SCYR Committee Meeting

37th PARLIAMENT, 2nd SESSION

Subcommittee on Children and Youth at Risk of the Standing Committee on Human Resources Development and the Status of Persons with Disabilities

EVIDENCE

CONTENTS

Wednesday, December 4, 2002

¹

1530

The Chair (Mr. John Godfrey (Don Valley West, Lib.))

Hon. Ethel Blondin-Andrew (Secretary of State (Children and Youth))

¹

1535

¹

1540

¹

1545

Ms. Susan Fletcher (Associate Assistant Deputy Minister, First Nations and Inuit Health Branch, Department of Health)

Ms. Ethel Blondin-Andrew

The Chair

¹

1550

Mr. Larry Spencer (Regina—Lumsden—Lake Centre, Canadian Alliance)

Ms. Ethel Blondin-Andrew

Mr. Larry Spencer

Ms. Ethel Blondin-Andrew

The Chair

Ms. Susan Fletcher

¹

1555

The Chair

Ms. Susan Fletcher

The Chair

Ms. Libby Davies (Vancouver East, NDP)

Ms. Susan Fletcher

Mr. Larry Spencer

Ms. Ethel Blondin-Andrew

The Chair

Ms. Ethel Blondin-Andrew

The Chair

Mr. Larry Spencer

The Chair

Ms. Diane St-Jacques (Shefford, Lib.)

º

1600

Ms. Ethel Blondin-Andrew

Ms. Diane St-Jacques

Ms. Ethel Blondin-Andrew

Ms. Diane St-Jacques

The Chair

Ms. Libby Davies

º

1605

Ms. Ethel Blondin-Andrew

Ms. Libby Davies

Ms. Ethel Blondin-Andrew

Ms. Libby Davies

Ms. Ethel Blondin-Andrew

Ms. Libby Davies

Ms. Ethel Blondin-Andrew

º

1610

Ms. Libby Davies

Ms. Ethel Blondin-Andrew

Ms. Susan Fletcher

Ms. Libby Davies

The Chair

Ms. Libby Davies

Ms. Ethel Blondin-Andrew

Ms. Susan Fletcher

º

1615

The Chair

Ms. Heather McCormack (Senior Policy Analyst, Research, Coordination and Special Projects Division, First Nations and Inuit Health Branch, Department of Health)

The Chair

Ms. Heather McCormack

Mr. Kenneth Kerr (Senior Director, Aboriginal Relations Office, Department of Human Resources Development)

The Chair

º

1620

Ms. Ethel Blondin-Andrew

The Chair

Ms. Ethel Blondin-Andrew

The Chair

º

1625

Mr. Larry Spencer

Ms. Ethel Blondin-Andrew

º

1630

Mr. Larry Spencer

Ms. Ethel Blondin-Andrew

º

1635

The Chair

Ms. Libby Davies

º

1640

Ms. Ethel Blondin-Andrew

Ms. Libby Davies

º

1645

Ms. Ethel Blondin-Andrew

The Chair

Ms. Ethel Blondin-Andrew

The Chair

Ms. Ethel Blondin-Andrew

The Chair

º

1650

Ms. Heather McCormack

Ms. Libby Davies

º

1655

The Chair

---

CANADA

Subcommittee on Children and Youth at Risk of the Standing Committee on Human Resources Development and the Status of Persons with Disabilities

---

NUMBER 002

l

2nd SESSION

l

37th PARLIAMENT

---

EVIDENCE

Wednesday, December 4, 2002

[Recorded by Electronic Apparatus]

¹  (1530)  

[English]

    The Chair (Mr. John Godfrey (Don Valley West, Lib.)): Welcome, everybody. We are expecting other people to drift in, but we are very pleased with the quality of those who have drifted in to date, including, of course, the witnesses. At one point we thought we might try to bring the minister in as a member of the committee. It's an ingenious thought. We'd just substitute her in. They used to do that, you know.

    But we're not reduced to these desperate measures, and we expect others to be joining us.

    I must say it's a pleasure. There has been some understandable confusion as to whether the minister could come or not, but that is because--and this is my interpretation; the minister will undoubtedly speak for herself--she has a unique position in the Government of Canada in that she relates to three different departments because of the horizontal nature of children. Those departments are represented here with her in human form: the Department of Indian Affairs and Northern Development, Health Canada, and HRDC. We're delighted to welcome all three of you. It must be quite an act, coordinating that, as we have discovered. That's what our report is about, after all.

    We'll go straight to your opening remarks in a moment, but I would just remind you, Minister, and your officials that this committee is extremely aware of these horizontal issues and that we have set out for ourselves an ambitious work plan, which is to produce four reports ultimately. The first, which we have done and received and which was reacted to last June, was about on-reserve children from prenatal to 6. The next piece of work we're going to be undertaking--we'll be looking at witness lists and so on next week--will be on off-reserve children zero to 6. This is your territory, all four reports. Then after that we'll do on-reserve 6 to 12 and off-reserve 6 to 12. We hope to connect up with the Senate committee, which is studying aboriginal adolescents, I guess you might say, or young people. We hope that over time this will form a coherent body of work.

    We have a very good committee here of people who park their guns at the door, if I may say so, and have a common interest in children and youth, which is your portfolio. We think it's absolutely wonderful that you're here. As you know, we've had, in our view, a pretty good response to our first report. You've been making announcements, reacting to our report, as we like to think of it. We're just delighted to see you and your three amigos there, amigas in some cases.

    Welcome. We look forward to your opening remarks.

    Hon. Ethel Blondin-Andrew (Secretary of State (Children and Youth)): I'd like to say good afternoon to everyone here in the room, including committee members. I thank the subcommittee for the invitation and the opportunity that it provides me to talk with you about the federal strategy on early childhood development for first nations and other aboriginal children, announced on October 31.

    Before that, I'd like to make a couple of remarks as a preamble, Mr. Chair. The committee and the subcommittee are to be thanked for the driving force that they've become in dealing with issues regarding children. The best policies are built on such work and I think resources being as scarce as they are, this committee and, in particular, the chair and all of the other devoted members of the committee have done really well for children. These things don't happen in and of themselves. So you're to be congratulated on the work that you've done. I mean that in the most genuine sense. I'm sure that other people share their views and they can speak to you personally.

    There are many reasons why the Government of Canada feels strongly that this initiative will make a significant difference in the lives of young aboriginal children and their families. I would like to touch on some of these.

    First, the strategy builds on a solid foundation of our existing programs and services for young aboriginal children and their families, and it will allow us to expand and improve these programs to benefit more children.

    I have been very fortunate since the beginning of my mandate to see firsthand the faces of young children at play in first nations and Inuit child care centres, and in the aboriginal head start sites across the country, on reserve and off reserve. I've been able to hear directly from their parents how important these services are to them and how good it makes them feel to see their children learning in a safe environment.

