2004 Legislative Session: 5th Session, 37th Parliament

HANSARD

The following electronic version is for informational purposes

only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

TUESDAY, MARCH 2, 2004

Afternoon Sitting

Volume 21, Number 4

CONTENTS

Routine Proceedings

Page

Tributes

Toni Onley

Hon. G.

Campbell

Introductions by Members

Statements (Standing Order 25 B )

Multicultural Helping House and

mentoring program

P. Wong

Charitable status of hunting and

angling organizations

B. Bennett

Government initiatives and economic

development in Burnaby

J. Nuraney

Oral Questions

B.C. Rail privatization process and

police investigation

J. Kwan

Hon. R.

Coleman

Hon. G.

Collins

Police investigation of government

officials

J. MacPhail

Hon. G.

Collins

Lillooet LRMP review

D. Chutter

Hon. G.

Abbott

Sale of fast ferries

M. Hunter

Hon. K.

Falcon

Tabling Documents

Public Service Benefit Plan Act,

report for year ending March 31, 2003

Hon. J.

Murray

Committee of Supply

Estimates: Ministry of Health

Services (continued)

B. Locke

Hon. C.

Hansen

J. Kwan

Proceedings in the Douglas Fir Room

Committee of Supply

Estimates: Ministry of Finance

Hon. G.

Collins

B. Kerr

A. van

Iersel

J. MacPhail

[ Page 8941 ]

TUESDAY, MARCH 2, 2004

The House

met at 2:03 p.m.

Tributes

TONI ONLEY

Hon. G.

Campbell: Yesterday I know we were all saddened to learn of the loss of Toni

Onley, who died engaging in one of the great loves of his life, actually —

flying. Toni was a true and exceptional talent. He took the watercolour art form

to new heights and new levels in expressing not just the natural beauty of our

surroundings but the connection between people and their environment. He helped

us see our province and its landscapes, in all their purity and shapes and light

and shadows, with fresh eyes.

Toni first

came to B.C. in 1955 and eventually settled in Vancouver. It was here in B.C.

that he acquired his passion for flying and where he travelled all over the

province to view and to paint our landscapes. He was honoured with the Order of

Canada in 1999.

As always

in these times of loss, our thoughts and prayers go out to the family, including

his two children, Lynn and James. We have all been enriched by Toni Onley's

talents, and today we'd like to say thank you to his family for sharing him with

us. On behalf of the Legislature, I would hope that we can send our condolences

and our prayers and thoughts to the family.

Mr.

Speaker: So ordered.

[1405]

Introductions by Members

W. Cobb:

It's my pleasure today to introduce some very hard-working, progressive mayors

from throughout B.C. They are the regional co-chairs for the Council of Resource

Communities. With us today are Mayor Gerry Furney from Port McNeill; Mayor Herb

Pond from Prince Rupert; Mayor Colin Kinsley from Prince George; Mayor Ross

Priest from Cranbrook; and their executive assistant, the urban cowboy Bruce

Rosenheart. Please make them welcome.

Hon. J.

van Dongen: On behalf of my colleague the member for Abbotsford–Mount

Lehman, I am pleased to introduce 52 grade 5 students visiting the Legislature

today. They're accompanied by a number of parents and their teachers, Ms. J.

Lander and Ms. Patricia Skjolde. I ask the House to please make them all

welcome.

H. Bloy:

It is my honour to introduce a friend today. I met him in the business world a

number of years ago, and a friendship developed. He's come here today to

celebrate his birthday. He's a retired chartered accountant. Would the House

please make Bruce Maybank welcome.

Hon. R.

Neufeld: It's again my pleasure today to introduce some people from my

constituency, Fort St. John — three lovely young ladies that are advancing

their education down here in Victoria: my daughter Kathryn Currie and her

friends, Lexie Kosick and Harmony Hubley. Would the House please make them

welcome.

Belsey: I would like to point out that the now-famous north coast seafood

dinner is being prepared this evening. We have four of the guests — the cooks

— that have joined us in the gallery. I would like to introduce Judy Fraser,

Vince Aramari, Debbie Tiapolis and Steve Smith — the cooks. So the louder we

clap, probably the warmer it will be tonight.

McMahon: I am pleased to introduce to the House the 2004 legislative interns

with the government caucus. They include Lesley Clayton and Joanna Ellis from

UVic; Chris Ferronato, Nathan McDonald and Paul Rushton from SFU; Tara Shirley

from UBC; and Regan Garbutt from UNBC. We look forward to sharing this unique

and exciting experience with them. I ask you to join me in making them very

welcome.

Mayencourt: Joining us in the gallery today are two young women that I would

like to introduce. The first is Alison Leontaridis, who is my legislative

assistant and that for the member adjacent to me. She is joined here by her

sister Jacquelyn Neary, who is a student in Vancouver. Would the House please

make them both welcome.

Statements

(Standing Order 25

b) MULTICULTURAL HELPING HOUSE

AND MENTORING PROGRAM

P. Wong:

The Multicultural Helping House Society is an incredible group in my riding that

is dedicated to improving the lives of new immigrants in B.C. They have programs

and services aimed at helping new residents fit into the social, economic and

cultural fabric of our province through language assistance, training and

employment counselling.

Recently

the group was granted startup funding from the Ministry of Community, Aboriginal

and Women's Services to launch the Bamboo Network mentoring program. This

initiative pairs B.C. mentors, in a wide range of professions, with new

immigrants. New residents can learn about certification and qualifications

required for employment and workplace culture, and can better understand the

many other features unique to Canadian and British Columbia business.

Over 50

immigrant engineers have applied for this mentorship program, and 16 have now

been paired with the nine mentors from B.C. Hydro. During each month, between a

mentor and a protégé…. There must be at least two interactions or meetings

over a period of six months.

[ Page 8942 ]

[1410]

I would

like to congratulate the staff and volunteers at the Multicultural Helping House

for their vision and dedication and extend my appreciation to the volunteer

mentors at B.C. Hydro who have committed their time and expertise. The Bamboo

Network in particular is a wonderful opportunity to showcase the compassion and

commitment of British Columbians, while providing unique opportunities for job

shadowing and knowledge sharing. I wish to see this program extended to other

businesses and Crown corporations. This will strengthen the social and economic

aspects of British Columbia, and immigrants will have opportunities to use their

considerable skills and contribute to our province.

CHARITABLE STATUS OF HUNTING

AND ANGLING ORGANIZATIONS

Bennett: Yet another new band of environmentalists, the Charity Action Team,

just announced that they don't believe hunting and fishing groups should be

charities. Apparently, some environmental groups such as the Friends of

Clayoquot Sound and Fur-Bearer Defenders have had their charitable status

revoked because they are too political. This group is allegedly scandalized by

the fact that blue-collar organizations such as the B.C. Wildlife Federation,

Ducks Unlimited and the Rocky Mountain Elk Foundation have charitable status

while they do not.

Let me

explain today, on behalf of the hunters and anglers of B.C., why they do deserve

charitable status. The B.C. Wildlife Federation, the B.C. Conservation

Foundation, the Rocky Mountain Elk Foundation and Ducks Unlimited raise millions

of dollars every year for conservation projects around the province. Hunters and

anglers put their money where their mouth is for charitable purposes. They don't

use their donations to blackmail forest companies, to attend protests around the

world or to hurt forest workers and their families. Hunters and anglers are

often the only ones who volunteer to assist wildlife during severe winters and

disease cycles and to help with labour-intensive habitat restoration projects.

There's

also the provincial government's own habitat conservation trust fund, which

injects $5 million annually into conservation projects around the province. The

HCTF raises its $5 million annually not from donations paid by preservationists

but from hunters, anglers, trappers and guide-outfitters who voluntarily fund

the HCTF through their licence and tag fees.

This

so-called Charity Action Team is promoting the fabrication that hunters and

anglers are not conservationists, even though Albert Schweitzer and many other

conservationists have said for years that removing excess animals from

burgeoning wildlife populations is an essential component of successful wildlife

management.

Let us here

today applaud the hunting and angling groups in British Columbia for their

apolitical charitable efforts to improve our natural environment.

GOVERNMENT INITIATIVES AND

ECONOMIC DEVELOPMENT IN BURNABY

Nuraney: Two and a half years ago our Premier shared his vision of how he

would like to see our province return to the days of prosperity and bring itself

to speed with the modern age of technology. He laid out his plans and worked on

initiatives like the Premier's Technology Council, the B.C. Progress Board, the

provincial congress, openness in government and the process of inclusiveness.

His promise of fiscal responsibility was evidenced by the balanced budget

introduced to this House on February 17. To resurrect our province from the

depths of despondency to that of buoyancy took hard work, cooperation and good

sense.

Our

measures are beginning to pay off. We are today leading in job growth, volume of

new investment and consumer confidence. This feeling of optimism is throughout

our province and also permeates my riding of Burnaby-Willingdon. Housing starts

and the housing market in my area are seeing unprecedented activity. Metrotown,

the largest shopping centre in B.C. and the second largest in Canada, has

entered into a second phase of redevelopment, investing over $80 million. This

will create 50,000 square feet more retail space with great entrepreneurial and

job opportunities.

Electronic

Arts, a world leader in the entertainment field, just announced today that they

will expand their facility to virtually double their present state by building

another 172,000 square feet and creating almost 2,000 new jobs.

BCIT, a

very progressive institute of higher learning, continues to expand. They are

laying the foundation for excellence in applied science. A $65 million facility

is being built for aerospace and aviation programs. This facility will be

operated with the cooperation of Embry-Riddle, the world's largest university

specializing in aviation and aerospace.

[1415]

These are

some of the activities taking place in our province as a result of our

government's sound policies. Confidence has returned to our province, and I can

assure you that the best is yet to come.

Mr.

Speaker: That concludes member statements.

Oral Questions

B.C. RAIL PRIVATIZATION PROCESS

AND POLICE INVESTIGATION

J. Kwan:

Here's what we know from the release of a

summary of the search warrants. In the

course of a proceeds-of-crime and corruption investigation involving the

Minister of Finance's top political aide, David Basi, the RCMP uncovered a

conspiracy involving Mr. Basi; the ministerial assistant to the Minister of

Transportation, Bob Virk; and well-known Liberal insider and lobbyist Erik

Bornman. That conspiracy offered personal benefit in return for inside access to

information related to the privatization of B.C. Rail.

