I have never had the opportunity to give a brief before such a committee, and I am really honoured.
Just to give you a little bit of background, Neighbourhood Link Support Services is a multi-service social agency providing service in the east end of Toronto. We serve approximately 20,000 clients every year; of that, about 2,600 are seniors.
We only have 80 supportive housing units and we have 80 clients living in those units. The remaining 2,515 clients live in their own homes, whether houses or apartments, in the community. We are not an institution in any way, shape, or form.
We say we serve the oldest, the loneliest, the sickest, and the poorest. To go to the oldest, 50% of our seniors are over 75, and 20% are over 85. We have 64 clients over 95 and 10 over 100. The average age for people in nursing homes is about 79. In our case, the average age of our clients is 80.
Let us look now to the loneliest. These are people without families. Ninety percent of our supportive housing clients live alone, and 70% of our community clients live either alone or in a situation that is not with family, whether they have shared accommodation, roommates, or something such as that. Most of them are simply alone.
They are the poorest. A third have incomes of less than $12,000, and another third have incomes of less than $25,000.
And they are the sickest: 75% or more have two or more medical conditions that compromise their independence and their mobility, and yet these people are living independently in their own community.
As you can imagine, seniors are typically women, and we have the classic split: 75% of our clients are women. This is a statistic from a U.S. study, but it showed that women are almost three times as likely to go into nursing homes as are men. They didn't go on and elaborate as to why, but I can well imagine the reason women are more likely to go into nursing homes is that they don't have the financial security to purchase those services they require to stay at home.
In Ontario, and I gather for most of the country, the most common community support is the community care access centre or something comparable to that, which brokers hours of professional or semi-professional care, whether it's occupational therapy, nursing, personal support, or what have you. Typically, they order hours for people who are coming out of hospital. For seniors or people with chronic ailments, they have to report that they require personal support to get any care at all. Personal support is things like help with bathing, toileting, feeding, and things of that nature.
The way they make that judgment is that the stranger goes in with the clipboard and asks very personal questions about bowel function, and very often the senior is too proud to admit the level of need they have.
If a client gets service through the CCAC, if they do qualify, the average is 1.4 hours a week, which means that the vast majority gets one hour a week. What can you do in an hour? You can have a bath, maybe. I'm not sure that my 93-year-old mother could be bathed and redressed in an hour.
If you are only getting an hour a week, then your house becomes messier. If you get groceries they're from the corner store, where it's more expensive, or you're paying the delivery fee to have them brought from the grocery store. Maybe you can't get out to visit your doctor. You can't go to the pharmacy to get your prescription filled, so you don't follow up the medical regime and you're back in hospital, probably using an ambulance to get there. You don't want to invite people in because your house is a mess, so you become more and more isolated.
If you do have groceries, the trouble of making your meal is so great. Who wants to eat alone? So you start to subsist on tea and toast and pretty soon your health deteriorates and you're back in hospital.
Somebody somewhere along the line suggests to you that you'd better go to a nursing home for your own good, and when you look around and you say that if this is all the service I can get, is the only support I have to stay at home, I had better get to that nursing home.
A community support service agency intervenes to provide all of those practical services that aren't traditionally considered health care. That means drives to essential appointments, social-recreational things, changing a light bulb, cleaning up, or doing the laundry. There are a myriad of things—whatever it is that a client requires.
If a client is institutionalized, the human cost is incalculable. Institutions are very good for people who genuinely choose to go there, or who can't rationally make a choice—people with such severe dementia that they really can't make a choice. But if your infirmity is macular degeneration, which causes your blindness, or arthritis, and 42% of the people in that nursing home with you have dementia and another 33% have had recent documented episodes of depression, that's not the right place for you. You know you are stuck there. You can't leave because probably you don't have a home any more on the outside, and if you did, you wouldn't be able to care for yourself. You know you're there to die.
The best nursing home in the world is still an institution, and we know that institutions are not good for people. You can see I'm not a fan.