    I only wish I could bottle the energy, enthusiasm, and really meaningful results I saw at projects such as the Little Red Spirit Head Start program in Winnipeg. I actually visited with the children and I spoke with the parents. They have a wonderful component to that program that is not really a part of it, but it's an aside, which is the parental leadership program. The money we've invested there is well worth it, I assure you.

    There is the aboriginal head start program at Oneida on the Thames, which I visited recently. They don't have all of the complete trappings and all of the structures of self-government, but they have everything that makes a community function the way it should with regard to children. They have one of the most outstanding head start and child care programs I've seen to date, and I've been to quite a few from sea to sea.

    I could then show everyone what a positive impact our investments in aboriginal children are having, having been to a number of sites.

    The proposed enhancement to first nations and Inuit child care would improve the quality of existing sites, and it would create new spaces as well as increasing the ability of parents to participate in the labour force. The enhancement to the aboriginal head start programs would increase the enrolment as well as enable projects to provide supports for children with special needs and improve supports to parents.

    It's interesting that this program, the head start program, as well as the child care programs complement programs like the aboriginal human resource development strategy. We can't expect parents to be out there working. We invest $1.6 billion into that program. We can't do that without having the proper support for those adults' children.

    New investments in FAS/FAE with a focus on on-reserve populations will let us enhance training for professionals and front-line workers. It will improve parent and family supports in federal community-based programs and permit us to create evidence-based new prevention and early intervention programs. You can well appreciate that this is one of the most difficult challenges we face, jurisdictionally as well as in terms of the resources needed to do, for one part, the diagnosis that's needed to get a clear picture across the country.

¹  (1535)  

    What is exciting about this first part of the federal strategy on ECD, the improvement and the enhancement of federal programs, is that the partner departments, Health Canada, HRDC, and INAC, have already put into practice the commitment to bring these programs closer together. Just this week, 400 front-line workers and program managers from aboriginal head start sites, on and off reserve, and from the FNICC attended a national training workshop here in Ottawa.

    The second reason the federal initiative is important relates to your key area of concern in building on success, how to create, in partnership with first nations, integrated ECD systems at the community level.

    The second part of the ECD strategy for first nations and other aboriginal children will work towards better integration and coordination of both existing and new ECD investments. Departments have developed a step-by-step plan towards service integration. The core components of this plan include an environmental scan of current programming and best practices in integration and coordination of services, the initiation of six pilot projects to test elements of integrated programming, consultations with first nations and other stakeholders to refine options for a new approach, and a report back to cabinet with a proposal for a new “single window” approach to service delivery.

    Again, I'm happy to report that progress has already been made on the implementation of this component of the federal initiative. A first post-announcement meeting was held between the national organizations and the three departments to listen to the comments and suggestions of these important partners. A second meeting will be held shortly to begin to develop together the details of the collaboration in all components of the initiative.

    Today 75 people representing a cross-section of stakeholders with an interest in ECD and officials from the three departments are holding a think-tank to discuss how best to set up an ECD service providers' network across the country. Indeed, some of the individuals who are here today have also been involved in that.

    Regional and national offices in all three departments have developed a set of criteria to guide the selection of communities that could host pilot sites. They are now proceeding with the analysis of communities against these criteria for recommendations to the interdepartmental ADM steering committee.

    The third reason that I'm confident we are moving the yardsticks forward with the aboriginal ECD initiative is that, through the third part of the strategy, we have committed to report on child outcomes. We are all aware that we need information on the health and well-being of our young children so that we can measure out progress in improving outcomes, so that communities can see for themselves in an objective way where they need to focus and where they are succeeding.

    We know the contribution to knowledge that the National Longitudinal Survey of Children and Youth--the NLSCY--and Understanding the Early Years has made and will continue to make. The investments in the development of a longitudinal aboriginal survey and the expansion of UEY to selected aboriginal committees will help us to understand the factors that influence the development of young aboriginal children and will give direction to future action.

    I've given you three reasons to explain why the government is enthusiastic about the potential of the aboriginal ECD strategy, but I want to give you other arguments to show you why this strategy will work--I don't want to argue; I just want to give you the arguments--and will address your concerns.

    The three departments that have collaborated on this initiative have developed a horizontal management approach that respects vertical accountability and applies the lessons learned from effective partnerships and alternative service delivery models. An overarching results-based management and accountability framework is in place. It describes clearly the specific responsibility of each department, such as how the departments will be responsible for reporting on program-related outputs and immediate outcomes, but also makes precise how departments will work horizontally as they implement each component of the strategy.

¹  (1540)  

    You must bear with me, Mr. Chair, I'm not much of a reader of speeches. I'm more prone to giving and talking and making a speech than reading one. They have been guided in the development of this RMAF by the Auditor General's report, as you cite and recommend.

    What is RMAF, please?

¹  (1545)  

    Ms. Susan Fletcher (Associate Assistant Deputy Minister, First Nations and Inuit Health Branch, Department of Health): It's the report on management accountability frameworks.

    Ms. Ethel Blondin-Andrew: I'm supposed to know that. It's the report on management accountability frameworks, in case the members don't know.

    It would be great if tomorrow we could see integrated ECD community-based systems for aboriginal children across the country. However, the lessons learned from such restructuring exercises demonstrate the need for clear, effective horizontal partnerships that require long-term direction and a phased-in approach to ensure full understanding and buy-in before implementation.

    Let me assure you, however, that no time is being wasted. For example, representing the Government of Canada, I opened ECD's summit in Winnipeg with Premier Doer on November 20. Close to 250 people, including regional and national officials from four federal departments, first nations officials and other aboriginal leaders, and officials from eight provincial departments and from non-governmental agencies, celebrated National Child Day together and committed to work collaboratively towards the achievement of ECD goals.

    It's actually quite encouraging to have someone like Tim Sale, who's the minister, a great partner of ours, and a visionary at that, who takes the overarching policies and applies them at the local level. It's very encouraging. Also, I couldn't resist letting the premier know that he should be very proud of his minister. We may not have the same political stripe, but I appreciate good work on behalf of children no matter where it comes from or who is doing it. I must say I was very encouraged while I was there to see on the ground what was happening in Winnipeg.

    It's quite reassuring to hear comments such as, if today is any indication of our future potential partnership relationship with the federal government, we have a lot to look forward to. Examples of such partnerships are occurring across the country.

    The objectives of the strategy, which reflect many of your objectives, will be attained. A more integrated system of ECD programs and supports will be built in at the community level. Programming and decision-making will be community-based and community-empowering. Program outcomes will improve, and so will accountability. Administrative burden will be reduced at the community level. Economies of scale in program delivery will be achieved.

    I feel confident in saying that we will reach these objectives because I know that aboriginal organizations are interested in working with government and that their priorities are congruent with the federal strategy. There is a strong foundation of interdepartmental and intergovernmental collaboration related to children, as seen in the development of the national children's agenda and the federal-provincial-territorial childhood development initiative. The government's plan will work because it is anchored in lessons learned. It builds in the time for consultation with first nations and for evaluating efforts before proposing a single-window approach.