[ Page 8943 ]

Soon after

the raids were executed, the Solicitor General assured the public that the

integrity of the B.C. Rail deal was in no way compromised. How can he possibly

stand by that statement today?

Hon. R.

Coleman: I am disappointed that the member, who would have read the

summary

of the warrants today, chooses to use the names of people when the warrants

actually only refer to "Official 1," "Official 2" and

"L 1." They do not refer to any names.

The fact of

the matter is that I know the B.C. Rail deal was processed properly through the

executive council of this government, and I have all the confidence in the world

that deal was done properly.

Mr.

Speaker: Member for Vancouver–Mount Pleasant has a supplementary question.

J. Kwan:

The fact is that today's stunning revelations go to the heart of the integrity

of this government. The fairness report proves nothing. The police had the

fairness report and still sought a warrant and raided the Legislature. Clearly,

there is much more to this story than the whitewash reports tell us.

Indeed, the

report itself speaks of leaks and potential competitive advantage. We've raised

that in this House before. The former minister wouldn't answer them then.

Perhaps the new Minister of Transportation has the courage to tell this House:

what was the source of those leaks, and what did they contain?

Hon. G.

Collins: I think it's fair to say that we're not about to try and go through

the allegations that are made by the members opposite and try them on the floor

of the House. The judge in the case has determined what information is

appropriate to make available to the public.

Interjection.

Hon. G.

Collins: The judge in the case has determined what's appropriate to make

available to the public.

Mr.

Speaker, I think it's important to note…. If you read the

summary carefully,

you will note that the individuals referred to…. Particularly "L 1"

has been publicly speculated and has in fact, I think, spoken to the media, and

has been identified as somebody supporting one of the unsuccessful proponents in

the B.C. Rail transaction. There is no suggestion whatsoever nor has there been

over the last couple of months….

Interjections.

Mr.

Speaker: Order, please.

Hon. G.

Collins: There has been no allegation or suggestion over the last couple of

months that in any way did the successful proponent receive any sort of

additional information that would compromise the transaction. They won because

they had the best proposal.

Mr.

Speaker: The member for Vancouver–Mount Pleasant has a further

supplementary.

J. Kwan:

The reality is that the fairness report speaks of leaks and potential

competitive advantage. What we're seeking is for the government to release what

was leaked and what was in that information that raises the issue around

competitive advantage.

The deal

has been under a cloud from the beginning, and now it is the subject of a

criminal investigation involving top political staff and insiders. Two of the

bidders complained before the deal was signed that it was fixed. CP and Omnitrax

took their complaints directly to the Premier — long before the police raided

this building.

The public

has the right to know. Will the Premier immediately release those letters? Will

he advise this House today which bid on the sale of B.C. Rail David Basi was

peddling?

[1420]

Hon. G.

Collins: I think one can look at the

summary that's been presented by the

court and determine that the area of concern to the investigators is potential

discussions between the officials and the lobbyists — the representative of

Omnitrax, one of the unsuccessful proponents. That can be gleaned fairly clearly

from the

summary that's been presented here.

I think one

can do that and deal with what has been publicly discussed already over the last

couple of months. It's pretty clear that they were not the successful proponent.

They did not win. The successful proponent was CN, and there is no inference in

this. There is no allegation that one can glean from the

summary that CN in any

way received any beneficial information.

The

transaction was done with CN because they had the best proponent. That was a

decision of all of cabinet, and government has not been advised that that is

anything different.

POLICE INVESTIGATION OF

GOVERNMENT OFFICIALS

MacPhail: Interesting that the Premier won't stand up and answer these

questions, that he puts up the very person whose office is tainted by this.

What we do

know is that the fairness report said that there were leaks and that there was

allegation of a competitive advantage, and this government wouldn't release it.

We also know that this government's top political aide to the Minister of

Finance is being charged with influence-peddling. David Basi is…

Interjections.

Mr.

Speaker: Order, please. Order, please.

[ Page 8944 ]

MacPhail: …being investigated for influence-peddling.

Interjections.

MacPhail: The top…. Oh, the government takes comfort in that.

When his

office was raided, the Minister of Finance told the public that Mr. Basi was not

involved in government business, including the B.C. Rail deal. We now know that

isn't true. Indeed, according to the police, the alleged corruption in the

Finance minister's office is tied directly to the sale of B.C. Rail and other

government business. This went on right under the nose of the Minister of

Finance, and he claims to know nothing.

Will he do

the right thing today? Instead of just saying, "Oh, we didn't give it to

the bid that was influence peddling," will he do the right thing and

resign?

Hon. G.

Collins: Mr. Speaker, I think there you've just seen a shameful

exhibition of allegations on the floor of this House for which there's no basis

in fact, and the member should be ashamed. She has taken, I think, a five- or

six-page document and created a house of cards.

The reality

is that the investigation is ongoing. It will continue until it reaches a

conclusion. I think it's important for the member to refer to page 5 of the

summary that was printed today. It says: "Further review of documents

seized and further investigation may demonstrate no persons have committed a

criminal offence." She should keep that in mind when she makes her comments

in this House as well as outside.

Mr.

Speaker: Leader of the Opposition has a supplementary question.

MacPhail: It was the Solicitor General that stood in this Legislature and

said it's not surprising that organized crime has penetrated the Legislature.

Did the Minister of Finance berate the Solicitor General for saying that?

Absolutely not, because he knows that the Solicitor General had full knowledge

of what was in the search warrants when he made that statement. The Solicitor

General said that statement with full knowledge of what's in the search

warrants, and now the Minister of Finance is trying to pooh-pooh the

summary of

information based on those warrants.

opposition, that Minister of Finance called for the resignation of countless

ministers on matters of much less significance. On a regular basis he did do

that.

The

Minister of Finance still claims to be ignorant of what was going on in his

office with his chief political aide, an aide he personally hired. Mr. Speaker,

ignorance is not a defence. The minister needs to take responsibility for the

corruption that took place right under his nose.

Mr.

Speaker: Order, please. Order. Order, please. Order. Does the member have a

question? Please put it.

[1425]

MacPhail: Yes, Mr. Speaker.

The

Liberals' New Era document, page 33, says: "A Gordon Campbell

government will serve you and all British Columbians with honour, respect and

integrity." If the Finance minister…. The shame of it is that they don't

even understand what that means, Mr. Speaker.

Interjections.

Mr.

Speaker: Order, please.

MacPhail: If the Finance minister…

Mr.

Speaker: Order, please. Order. Order, please.

MacPhail: …believes those words, he has no….

Mr.

Speaker: Order. Would the member now please put her question.

MacPhail: If the Finance minister believes those words, he has no choice but

to resign. Will he resign today?

Hon. G.

Collins: Contrary to the rants and raves of the member and the screeching

opposite, there are allegations that have been made. There is an investigation

underway. The member is aware of that. If she would read the

summary again on

page 5, she will see that what was stated two months ago continues to be stated

today: "No provincial or federal elected officials or ministers of the

Crown are…." Mr. Speaker, it says….

Interjections.

Mr.

Speaker: Order.

Hon. G.

Collins: Mr. Speaker, I think the member should be careful of the

allegations that she makes. There is an investigation underway. She should await

the results of those investigations. I know her preference would be that we

could execute people on her demand, but that's not likely to happen. Mr.

Speaker, page 5 of the

summary, if the member takes the time to read it, states

— and I'll read it for her: "No provincial or federal elected officials

or ministers of the Crown are targets of the investigation." We continue to

run this government…

Interjections.

Mr.

Speaker: Will the Leader of the Opposition please come to order.

Hon. G.

Collins: …with honesty and integrity, which is what we were elected to do.

Interjections.

[ Page 8945 ]

Mr.

Speaker: Order, please.

LILLOOET LRMP REVIEW

Chutter: My question is to the Minister of Sustainable Resource Management.

In 2001, on the eve of the election call, the NDP cherry-picked a protected area

from within the Lillooet LRMP and imposed it on the local community without

consensus and without the support of my constituents. Now Carole James and the

NDP have the nerve…

Interjections.

Mr.

Speaker: Order.

Chutter: …to falsely suggest that this government is carrying on backroom

deals to allow mining in the South Chilcotin Mountains Park.

Interjections.

Mr.

Speaker: Order.

Chutter: Can the minister give my constituents, and especially Carole James

and the NDP, the real facts about the Lillooet LRMP review that is currently

underway?

Hon. G.

Abbott: There is in the NDP, as you know, Mr. Speaker, a very long tradition

of revisionist history, and we've seen the latest

chapter of it here today in

the Legislature. Really, whether it's the fast ferries or the Lillooet LRMP, the

NDP has an affection for revisionist history that I think would make Stalin

blush. Carole James certainly may be a new leader for the NDP, but she's

certainly following the old tradition of imposing the NDP will on communities in

this province.

There

clearly was no consensus around the 2001 Lillooet LRMP. Communities were not on

side. First nations were not on side. You don't have to take my word on that.

I've got a couple of sources here, which I'll quickly note. First, a letter from

Chris O'Connor, the mayor of Lytton, who says: "NDP leader Carole James's

suggestion that communities and stakeholders came to a consensus regarding the

Lillooet LRMP and the creation of the South Chilcotin protected area is a

complete slap in the face and a betrayal of our communities."

Further,

even closer to home, I have a quote here from the former MLA for Yale-Lillooet

and former NDP cabinet minister, Harry Lali, back in 2001. Mr. Lali says:

"There's absolutely no reason for this decision to have been made now.

There was no consensus at the LRMP table. There was no consensus in cabinet, and

there was no consensus in the cabinet committee that reviewed it. The

Premier" — and the reference is to Mr. Dosanjh — "made the

decision himself in a desperate attempt to gain green votes in urban B.C. at the

expense of rural B.C. He buckled under…."

Interjections.

Mr.

Speaker: Order, please. Order.

