Interventions in Committee
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Joseph Wamback
View Joseph Wamback Profile
Joseph Wamback
2019-06-13 9:55
Thank you.
I'm Joe Wamback.
Mr. Chair and members of the committee, I want to thank you for for giving me the opportunity to testify today.
I am the chair and founder of the Canadian Crime Victim Foundation, which has been in existence since the year 2000. We have almost two decades of experience in dealing with victims of extreme violence from coast to coast, from Victoria to St. John's.
I've also partnered with the health sciences psychology department at York University so that we can create a greater understanding of psychopathy and extreme violence among individuals in Canada and the resulting trauma to victims and their families. We also sponsor psychological counselling for victims of extreme violence throughout the country.
I am here today in support of Bill C-266. I believe it is a win-win situation for all involved. The bill maintains the judicial independence that we all seek in Canadian society. Secondly, it prevents the continued revictimization of those who have suffered so much through acts of horrific crime in Canada.
We're not dealing with a large constituency. We're dealing with a handful of individuals who have created such devastation in Canadians' lives that we have to find a better way of dealing with them than by revictimizing those who have to attend Parole Board hearings time and time again.
My first introduction to this type of situation was Clifford Olson. We are now friends with 11 family members of victims of Clifford Olson. The revictimization that those individuals had to suffer and live through during those parole hearings—Clifford Olson was a master at calling for these hearings almost every year—was just unprecedented.
Throughout the 20-year history that we have been working with victims of crime and from the 20 years of research, we've specifically seen increases in disease. Cancer is four times the national average in that particular constituency, as well as heart disease and mental illness. The revictimization that occurs through continued parole hearings takes it toll on the lives of not only the direct victims but also on the victims' families. It is a large circle, and it gets larger and larger as time goes on. For example, when my son was hurt, my grandmother passed away. She could not deal with the injuries my son incurred.
Typically when you're debating and deliberating on criminal justice changes, measures and policies, including parole, for the most part those debates have ignored one vitally important variable, which is the victims and their families. I believe the victims' lives have value that is of equal value to anybody else's in this country. They should not be ignored when we are concerning ourselves with any factor in criminal justice reform. Our obligation here, as Canadians, is harm reduction. I'm convinced that Bill C-266 is a step in the right direction.
I've looked at the Parliamentary Budget Officer's report, which indicates that we're dealing with nine to 10 individuals a year, but I don't know where he got the number from statistically. If they were kept incarcerated for another year, the cost is approximately $1 million per incarcerated individual. That was the end of the report.
Unfortunately, the analysis—either intentionally or unintentionally—did not consider the cost to society of allowing earlier parole applications for those most violent individuals who are targeted by Bill C-266. It deals singularly and specifically with the increased length of incarceration.
It does not consider the cost of repeat offender parole programs, which police-based statistics tell us are in the tens of millions of dollars annually. It does not consider the financial impact of social services for supporting the victims. I have witnessed first-hand the agonizing grief and revictimization forced upon victims, families and even their communities at large when they must relive the horrific details of the most heinous crimes committed against their loved ones.
Trials, convictions and sentencing are not cathartic for survivors. Grief is a never-ending journey, and parole hearings extend and reignite that grieving process. Many victims, survivors, friends and family members are unable to work for months before a hearing. After the hearing, they are terribly affected by having to relive those experiences. Some lose their jobs. They can't participate. They can't continue to become participating members in Canadian society. They can't pay their taxes or any other societal obligations, and many rely on the social safety nets we have in Canada today. All these have costs that are associated with revictimization.
My research also demonstrates that divorce is the inevitable consequence of a child homicide, which creates incredible financial and societal inequities for siblings of homicide victims. Some become a permanent burden on Canadian society. Medical complications are rampant, and revictimization is rampant, equally staggering and profound.
In 2016, Alberta justice minister Kathleen Ganley stated that consecutive parole ineligibilities can be a “useful tool” as a signal to criminals that multiple crimes may lead to a longer sentence. She stated, “It can potentially have a beneficial effect in terms of signalling to people who are doing these things that it's not a good idea.” These are direct quotes, by the way. “It can have a sort of deterrent effect. That being said, obviously it's only intended to be used in certain circumstances.”
She is referring to the most violent and horrific of crimes. We don't see a lot of those in Canada, fortunately, but they are becoming more frequent. I've just attended a conference in Toronto on mass homicides. People in this country and around the world are dealing with this, because it's becoming more and more prevalent as society moves forward. We've had two of them in Toronto just recently. One was the van attack on Yonge Street. The other one was the shooting on Danforth Avenue.