    On a more personal note, I know that the plan will work because I've seen first-hand the commitment of hundreds of front-line workers in federal programs for young children. Many of those individuals' beginnings are rooted at the community level. They have dedicated their lives to building experience in caregiving roles for children and other young people at the community level. I've spoken to aboriginal leaders and experienced their resolve to take action to improve the outcomes of their children, families, and communities.

    So on behalf of the government, I want to thank you for your valuable work, and I look forward to the next phases of your study of aboriginal children in Canada.

    I understand that you will have many challenges. It would be so good if we could have one single approach for all the different groups, but we have the whole issue of rights accorded long before we came along that set us into the context of having to deal with these individual groups as their rights prevail on- and off-reserve, and there are age categories as well. I wish you well.

    Thank you.

    The Chair: Thank you very much, and again, thank you for coming at really very short notice.

    I think the committee could just take about a thirty-second pause to congratulate itself, patting itself on its collective back, because in its quiet, unpublicized way it shows government at its best, when a committee works hard on a specific problem and has such a positive response from the executive.

    We will of course be monitoring, supporting, cheerleading, and criticizing sometimes, but really it's very gratifying that far from falling on deaf ears, our report has actually had tangible responses.

    Mr. Spencer.

¹  (1550)  

    Mr. Larry Spencer (Regina—Lumsden—Lake Centre, Canadian Alliance): Thank you, Mr. Chair, and I thank our witnesses for being here.

    You sound favourable to the way I think. I hate reading speeches and all the governmentese that comes out of there as well, so I'm going to ask you to just talk like one of us, if you don't mind, and put things in simpler terms, especially for me. Everybody else knows the answers, but I don't.

    What would you describe as the primary aims of the head start program, which we know is sort of the cornerstone here, in just really brief, personal terms?

    Ms. Ethel Blondin-Andrew: There are a number of them. There are a number of deliverables--I shouldn't even use that word, right? That's kind of a government word. What we're trying to achieve with head start is to give children a healthy start. Many children who live below a certain threshold of income or within a certain economic status need that extra support and help, and so do their parents and their community.

    The evidence I have seen at the community level is that children are becoming socialized to learning situations. We're preparing children to be ready to learn when they get into institutionalized situations, in schools for instance. It really does an enormous job on that. It makes children ready to learn in the primary schools. Also, the other thing it does is involve parents, and the most effective programs are the ones that have the full participation of parents.

    The example I gave is only one of many where parents play a role, where they actually come in and become involved with the head start programs. Both the Thames program and the Oneida program, as well as the one in Winnipeg, have parents come in. The program we had in Winnipeg was where the parents were actually in the other room doing things like beading; they do cooking, and they learn about nutrition, how to feed their children properly. It's really quite magic.

    I was also in a place called Kugluktuk up in Nunavut, where there are children, infants, and elders' programs where the elders come in and teach the language, the dancing, and the traditions of the Inuit people. It's really very good. It's a great bonding exercise for parents, for grandparents, and for other community members, the caregivers as well. There's a very close bond between them and the children.

    The other thing is that every child who is in a head start program feels some level of acceptance, feels that they're worth something, that they're worth caring for and loving. That's really as basic as I can get about it.

    Mr. Larry Spencer: How long has the head start program been operated?

    Ms. Ethel Blondin-Andrew: I think it started on reserve in 1999.

    The Chair: Perhaps, Ms. Fletcher, you could just remind us of the on-reserve, off-reserve differences and give us a quick sketch of the program.

    Ms. Susan Fletcher: The aboriginal head start program originally started off reserve, so it was available for urban aboriginal people, and that was around 1994-95, as I recall. Then, during the mid-1990s, we started evaluating it and started to see the kinds of positive outcomes the minister has just described, and we received money in the 1999 budget to start the same kind of programming on reserve.

    In 1999 we received money that allowed us to reach around 12% of aboriginal children aged zero to six with an aboriginal head start program. The programming the minister just recently announced, to which she was referring in her speech, has allowed us to expand that programming to 18% of children as well as putting in existing communities more supports for some of the riskier situations.

¹  (1555)  

    The Chair: Sorry, is that 18% on or off reserve?

    Ms. Susan Fletcher: On.

    The Chair: On. Thanks.

    Ms. Libby Davies (Vancouver East, NDP): What is it off reserve? Is it still 12%?

    Ms. Susan Fletcher: It's 12%.

    Mr. Larry Spencer: The reason I asked that question is to get an idea of how many years' experience you have of seeing those who've moved out of preschool into school, and what results you are actually able to see there. Obviously we need to wait maybe another 10 years to see it really well. Are you actually seeing some dramatic differences in these children who've been in the head start program in their first years of school?

    Ms. Ethel Blondin-Andrew: There are a lot of anecdotal results. There are a lot of positive ones. But what we want to do is make sure we have a diagnosis that's precise and has a more qualitative and quantitative document that'll allow us to plan better and allow us to be able to state empirically what the progress has been. I don't think we're at that stage, but we know the results have been good. We know that. We know that the outcomes have been very good.

    In some of the regions they have differing strengths. Some are good at parental leadership efforts involving parents, and others are good at including the culture and the language and the tradition. They're not all the same. They basically function to achieve the same objectives, I guess, in the end, and that's to socialize kids, to give them an early healthy start, and to provide the support they need. But the way in which that is achieved isn't always the same. But we can tell from all of the information we have that it has all been positive.

    The only problem we may have had is that there are not enough. We're always oversubscribed. We could always use more money. It's in fact seen as being so very positive that other people, other groups, outside of the aboriginal community want a national head start program.

    The Chair: Just to tack on to Larry, and not to take away from his time, the original head start program in the United States goes back to the 1960s, and there has been a longitudinal study of a rather small group of people who originally went into it and then the control group. Is Health Canada or somebody now monitoring those kids, so we'll be able to do a longitudinal follow-up both on reserve and off reserve?

    Ms. Ethel Blondin-Andrew: We are undertaking the longitudinal survey and we are also looking at gathering the proper information to be able to plan for the proper outcomes for early childhood development for children. We're investing money in that. There is a plan with regard to early childhood development. There is actually a plan to make a specific investment for that purpose.

    There has also been some other work done already that's not directly related to children on reserve, but there is money set aside within the ECD allocation for that purpose.

    The Chair: Do you have more questions now, Mr. Spencer?

    Mr. Larry Spencer: Yes, but I can wait if you want me to.

    The Chair: Okay, why don't we move around and then we'll come back. We're such a small number that, particularly if they're follow-on questions, once we develop a subject, if people don't mind, we can be a little less programmatic.

    Madame St-Jacques et puis Madame Davies.

