George situation raises questions about how B.C. contracts services for its most at-risk children.

On the surface, the April 7 incident in Prince George is about a boy stabbing a group-home staffer after the worker pursued the upset boy into a trailer on the property. The boy was then Tasered by police.

But in the early days of her investigation, Turpel-Lafond discovered another layer to the story after learning that some group homes call police when a child gives them any trouble, even if it’s just refusing to go to their room.

“The incidents are numerous, and they aren’t related to criminal activity by the child or youth,” she said, expanding the scope of her review to include investigating how often police are called to resolve group-home problems.

And there are more layers than that in the Prince George case.

The owner of the group home, Taborview Programs, is a home-grown Prince George entrepreneur, Jordy Hoover. He’s better known in the region for the many bars and liquor stores he owns.

Hoover also owns 30 greenhouses, a nursery growing three million seedlings for the forest industry, and a gravel operation. A 2009 story in the Prince George Citizen described him as having “a diversified portfolio of business in the city.”

That portfolio includes 26 beds for youth with profound behavioural problems, disabilities or other special needs. Hoover received almost $3 million from the Ministry of Children and Family Development in 2009-10 to provide those services. (That same year, he and his companies donated more than $32,000 to the B.C. Liberal Party.)

Hoover didn’t return my call, so I couldn’t ask how he got into the youth-care business. But the fact that he did underlines not only that it’s common for MCFD to contract with private companies for specialized foster care, but that the process for awarding contracts has some interesting wrinkles in it.

None of this is to presume there’s something wrong with Hoover’s group-home services.

In the business world, you don’t have to be a youth-care specialist to own a group home any more than you have to be a miner to own a mining company. JC Hoover Holdings certainly isn’t the only private company doing this work, as a browse through the public accounts confirms.

Contractors receiving more than $500,000* a year from MCFD also have to be accredited. Taborview is.

Still, it’s definitely a new day when running group homes for high-risk kids is now just part of a diverse business portfolio. Call me old-fashioned, but I can’t shake a nagging concern about what it means when the provision of child and youth services is just another business venture.

How did Jordy Hoover get into this? In theory, creating 26 beds for high-risk, high-needs youth - a big project - requires going to tender, and the successful bidder would probably need significant expertise in the field to land the contract.

But the reality is that MCFD regularly enters into short-term contracts for a particular child or youth who can’t be placed at an existing group home. (The government still calls them "specialized resources" when only one child lives there, as was apparently the case in Prince George.)

Those short-term contracts have a habit of being renewed automatically if all is going well, for years in some cases. One “emergency” contract begets another as MCFD and the contractor grow familiar with each other. Next thing you know, you’re a bar owner with $3 million in MCFD contracts and responsibility for 26 fragile lives.

And when the flash of a Taser brings it all to light, surprised British Columbians can only wonder what else we don’t know. Plenty.
*This figure was wrong in my original column, but has been corrected here.

An excerpt from Hansard, from the May 3 session of the BC legislature. Social Development Minister Harry Bloy, a brand-new cabinet minister, has obviously learned the lesson well of just repeating the same key message over and over, even when it makes no sense whatsoever in the context of the information that the Opposition members are bringing forward. 

Really, the public should not let Community Living B.C. and the government get away with this fairy tale about how nobody with a developmental disability has been forced out of their group home against their will - it simply isn't true. And yes, there have been cuts, regardless of what Bloy says - when you add in new people who qualify for service without increasing funding, the others who have been receiving services up to that point have to take a cut for that to happen. It's basic math. 

SERVICES FOR
DEVELOPMENTALLY DISABLED PERSONS

N. Simons: Last week in this House the minister responsible for Community Living B.C. said that no adult with a developmental disability was forced to move out of their group home. Perhaps the minister could tell that to Renata Cole of Terrace, whose daughter and three other residents of a home were required to move because of the budget pressures put on by this government to Community Living B.C.

Can the minister please explain to that family how their daughter was forced to move?

Hon. H. Bloy: To the member across the way, in my short time in this ministry I have been assured by Rick Mowles, the CEO of Community Living British Columbia, that no one has ever been moved without their prior approval, without being part of the planning process.

In my meetings with the British Columbia Association for Community Living, Faith Bodnar and some of the families associated with them talked about the great work that Community Living British Columbia does. In fact, they were recognized as the leader across Canada in the work that Community Living B.C. does.

Mr. Speaker: The member has a supplemental.

N. Simons: Maybe the minister's responsibility now is to look objectively at the programs his government provides instead of listening without question to everything he's been told by the people who are propping him up. These are families that are being impacted by the minister's cuts. These are families that are being told contradictions to reality. Despite what the minister said last week, we've had group home closures, forced moves. We've had program cuts, budget cuts, and now we have a minister who's in denial.

There's a person in British Columbia who waits by the door. After 20 years of going to a day program, he's no longer funded. He puts his coat on, and he waits by the door for his lift. If that's not a program cut, I don't know what is.

What is this minister going to do to get to the truth of the issue in his ministry and actually address the needs of families who have a member with a developmental disability?