The victimization that occurs, and the cost of that victimization, cannot be calculated. It's the same thing with parole hearings. When victims have to attend parole hearings and face the individuals who have harmed their child or loved ones, the effects are devastating.
My hope is that you will give great consideration to Bill C-266 to allow the judiciary to introduce extended parole ineligibilities for the worst of the worst.
I want to thank you for your time.
View Dave MacKenzie Profile
View Dave MacKenzie Profile
2019-06-11 10:07
I think you've already indicated this, but I'll just reiterate that many of these people who are incarcerated for those crimes play on the opportunity to get parole to harass victims all over again—families and friends.
View James Bezan Profile
Yes. We witness that all too often. These individuals love to go to their Parole Board hearings, knowing that they will be refused parole, and just relish how the families are reacting to them. We're not dealing with people who have any empathy. They're not compassionate. They feed off the fear of others. That to me is what we want to prevent in the future.
Craig L. Dalton
View Craig L. Dalton Profile
Craig L. Dalton
2019-06-10 15:36
Mr. Chair, committee members, thank you for inviting me here today and for providing me with the opportunity to share the results of our 2019 Office of the Veterans Ombudsman Report Card.
As mentioned, I'm joined here today by the deputy ombudsman, Sharon Squire.
Excuse me if I go back a bit to first principles, as this is my first time to appear before you. As you're aware, the Office of the Veterans Ombudsman has really a two-part mandate, and the first and most important part of that mandate is to respond to individual veteran's complaints, or complaints raised by spouses or survivors. The second part of our mandate is to recognize and identify issues that may be affecting more than one veteran, therefore representing perhaps a systemic issue. Under our mandate, we have the opportunity to investigate those issues and, where appropriate, make recommendations to VAC to improve programs and services. That's really where the report card comes in and that's why we're here today.
This is the third year that our office has released the report card. It was first released in 2017. The report card is a tool for us that allows us to capture, track and report publicly on recommendations that our office has made to Veterans Affairs Canada to improve programs and services.
The report card allows us to do a couple of things as we report publicly. The first is to acknowledge progress that's been made, and in fact to celebrate where changes have been made to programs and services to the benefit of veterans and their families. More importantly, from our office, it allows us an opportunity, on a regular basis, to shine a light on areas that we think still need some attention, and that's what the report card this year does.
I'd just like to share a few highlights with you, if I may.
Three areas where we've seen progress this year, progress that we believe will be well received by veterans, are as follows. The first is that veterans will now be able to retroactively claim reimbursement for treatment costs to the date of application as opposed to the date of decision for disability award and now pain and suffering compensation applications, which we believe is a significant improvement. The second is that, at the age of 65, all veterans who have a diminished earning capability assessment will now receive 70% of their income replacement benefit, which is very important in terms of financial security post-65. The third is that it's good to see movement on issuing of veterans' service cards, which the veterans community has been calling for, for quite some time.
We do like to acknowledge and recognize these improvements that have been made.
As I said, it's also an opportunity for us to shine a light on areas that still need some attention. As of the point of reporting this year, there are still 13 OVO recommendations that have yet to be addressed. The majority of those recommendations relate to the two areas that we hear about most commonly in complaints from veterans. They are in the areas of health care supports and service delivery.
In releasing the report card and sharing it with the minister, I took the opportunity to highlight three of those recommendations that we think would warrant attention as a matter of priority. They are as follows.
The first is expanding access to caregiver benefits, which is something we hear and continue to hear about on a regular basis from veterans groups and veterans advocates.
The second is covering mental health treatment for family members in their own right. Having had the opportunity in my first few months to meet with a number of veterans, and spouses in some cases, and to hear about some of the circumstances and challenges that family members, and in particular children, face when dealing with having a parent who was injured or is severely ill as a result of service, makes me wonder whether or not we're doing all we can do to support children and families. We think that's an important area.
The last is to provide fair and adequate access to long-term care and, to a lesser extent, the veterans independence program.
Those are three areas that we believe are important and I highlighted those to the minister. We will continue to follow government's actions in response to our recommendations and will continue to report publicly to you, the committee, and to Canadians on progress as needed.
As I mentioned earlier, I'd also like to take this opportunity to share my priorities with you, after having spent six months on the ground now and having had the opportunity to speak to a number of veterans, a number of veterans groups and advocates. We've taken some time to identify the priority areas that we think need to be addressed next. Again, these aren't ideas that we came up with sitting and talking amongst ourselves. This is what we hear from veterans who phone our office and from veterans groups and advocates. I'd like to share those priorities with you briefly.