[Translation]

    Ms. Diane St-Jacques (Shefford, Lib.): Thank you, Mr. Chairman.

    Thank you for being here, Madam Minister.

    I'd like to talk to you about the pilot projects to which you alluded in your presentation. Could you elaborate further on the nature and duration of these pilot projects and on how you plan to assess their impact and the results achieved?

º  (1600)  

[English]

    Ms. Ethel Blondin-Andrew: We have just started the planning on the pilot project, so we'll be five. We are not in a position to give details on that right now, because we're working with the National Aboriginal Health Organization and different groups to make sure we have the right mix--that we have regional balance; that we make the right choices so that there isn't exclusion; that it's inclusive, and it appears to have, as demographically as we can have it, those pilot projects situated in the areas that are probably going to demonstrate that's what works in terms of early childhood development. But once we are ready, you will have all the information. We're just not there yet.

[Translation]

    Ms. Diane St-Jacques: Will these pilot projects be targeting only children from birth to 6 years of age, or will they be expanded to include other age groups as well?

[English]

    Ms. Ethel Blondin-Andrew: It's zero to six.

[Translation]

    Ms. Diane St-Jacques: Thank you. That's all for now.

    The Chair: Thank you.

    Libby Davies.

[English]

    Ms. Libby Davies: Thank you very much for coming today.

    This is a very important subject we're discussing. I was just looking at the notes on comparing the report this committee issued and the government's response. I must say that if I think back over the committee's work, there's been a very strong theme to try to link all of the various initiatives that are taking place totally within children's services but focusing on early childhood development and particularly now on services to aboriginal children, both on reserve and off reserve.

    The thing that occurs over and over again is that it's not just an issue of coordination, but it's also an issue of accountability, which was clearly one of our key recommendations, and how much input there is, in a meaningful way, of organizations or community groups.

    I guess the question I have is this. When you talk about your results-based management accountability framework, what does that really mean? We have three departments here today, but there are also other departments involved, not only at your level in terms of within government. How do we ensure that stakeholders, to use government jargon, people who are actually in the field at a community level, at a local level...? How does your strategy, through this results-based management accountability framework, ensure that those people are heard? That's one question.

    Secondly, in terms of the aboriginal head start program, which we hear a lot about, I think everybody agrees it's a very good program. It's positive that it's gone from 12% to 18% of the population on reserve, but it's still really a very small group. How do we ensure that the results or the outcomes of what has taken place over ten years or more are reflected either in issues that are flagged for other support services or even in terms of the longitudinal study?

    I always have this recurring nightmare that all of these things are out there and none of them are really connected. It's such a disjointed picture. The longitudinal survey has been a very important way to try to have some sort of measure overall of what's happening to kids.

    So those are the two questions. How do you ensure the accountability, not just amongst yourselves as bureaucrats and departments but at a community level, in terms of people having input? Then, how do we ensure that the results or what needs to be done, what needs to be followed up, are reflected in things like the longitudinal study so that we're not sort of losing it as we go along? How do we ensure that we're actually making the picture clearer and it doesn't end up being more fragmented? I don't know if that is coming across.

º  (1605)  

    Ms. Ethel Blondin-Andrew: You asked two very important questions.

    As for the one on accountability, I don't think you mean management practices and that sort of thing. You mean accountability, to make sure the money that's been allocated for this purpose is producing the results we want for early childhood development.

    Ms. Libby Davies: Also I would say that people who really have a lot of expertise at a very grassroots level are able to have input into how these services are being designed or evaluated or monitored so that we're not just sort of operating in a vacuum within departments. It's hard enough as it is to get accountability between departments.

    Ms. Ethel Blondin-Andrew: I think you can be assured that these programs, particularly early childhood development programs, prenatal nutrition, aboriginal head start, early childhood Inuit and first nations child care, are rooted in the grassroots approach. The strategy is that it's a bottom-up approach.

    Ms. Libby Davies: But what formal mechanisms are there to actually make sure this happens?

    Ms. Ethel Blondin-Andrew: We actually have participation of aboriginal people. In this case it's on reserve.

    We have, as best as we can, planned to have representation from the communities in terms of how the programs are structured, how they're run, and what the actual local programming involves. It's very grassroots oriented, and today we have a networkers and stakeholders meeting in town and we also have 400 front-line workers who are here participating in planning and working on these programs. And specifically in this case they are dealing with aboriginal head start and considering all of the other things that are happening, which I mentioned, all of the other programs and services and how that relates to how it affects this particular initiative.

    I must tell you that you can be assured that if we can integrate and bring together the children's programs the way we did the youth, I think we will have some success, because we did have a huge hodgepodge and large menu.... And we still have not repatriated all youth programs to one department, because we have 14 involved and just the very nature of summer employment doesn't allow us to do that. We still have money resting in different departments like Parks, and Heritage, and Defence, and International Affairs.

    But we have brought together under the youth employment strategy all of the programs that relate to youth in our department. We've structured it in a way that it has an overriding goal to integrate young people into the labour market.

    So we look at, for instance, the whole issue of children and how we might bring that together into a more cohesive and manageable entity like the youth employment strategy is.

    We're not there yet. We implemented these programs not so many years ago and we're putting in place, from a departmental perspective, a steering committee and working groups of senior officials to oversee this and to partner with the entities in the community to be able to do likewise on the whole issue of accounting and management. But in terms of delivering what this was intended for, I think we see evidence that this is already happening.

    How do we bring this all together? That's the $320 million question, Ms. Davies. I think we are trying to do that and I think we're going to get there, because we are not doing it on our own. We're working with the community leaders. We're working with the national organizations, and it's a very bottom-up approach, from what I can see.

    Those are the results we're looking for. I don't know if that answers your question. I'm trying to decipher your exact question and answer it at the same time because I know what you're basically getting at.

    Ms. Libby Davies: Could I follow up?

    As far as the conference that you just spoke about is concerned, is it happening right now?

    Ms. Ethel Blondin-Andrew: Yes, there are 400 front-line workers meeting--

º  (1610)  

    Ms. Libby Davies: And these are all people involved in aboriginal head start?

    Ms. Ethel Blondin-Andrew: Yes, it's in town.

    Ms. Libby Davies: So to make it more specific then, you told us a little bit earlier that the head start program has gone to reach from 12% to 18% of the population. Are those front-line people engaged in some way, and how often does it happen, to actually help you change the programs, deliver them differently, particularly if you are looking at an expansion?

    I think that would make it more specific. How are you actually doing that? Do they come together once a year for two days, or is there a way that you ensure that there's a real sense of meaningful involvement in how this accountability and the service delivery that's taking place is evolving or how it's changing?

    Ms. Ethel Blondin-Andrew: First of all, since the establishment of head start, I've never missed an annual general meeting that they've held. I've always tried to be there for every single one of them to share with them, even in an evening or through a speech of encouragement. I have interacted with them, so I know personally that they do it on an annual basis. But that's not all they do. They have training sessions and they have a number of other initiatives that I'm sure the officials can speak to.