[1430]

SALE OF FAST FERRIES

Hunter: Somewhere in his response, the minister mentioned fast ferries. How

prescient, Mr. Speaker, because that's what I want to ask the Minister of

Transportation. The B.C. shipyard workers union is starting to complain about

the resale again of these vessels that disgraced the waterfront of Nanaimo for

so many months. I want to ask the Minister of Transportation to assure this

House that better offers for the sale of those ferries were not overlooked.

Hon. K.

Falcon: Thank you very much, member. It will be no surprise in this House

that taxpayers took a $460 million bath on those fast ferries. We had to spend

$10 million leaving them sitting in the harbour while we tried to sell them. You

know, the frustrating part about this is that there were actually two offers —

two offers — that came to the previous government with relation to the fast

ferries. In 1999 an offer of $210 million was made to those members.

Interjections.

Mr.

Speaker: Order, please. Order. Order!

Interjections.

Mr.

Speaker: Mr. Minister, order, please.

To all

members: we will continue with question period when we have order in this

chamber.

Hon. K.

Falcon: I was trying to say that the previous NDP government had rejected

two potential offers for those fast ferries. In 1999 an offer of $210 million

was rejected by those members over there. In early 2001 the member for

Vancouver-Hastings actually rejected an $88 million offer — an $88 million

offer that could have helped recoup some of the costs. We found ourselves in a

position where for three years we tried to sell these boats around the world,

and all we were able to get after three years…

Interjection.

Mr.

Speaker: Order, please.

Hon. K.

Falcon: …of flogging these boats around the world was $19 million. That is

the loss that British Columbians have to take because of those people sitting

across the way.

Interjections.

Mr.

Speaker: Order, please.

[End of

question period.]

[ Page 8946 ]

Tabling Documents

Hon. J.

Murray: I wish to table a report pursuant to the Public Service Benefit Plan

Act for the year ended March 31, 2003.

Orders of the Day

Hon. G.

Collins: I call Committee of Supply in this chamber as well as Committee A.

[1435]

Committee of Supply

The House

in Committee of Supply B; J. Weisbeck in the chair.

The

committee met at 2:36 p.m.

ESTIMATES: MINISTRY OF

HEALTH SERVICES

(continued)

On vote 25:

ministry operations, $10,404,260,000 (continued).

Locke: One of the challenges we face in Surrey is significant growth. In

fact, our community is growing by approximately 12,000 to 15,000 people a year.

That's equivalent to adding a whole new town every single year. Can the minister

tell me how the medical system is planning to address the significant growth?

Hon. C.

Hansen: In fact, if you go back a couple of years under the previous

government, they had a very ad hoc system of allocating funding to the various

health authorities around the province. It was particularly unfair to those

health authorities that were experiencing very rapid growth, because it was

locked into a base budget that…. Really, nobody that I have ever talked to has

been able to explain the basis for those global budgets that were put in place

in those days. Certainly, that process did not recognize the very rapid growth

rates in some parts of the province.

What we did

upon forming government in 2001 was bring in what is referred to as a population

needs–based formula. Once we have determined what the allocation is for the

budget for our regional health programs in the province, that is divided up in a

way that ensures fairness throughout the province. It's not just a case of

taking the number of residents of a health authority and dividing it up on a

per-capita basis. We actually factor in the various cost drivers that will drive

up the cost of a health care system in any particular region. We factor in

demographics; we factor in rate of population growth. For example, we factor in

the number of seniors, because we know that seniors are higher consumers of

health care than younger populations. We also factor in, for example, the number

of residents of a particular region who have to access care in a different

health authority.

In the case

of the Fraser health authority, where the member is from, they actually have the

highest percentage of care for residents of that health authority being

delivered in other health authorities. In the case of the Fraser health

authority, it's typically because a lot of people work in Vancouver coastal and

access their doctor's and specialist's care and other health care services in

the Vancouver coastal region. All of those things get taken into consideration,

but the good thing about this model is that as populations grow, we can actually

be flexible and ensure that they get a proportionately larger share of the

allocation to reflect the fact that their population is growing rapidly.

Locke: Surrey Memorial Hospital is noted to be the busiest ER in British

Columbia and the second busiest in the entire country. Can the minister confirm

that the ER at Surrey will be expanded to meet the growing needs in our

community? If there's a time frame, I'd be interested in knowing that as well.

[1440]

Hon. C.

Hansen: Again, I think we almost have to go back and look at a bit of a

historical perspective on this. Under the previous government, they actually had

two separate budgets. One was an operating budget for the health authorities,

and the other was the capital budget. I heard frequent complaints before the

election from health administrators in the province who really didn't feel the

ministry was being sensitive to local needs when it came to what priorities

should be given to various capital projects.

One of the

things we have done is combine the capital budgets with the operating budgets

and allow the health authorities their own flexibility to choose their

priorities. What we're saying to them is that they have to, within their

financial means and their projected budgets, be able to manage their

debt-servicing costs. As there is a need identified — for example, it may well

be a future expansion of the emergency rooms at Surrey Memorial Hospital…. If

the health authority was to determine that that need is there, then they have

the flexibility within their operations and their budgets to put whatever

priority they think is most appropriate to those capital needs in the province.

We also

have underway, under the direction of the provincial health services authority,

a review of emergency services in the province to determine how we can make sure

that the needs of residents get met. In the past, I think, too often we have

looked at each emergency room as an island unto itself. What we really need is a

coordinated network of care that factors in the ambulance service, what capacity

there is at a facility at any one point in time, and the other resources and

access to specialists and things like that, which various hospitals will have. I

think we're moving from a system that was, first of all, one in which capital

dollars were not necessarily pinpointing local priorities but also a system that

was very fragmented to one that is going to be better coordinated, with flexi-

[ Page 8947 ]

bility at the health authority level to meet the needs and priorities of

their citizens.

Locke: One of the difficulties our ER faces is congestion in the wards.

That's due to patients not being able to be moved from the ER into the wards. In

addition, a lot of the patients that probably should have palliative care are

not getting that. I'm wondering if there is any way of alleviating that problem

so that patients could be moved out of the ER and into palliative care to

relieve some of the pressure on the ER.

Hon. C.

Hansen: First of all, with regard to the palliative care programs, the

Fraser health authority has a very good program that it is developing. Clearly,

that is a need that is across the province. The Fraser health authority, for

example, just opened a new 16-bed hospice unit in Burnaby at St. Michael's

hospital and has reconfigured the existing Burnaby Hospital palliative unit to a

regional referral centre for tertiary palliative care. That's 11 beds in that

facility.

With regard

to the alternate level care bed-days, I guess the Fraser health authority

actually has the biggest challenge, but I think what's important is that they're

making progress. For each of the last three years they have actually seen the

number of acute care beds tied up with patients who should be in some other

level of care, which is how we define ALC or alternate level care beds…. For

each of the last three years we have seen that rate coming down in the Fraser

health authority. But when we were elected as government, at that point they had

over 20 percent of their bed-days being tied up with ALC patients, which is by

far the highest in the province. As I say, in each of the subsequent years we

have seen them make some progress to getting the number of ALC bed-days down to

more appropriate levels.

Locke: One of the other challenges that the ER faces is people going to the

ER that may be able to get help elsewhere. I wonder if there's any consideration

of some kind of education to the public to help them redirect their care needs

to maybe their own GP or a clinic or something like that so that they're not

plugging up the ER.

[1445]

Hon. C.

Hansen: There are a couple of things on that particular subject area. First

of all, we are expanding the use of the NurseLine and the public awareness of

the NurseLine. As I mentioned in my opening remarks, in the last year alone the

use of the B.C. NurseLine has gone up by over 50 percent. This is, I think, an

important resource for the public. What it does is allow the public access to

information to help them make their medical decisions, short of going to the

emergency rooms. It's been a huge benefit in alleviating pressure from the

emergency rooms, and we will continue to build upon that and build public

awareness of that.

Also, we

are working through some of the primary care initiatives to try to encourage

models that extend the hours of operation of access to GPs throughout the

province. We have a $20 million fund that has been put in place to try to

enhance primary care. We have a group which is known as the general practice

services committee, which is looking at some of those options. There's good

cooperation among the doctors and government and the health authorities to try

to make sure that there are more options for residents of the province outside

of the emergency rooms.

Locke: It seems to me that general practitioners are the unsung heroes of

the medical system. Certainly, I know my own doctor is my own hero. Having a

family doctor can save the system by delivering solid, personalized care right

in the doctor's office. While I appreciate the need for walk-in clinics, it

concerns me that walk-in clinic doctors generally receive equal or greater

remuneration than GPs do. Can the minister comment on this issue and if there

has been any discussion or plans for any discussion with the BCMA with regard to

changing the way these two different doctors are paid?

Hon. C.

Hansen: First of all, I mentioned earlier the GP services committee and that

$20 million allocation. They are looking for ways to encourage full-service

family practice using that fund, specifically, but also how to encourage more

graduating doctors to go into full-service family practice. That is certainly a

focus of the primary care transition projects across the province. Also, we've

had good discussions with the B.C. Medical Association around how to encourage

full-service family practice. There is a report that was done recently by the

BCMA around primary care reform, which has been very helpful and certainly a

document that the ministry is looking at in terms of how we can use it and move

forward on this. Also, with regard to the expansion of the medical school in

B.C., we are developing a model that will in fact encourage physicians to look

at community care.

[1450]

Just one

other thing to point out. B.C. has one of the best population-to-physician

ratios, generally speaking, but in particular with regard to rural communities

in the province where we in fact have the lowest number of patients per

physician of any province in Canada. I think it shows that we're on the right

track. Also, if you look at the recommended ratio of the number of GPs to

population, we have a better ratio than most other provinces in Canada, and we

are below what the Canadian Medical Association has indicated as being the

preferred ratio for Canada as a whole.

Locke: Surrey has witnessed some new building of long-term care facilities.

However, we've also seen a couple of them closed. One is Shirley Dean, and

another one was a private facility.

Can the

minister explain why these facilities are closing and if there are any

additional new long-term care facilities in the works for Surrey?

[ Page 8948 ]

Hon. C.

Hansen: First of all, we undertook an inventory of long-term care facilities

around the province as a government — I believe it was done through B.C.