The first priority, from my perspective, goes back to the key component in our mandate, and that's providing direct support to veterans and their families when they believe they've been treated unfairly. We're still a fairly young office, and our front-line staff have done very good work to this point in time. However, based on what we've heard from veterans and what we hear through our client satisfaction surveys, we have some work to do to make sure that we deliver an even better service and that we clarify what our mandate is, what we do and what we don't do, so that veterans who need our help will actually come to us. This is a significant priority for me and our number one priority.
Additional priorities include health care supports. As I mentioned earlier, this is the area that we receive complaints about the most. I'm led to believe that this area has not been looked at in quite some time, so we want to help move things forward in this regard by taking a broad look at VAC health care supports to identify areas we think might need some attention.
Third would be transition. I think we're all well aware of the importance of the transition process and ensuring that veterans and their families are well set up for post-service life. This is an area that continues to, thankfully, gain a lot of attention. We're particularly interested in looking at the area of vocational rehabilitation and the programs and services that help veterans find purpose in post-service life.
As we do this work—and we've also heard this through engagement over the last number of months—there are a few groups that we believe need to be considered a little more closely and a little more deliberately. They include women veterans. I've had the chance to speak to a number of women veterans and women's advocates. It's clear that a number of the programs and services they have access to were not designed specifically with women service members in mind or women veterans in mind. This is an area that we think is going to require significant focus going forward.
Second are veterans of the reserves. We've received a number of complaints, again related to specific programs. In looking into those complaints, it's become clear that, while the program is well intended, well designed and works well for regular force veterans, that's not always the case for reservist veterans. We think there's enough of an issue there to broaden that scope a bit and make sure the programs and services that are being provided adequately take into account the unique nature of reserve component service.
The last priority—and I mentioned this earlier—is families. Just in the brief amount of time I've been here speaking with veterans and families, we believe that this is another area we need to look at a little more closely to make sure we understand what the impacts on families, particularly children, are and that we have programs and services that adequately take this into account.
The last piece I would mention is just a bit of ongoing work that we initiated a number of months ago in terms of conducting a financial analysis of the pension for life. That work is more than just a financial analysis. We're going to monitor the implementation, and we are monitoring the implementation with a view to producing a report sometime late this year or perhaps even early 2020, after we've had time to watch it be implemented and get a sense of what the impact is on the ground.
Thank you very much for the opportunity to share an overview of the report card and also speak to some of our priorities going forward.
I'd be happy to take any questions, if there are any.
View Marilyn Gladu Profile
That's very good.
What about the B.C. Nurses' Union? Do you have any specific recommendations for dealing with patients who have mental health issues?
Adriane Gear
View Adriane Gear Profile
Adriane Gear
2019-06-06 16:46
I think our first recommendation would be to invest in our mental health care system. We need to make sure there are proactive strategies to support those living with mental illness. We certainly want to see a reduction of stigma, and that there's access to care.
Unfortunately, what happens in a lot of cases is that patients have decompensated to the point that they are in a real crisis. It's in those situations that we are seeing an escalation of violence. If we can provide appropriate care in a timely way, I think that would go a long way toward addressing some of the violence we see within that population.
It's access to care.
View Doug Eyolfson Profile
Lib. (MB)
Okay, thank you.
I'll ask this of you because this is, again, an issue with the nurses' union, and I will ask Ms. Van hulle as well for her take on this.
I am from Manitoba. There has been a recent change to the Mental Health Act in Manitoba. When a patient was brought in with a suspected psychiatric complaint, the police would be called. If the patient was to be moved to another facility, the police would be the ones to transfer them if there was a safety issue. If they were picked up in the community, the police would take them in, and they would have to stay with the patient for safety until the patient had been seen and it had been determined that they were admitted to a suitable facility.
This change to the act says that the police no longer have to wait, because the province says that there are more people in the hospital with the training to deal with them; however, there is not more staff.
Can you see any safety considerations or implications with this change?
Adriane Gear
View Adriane Gear Profile
Adriane Gear
2019-06-06 17:01
I think that is disastrous. The reality is that mental health patients come into our emergency rooms, and they sit for hours, sometimes days. They sit on stretchers in bright lights, and they're in very exposed areas so people can observe them. We have floor cleaners going by, lots of noise and lots of things to trigger them.