    I must tell you that I've been very encouraged at the various sites I have been to, and I've been to many of them, from coast to coast to coast. Walking through the establishment and looking at the people who sit on the boards, the representatives--and I meet with them as well--I'm very assured that what we say is supposed to happen is going to happen, that they are totally involved, that they have support. We have allocated money for those activities. It's not something that was inadvertently planned on the way to happening; it's actually planned and they meet every year.

    Are there any other details you want to provide?

    Ms. Susan Fletcher: Yes, I have two. One is that this is the first training session where we've brought them all together. One of the follow-up activities that's actually happening today is to look at planning for a network so that we can find and figure out the ways that we can have more regular sharing of information in bringing people together.

    You did put your finger on something, and that is that we still have to deal within the context of different departments and different departments' program authorities. Certainly, as the minister says, we are committed to trying to break those down. The three departments are working together. We do want to work towards a single-window approach, but there are a number of sort of machinery hurdles along the way. One of the purposes of the pilots is to look at those hurdles to try to find and identify ways that we can have appropriate accountability from different departments while easing up the hodge-podge, if you will, of different authorities that currently exist across departments.

    So we are committed to working on that and we will be doing that over the next couple of years. Ministers are also committed, as Ms. Blondin-Andrew says.

    Ms. Libby Davies: Can I just say something on the second question?

    The Chair: Briefly.

    Ms. Libby Davies: The second question I had is very similar to what Mr. Spencer has raised. If the head start program is very successful, how will we see that measured in the longitudinal study? How does that show up? Where is the connection between those things and somewhere else?

    Ms. Ethel Blondin-Andrew: It's actually going to be embedded in the work that happens on the research and the information we derive from that research. There's dedicated funding within this allocation for that very purpose. I'm not sure of the exact construct of how in detail that will happen, but that's something we're working on. That's definitely going to be part of how we measure the outcomes of this program and how we plan any further initiatives.

    Does either one of you want to say something on that?

    Ms. Susan Fletcher: Can we ask Heather McCormack to come to the table? We do have specific outcomes that she could mention.

º  (1615)  

    The Chair: Ms. McCormack, would you mind identifying yourself formally for the record?

    Ms. Heather McCormack (Senior Policy Analyst, Research, Coordination and Special Projects Division, First Nations and Inuit Health Branch, Department of Health): I'm Heather McCormack. I work at the First Nations and Inuit Health Branch at Health Canada.

    There are actually a couple of things that we've put in place to be able to monitor the progress of kids. With respect to specific programs, we actually have program evaluation mechanisms in place. With respect to aboriginal head start, we have an impact evaluation that we're just beginning to put into practice. One of the challenges we faced in terms of looking at evaluation was that the instruments that were available were for more a general, mainstream population. We had to actually adapt the evaluation tools so that they did suit the population we were looking at.

    With some of the pilots we'll be putting in place, what we're actually going to be doing is developing those kinds of outcome evaluation tools to see if they can be used across the ECD programs that the government delivers. If we have a program evaluation tool for head start, is it equally reliable if we use it in a child care setting? Can we develop a more common way, across the three departments, of reporting on the outcomes of the specific programs we deliver? That's one of the things we're going to be pilot testing as we move forward. That's the program-specific kind of evaluation piece. These are the kids who are actually in the programs that were capturing the results of those program investments.

    If you look at aboriginal kids more broadly--I think they've referred to the aboriginal children's survey--then yes, we've also put resources in place so that we can measure aboriginal children and the outcomes and well-being of aboriginal children writ more largely.

    So there are the two streams in terms of measuring the impact we have--the general one of how aboriginal children are doing in Canada, and then the more specific one of what's the impact of the investments we're making in our program across the three departments.

    The Chair: I want to follow up on that, if I may. In a sense there are two control groups, then. There would be the aboriginal kids who hadn't had the programs and then the mainstream populations who may or may not have had programs.

    I don't want to get hung up on this, but I find it a fascinating topic, the classic study, the Ypsilanti study, which goes back to the 1960s. Basically, by tracking populations over a long period of time, it discovered that--roughly the literature goes like this--the early impacts on schooling or traditional measures of school learning were not all that impressive. Over time, as they began measuring high school drop-out rates, teenage pregnancy rates, job retention, salary at 30, life earnings, etc., which you would only capture over a long period of time, the results turned out to be a lot more impressive than simply school learning.

    It was a very small study, and I know that when Moncton looked at its head start program there were some difficulties methodically. Are we starting from that template and then trying to adapt to the...?

    Ms. Heather McCormack: We are starting from that template and there will be some challenges along the way, though, because the aboriginal children's survey will be longitudinal so we will know the progress of aboriginal children at large.

    I'm not sure how long we'll be able to follow the children from our programs in terms of how they do over the longer term. We'll have to look at what kinds of resources we have to spend on that. It's always a balance between spending on the research and monitoring the children or investing in new spaces so you can reach more children. We'll have to try to find a balance between those two things so we can look over the long term.

    Ken wanted to make a comment on that, too.

    Mr. Kenneth Kerr (Senior Director, Aboriginal Relations Office, Department of Human Resources Development): I will try to address the issues that the committee has seized on. The committee made such a strong point earlier about horizontal management and, when you look at it from this distance, the confusion at the local level. Over the last year and a half we've been making a point in systematically bringing also the child care workers from the first nations and Inuit child care program to the training sessions organized by the aboriginal head start program as part of their professional development.

    I'm also a great believer in the community as an integrator. And the minister spoke about how this is a bottom-up approach. The communities that we're involved with play a great role in taking these resources that come down to the communities that we have to report on and in organizing their unique array of services that cover their territory and meet the needs of their populations.

    The Chair: This point was even further reinforced by yesterday's Auditor General's report on aboriginal programs, in which there was a heavy emphasis on administrative burden and the reporting requirements. I think the point was made, entirely in the spirit with what we were proposing, that it was absolutely not the case that aboriginals were consulted about the reporting requirements.

    Therefore, you have a double whammy. You have a burden caused by multiplicity, and then you have a burden caused by a lack of consultation about what's appropriate. Of course, people are doing it for the right reasons; they want to show that they're spending the dollars properly. That is something you might want to hold as a question.

    The committee really was trying to get, in the language of social policy geeks, the architecture right on two points and to make sure, if I may mix my metaphors here, that the architecture connected correctly.

    Point one was the architecture of government itself. That is to say here in Ottawa, how do we link, as we see the physical representation here at the table today of three departments...? How do we actually make it work at this end so that the architecture then works at the other end, which is why our second recommendation was specifically about pilot projects?