As health care costs escalate, the health dollars are more and more specific to acute care. The cost of a nursing home is $700 a week, approximately. It's hard to assign a sensible number to the cost of community support services. In our agency, we expend $3 million a year on senior services, and we have 2,600 clients. Divide that by 52 weeks and it comes up to $22 a week. So it's $22 a week versus $700 a week.
The problem is, who gets to pay for that? What silo should that money come out of? Is it housing? Is it community and social services? Is it health care? Is it a federal problem? Is it a provincial problem? And since nobody really knows, it ends up being given very short shrift, indeed.
In Ontario, I know there are quite comprehensive community supports in Ottawa and in Toronto. Everywhere else in the province, they are sketchy, if they exist at all.
What I believe is necessary as a sort of national initiative to support seniors, and in particular senior women, is to develop local agencies to provide senior services. You could use the mature agencies such as Neighbourhood Link to mentor those agencies that don't have experience giving senior care. Existing agencies also need to be funded to enhance the services they're already providing.
This should not be a big, heavy bureaucratic kind of undertaking. We don't need another broker like a CCAC. If the neighbourhood agencies can remain flexible and responsive to need, that's clearly the better way to go.
Thank you very much.
:
Good afternoon. Thank you for inviting us.
We sent you our brief, but it is being translated. It will not be available to committee members until tomorrow.
Our federation has been in existence for more than 30 years. Over the years, we have worked in particular to ensure the greater welfare of single parent and blended families. The federation's major issues are obviously the fight against poverty, the automatic collection of child support, family allowances and all issues concerning studies for the heads of single-parent families.
Today, we do not claim to be providing a representative picture of all Canadian single-parent families, since the federation is more concerned with the Quebec context. We work much more with Quebec's policies. However, we will try to make connections with federal social policies.
The major points we particularly want to discuss with committee members are the following five aspects: welfare, family support measures and the minimum wage, access to studies, social housing and work-education-family balance measures. All these issues are of more particular concern for women who are the heads of single-parent families.
According to the figures of the National Council of Welfare, the NCW, the poverty rate of single-parent families headed by the mother—since the majority of heads of single-parent families are women still today—is still, on average, between five and six times higher than the poverty rate among couples with or without children.
According to Statistics Canada, in 2001, the poverty rate among single mothers under 65 years of age was 42.4%, compared to 19.3% for single fathers, 9.5% for couples with children and 8.1% for couples without children.
In 2001, there were 1,260,000 families in Quebec. Of that number, 27% were single-parent families, the vast majority of which, 80%, were headed by a woman. In 2003, the rate of low before-tax income for two-parent families was 9.5%, whereas it was 40.9% for single-parent families and nearly 50% for single-parent families headed by a woman.
Inadequate social assistance benefits are one significant component affecting single-parent families. In August 2006, nearly 50,000 single-parent families in Quebec relied on welfare benefits in order to live.
Again according to an NCW report published in the summer of 2006, the estimated annual social assistance income for 2005 for a single-parent family with one child, including supplementary benefits and federal and provincial credits, varied between $13,000 in Alberta, which is theoretically the richest Canadian province, and $23,000 in the Northwest Territories. In this area, Quebec ranked slightly below the national average, with income of nearly $16,000.
These distinctly insufficient amounts are far from enabling these families to meet their essential needs. In addition, in Quebec, child support continues to be deducted from welfare benefits, except for the first $100 per month, even though those amounts have been tax-free since 1997. Some of you are perhaps familiar with the Suzanne Thibaudeau affair, which occurred in 1997. As a result of that decision, child support, across Canada, is no longer recognized as income, whereas it is for the purposes of welfare and social programs.
Various rate increases have also affected individual incomes in recent years: hydro costs, which have risen 11%, child care costs, 40%; public transit costs, 18%; and gasoline, 35%. During that time, welfare benefits were only indexed by half in January 2007, after a number of years of non-indexation.
:
All that obviously has a major impact on the consumption spending power of single-parent families.
In recent years, major tax gains have been made in Quebec under social and family policies. Among other things, the payment of support for children is a much more generous measure than under the former family allowance system in Quebec. Furthermore, this is a universal measure, which is very much appreciated.