Leaving them unattended is not the answer, although I absolutely appreciate the challenge, of course, that law enforcement needs to move on and do what they do best.
Again, I go back to our needing appropriate, timely access for people who are suffering with mental health issues, so that's the problem.
View Jean-Claude Poissant Profile
Lib. (QC)
The long-term health of our agriculture is something that is particularly close to my heart. You talked about the psychological distress of our producers. I know that a report was submitted and that it contains recommendations.
Can you tell us a little more about how things are going?
View Jean-Claude Poissant Profile
Lib. (QC)
We submitted a report with a number of recommendations. Can you tell us a little more about what is going to be happening with those recommendations?
Chris Forbes
View Chris Forbes Profile
Chris Forbes
2019-06-06 12:33
Normally, we look at a report and an official process follows, in which the government becomes familiar with the details and subsequently provides a response. That is the process followed each time a standing committee submits a report.
As a department, we take the recommendations very seriously and we look at them in detail to find out how we can adjust our processes and our priorities. We work with the government to provide the committees with a more official response.
View Christine Moore Profile
I would like to know a little bit more about the process of reviewing flagged videos, and who reviews them when it's not done by a computer.
Also, are the workers reviewing these videos provided with any services, because having to listen to these kinds of things all the time causes a lot of distress to people? What services are you providing to these workers to make sure they do not go crazy from listening to all of these things all the time?
Colin McKay
View Colin McKay Profile
Colin McKay
2019-06-04 16:34
To begin with the process itself, as I mentioned, especially in the context of hate content, we are dealing with such a quantity that we rely on our machine learning and image classifiers to recognize content. If the content has been recognized before and we have a digital hash of it, we automatically take it down. If it needs to be reviewed, it is sent to this team of reviewers.
They are intensely trained. They are provided with local support, as well as support from our global teams, to make sure they are able to deal with the content they're looking at and also the needed supports. That is so that as they look at what can be horrific content day after day, they are in a work environment and a social environment where they don't face the same sorts of pressures that you're describing. We are very conscious that they have a very difficult job, not just because they're trying to balance rights versus freedom of expression versus what society expects to find when online, but also because they have the difficult job of reviewing material that others do not want to review.
For us, whether they're based in one office or another around the world, we are focused on giving them training and support so they can do their job effectively and have work-life balance.
Jennifer Lyle
View Jennifer Lyle Profile
Jennifer Lyle
2019-06-04 16:03
Thank you.
My name is Jennifer Lyle. I am the CEO of SafeCare BC and one of the founding members of NASHH, the National Alliance for Safety and Health in Healthcare. I am here today on behalf of CALTC, the Canadian Association for Long Term Care, as the NASHH-CALTC liaison.
CALTC is a national organization composed of provincial associations and long-term care providers that publicly deliver health care services for seniors across Canada. It also represents care providers who deliver home support services and care for younger adults with disabilities.
The National Alliance for Safety and Health in Healthcare, NASHH, is a national-level collaboration of workplace health and safety associations that works with health care organizations and workers across Canada to promote safer, healthier workplaces.
Mr. Chair, honourable members, our continuing care sector is in a state of crisis. Our care providers are understaffed, under-resourced and under incredible pressure to provide quality care to an increasingly complex population. This set of factors creates a toxic mix that not only leads to burnout but also to workplace injuries.
Consider the numbers. Nationally, time lost claims due to violence in health and social services have increased by over 65% in the past 10 years. In B.C. alone, health and social services account for over 60% of all workplace violence claims among major industry groups, according to WorkSafeBC, and yet this sector amounts to only 11% of the total provincial workforce of this group.
Overall, violence is one of the leading causes of workplace injuries in B.C.'s continuing care sector, and B.C. is not unique. Across Canada we all face the same challenge: how to address the root causes of workplace violence in health care.
In order to address the root cause of an issue, you first need to identify and understand it, and that leads me back to my earlier remarks about being understaffed, under-resourced and under pressure.
To understand the pressure care providers are under, you need to understand how those relying on the continuing care sector have changed over the past decade and where we're headed. Today 62% of long-term care and 28% of home care clients have some form of dementia, a number that's expected to increase. By 2031, over 937,000 Canadians will have dementia. That's an increase of 66% from the present day.
In addition to the trends we see around dementia, we're also seeing an overall increase in complexity of the needs of those being cared for in a community setting as we continue to move away from an institutional model of care. This includes people with psychiatric disorders and addictions who may also now be facing dementia as they age. These things are all risk factors for violence.