    We're very encouraged by everything you've said, and the direction seems absolutely correct. But because we are your committee, Minister--you have to understand that we're yours, you are ours; there's no escaping each other here, you have your own dedicated subcommittee--we want to keep helping, working, and inquiring. But also we think that we were fairly tough in outlining the appropriate mechanisms, criteria, and targets--I'm talking now about recommendation number one, this is at the Ottawa end--on how you folks get your act together up here.

    So we're very anxious to know how we can...let me put the question two ways. First, was there anything that we said in the report, either under recommendation number one, the Ottawa bit, or recommendation two, the community bit, that anyone has a problem with? That is to say, was there anything for which you'd have to say, sorry, guys, you're asking for something but it's not going to work? Obviously, if the answer is, no, we didn't have a problem with any of it, then we would expect that over time we would see a reflection of these very precise things that we laid out, both under recommendation one and recommendation two.

    Let me ask that loaded question, because we will be following up. We're very perseverant here.

º  (1620)  

    Ms. Ethel Blondin-Andrew: As you probably know, the government doesn't have any issue with what was said, or the way in which it was stated. We understand the necessity for integration. We understand the issue of horizontal management and how we hope to bring things together to a single window. Those are all very understandable. It's just a matter, as you would probably expect, that it would take time.

    The Chair: What we want to know--and you may want to give us a hint--is when, for example, it might be reasonable to expect that the five communities would be chosen, or when we could find, at the Ottawa end, the mechanisms, criteria, and targets. That would be useful.

    Also, is it reasonable, when we see you again on this particular report some time down the road, that we could use it as a check list? So there are all the things that we were quite specific about. It would be fair to say we asked you about the involvement of aboriginal groups, that we want to make sure there's adequate funding that carries on for the communities, and all the rest of it.

    Is there anything in here that is unreasonable or unfair to ask you in the future? Speak up or forever hold your peace. Anybody at the table is allowed to answer. This is called a set-up piece, I think.

    Ms. Ethel Blondin-Andrew: I might just say on the pilot projects, one of the things on your list, we anticipate that you would probably hear about it within the next several months. There are a number of steps that have to be taken in getting to that point and it's a work in progress. We're hoping that you'll be able to hear from us in a couple of months.

    The Chair: I think I'm speaking on behalf of those present when I say that we are so enthusiastic about your reception of our report that we want to stay involved, and we'll interrupt what we're doing to hear from you on any basis you wish. Do I reflect the wish of the committee in saying this? I see agreeable nods all around, so that's absolutely first-rate.

    By the way, I'm going to make one of those seat-of-the-pants administrative suggestions the committee has perhaps come to appreciate or not. I'm going to recommend that because your mandate, Minister, is not by any means restricted--it's for all Canadian children and youth, so by definition it is not restricted to on-reserve or anything else--I would like to see the four of you, if I may be so bold as to suggest, as our first witnesses when we come back in February so we can start to focus on the zero-to-six population off reserve. We could get at it in an informal way today, but I think it would be much better if we were to allow you to prepare for that. I think it would help us set ourselves up very well indeed.

    Do I have the permission of the committee to make that offer? Is it reasonable? This is how we do things around here, so consider yourself invited, and we'll just make sure that it fits your schedule. I think it will be entirely appropriate and a nice segue.

    Mr. Spencer.

º  (1625)  

    Mr. Larry Spencer: We could talk about those two programs for a long time.

    For just a bit of a change here, I'd like to hear a few more specifics than what I've just read here on what you're doing for intervention and prevention when it comes to FAS and FAE. I have a particular interest in that, seeing as I have an adopted aboriginal son who is probably affected by one of these, something we didn't know about 25 or 28 years ago. I'm quite interested that something is being done.

    Ms. Ethel Blondin-Andrew: On fetal alcohol syndrome, believe it or not, it's not a new subject, but it has certainly taken on a new life in the last number of years. There's been a lot of awareness created and we have worked very hard to achieve some allocation of budget for that. Previously there wasn't enough money. Across the country we had way more.... I announced a $1 million allocation for a number of activities--it must have been a couple of years ago, about two years ago--and we were oversubscribed before we even made the announcement. We were involved in looking at basically an awareness campaign to let people know what this was about, but that's not the most, I would say, obvious need.

    We have a need for diagnoses and we have a need to standardize diagnoses, for instance. There are people all over across Canada who are doing each their own individual thing on FAS/FAE, right from the Atlantic to the B.C. region, and there are very good people out there. There's no lack of expertise.

    We've had numerous expert panels and conferences. We've had the Prairie Northern Conference. We have had discussions by our colleagues in Health and other departments who have an interest in this, with their federal-provincial-territorial partners. This is not a moneyed item. It's something that happens as a routine proceeding of their meetings, because if you have the ministers of justice meeting, implied there with young offenders is the issue of FAS/FAE.

    We also have that same issue with the Solicitor General as well. We have, as well, with the ministers of education, the whole jurisdictional issue, because FAS/FAE is seen as a disability, a preventable one, but it's also seen as a very special needs issue and a jurisdictional issue that has been very difficult for us to resolve. The provinces think it's our issue because it has to do with children and young people and we have programs to deal with that, and it's something new, so that the federal government should take the lead responsibility because they don't have allocations for that.

    We tend to see a lot of the issues happening in the schools and we have arrangements not to go into the schools and do what has to be done by the provinces, because they have agreements on education. Quebec wouldn't allow us in their schools to deal with FAS/FAE. That being said, we've made a number of announcements. We have put out some publications. We've done that. That was the first phase. We have undertaken a number of announcements to look at issues to create awareness out there. The things we are still challenged with is how do we provide services for children in classrooms in overstimulated schools that don't have the professionals who are trained to deal with this issue. It's a huge problem.

    How do we deal with all of the young offenders who some of the judges are talking about, who fill their courts, and of whom a large number--and obviously all of them haven't been diagnosed with it--have FAS or FAE? How do we deal with that in terms of the resources? How do we get a clear picture? We need to do a diagnosis that is massive and we don't have the money right now to do all of that. But what we have done, in the ECD allocation of $320 million, is set aside some money. It's $10 million this year and $15 million next year. I'm sorry, but I deal with so many numbers that--

º  (1630)  

    Mr. Larry Spencer: I appreciate the large answer, but I may have misled you in the way I said it. I was asking about your intervention for prevention. I wanted to know what are you doing to head this problem off before it becomes the one you're talking about.

    Ms. Ethel Blondin-Andrew: In all of the issues dealing with fetal alcohol, we have not just looked at a specific initiative for FAS/FAE, but also at all of the different programs, such as prenatal nutrition. As part of that, we have ongoing information we give to parents. With the head start program, part of its parental leadership and parental programs include providing information to the families and parents. With the money we have, we're also working now with young parents to be able to get the information out to them.

    But more than this, we've had to go to and do training with professionals too. I'll give you an example. The reason I'm struggling is that I'm trying to remember which ones we've done and which ones we haven't, because it's a work in progress. It is still early days on what we're doing.