Buildings Corporation, if my memory is right — to do an audit or an assessment

of existing facilities in terms of which ones had outlived their usefulness,

which ones were too old to meet needs, which ones were lacking in just design to

meet the needs of residents. Based on that review, there are some facilities

that are being phased out, mostly because they no longer meet the needs in that

particular community.

exchange, there's a whole bunch of new facilities that are being developed. For

example, in Chilliwack there are 40 new assisted-living facilities at the

Waverly project and new residential care beds being opened at McIntosh. There

are new assisted-living supplements at Logan Manor in Agassiz. If you look at

Surrey in particular, which I know the member is interested in, there are 60 new

residential care beds opened at Guildford Seniors, 60 new residential care beds

opened at Morgan Place and 84 independent living spaces opened since January

2001 in Surrey. In White Rock — new beds opening at Evergreen Cottages. Let me

see if I can find some other examples here — new assisted-living developments

in Chilliwack and Delta and new assisted-living spaces at Hawthorne lodge in

Port Coquitlam.

There are

lots of examples, and I know that the Fraser health authority has lots more in

the planning stages now to make sure that those needs get met. Yes, there are

some facilities that are being phased out because they no longer meet needs. In

place, we're putting in new places that are modern. They are designed for a

modern style of care, which really maximizes the independence of seniors when

that's appropriate and makes sure that they get the health care services they

need depending on their particular and individual needs.

Locke: Some people are concerned that changes to privatized services at

Surrey Memorial will compromise patient care. Can the minister tell me what the

experiences of other jurisdictions are with respect to privatized security, food

services, cleaning and laundry?

Hon. C.

Hansen: As we have pursued options for getting a more cost-effective

delivery of services in the health care sector, one of the things that we are

absolutely committed to is that we will not compromise the quality of services

that are needed by patients in the province.

If you

start looking at some of the other facilities that have contracted out security

services, for example…. What we've seen as a result of that is we're getting

more hours of coverage and more comprehensive coverage than we were under the

old model. One example is the contracting-out of housekeeping services at

Vancouver General Hospital. I was talking to a nurse who has worked in Vancouver

General Hospital for 15 years, and she told me that in all that period of time,

she has never seen the place cleaner than it is today.

[1455]

We have put

in place the kind of guarantees that we require to make sure the standards are

not compromised. Indeed, in many cases we're seeing that these private sector

providers are providing an even better service than was in place prior.

Locke: Many people from Surrey, including myself, went to St. Mary's

Hospital for eye surgeries, especially cataracts. Can the minister please tell

me what plans are in place for Surrey patients requiring eye surgeries, now that

St. Mary's is closing?

Hon. C.

Hansen: First of all, I just want to say that St. Mary's Hospital has a

tremendous and very proud history, and one that I know — in the discussions

that I and other officials in the ministry have had with the Sisters of

Providence, who are the owners of St. Mary's Hospital…. It's one thing that

the sisters are very proud of. As we have been working with them on the moving

of some of these services to other facilities, it's certainly a history that we

want to make sure is celebrated.

I think

what is key is not around the bricks and mortar of how health services are

delivered, but it's the services themselves that are important. As we move

forward, we are making sure that the individual patients who were to have had

procedures performed at St. Mary's Hospital during these coming weeks and months

get their needs met, and they will get met in other facilities. In the case of

eye surgery, some of the services that previously would have been provided at

St. Mary's have now been shifted to Burnaby Hospital. There are also some

services that would go to Surrey Memorial, and indeed there may be other

facilities. I think the bottom line is that the needs of the patients are going

to get met, because we are expanding the services that are provided in other

neighbouring facilities.

Just one

other thing on that subject of St. Mary's. It is important to point out that of

all the patients that came to get care at St. Mary's over the past year or the

most recent year that was completed, only 17 percent of those residents actually

lived in New Westminster. What we had was that 83 percent of the patients who

came to St. Mary's were in fact from other cities and other municipalities

around the Fraser Valley and had to travel to New Westminster to get care. What

we're doing now is expanding the services that can be provided in the hospitals

that in many cases are closer to where, in fact, the patients actually live. I'm

sure the constituents of the member will be benefiting by the relocation of some

of those services to a facility closer to their home.

Locke: There's still a considerable challenge for people to contact MSP by

telephone. I wonder if the minister can tell me and my constituents what the

ministry is doing to help alleviate that problem and that frustration of getting

through to MSP by phone.

Hon. C.

Hansen: This is a subject area where I think all of us in this chamber have

received numerous com-

[ Page 8949 ]

plaints from our constituents with regard to the time it takes to get

something as basic as an application for premium assistance processed. Clearly,

those are all circumstances where people, I think, are entitled to timely

service. It has been a problem that has gone on for years, and it's not the

fault of those who work in the ministry to try to pump this paper through.

[K. Stewart in the chair.]

The problem

is that we're working on technology that is grossly out of date. This has been a

paper-based system that really has made very few changes from 30 years ago. As

we know, the whole technology of how business is done has changed phenomenally,

and we need to make sure we take advantage of some of those new computer

technologies.

[1500]

What we are

in the middle of right now is looking at a private sector partner who can bring

some of those technology solutions to this file so that in fact we can speed up

the time it takes for individuals to get answers, speed up the time it takes for

applications to be processed and speed up the time just to get a response to a

telephone inquiry. Those are all underway now. It's my understanding that the

process of identifying a private sector partner has now narrowed it down to two

companies. I expect that by roughly the end of March or hopefully not later than

the end of April, we will have been able to finalize the private sector company

that we wish to partner with.

I hope that

in the very near future, certainly by the end of this year, the public is going

to be able to see a considerable change in the amount of time it takes them to

get information processed and other information from what we refer to as the

health benefits office of the ministry.

Hon. I.

Chong: I ask leave to make an introduction.

Leave

granted.

Introductions by Members

Hon. I.

Chong: Today in the gallery we have visitors from St. Andrew's Regional High

School, a class of grade 11 students. There are 24 of them, two adults and Mrs.

Paul, their teacher. I understand they've had a tour, and they're here to watch

the session. I am introducing them on behalf of my colleague the Minister of

State for Mental Health and Addiction Services, the member for Saanich South,

who could not be here today. She wanted to ensure that they were indeed welcomed

to this chamber. I ask the House to please make them welcome.

Debate Continued

B. Locke:

There seems to be some confusion in Surrey with regard to elective surgeries and

about cancellations of elective surgeries. Can the minister confirm the number

of elective surgeries that have been cancelled at Surrey Memorial — outside of

those that happened during the job action time? How many have been cancelled

over the last two and a half years?

Hon. C.

Hansen: I do not have at my disposal the exact numbers that the member is

looking for, but certainly when we did have the job actions that took place —

I guess it would be just under two years ago now or a year and a half ago —

that did result in the cancellation of thousands of elective surgeries. That

really does slow down the system, and it takes a long, long time to ever try to

catch up. I would say that even after this point, we probably haven't caught up

from the number of surgeries that we lost during that period of time — in

certain areas, at least.

We are

undergoing a process now, which is being led by the provincial health services

authority, to do what is referred to as a surgical review to try to make sure

that patients get access to care based on their individual priorities. We know

that when a patient has been booked for elective surgery, the wait time for that

surgery varies depending on the individual circumstances. We rely on the

individual doctors to determine the priority with which their patients should

get access to that care.

The

individual surgeons and other specialists are allocated operating room time or

diagnostic time. They have to determine which of their patients should be

getting the priority for accessing that in a way that makes sure they meet their

needs. This is an area that I think all provinces are wrestling with. We're

trying to find ways to make sure that we do get appropriate and timely access to

elective surgeries, but that is not an exact science. A lot of work is being

done on it. I think we're making some progress as a result of the leadership

from the PHSA.

[1505]

Locke: Operating room availability is also a challenge at SMH. I know there

have been some new operating rooms developed there. I wonder if the minister can

outline them and address what's being done to alleviate that concern.

Hon. C.

Hansen: When it comes to operating room capacity in the Fraser health

authority, we recently just opened…. In fact, I guess it was October 20 of

just last year that the fifth operating room at Eagle Ridge Hospital was put

into service. Very soon we expect to be opening a sixth operating room at Eagle

Ridge. That is a direct result of shifting some of the services that used to be

provided at St. Mary's Hospital, freeing up some of those financial resources to

make sure we can actually meet the needs of patients in the communities where

they live.

Specifically

with regard to Surrey Memorial Hospital, which I know the member is interested

in, I don't have any information at my fingertips with regard to the capacity in

that emergency room. I do know that there was a very exciting project that was

opened re-

[ Page 8950 ]

cently with Surrey Memorial with regard to the computer technology that was

being brought into the operating rooms. It was absolute state of the art. I know

that across Canada, others are looking at that technology as a model. I think

it's certainly part of what the future operating room is going to look like, but

that future operating room is here and now and is being used in Surrey Memorial

Hospital.

Locke: This is my last question. There is no doubt that anaesthesiologists

are highly trained, highly skilled doctors and in short supply. Can the minister

tell me what is being done to attract and train more?

Hon. C.

Hansen: There is a fair amount underway to recognize that there is a

shortage of anaesthetists certainly across Canada and, I believe, really

throughout North America. That is a challenge we're facing. We recognized those

pressures in the last increases that were provided as part of the $392 million

increase we put in place for physician services in the province. The

anaesthetists actually got an above-average percentage increase in their

fee-for-service payments. In fact, it went up by 24 percent as a result of that

last round of increases for doctors.

When it

comes to the service agreements — and these are for the anaesthetists in the

province that would not be working on fee-for-service but on a service agreement

— we now have a comparable increase, which is also somewhere in the range of

about a 24 percent increase over what was there before, to bring them up to a

current level of about $235,000 to $294,000. That is the range for those

particular individuals.

Certainly,

the UBC medical school is recognizing the need for educating more anaesthetists

as we go forward. They are in fact developing programs to encourage more medical

students to go into anaesthesiology as a career.

I think on

a bunch of fronts we're trying to meet those needs. While we are facing

shortages continentwide, I think we are certainly paying our anaesthetists well,

and that alone will help make sure the needs get met.

The

Chair: We're just going to have a very short five-minute recess, so we'll be

resuming in five minutes.