There is also a tax credit, the working bonus, which increases the incomes of low-income persons. That's also very good. Unfortunately, this measure has a harmful effect. It enables businesses to keep the minimum wage at its lowest rate. In our view, an increase in the minimum wage should be considered in the short term, particularly in view of the fact that the vast majority of low-wage workers are women.
In Quebec, the minimum wage will be set at $8 an hour on May 1, 2007. A person working 40 hours a week at that rate can only accumulate $16,600 a year, which is well below the poverty line.
In July 2006, the federal government granted an allowance of $1,200 a year to families with one child under six years of age. Our federation gave this measure a lukewarm welcome, on the one hand, because the federal and provincial taxation of those amounts cut into the actual benefits of families and, on the other hand, because single-parent families were put at a disadvantage by that measure, since they cannot transfer income to someone else: since they are the only income earners in the family, this put the heads of single-parent families at a disadvantage. Perhaps we can come back to this issue during the question period. In our opinion, a refundable tax credit would have been much fairer for all Canadian families.
Compliance with the child care agreement signed by the previous federal government, allocating $1.2 billion to develop child care services, would have enabled Quebec to consolidate its child care services system. The effects of non-compliance with that agreement are being felt even more in the rest of Canada, where the other provinces do not have reduced contribution child care services systems.
Another way to increase income is to have access to education. Considering that 80% of new jobs created today require postsecondary education, the importance of facilitating access to education as much as possible is readily recognized. The problem for women who are heads of single-parent families is that this access is reduced, particularly when they have young children. The situation is quite difficult in Quebec. Some women heads of single-parent families receive smaller loans and bursaries than they would receive if they were on welfare. As is the case with welfare, support is considered in computing financial assistance for education, which deducts points.
The federation believes that an increase in the Canada Health and Social Transfer would be a more effective way of helping the provinces support Canadian students. Fair financial restitution of the transfer to the provinces would also enable the provincial governments to enhance their loan and bursary systems.
Another major problem for low-income families, particularly single-parent families headed by women, is housing. Greater effort should be focused on funding social housing, particularly at the federal level. In Quebec, women tenants are the most likely to have problems paying their rent. Since they are poorer than the average of other households, more single-parent families spend more than 30% of their incomes on housing, particularly where they are headed by women. According to the last census, in 2001, nearly 40% of single-parent families headed by women were in a precarious situation with regard to housing.
The last aspect we would like to address is work-education-family balance. This balance is already hard to achieve for two-parent families. You can therefore imagine what it represents for a single-parent family. Changes in the labour market in recent years have made life even tougher. There are increasing numbers of temporary and on-call jobs. It is hard to establish a schedule in advance, and work days are growing increasingly longer.
In Quebec, however, we must point out that Quebec has introduced a new parental insurance system, which is much better and more generous than Canada's employment insurance system. We must also note the advantage of having a public reduced-contribution child care services system, which plays an essential role by enabling women with young children to enter the labour market.
In conclusion, I would like to remind you that, according to the Canadian Centre for Policy Alternatives, in Canada, in 1976, one-tenth of persons with the highest incomes had incomes 31 times greater than one-tenth of the poorest individuals. In 2007, the incomes of the richest Canadians are 82 times greater than those of the poorest. These figures show that matters are deteriorating, instead of improving.
As previously mentioned, and as the Standing Committee on the Status of Women itself has noted, single-parent families headed by women are among the most vulnerable in Canada and the most likely to be poor. It is therefore imperative that measures be taken soon to remedy the situation and to ensure that all Canadian families can actually meet their essential needs.
:
Thank you, Madam Chair.
Welcome to all of you and thank you very much, in particular to Madam McGowan, who is from my riding and with an organization that is 30 years old, I believe, and very well recognized and respected in the community.
I'll start with you, because I've always felt—just from going in the buildings and going into the nursing home when my father was ill—that women were by far the largest percentage of retired, but you've given us quite an astounding figure, 75%. Not only are they the largest number surviving, but they're also the poorest of the people surviving. Generally what happens when the husband dies is that the income goes down, and some women have had to give up their homes or at least are isolated in their homes, and, as you've said, are quite—
I know a great deal of what you've said, and I accept it and I understand it. I wanted to ask, though, in the last budget, for instance, there's a splitting of pensions that can happen, but if you're a couple already today without the splitting, I know that couples can live much more comfortably or a bit better off even if their income is not as high because they're sharing. A single person, a man or a woman—in this case most of them are women—on a reduced pension is even worse off.