    What we have not actually been able to do is to get the Canadian Medical Association as one of the key messengers for FAS/FAE. If there is one body with the credibility and the capacity to be a good messenger for us, it is the CMA. We don't have them yet, but it would be an enormous help if we did have them. So we haven't reached all groups.

    But we have done some things in terms of awareness. We have done quite a few announcements. How do we work on prevention? We do this by trying to reach young people, by trying to reach the young mothers and parents. We are trying to create awareness with the people they associate with, as in the medical profession, to talk about prevention. What would be better and more powerful than for an expectant mother to be told before she conceives there's a danger of FAS/FAE? Just recently we had a conference here, where they talked about the effects of fetal alcohol right at conception. The damage neurologically is probably done when the child is conceived, if you're taking alcohol.

    So we have had a lot of....I would say, out of the last so many years we have been involved with this, we have spent money on publications and we have done an awareness campaign to make people aware of....We are making some headway. We have great advocates. We have people out there who are professionals. We have groups in provinces. We have ministers onside. There is a lot of dialogue about it.

    I guess you could say this is not enough. I would agree with you. I think we could do more. We have allocated or put money aside in this initiative to do this.

    I think the really, really big issue is, for one, prevention and awareness. The other is, we have a problem. What do we do with those children who are affected? What do we do with those children who are in the courts and who are in those schools? What do we do with teachers, youth workers, and caregivers? Even children who are in care—and there are so many of them who are in care—need professional help, and they need the kind of help and understanding and professionalism that really isn't there, and even with the clothing they wear.

    As a country, we don't yet have the capacity to say we provide the level of service for those people who are affected. We have not reached the 100% awareness we need to have an impact on prevention. But we are getting there. We're in a better space, I would assume, than we were in 1993 when we took over as government. I think the first political question that was asked was at an accountability session in 1994 on FAS/FAE. The ball has just been rolling on this one, and we pick up more support and more people across the country.

    One thing I should tell you is that the provinces do fantastic work. I am neglecting other provinces, but I know New Brunswick and Manitoba stand out. Under the direction of Tim Sales, Manitoba really does great work at the community level on this, working with young and expectant mothers. I think these kinds of initiatives are really important.

º  (1635)  

    Sorry, I went on too long.

    The Chair: It's great. I know this is one of your passions, and it comes through. It's wonderful to have a champion like that.

    Libby.

    Ms. Libby Davies: Yes. I wanted to come back to the issue of whether things are connected or not. In the government response, we do see there has been an increase of funds by $21 million a year for aboriginal head start on reserve. Then it says it increased by $12 million in the urban areas. I don't know why there's such a difference between the two figures. Obviously there has been additional money put in.

    I still have a lot of concerns about how many kids we're actually reaching. To go from 12% to 18% is better than staying at 12%, but is there any timeline or target that will get us closer to 100%? Is it unrealistic? Is it a pie in the sky? I hope not.

    Secondly, when we deal with the programs, I certainly acknowledge there are many issues within the programs on proper evaluation, monitoring, and all of that stuff. How do we ensure that we're connecting to other needs that exist?

    I'm thinking of a program in east Vancouver, where I'm from. The Sheway program probably gets head start funding, I'm not sure. I think they do. They're dealing a lot with FAS and FAE. They're dealing with addiction issues. They try to follow moms through pregnancy, through healthy nutrition, through the birth, and back at home. They try to do all of it, but their funds are so limited.

    There are huge gaps, right? Basically, even through a program like that or through a head start program, there's other issues that come up, like appropriate housing. If you're sending a mom with kids back to a single-room occupancy, or you're sending someone back into an environment where they're 50% or 80% below the poverty line, you can't even talk about good nutrition when the money runs out two weeks into the month. That's what I think of when I think about whether these issues are connected or not.

    I don't expect that you can have all of the answers here today. We're looking specifically at those programs and there are a lot of issues there. It really does worry me. In the bigger picture of the connection between services and poverty issues, the fact is that we're really reaching a very limited number of people who are at risk and need help. It is very serious.

    Yes, you have more money. Do you actually have some targets for getting closer to 100% of identifying aboriginal children who are at risk?

º  (1640)  

    Ms. Ethel Blondin-Andrew: I've long thought about this question you've raised about a comprehensive approach, an integrated approach, something that's connected in a way that gives us the best results and builds in the best efficiencies and economies of scale so we're getting the best value and the best results for children and family. I look at it like this because I struggle with this all the time with the 32 communities in my home. They're not on reserve; I guess they're off reserve, but they're remote and northern.

    We can invest millions in working with children, but if their families don't have proper homes, if their parents or their caregivers are addicted and abusive, if they don't have the kind of income support they need to survive, or any combination of things, then we have problems.

    I see it in a much bigger way from an aboriginal context. I look at it through the United Nations model of human development, community development, and also the kinds of things we're promoting with self-government. What are the rudiments of that? What do we need to do? We need to build. The human being has to have a number of supports. The community has to have a number of supports. In an ideal world we should have started from scratch and gone from there, right? To raise a child you would have to have all these things around them.

    We do the best we can with what we have, because we already have models, and some of them are not the best. Some of them are entrenched and hard to take apart. How do you go to a community and say, you can't do that this way any more, you have to do it another way? What do they do? They ask us for more money to change it. They don't ask how we're going to integrate and have horizontal management; they don't care about that. They want to make sure they get money for their head start. They want to make sure we don't give the head start to the provinces or territories, that we keep it a federal program. Those are the things they care about.

    My feeling is that we have to try the best we can to complement what we do, building in those efficiencies and bringing all this stuff so it's a workable unit with what's in those communities. Some have very strong children's programs. I was in one community that had 12 points of access for federal programs. I guess it should be in one big cheque, and then they could spend it on anything, but then we also lose the capacity to manage that and to account for that money. That happened with the provinces when we got into making deals with them. We weren't always sure they spent the money where they should have spent it.

    What you have suggested, which seems like a simple issue, is not. It's very complicated, and I can tell you it's very complicated because we don't even have the capacity in some of the communities. One of the main things the environment and sustainable development committee talked about was capacity-building for communities. We need to build capacity. We need human development. We need community development. We need capacity development in order to have a context for a child to flourish, for a family to grow, or for businesses to grow. They're not removed from one another. I agree with you.

    How do we achieve that? I'm not sure I have the answer, but I know all the questions, as you do.

    Ms. Libby Davies: I certainly know it's not a simple question. If it were and if it had been done, we wouldn't be sitting here. But it seems to me that it comes up every single time we have a discussion or study. These issues are clearly identified, and there are obviously many barriers that exist both within government and in how people look at services in the community or how things are delivered.

    I'd really appreciate knowing whether or not there is work going on to, in a very pragmatic way, connect these dots, to connect these services, and to make sure that where we have one program that's working well and we are doing all the right things--but clearly we're not doing anything on the housing front, the income front, or whatever it might be--somehow that is being captured and being dealt with.