The

committee recessed from 3:10 p.m. to 3:12 p.m.

[K. Stewart in the chair.]

On vote 25 (continued) .

J. Kwan:

Just prior to the break, I was canvassing with the minister about the 5,000 new

beds commitment. I was asking him for the breakdown of those 5,000 beds. How

many new beds have been created and under what categories? Perhaps the minister

can provide that information now.

Hon. C.

Hansen: At this point I don't have the kind of precise numbers that I think

the member is looking for. What I want to share with her are some things that

actually show that we are heading into the right direction and that we're

confident we're going to be able to achieve the numbers we have targeted.

As we were

discussing this morning, when it comes to the supportive housing, we need to be

able to determine which ones actually have a care component that would fit into

the

definitions we discussed this morning.

[1515]

Actually, I

was trying to pull out the numbers. I remember seeing this chart recently, and

it actually gave the summaries. Realizing that the way it is formatted, what I

have in front of me doesn't allow me to pull those numbers out quickly, but

there is…. I know I can tell you the numbers that are coming out of the health

authorities, for example, around assisted-living projects. But as I mentioned

this morning, it is not just the health authorities that are part of meeting

this objective. It is B.C. Housing that's part of that, and we've also got all

kinds of other community not-for-profit and private initiatives in the province

that aren't directly connected to a health authority initiative.

The numbers

that I think may give the member some comfort are a survey that's done by CMHC

to give…. The reason I point to this one is that it gives an arm's-length

indicator — not our data, but in fact CMHC's data — around the net increase

of beds. What they point to in…. From year 2001 to 2003 there has been a net

increase of 1,046 under the title of care facilities. Under the subject area of

congregate residences, which includes both congregate housing and assisted

living, the net increase from 2001 to 2003 is 3,149.

Now, I'm

the first one to admit that we can't count all of that congregate housing,

because not all of them will have a care component to them. I apologize that I

don't have that tally ready at my fingertips here. I know we did talk about this

before, this morning, and I thought I would have that specific tally. But those

numbers, I think, give at least some independent reassurance, aside from what we

have internally, that indicate that, in fact, CMHC recognizes there is a net

increase. If you project some of the new projects that are coming on stream, we

are quite confident that we are going to be reaching those targets.

J. Kwan:

I could appreciate the minister may not have the information readily at this

moment. Estimates debate for health will continue on, I'm sure, for a few days

if not longer than that. At some point — perhaps tomorrow, if we go back to

health estimates — if the minister can bring that information forward, that

would be much appreciated. I can then build my questions based on what I have

received from the minister with that. I'll set that aside for one moment in

terms of those numbers, and I'll wait for the minister's information tomorrow.

Let me go

back to the

definitions question, because I want to make sure we're going to be

comparing ap-

[ Page 8951 ]

ples to apples in terms of the increase in beds we're talking about. The

minister earlier today has basically redefined long-term care and intermediate

care, suggesting that the three conditions that must be met will fit into that

definition. It being purpose-built, having the right design for providing health

services, and that the people living in those units would have 24-hour access to

health care — those were the three conditions set.

If the

minister can advise me, then, how that definition the minister is now using has

changed from the previous definition of intermediate care — level 1, level 2,

level 3 — as well as long-term and extended care. I just want to become

completely clear so that we know what we're talking about.

Hon. C.

Hansen: I think, first of all, if the member goes back and checks the record

from this morning…. When she set out those three conditions of the

definition…. I did come back and clarify that when we talk about…. Yes, we

are talking about a facility that has a health care component to it within the

scope of what we used to know as intermediate or long-term care and that,

secondly, this be purpose-built housing. We're not counting the family home just

because a community care nurse goes in and visits from time to time.

[1520]

The third

point, I think, is the one that's important, because the clarification that I

gave after she set out those earlier today was that we will determine the degree

to which there needs to be health care coverage based on the needs of the

patient. We're not saying there's going to be a registered nurse sitting outside

the patient's door 24 hours a day. We are saying that based on the individual's

assessment, there would be access to that care. I did make that clarification

earlier today.

I do have

the definition that comes out of the home and community care policy manual

setting out the criteria for the different levels of care — IC 1, IC 2, IC 3

— as we discussed this morning. Maybe what I should do is give…. I was going

to say it's about nine pages altogether. In fact, just on IC 1 alone there are,

I think, three pages. What was just handed to me is a

summary, which might be a

little bit better to work from.

Definition

of IC level 1. Clients are reasonably independent but often need a moderate

amount of help with bathing, dressing and housekeeping. A typical client may be

a slow-moving arthritic person who requires a walker to mobilize independently

or someone needing specific nursing care to help change a surgical dressing or

manage a catheter or ostomy apparatus. I can go into more detail if the member

wants, or if she wants a copy of all nine pages, I'd be pleased to provide that

for her.

Intermediate

care level 2. Clients can mobilize but require heavier care or supervision

requiring professional support. Clients may require daily supervision with

dressings, colostomy, oxygen therapy, etc., rather than on occasion. A typical

client may be living with Parkinson's or multiple sclerosis and need more

prompting and supervision around transferring related to physical frailty and

greater input to maintain hygiene and have their daily living needs met, such as

feeding and dressing. A client with a dementia will need considerable

directional assistance and supervision.

Intermediate

level 3. There are both behavioral and physical IC 3 clients. Behavioral clients

assessed at this level are often coping with significant psychogeriatric issues

resulting in severe behavioral problems and requiring high input. These persons

usually require facility placement. Clients with severe physical deficits at the

IC 3 level require ongoing direction, supervision and assistance with the

activities of daily living.

I can go on

to extended care if…. Let me read in extended care just for the record here as

well. This level of care recognizes persons with a severe chronic disability

that have functional deficits requiring 24-hour-a-day care, professional nursing

services and ongoing medical supervision. Traditionally, the complexity of care

issues has necessitated facility placement for this client. Clients are

generally wheelchair dependent and unable to mobilize independently with or

without aids and require professional and non-professional care.

J. Kwan:

Thank you to the minister. Yes, I would appreciate the long version of the

definitions as well as the short version. If the minister can make that

available at the end of today's debate for our office, that would be great. I

can then look at it after we adjourn from here.

[1525]

Okay, so on

that basis, the

definitions the minister had put on record for levels 1, 2 and 3

and extended care…. Is the government still using those

definitions for

assessment and the terminologies associated with it? Or has that changed also?

Hon. C.

Hansen: This is actually going through a transition now. There are new tools

that have been developed. In fact, they're based on a project that was piloted

in North Vancouver, which really is becoming a standard not just across B.C. but

indeed across Canada as an assessment tool used by community care nurses to

assess the needs of an individual who is developing some health or medical

dependencies.

The terms

IC 1, IC 2, IC 3 are still used in much of the industry today, but there are new

definitions being developed that are far more refined that I think will ensure

consistency across the province in

definitions. Those tools are being used

increasingly. Right now we're in a world where some are still using the old

model and some are using the new model.

If the

member is interested, I will also be pleased to provide her with the new

definitions that we're moving towards as well as those old

definitions, which

are being phased out.

J. Kwan:

Yes, I would be interested in the new

definitions. The reason why, of

course, is that I want to compare the old

definitions versus the new

definitions

and whether the level of care has changed. If so, in

[ Page 8952 ]

what ways? Then we are actually going to be comparing apples to apples rather

than apples to oranges so that we know what we're talking about — which I know

is a bit trying sometimes, particularly in the House. That would be appreciated.

For the

time being, could the minister just give me a quick

summary of what the new

definitions are and a quick overview of what those

definitions are so that we

can carry on debate for the purposes of discussion?

Hon. C.

Hansen: What I have with me right now that I could share with her are some

examples around what they refer to as complex care groupings, for example. We

used to refer to this generally speaking as extended care in the past, but

because there are…. Maybe I shouldn't try to say it's a direct parallel. I

will read you a couple of the new

definitions around complex care groupings.

Group A is

a person who has severe behavioral problems on a continuous basis. The person

may or may not be independently mobile. Assessment indicators for this grouping

include that the person may endanger their own life; exhibit destructive,

aggressive or violent behaviours; exhibit antisocial behaviours; require a

behaviour modification program on a time-limited or highly structured basis; be

psychiatrically handicapped with one or more severe behavioral problems which

make a person unable to function in a supported housing, assisted-living or

group home setting. That would be what we would refer to as group A within that

complex care grouping.

Group B is

a person who has cognitive impairment ranging from moderate to severe but who is

socially appropriate. The person may or may not be independently mobile with use

of ambulatory aids. Then it lists some of the specific indicators under that

group.

Under the

third group, group C, would be a person who has cognitive impairment ranging

from moderate to severe but who is socially inappropriate. The person may or may

not be independently mobile with assistance. Again, it runs through more detail.

Group D

would be a person who is physically dependent but cognitively intact with

medical needs that require professional nursing and whose condition requires a

planned program to retain or improve functional ability. Again, it goes into a

bit more detail.

[1530]

Group E is

a person who is clinically complex — for example, a person who has multiple

disabilities and/or medical problems that require professional nursing care or

who has complex medical conditions that require monitoring and specialized

skilled care. Again, more detail.

I think the

point is that we are refining this more. It's not simply a catch-all phrase like

"extended care." We are really trying to be more specific to the

individual needs of the patient so that they can be placed appropriately to get

the services they need and also so that these

definitions and the application of

them are in fact consistent regardless as to whether you are living in Dawson

Creek or whether you are living in downtown Victoria.

J. Kwan:

What it sounds like to me is that the complex care groupings A to E are

individuals that require perhaps more assistance. Generally speaking — and I

think the minister has stated as well — they're almost an equivalent to what

was formerly defined as the extended care. That sort of deals with the extended

care piece.

What about

intermediate care levels 1, 2 and 3? What is the new terminology now being used

for these three groups?

Hon. C.

Hansen: We were actually just looking at some of the documents, which I

don't think answer the question the member is asking. The one document I do have

here is that one around the

definitions, the complex care groupings. I will have

to undertake to get the information that she is looking for regarding the other

levels of care in terms of assisted living, but I don't have that right at my

fingertips. I apologize.