Violence is not a foregone conclusion in any of these instances, but too often our system puts care providers at risk because of how care is being delivered. That brings me to my next point—being understaffed.
In a recent survey conducted by SafeCare BC of the continuing care sector, 95% of respondents indicated that their organization was short-staffed. You might wonder what staffing shortages have to do with violence; in that survey, we asked. We asked how staffing shortages impact care provider safety, and what they told us is that staffing shortages lead to rushing, to fatigue, to feeling like you don't have time to ask for help. All of these things put care providers at risk.
Not only that, but when you're working with vulnerable populations—for example, seniors with dementia—it's vital that you have the time to understand their needs and their triggers, yet it's this time that's in such short supply for our care providers because of chronic staffing shortages.
Not only that, but just as staffing shortages lead to workplace injuries, workplace injuries lead to staffing shortages. Take B.C. as an example. In 2018 the equivalent of nearly 650 full-time positions were lost because of workplace injury. Imagine an organization—or several organizations, for that matter—losing that number of full-time employees. Imagine the impact. That's the cost of workplace injuries.
Beyond the numbers, there is the human toll. There is the care aid who is sexually assaulted by a home care client with dementia. There is the nurse who is punched in the jaw by a senior suffering from delirium. There is the personal support worker who doesn't know how she could possibly face going back to work. Finally, there is the senior whose care is impacted because the person they rely on, the person they have developed a relationship with, is no longer available to help because of workplace injury.
What can be done? One option is a renewed national health human resource strategy—one that incorporates a seniors care lens and a workplace safety lens, one that reflects the changing demographics of our society and the shift towards community-based care, and one that places both the physical and the psychological well-being of our care providers at its centre, because ultimately we're talking about people, people who are trying to do the very best they can with what they have.
That brings me to my last point: being under-resourced. This is a big topic, so for brevity's sake I'll focus on three key areas: infrastructure, education and data.
From an infrastructure perspective, research has proven the power of design, specifically dementia-friendly design. Dementia-friendly environments support the person with dementia and minimize the risk of responsive behaviours. Put simply, dementia-friendly environments are not only associated with better care, but they're also safer for the care providers.
However, we face significant challenges across the country. CALTC estimates that 40% of care homes need significant renovation. In B.C., the average age of a care home is 30 years. A lot has changed in 30 years. Our understanding of dementia and the power of smart design has increased significantly, and at the same time, seniors entering care homes have changed. Gone are the days when a senior would drive herself to the care home and unpack her own suitcase. The care homes in which these seniors live are no longer designed for their needs, and that absence of design affects both the quality of their lives and the safety of the care providers who support them.
The federal government has an opportunity to make an impact in this area. One opportunity is to build on the $6 billion in community health investments made in the Investing in Canada plan to include investment in care home infrastructure, because, make no mistake, these are not care facilities or hospitals: These are people's homes. Such investments could be used to incorporate the last three decades' worth of research and knowledge into retrofits and new builds that better support safe care.
Our care providers are also under-resourced when it comes to education. Presently there's no national standard on workplace safety core competencies for health care workers, and there's also significant variation between health care occupations as to what core competencies are required.
Part of our work at SafeCare BC has been focused on making inroads with this group for that very reason. Working in continuing care is a high-risk activity, and therefore all health care providers should be required to exhibit baseline workplace safety competencies prior to entering the field, yet we see that this is not the case.
Part of this stems from a lack of awareness, and therein lies opportunity. There is opportunity for a public-facing campaign to raise awareness of the issues of violence in health care and the tools and strategies available to mitigate it. There's also an opportunity to address the lack of standardization in education, such as by establishing a national task group to create guidelines on core competencies and workplace safety for care providers.
Finally, there's data. Data is how we make informed decisions. It's as much a resource as physical infrastructure, yet when it comes to national-level data, we struggle. There is no standardized national definition of “the health care industry”, and when it comes to workplace injury data, each province's workers' compensation board codes workplace injury data differently. That makes it difficult to do an apples-to-apples comparison of the data and identify national trends.
In this challenge lies opportunity again, such as taking a leadership role to create a national-level workplace safety data benchmark, as was done similarly in previous pan-Canadian projects such as the Canadian medication incident reporting and prevention system.
Understaffed, under-resourced and under pressure—there's no doubt that these are big challenges, but there is an opportunity for the federal government to drive positive change, and change we must. The future of the health care system depends on its people. If we don't take care of the care providers, who's going to take care of us and our loved ones when we need it?
Thank you.
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