º  (1645)  

    Ms. Ethel Blondin-Andrew: I must tell you, it's not all bad news, Mr. Chair. Through all the program reviews and all the cuts, it's thanks to your work, the committee's work, that the children's issues have been kept in the forefront and that we have budgets dedicated to children at a time when programs were basically being eliminated and not renewed and when others that were put forward did not get a second glance.

    The children's agenda grew. We got the national children's agenda, the NCB, and the head start program. These all happened at a time when we were cutting in other areas, so you've done quite well. That's not to say there isn't more that can be done, but I do believe the key is in integration.

    If we don't find out what Diane is doing, what Health Canada is doing, and what HRDC is doing, and try to work together in a more meaningful way to achieve those economies and efficiencies, I think we're just heading down the wrong road. That's what's happening right now; we're trying to bring these together. We're trying to work together, and you know how difficult that is.

    The Chair: I have a follow-up suggestion, if I may, one that I think is a segue from Ms. Davies' question. I heard in your speech, Minister, reference to the UEY program, which for the uninitiated is the understanding the early years program, which comes out of the applied research section of HRDC.

    My original question was going to be, gee, that's great, because I know this is a program this committee has looked at in the past. It's a very interesting longitudinal piece of research. There's community mapping, and it plays to the sorts of questions Ms. Davies raised.

    This rather simple idea occurs to me. First of all, I want to know about where we are in the search for aboriginal UEY communities. Second, since the five model communities haven't been chosen yet, is it possible, in order to produce the kind of horizontality and measuring we're talking about, that we might want to consider one or two of the UEY communities? I don't know how many are envisaged. I know that at one level it sounds like mixing and matching, but on the other level it is actually getting a double bang for the buck. You're actually bringing two different measures together, but I think they're both extremely useful.

    Is that an idea worth pursuing?

    Ms. Ethel Blondin-Andrew: Well, as you probably know, we're talking about a very specialized group of people. There's nobody here specifically from the early years program. We have quite a large department and we have these separate initiatives that are happening, but it's certainly something we can undertake to look at and raise with the principals of that group.

    The Chair: Would it be possible--I don't want to press too hard, but we are a pushy lot; that's how we succeed in life--to get some understanding? We don't need to know right away, but could we get a written answer to the suggestion? Maybe there's an obvious reason not to do it.

    Ms. Ethel Blondin-Andrew: I don't know if we'll need a written question to get a written answer, but it might be a good idea.

    The Chair: That is, if you wouldn't mind taking that on board.

    The other question I had is, again, a sort of FAS/FAE research question. One has some sense of the pathology of this problem. It has the real danger of becoming intergenerational by definition just because you have a set of parents who are not able to cope, and then they give birth to children who are then seriously handicapped as well.

    As in all of these things, what we're trying to do is break a cycle, understanding that there are many other pieces, such as housing, income, jobs, and all that sort of stuff, that are part of the story. In the specific pathology of FAS/FAE, do we have scientific or anecdotal evidence of the single best intervention to get a mom not to go down that road? Is it better to go to younger parents, for instance, younger moms? Have we discovered through the Canada prenatal nutrition program that if you can get them into a position of self-esteem, that's what breaks the cycle?

    I'll go with any piece of information on this. What do we know to date? Tell us about the single best intervention for getting at these moms.

    Ms. McCormack.

º  (1650)  

    Ms. Heather McCormack: I'll give you a little bit of the information, and the minister may want to add to it.

    We often find the pregnant woman who is at risk of having an FAS child through the diagnosis of their first FAS child, sadly enough. The most effective interventions we've seen through the research that's been done has really been through the very intensive peer support programs, at least for the population we're talking about today.

    On the most effective programs, Manitoba has put in place a STOP FAS program that has trained lay workers. It provides peer workers who are familiar with the conditions in which the client is currently living, and provides ongoing support to that person. The worker himself will deal with only three clients at a time. So it is very intense in terms of the supports they're providing, and it's almost continuous.

    As can you well imagine, many of the clients we're talking about are addicted to alcohol. It may be 10 at night when they feel the need to have a drink, and there has to be someone at that time that they can call to talk to.

    So we have found that the most effective thing is the intensive peer support program that Manitoba has put in place, as has Seattle. Our case finding, for the most part right now, is through the diagnosis of the first child. We'd really like to move that back and be able to diagnose earlier, but we also want to know when a pregnant woman is at risk, as opposed to waiting.

    Ms. Libby Davies: I want to add a comment to that, because I've been on the Special Committee on Non-medical Use of Drugs, and our report's coming out next week. A very big issue has been the questions: where are the appropriate interventions, and where do you begin? I know from my own experience in east Vancouver that the strategy has to look at low-threshold services to long-term services. One of the problems is that we often design programs that basically become very inaccessible to people who face all kinds of multiple difficulties. We set the bar so high that we almost set people up for failure.

    The idea--and this is very true for drug users--is to have low-threshold services, where you're basically making contact, and that's your first point. It has to be a very supportive environment. The peer involvement is very important. One of the most important changes in Vancouver has been that the voices of drug users themselves are being heard. Many of those people are women who are also involved in the sex trade, so you're looking at all these multiple things.

    One thing I've learned from a lot of people is that you build on this idea of low-threshold services that make the connection, whether it's to treatment, follow-up, or longer-term support and recovery. But if we don't have those low-threshold services, forget it; you're actually writing off thousands of women and families who are on the street. That's where their lives are.

    That's just an observation.

º  (1655)  

    The Chair: Well listen, I think we've had a terrific afternoon. We're the allies, we're the A-team here. It's so good to see all of you here, and I hope you realize how much we're in your corner and working for you and pushing on your behalf and are prepared to plot and scheme at length with you. Also the expertise and concern around the table goes well beyond party lines and comes to our common humanity.

    As I say, just for the benefit of the committee, we'll be meeting next week to consider a first cut at the work plan, which I've just altered, of course, by inviting the minister and her friends to come back at an appropriate time when we can adjust our schedules, but early on in the proceedings.

    I'm also reminded we should probably ask the oddly named--though not an odd person in himself--federal interlocutor to come along. I guess he would be an important fellow to talk to. We'll have an offline conversation as to how you all relate to him. Anyway, that's another subject.

    You didn't know what I was talking about there, did you? No. We have a strange title called the Federal Interlocutor for Métis and Non-status Indians, who is Ralph Goodale. This is a function that has followed him around from job to job, but it's basically to deal with first nations off reserve and Métis and... So it's status, non-status, Métis, off reserve. And since we're going to be dealing with off-reserve people we have to talk to him, wearing one of his innumerable hats. So we will line that up as well.

    So again, Minister and amigas and amigos, thank you very much for coming. I think it's been a great afternoon, and we thank you.

    This meeting is adjourned.