J. Kwan:

If we could get that information, is it reasonable to expect it by the end of

today?

Interjection.

J. Kwan:

It is reasonable. Then we can carry on debate, if we go back to health estimates

tomorrow, with all the

definitions the minister will pass on to my office.

Let me ask

the minister this question: what is the terminology "residential

care"? What does that refer to? That's new terminology, as I understand.

In fact, as

we were debating this, this morning, we received an e-mail from a group that

advised us that…. It was ELMS, actually, who were watching the debate. They

advised that the terms "intermediate care" and "extended

care" have now been dismantled by the government. In fact, there was a memo

sent out in September at a place called the Overlander Residential Care

Hospital, which prohibited the staff from using either term in writing or in

oral communications. The group that had used "residential care" in

their terminology had been prohibited from using it.

I'm sorry.

The group that used the term "extended care" had been prohibited from

using it, and they've now been told they have to use the term "residential

care." In fact, there was a memo going out to that effect telling folks

that the registration categories for intermediate and extended care are no

longer valid, that the new terminology is "residential care" and that

therefore people were to use that term.

Maybe the

minister can advise: what is residential care?

[1535]

Hon. C.

Hansen: The first thing I want to point out is probably the

definitions we

want to be using going forward. Those are the

definitions contained in the

[ Page 8953 ]

Community Care and Assisted Living Act, which I think probably will help to

guide us and give clarity moving forward.

In the

policy manual there is actually a reference to what residential care services

may include. I will just read it to the member. "Residential care services

may be provided in various types of residential care facilities, which include

intermediate care facilities, private hospitals, multilevel care funded

facilities, extended care hospitals or units, and acute care hospital beds

designated for long-term care." Then the second general category would be

family care homes. The other general category would be group homes, where

residential care services may be provided.

Residential

care is a much broader term, which I don't think is particularly new. I think it

has been around for some time, but it gets used in different aspects. I think if

you look down the list of the kind of residential care facilities that may

provide residential care services, we are going through a change in trying to

get some consistency around the terminology that is used. For example, I know

that the term "private hospital" is one that is often confused and

that we have private hospitals that are long-term care facilities. Some people

think that maybe they provide a broader range of services that we tend to think

of from our acute care hospitals.

I think we

do have some challenges in terms of the kind of

definitions that have been used

in the past, but what we're trying to move towards are the

definitions used in

the Community Care and Assisted Living Act. As to why a facility would put out a

directive around the use of the term "extended care," I'm not aware of

that kind of detail. The only thing that can come to my mind is that we are

trying to move to more consistent

definitions to be used across the province,

and those are the

definitions in the Community Care and Assisted Living Act.

J. Kwan:

It appears to me that the directive to change the language stems from government

policy changes, as the minister had identified himself that they are going

through a process of phasing out the language that was used before —

intermediate care levels 1, 2 and 3 and extended care to complex care groups

to…. I don't know what levels 1, 2 and 3 are being replaced with. We will get

that information when we get it. I think that's where it stems from, and that's

how people are being told that they should no longer use these terminologies.

Irrespective

of terminologies, what is behind the terminologies and how they are defined

becomes critical so that we can, again, know that we're talking about apples and

apples and oranges and oranges. It seems to me, though, in this instance the

information the minister provided around residential care really deals with

intermediate care facilities — or sort of a replacement word for intermediate

care. Certainly, it doesn't seem to me to replace extended care, because

extended care seems to me to fall under the categories of complex care groups.

So that's something to note.

[1540]

Now, having

established the terminology changes — and we'll get more information later

today — could the minister advise, using the

definitions that the minister and

the ministry now use, how many beds there were in 2001 — the beds that used to

be referred to as extended care, intermediate care, levels 1, 2 and 3, etc.,

which are now referred to as something else? How many beds were there, under

this new set of

definitions that the ministry is now using, in 2001?

Hon. C.

Hansen: What I've got is a slide that is a table that shows the total number

of bed-days broken down by the various levels. The best I can do at this stage

for the member is to approximate…. This is how those 25,000 beds that we were

talking about this morning are broken down. I'm just trying to get a rough

estimate. I would say that this particular bar graph…. About 30 percent would

be at the IC 2 level. About another 35 percent would be at the IC 3 level, and

the remaining 35 percent would be at the extended care level.

J. Kwan:

Could the minister also give me the approximate actual numbers of the

25,000? I can work it out — 30, 35, 35. It would just save me the trouble of

having to do it.

Hon. C.

Hansen: I will endeavour to get the numbers that were used to calculate this

bar chart. I should also point out that there is actually a very small number of

beds — barely makes the chart — in the IC 1 level as of 2001.

I think the

other thing that's important to point out is that we need to also focus on the

patients, not just the beds. I think what's important is how we are meeting the

needs of those individual patients, and that's really what we're talking about

in this transition. It's not just change and definition for change's sake; it's

change that actually can better meet the needs of individual patients, which has

the sensitivity towards their needs instead of some of the classifications and

categorizations that we have used in the past.

J. Kwan:

I would agree with the minister. It is about meeting the patients' or the

communities' needs. What I'm worried about is that as extended care,

intermediate care, long-term care homes are being shut down, we are losing those

beds, and the replacement may not meet the same levels of need that the

community is requiring.

A case in

point would be Comox, I believe. In the community of Comox extended care beds

are in such need that the health authority is utilizing a hotel — I believe it

is the Ramada hotel — to provide for services for the people who are in need.

It is important to make sure that what is being provided actually meets the

needs of the community absolutely.

It's also

important to compare the government's commitment to developing 5,000 new

extended and intermediate care beds — that those beds are actually

[ Page 8954 ]

being met by the actions of this government not just through the change of

terminology but rather the needs associated with what was defined as extended

and long-term care beds and replaced with these new beds under new

terminology…. But they have to be equal in level of service; they can't be

lesser in terms of level of service. Therefore, getting the benchmark of what

was in 2001, what we started with, and then comparing it to the future of what

new beds are being added would be critical. Hence, I ask the question of how

many beds were there in 2001.

[1545]

Now, when

the minister said 25,000, and he confirmed that earlier today, that is still the

correct number — roughly 25,000 as the base number. Is that 25,000 defined

under the new

definitions that the government is utilizing, or is that defined

under the old

definitions?

Hon. C.

Hansen: The commitment that we made to British Columbians is a net increase

of 5,000 intermediate and long-term care beds, so what we will measure ourselves

against are the

definitions that were in place for intermediate and long-term

care in 2001. It's not a case of saying that we're suddenly going to transfer

everything over to these new

definitions. We're going to be held accountable for

the commitment that we made based on the

definitions that were in place at the

time. We will certainly live up to that.

I think one

of the things the member said that I do have to take issue with was when she

said that the number — I forgot if she used the words "complex care"

or "extended care" — of high-level care beds should at least

increase. That's not necessarily in the best interests of the communities and

the patients that are being served. We have seen all kinds of cases where

individuals were put into what used to be known as extended care before they

were ready for that, when they still had some independence that should have been

nurtured and supported. They went into a purely and totally dependent

environment. What we find in those situations is those individuals will

deteriorate quickly to the level of care that they're put into. We are trying to

make sure around the province that we have an appropriate level of beds for the

varying degrees of dependence and independence of our seniors as they advance in

years.

The member

referred to the Comox Valley, which is my hometown, and I stay familiar with

some of the things happening there. For example, I'll read you these bullets on

the Comox Valley: 328 residential care beds as of April of 2002. And 13

assisted-living beds are already occupied. There's a conversion of 100

intermediate care beds to 200 complex care beds on one site and 76 beds being

converted to 66 beds on another, to total 291 complex care beds. There is a

decommissioning of 27 intermediate care beds, replaced with 75 assisted-living

units. Total spaces in 2006 that are possible with the existing funding will be

379. The community is expecting funding for an additional 40 complex care beds

to address ALC pressures at St. Joseph's Hospital. That's one community alone.

Are we

talking about some beds being decommissioned? Yes, because of the particular

circumstances around that facility, but we're also talking about a whole bunch

of new facilities that are being developed or converted or renovated. I think

this is all good news for the seniors that are living in the Comox Valley —

that there are going to be some exciting new options for them. I think that's

the key word around all of this — options to actually meet the individual

needs of seniors depending on their particular circumstances and their need for

independence versus their need for ongoing health care support. That's the goal,

and I think the Comox Valley is a perfect example of a community where we're

making progress towards that objective.

J. Kwan:

Well, I wanted to ensure — and the minister has actually committed on record

now — that the comparison of the 5,000 new intermediate and long-term care

beds would be to the same standards, no matter how the

definitions are being

used or redefined right now, in terms of what those 5,000 new beds would be.

That is important, and the standard of care is important insofar as what was

then and how it was defined and what it is now and how it is being newly

defined. That's important to establish.

[1550]

When I said

that the extended care beds that are needed…. As I mentioned earlier, this

morning, the idea of the extended care beds is to alleviate the pressures in the

emergency rooms and hospitals, and I think that need is still in existence. That

need hasn't disappeared. The continuum of different levels of facilities for

seniors is still needed. I appreciate that, but I do want to make sure that the

government does not replace with lesser-supported beds to what was in place,

which had a higher level of support, because then it is not comparing apples to

apples in terms of what the government's action is.

That's why

I ask about the baseline of 2,500. The government has now committed that it will

replace the same levels of health care facilities to that which was in place

before. That is good. That's good to know, so we can use that as a measurement.

Now, with

respect to the notion that the government is trying to assess seniors

appropriately so that seniors will get put into appropriate support services and

the right kinds of beds, etc., I can appreciate that. Can the minister advise,

then: is the assessment being used completely health related, or are there other

measures that the government is using to determine whether or not a senior

should go from intermediate care to, let's say, assisted living?

Hon. C.

Hansen: I just want to come back to a comment that the member made earlier,

before she went on to a new subject. She was talking about that there shouldn't

be any lesser beds; I forgot the way she termed it. I think if you went to talk

to a senior who was given the choice at a stage in their life where they may

need extra help but still had the capacity for some independence…. If you gave

them the choice of a bed

[ Page 8955 ]

where they would have 24-hour-a-day, seven-day-a-week nursing care, a totally

dependent model where they really could not enjoy whatever independence they

were capable of, and compare that to the option of assisted living — where

they've got their own apartment-like suite, where they get meals that are

prepared for them down the hall, where they can socialize with other members,

have a sense of independence and still have some opportunity to have

independence in their own apartment or their own unit with a small fridge or a

small cooking unit and things like that — I think many seniors who still have

a capacity for independence would say that the assisted-living model is the

preferable model.