Is there any other thing that you would suggest, in addition to, of course, the things that you've mentioned, such as housing and long-term care? At the moment we do not have a national long-term caregiver program, and I wondered if you might comment on whether that would be needed to set some standards or some drive.
In terms of income support, one of the things I suggested was that there be not so much income splitting as pension splitting, so when the couple are both ready to retire, the pensions are split so that the women receive 50% of their household pension right from the start, rather than losing it when the husband passes on.
Could you comment on those two things as one of two ways, anyway, of helping out?
:
Absolutely. That's a wonderful question, and I've got a great plan, but it will take me longer than ten minutes to explain it.
I believe sincerely there should be a blanket of community support services across the country. I think what it would take would be to break down some of the silos that presently exist. It clearly is of benefit financially. If you look at the system as a whole, and all taxpayers' money went into one pot and was redistributed out, two-thirds of our clients who live in their own homes would be eligible for subsidized nursing home beds at $700 a week—yet we keep them at home for $22 a week. So there's this huge difference, and that money could be so much better spent than on nursing homes. So if the investment in community supports were made, fewer people would need to draw on the more expensive health care and long-term care facilities.
I did bring a study that Neighbourhood Link undertook with the University of Toronto and Ryerson. Unfortunately it's only in English, but I understand that the executive summary is going to be translated and be distributed to the committee. That specifically looks at supportive housing, but it can certainly be extrapolated to the services in the community.
I'm not sure I've completely answered what it would take. If we said a person is evaluated as eligible for a nursing home at a full subsidy of $700 a week and we said to the community agency, the government will fund you to spend up to 60% of that to keep that person at home, then whatever that individual needed—And somebody will need transportation and personal support, and somebody else will need nursing and housekeeping, and so forth. You can spend up to 60% that the client directs and the community worker organizes, for example. And where there are no community agencies such as mine and the many that are in the Ottawa area, in those spaces there are already good community agencies. They may be dealing with newcomers or youth or families, or what have you, but they would be the ones who could best provide the senior services.
The fact that no senior service exists in Hamilton doesn't mean there aren't good community agencies. It's better to start with one that already exists and already has roots in the community than to try to develop a brand-new one, because all you're doing then is building one more silo.
:
Thank you, Madam Chair.
Thank you for being here. It's good to have such expert advice.
I want to ask questions of everyone, but I'll start with Ms. McGowan.
In June 2006, the NDP critic for seniors issues introduced what we called “the seniors charter”. Some of the elements of that charter were income security, protected pensions, indexing public income, access to affordable housing, access to universal health care including primary care, home care, palliative care, geriatric care, pharmacare, free pharmacare and dental care, in addition to access to affordable recreation, education, training, government services, programs, and included family reunification for immigrant women.
What is your reaction to that idea? Would implementing that seniors charter help senior women? Would it be of benefit?
:
Blended families must have been blended for a long time. A number of families are blended, but they fall apart because the more children there are, the more difficult factors there are, depending on the state of the relationship, the break-up and so on.
However, in economic terms, a first break-up, in 90% of cases, in general mainly impoverishes the woman. Men are impoverished as well, but, since we know there is no pay equity, it is mostly women who find themselves in poverty.
If a second union occurs, that leads to specific situations. For example, in a blended family, family allowances may be lost. Family allowances are often based on family income. So when women remarry or have a second union, they in fact lose money. There are economies of scale because they are living with someone, but, at the same time, they lose income; that's clear. Some things must be reviewed regarding taxation, because a blended family is different, even though it is a family.
In the case of second, third or fourth unions, and where support must be paid after each of those unions, that obviously impoverishes couples as a whole—that's definite—more particularly, women. It isn't because you're in a second union that you no longer need support for the children. Sometimes the fathers try to go back to court to have support amounts reduced, as a result of which these women in fact suffer a drop in income. So there are various situations, and blended families generally aren't very rich either.