Hon. H. Bloy: I want to reiterate to the member across the way that group homes are not a choice. Group homes have not been closed. Every individual has been asked if they want to move out. Not every person wants to live in a group home.

You know, this is not about the budget; this is about a plan which is best for individuals. There are lots of people that live in our communities. They work in our community, they have disabilities, they study in our community. We have athletes that are training, living in our community. These are about choice, and these choices are made by individuals without any question of being forced to move.

M. Karagianis: I just heard the minister say that government offers a plan that is best for individuals. Well, I'd like the minister to tell that to Kirsten Eikenstein. She has been caring for her daughter Corrine for the past 19 years here in greater Victoria.

Corrine has cerebral palsy, is unable to use her hands and is 100 percent dependent on all aspects of care. Now, Corrine was receiving 12 hours of care a week, but this B.C. Liberal government cut that. Now Corrine gets two hours respite a week, and when she turns 18 and finishes high school, that will be cut.

So I'd like to ask the minister: do you think it's okay for people like Corrine to be cut off of services entirely when they turn 18 years of age?

Hon. H. Bloy: I can assure the members across the way that Community Living British Columbia is reviewing, Members, and…. What's the word I'm looking for? They…. I'm sorry.

[1415]

Interjections.

Mr. Speaker: Members.

Continue, Minister.

Hon. H. Bloy: Community Living B.C. reviews each client that comes into the system, and clients with special needs are reviewed from about the age of 15 so that they are prepared

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I'm sorry.

Interjections.

Mr. Speaker: Members.

Continue, Minister.

Hon. H. Bloy: Community Living B.C. reviews each client that comes into the system. Clients with special needs are reviewed from about the age of 15 so that they're prepared. They have a plan ready for that individual when they come into Community Living British Columbia.

Mr. Speaker: The member has a supplemental.

M. Karagianis: I'm actually quite shocked that the government thinks that zero support is a plan for any child aging out of school. But maybe the minister can defend the numbers to Janet Gann. She has been the primary caregiver for her disabled son for the past 19 years, despite her own health issues.

Janet's son has been doing a job training program in Burnaby and is part of the Special Olympics skating team. Community inclusion is very paramount to her son's mental health. Yet, once Janet's son completes high school, he will no longer receive any supports — none of the supports necessary to be part of his community.

Janet wants to know from this minister why her son should have to pay for the B.C. Liberal government funding squeeze for this ministry?

Hon. H. Bloy: Community Living British Columbia has not cut its budget. It has increased by $13 million over the last year, and it continues to work with innovative approaches to help all individuals.

You know, we had a report out last week from B.C.-CLAG. I've read that report, I'm reviewing it, and I look to further talking with my staff about that report.

S. Simpson: This minister and the B.C. Liberals are failing people with developmental disabilities in British Columbia. That's the reality, particularly for people who are living in group homes. So 33 closures, and young people moving from children and families to CLBC are finding that there is no service available for them when they get there. That's the reality we're facing.

This minister talks about the assessments that are done. Well, let's talk about that. This assessment is done by the Guide to Support Allocation. That's what CLBC uses. Let me read you one clause out of this flawed report: "Staff are to focus on current disability-related needs as outlined within the plan, rather than past or anticipated future need."

My question to the minister. Does he think it makes any sense that with a person with a developmental disability, when you do their assessment, you ignore their history, and you ignore their potential future condition? Is that his idea of an assessment?

Hon. H. Bloy: Our first priority as a government and through Community Living British Columbia remains the individuals and the families that we support. There have been no budget cuts. I want to reiterate that. There's been a $13 million increase.

Community Living British Columbia remains committed to serving our clients with innovative support and services. We want to reach out to each client that we have within the system. I'm proud of the work that Community Living staff and their 3,200 contract providers provide to these people across all of British Columbia.

Mr. Speaker: The member has a supplemental.

S. Simpson: Let's talk about those providers. This minister talks about the providers. Well, most of them are members of the B.C. Association for Community Living. This minister talked about Faith Bodnar, their executive director. So what has she said about the performance of this government? "We know that service redesign is not an answer to addressing the funds needed for those who are waiting for service. It is short-sighted, a poor and harmful excuse for fiscal planning, and completely unsustainable." That's what the community thinks about this government's plan.

Hon. Speaker, the plan has failed. The reality is this: 600 people a year, new people coming into the system, and no money for them.

Will the minister go to his friend, the Finance Minister, and get him to give a few of that $2½ billion of cushion to Community Living B.C. so that the developmentally disabled don't have to pay for your fiscal mismanagement?

[1420]

Hon. H. Bloy: I want to reassure, to the members opposite, that our first

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Hon. H. Bloy: I want to reassure, to the members opposite, that our first priority is always the individual and their families. You know, I can tell you that Community Living B.C. has not had a cut in budget. It's had an increase of $13 million. I've met with the community living association of British Columbia in the discussions that I've had.

They're so proud of the work that CLBC does in British Columbia. They recognize them as a leader is what they told me in a meeting that I had with them and some of their family members. I look forward to meeting with them again in the future. But they were pleased with the work that we were doing. They considered Community Living British Columbia a leader in providing services for individuals with developmental disabilities.