[1555]

I think one

of the things that frightened a lot of the seniors in the past was when they

were faced with the prospect that the only alternative to the family home was to

go into that totally dependent nursing home model we knew of in the past. To say

that we are going to have as many beds in that 24-7 model as we had before would

not be meeting the needs of seniors. What we need are the new options — the

new assisted-living models and supportive housing models — that I think

seniors who can enjoy independence find much, much more attractive. I think the

commitment we've made is based on that benchmark we talked about earlier of

25,000 beds that were there as of 2001. We will, by the end of 2006, have a net

increase of 5,000 beds in this province that meet that range of needs. I think

that's the important thing to be kept in mind.

With regard

to the kind of assessments that are done to determine at what level an

individual would be placed, I can just give you a sense of the kind of

assessment done by our community care nurses or others that will work with

individuals in this regard. I'll just read out some of the assessments. I think

it's a total of about a six- or seven-page assessment document, but I'll just

read out some of the titles: cognitive patterns, for example; communication;

hearing patterns; vision patterns; social functioning; mood and behaviour

patterns; informal support services, which include a whole range of aspects of

their daily living; physical functioning; continence in the last seven days;

disease diagnoses; health conditions and preventative health measures; dental

status and oral health; skin condition; environmental assessment; service

utilization. These are all the different categories that are part of the

assessment tools that are done.

Medications

are another area that is looked at in that assessment. It is quite

comprehensive, and it certainly does include a full range of the challenges that

seniors may be facing.

If I can

read one other…. This refers to: "The interRAI assessment tools are a

standardized comprehensive family of tools that have been developed by an

international group of researchers and used in over 30 countries."

Currently in Canada, the provinces of Nova Scotia, Ontario, Manitoba,

Saskatchewan, Alberta and the Yukon are in various stages of implementing the

interRAI home care and residential care tools. In British Columbia the health

authorities will be implementing this new home care and residential care

assessment process over the next few years as outlined in the performance

agreements.

J. Kwan:

In the long list of things for evaluation in determining whether or not a person

should go from intermediate care to assisted living, is the person's financial

situation taken into consideration?

Hon. C.

Hansen: The answer is no. When we are doing an assessment to determine the

level of need that an individual has, it is not based on their income status. I

think once they are placed — if they are placed, say, in an assisted-living

environment — then the degree to which there is financial support from

government for those needs is income-based. For those seniors on low income,

they do get far more financial support from government for those needs than a

senior with a very high income in any one year.

J. Kwan:

It's interesting, because I've got an e-mail here which advises that it has been

this organization's experience that those who go from intermediate care to

assisted living… It's based largely on fiscal criteria — i.e., those with

greater financial resources are very much encouraged to take the assisted-living

route. In fact, those seniors have been singled out to even receive physical

therapy in order for them to be at a health care level where they can live in

assisted-living facilities, and it goes on to highlight a particular case.

[1600]

Then, the

other criterion for determination is the dementia assessments, it advises in

this e-mail. It states that it has been their experience that seniors from

intermediate care are being assessed as having high levels of dementia in order

that they may fit into what the government now calls complex care. Maybe, first,

the minister can shed some light on this issue. Again, the e-mail came this

morning as a result of our debate this morning. People who have been watching

and the organization who has written to us advise us that it's been their

experience that fiscal criteria are the major influencing factor in deciding

whether or not a person should go from intermediate care to assisted living.

[J.

Weisbeck in the chair.]

Hon. C.

Hansen: Without more detail with regard to that e-mail the member has

received, I'm at a loss as to how to answer that particular case. I guess it

comes back to…. The interRAI tools we have put in place are not in any way

dependent on the income level of the individual being assessed. If there is a

case where somebody is trying to put somebody in a different classification

because of their income level, I would certainly be interested in learning more

details of it. The whole purpose of the standardized classification around the

province is to bring consistency based on the individual needs of the person,

not based on their financial needs.

[ Page 8956 ]

J. Kwan:

I'm just checking with my staff to see whether or not I can put this information

with the names of the organizations and the individuals impacted on the record

publicly. I haven't obtained that assurance just yet, so I'm a little bit

reluctant to do that, for confidentiality reasons. I wouldn't want to do that

unless I have the authorization to do so.

However, I

want to be very clear. The information we've received from this organization is

that seniors are being assessed largely based on financial situations as opposed

to their care needs. This is the information we've received, so I'll probably

come back to it. I suspect that the people who e-mailed us would want this

information on the record, and I'll come back to it. But it's good to actually

have the minister say on record that financial considerations would not be part

of the assessment. Then in the situations where that is happening and where that

information comes forward and we're able to bring that to the minister's

attention without jeopardizing confidentiality, we certainly will be doing so.

Let me ask

the other question in this e-mail, which contained the criterion of dementia as

the assessment tool. Again, the e-mail advises that it's been their experience

that seniors from intermediate care are being assessed as having high levels of

dementia in order that they may fit into what the government now calls complex

care. Is that the case?

[1605]

Hon. C.

Hansen: As I think I mentioned earlier, this assessment tool is meant to be

objective. It is meant to bring standardization around these. I think, even as I

read out earlier some of the

definitions around the groupings within complex

care, just that little

summary that I read gives some indication of the detail

to which they have refined these

definitions to try to get that standardization.

The ones that are doing these assessments are well-trained community nurses who

have specific orientation around how to undertake these assessments so there is

consistency throughout the province.

Certainly,

if anybody has any evidence that there is subjectivity being brought into these

assessments, I would be pleased to hear about it because we clearly are trying

to get to a model that brings certainty and consistency within those refined

definitions to make sure we've got a standardized process around the province.

J. Kwan:

Is it fair enough to say that given the reclassifications that the government is

embarking on, the complex care group is the one group and the other one, I

assume, is assisted living? Is it fair to say, then, there are basically two

groupings to which individuals could fit under — either assisted living or the

complex care group category?

Hon. C.

Hansen: I think what the member is starting to look at is: what are the

housing needs, and how do those get met? Assisted living is a housing model that

has a health care component to it. When you start looking at the interRAI tools

that are being used, what they will do is evaluate the needs of the individual.

At the end

of the day, how those needs get met could be in a variety of ways. You could

wind up with an individual who is in one of the complex care groupings but can

still stay in the family home and be supported in the family home in a way that

makes sure that their needs get met. In other situations, it may be that that

individual's circumstances require more security, more secure care — perhaps

because of a dementia, for example.

If you

start looking at individuals who would have assessments that would be less than

complex care, there's a whole range of different classifications that they could

fit in, each of which will then drive the kind of support that they would get.

That support can be provided in a variety of settings. It could be in the family

home. It could be in a supportive-housing environment. It could be in an

assisted-living environment. Really, the assessment doesn't, at the end of it,

come up with a result that says: "Oh, that person is eligible for an

assisted-living unit." What it does is assess their individual needs, and

then they work with the individual and the family to determine what kind of a

housing placement is most appropriate for them. It really is individualized —

trying to look at the individual needs, the individual capacity for independence

and the kinds of supports that that individual may require.

J. Kwan:

There used to be these categories: intermediate care level 1, level 2 and level

3, supportive housing, assisted living, long-term care or extended care. That

used to be the spectrum. Now, as things are being redefined — and I haven't

got all the terminologies before me — what I do know so far is that there's a

grouping called the complex care grouping. Then there is, I presume, a grouping

called the assisted-living grouping.

[1610]

Now, the

minister says there is a range of classifications. What is that range of

classifications that's being used now by this government?

I'm just

going to add to that, because I only know of two right now, and those are

assisted living and the complex care groupings. Supportive housing I'm not

considering as part of the groupings, because supportive housing…. Well, no. I

should actually consider supportive housing as part of the classification,

because the minister said earlier of supportive housing that there are some that

would fit into the 5,000 new beds and there are some that would not.

Okay, so

there are three categories: supportive housing, assisted living and complex care

groups. Am I missing any other categories?

Hon. C.

Hansen: I think what's important is to come…. I think we're confusing two

things here. One is the care needs for the individual and the degree to which

they have lost their independence — the degree

[ Page 8957 ]

to which they need supports. That's what these tools — the interRAI tools

— are all about. I think the member may be getting confused by trying to stay

in a housing model. There are two things here. One is the kind of housing that

is appropriate for seniors, and the other is the kind of care and support they

need. Those are two very separate things.

If I could

just read a definition as to the transition that is taking place: "The

Ministry of Health Services identified the need for an improved, reliable and

valid assessment tool to replace the 20-year-old long-term care assessment form.

In January of 2002 the Ministry of Health Services mandated the interRAI home

care (MDS-HC) and residential care (MDS 2.0)." Those are the two assessment

tools that have been mandated as the new standard for the province.

Now, if an

individual is assessed under the basis of the home care tool, they could still

wind up in a range of different housing environments. They could wind up at home

with home care support, they could wind up in supportive housing with home care

support, or they could wind up in assisted living with home care support — all

coming out of this assessment tool.

In the case

of the residential care assessment tool, that would actually look at the kind of

facility care that may be required because of the particular circumstances of

the individuals. I think we've got to recognize that we have to look at care,

and that can be anything from lower levels of care right through to dementia

care, which could all be provided in the individual's family home, or it could

be provided in supportive housing or assisted living or, indeed, in a complex

care setting.

There are

two things. One is the assessment tools to determine the level of support that

is required, and the other is the housing options that may be available to them.

I think we have to be careful not to confuse the two.

[1615]

J. Kwan:

Yes, I'm trying not to confuse the two in terms of housing options versus health

care options.

The

minister says that perhaps under the assisted-living model, if home support is

needed for the individual and where home support is provided for, then the

senior or the person could continue to live independently because all they need

is home support. Then maybe the minister can tell me first: in the situation

where home support is needed for the person to live independently, is that

considered assisted living? Under what category does that situation fall?