:
Thank you, Madam Chair.
Thank you to our witnesses for your very well put-together presentations this afternoon.
One of my questions is part of sort of a recurring theme, and I'll direct it first to our witnesses from Quebec.
It's great to have you here. You talked a lot about issues that in my view were largely in the realm of provincial jurisdiction, essentially home care and social services. I think at one point, when Madam Desjardins was speaking about education in particular, she noted that the best way to deal with that was through transfers. Even in Madam McGowan's presentation, I had the sense that there was great need. I don't disagree: there is definitely need for these types of social programs to exist to help those who are particularly vulnerable in our society. I'd ask both of you for a general comment.
Would it not be better to have the federal government make sure that provinces have the dollars they need, and then allow the provinces to manage those programs? They're closer to the situation. I get concerned when we start talking about a national program. Believe me—I've been here fourteen months, and this is no criticism, but it's a reality that national programs can become very costly from an administrative point of view. As well, you are removed from the reality of delivering those programs to citizens.
One of the biggest themes of this week's budget was to make sure that those transfers were better divided and that those dollars got into the hands of the provinces so that they could do that work. I wonder, since the budget just came out Monday, if you would have some comment on whether that in fact will help, particularly for Quebec. I think that the new transfer there was some $3.5 billion.
Madame.
:
Thank you, Madam Chair.
Thank you for being here, Mesdames. I'm pleased once again to meet those of you whom I knew well in another life.
Good afternoon, Ms. McGowan. You said that institutions were not good for people. Can you elaborate on your remarks? In my opinion, institutions aren't good if people only use them as a last resort. But when people have gotten to the point where they really need institutional help, it is important that they get it. By enabling people to stay at home longer, your organization is becoming much more appealing and important for people who want to stay at home. You have to take into account people's wish to stay in their home environment for their own well-being. I'd like to hear your comments on that.
Ms. Lévesque and Ms. Desjardins, since we've been talking about the fight against poverty, we've seen that, ultimately, nothing has changed. Measures are taken here and there and, when things move to the left, they then take a turn to the right.
Is that because we, as women, have not yet managed to become aware of the situation of poverty in which we find ourselves as a group and to take action so that measures actually correct the situation. We really get the impression that all we're doing is helping people live better in poverty, whereas the purpose of all these struggles was to get people out of poverty and to ensure they didn't return to it.
Comprehensive seniors services run a pretty broad range. There are social-recreational programs for the healthy senior. You know, that's where you go and you have tai chi and cribbage and things like that. There are also any number of types and varieties of congregate dining. Congregate dining seems so very cold, but we have breakfast programs and lunch programs and supper clubs and diners clubs. People like that, because sharing food is so fundamental, and you tend not to eat very well if you always eat alone. You don't eat very much, and you certainly don't eat much variety.
Moving up the scale from that is personal support. You need personal support for laundry and shopping and transportation. Transportation is huge, so fundamental. If you can't get to the doctor, you call the ambulance and you end up in emergency. You know, it's that kind of thing. If you're not regularly going to the doctor, if you can't get the prescription filled at the pharmacy, you end up sick again. So it's community transportation.
It would be supportive housing, where the unit is designated and personal support workers go in on a regular basis, or adult day programs for people with dementias. You shouldn't be put into a nursing home as soon as you are diagnosed with Alzheimer's disease. There is a progress of the disease, and certainly in early stages, they're perfectly able to stay in the community. There's also meals on wheels, for sure that kind of thing.
But the biggie is what we call client intervention and assistance. That is the community worker who ties all the pieces together, works with the client to determine what that client needs, finds where that service is available if the agency doesn't provide it, and ties them all together.
And sometimes, you know, as I say, it's not, strictly speaking, health care. We have a client who had sold ice cream at Maple Leaf Gardens, and all he wanted to do was go back and watch a hockey game. Well, I tell you, it wasn't hard to find volunteers who would take him, and Maple Leaf Gardens, I'd like to say, provided the tickets. It made him happy.
So does that explain it? You need the cluster of services and you need the community worker to tie them together.