Hon. C.

Hansen: You could have an individual who is provided with home support in a

range of facilities. As I say, it could be the family home, but it could also be

assisted living. There's a whole range of options. It is the care component that

is driven by these assessment tools, and that care can be provided anywhere —

well, not anywhere, but in a variety of circumstances that may meet the

individual needs of that senior. What comes out of the assessment tool, in terms

of the kind of home support or home care that may be required, does not in

itself dictate the kind of housing option that is necessary.

J. Kwan:

Yes, I can appreciate that home support could be given in any situation,

whether it be assisted living or in the person's own home or whatever the case

may be. Well, then let me try and recast my question. What is deemed to be

assisted living?

Hon. C.

Hansen: This is defined, actually, in the Community Care and Assisted Living

Act as well. Just to give a bit of a background, which is probably not in the

same kind of legalese as it would be in the act itself: "Assisted living

means a housing arrangement that consists of the following three elements….

I'm just

trying to see if this may, in fact, be a better one to read out. Yeah, this may

be a bit more concise:

"Assisted

living refers to residences that provide housing and a range of support

services, including personalized assistance for seniors and people with

disabilities who can live independently but require regular help with daily

activities. The services are designed to promote occupants' dignity and

independence and involve family and friends. Assisted living is intended for

people who are capable of directing their daily living routines with

assistance and support.

"The

act makes an exception where the spouse of an occupant is housed in the

assisted-living residence with the person and is able to make decisions on

their behalf.

"Most

people who move into an assisted-living residence do so because they need

daily assistance and, in particular, assistance with personal activities such

as grooming, bathing or taking medications. Assisted-living occupants may

require an hour or more of these personal assistance services each day."

J. Kwan:

The 5,000 new beds — that would include assisted-living housing units

under the definition the minister has just put out? Am I right in understanding

that assisted-living units, utilizing this definition, will be included in the

composition of the 5,000 new intermediate and long-term care beds?

Hon. C.

Hansen: Yes, that's correct.

J. Kwan:

The minister doesn't have the numbers of how he's broken it down. He's going to

provide that to me, in terms of what those 5,000 new beds would look like and

what it consists of to date — not by 2006 but to date. He's going to provide

me with that information. Okay.

[1620]

Let me just

follow up with this, and then I want to go back to the Comox situation. I know

we sort of entered into that discussion briefly, but I want to come back to

that. Let me follow up with this line of questioning around the breakdown of

what has been built to date of those 5,000 beds. The former minister of state

for seniors had advised that 811 residential care beds have opened since June of

2001; 429 assisted-living units have been provided; 173 independent supportive

housing units and 479 rent supplements. And 1,941

[ Page 8958 ]

independent living units have been requested, but they're not yet ready. That

totals 3,833.

Are these

numbers still valid? Can the minister provide me, then, with the update of these

numbers in these categories since estimates debate of last year?

Hon. C.

Hansen: I think, as we were talking this morning, it's at any point, at any

particular snapshot in time, looking at all of the various players across

government that are part of meeting this commitment…. It's difficult to get

that snapshot in time, so I'm not sure what particular numbers the previous

minister may have been referring to at the time.

Again, I

just want to remind the member of our discussion this morning, where it's

not…. You know, we at no time in 2001 said that by 2006 there's going to be X

number of these beds, X number of those beds and X number of those beds. What

we're doing is saying we need to meet the needs of individual communities, and

some of that changes. A direction that may be looking at going into complex care

beds may in fact realize that actually the real community need is for other

levels. So we are trying to be flexible in that regard.

I think if

you look at this one data…. I just want to make sure I know what I'm looking

at here. In terms of assisted-living units, for example, from 2001…. I'm

trying to think when this would be current as of — updated as of last October.

Assisted-living units that had been opened since the middle of 2001 were 668;

assisted units that are in planning or in construction, 2,696. If you look at

independent housing units that have opened since the middle of 2001, it was 288;

the independent housing units, planned or in construction, 302. Residential care

units — a net change of 596.

[1625]

Again, this

is within the specific health sector where some of these projects have a

subsidized component to them. But you know, in addition, this would include some

of the work being done by B.C. Housing but would not include a lot of the

initiatives that are underway around the province where community groups and

private sector developers are building facilities and then designing them in a

way that would provide for those assisted-living needs. In many cases, the

health authorities are looking at some of those projects as options to provide

for the needs in those particular communities as well. So there may well be some

mix of funded and unfunded beds in some of these facilities as we go forward.

Those

numbers that I just read out do give you a sense of the information that is

provided by the health authorities. Actually, just to refine that, it's

information provided by the health authorities that was updated in October 2003

and updated in February 2004 with information provided by B.C. Housing. That

gives a bit of an indication of some of the progress that we're making to date

on this file.

J. Kwan:

The information that I'm putting forward from the former minister of state for

seniors came out of estimates debate on May 26 and 27, where I was exploring

with the minister in detail about the 5,000-bed commitment. What the minister

had provided was the breakdown of 811 residential care beds that have opened

since June 2001. The 429 assisted-living units, 173 independent

supportive-housing units, 479 rent supplements and 1,941 more independent living

units have been requested but not yet readied, which brings it to a total of

3,833.

I'm using

that as a base — as a record — to ask these questions in terms of what the

update is, and I'm confused as to the information that the minister had

provided. Let me just try and go through that.

The

minister advises that the residential care beds are now at 596. That would

appear to me as a reduction of beds, because what the former minister had

advised last year in estimates debate was 811. Maybe just let me take these step

by step. Let me just stop there on the residential care beds, and maybe the

minister can clarify for me. Is it an actual reduction from 811 to 596?

I want to

be very clear, Mr. Chair. In these questions, I'm not saying that the minister

or this government had committed by the year 2004 that out of the 5,000 new

beds, they would have built this many. I just want to ask: how's it going?

Because 2006 was the commitment that 5,000 new intermediate and long-term care

beds will be built by and will be available in the community.

We're now

at 2004, and I'm just wondering: how's it going, and how many have you built

under that new-era commitment?

Hon. C.

Hansen: It has just been pointed out to me that actually I was reading off

of the wrong line here. I'd better be really clear in the numbers that I'm

giving her. This is residential care beds opened since June 2001 — a total of

885. The assisted-living units opened since June 2001 is 668. The independent

housing units opened since June 2001 is 288.

[1630]

J. Kwan:

Okay, that makes sense. So it's not a reduction in beds; it's actually an

increase in beds to 885.

Now, the

former minister also provided information with respect to rent supplements. She

advised that 479 rent supplements are existing. I just want to make sure that

we're, again, comparing apples to apples. When we talk about rent supplements,

we're talking about rent supplements to units that provide for or meet that

minimum definition that the minister had stated. That is: (

a) that it's design

built; and (

b) that it provides for 24-hour care, as it is required by the

individual living there — that it provides for access to 24-hour care, I

should say; and (

c) that it is designed to meet the health care needs. Those

were the three conditions. Am I right in understanding that the rent supplements

that are included in this list by the former minister of state for seniors —

that those rent supplement units include those conditions?

Hon. C.

Hansen: First of all, I want to come back to something the member said

again. I'm not sure where

[ Page 8959 ]

she got this notion of 5,000 beds all having a 24-hour-a-day component to

them. I might have to take responsibility for that. It might be something I said

that got misinterpreted. When we're talking about our 5,000 beds, we're talking

about a care component addressed to meet the individual needs of the resident.

It is not necessarily 24 hours a day, but it is the appropriate amount of care

to meet those individual needs.

When we

look at rent supplements, there are two ways that the needs of an individual can

be met in a facility that is not 100 percent owned by, let's say, a health

authority. That is that the health authority may go in and contract for a

certain number of beds in that facility. Once the resident is placed in that

facility, the owner of that complex gets their monthly pay for that unit from

the health authority. Then the health authority, in turn, may recoup a certain

percentage of that from the individual based on the income test for the

individual.

In a rent

supplement model, it would be a situation where it is the resident who is in

fact renting the housing component of that and the care component that may come

along with it, but government is providing a subsidy based on the financial

needs of that particular individual.

When it

comes back to our whole goal of 5,000 additional beds, we would only be counting

those rent supplements where there is in fact a health care component that is

provided along the lines that we talked about earlier today.

J. Kwan:

No, I just want to be clear. The 5,000 new beds that I'm using to measure the

government's commitment is based on what the New Era document says, and

that is 5,000 new intermediate and long-term care beds. I never said that it was

required that it have 24-hour nursing care or anything like that, but using the

old definition of what was intermediate and long-term care beds, that's the

measurement I'm using to hold the government to account. I want to be clear

about that, which is why we canvassed for hours, it seems like, this morning and

later on today about the definition — so that we're again comparing apples to

apples. That's where I'm using those 5,000 new beds measurement — where that's

coming from.

[1635]

The

minister clarified, on the rent supplement side, that the rent supplements must

have a health care component to them. Earlier today I asked the minister what he

deemed to be a health care component. He advised that there are three things it

must provide: (1) that it is purpose-built; (2) that it has the ability to

provide health services, that it is designed to provide health services; and

(3) that the persons living in it would have 24-hour supports to meet their health

care needs. Those are the exact words the minister said. I want to make sure —

and I think it's been confirmed by the minister — that those rent supplements,

in fact, meet those three conditions. Let me just stop there and get that

confirmation.

Hon. C.

Hansen: With regard to the rent supplements, in order to qualify for the

funding that has been available — this is the portion of the 3,500 units being

provided through Independent Living B.C. — those rent subsidy units must have

a care component to them. That is one of the requirements.

With regard

to the three elements the member keeps coming back to, yes, we are talking about

facilities that are built to provide care for seniors, and we are talking about

facilities that are built with the intention of having a care component to them.

When we talk about the 24-hour, we're talking about a 24-hour emergency

response. What I came back to is that we're talking about the level of care that

is required by the individual.

I think

when it comes down to the

definitions, which I know the member wants to spend a

lot of time on, what it comes back to are the

definitions around what

intermediate care would have been in 2001. I read out some of the

definitions of

what used to be IC 1, IC 2, IC 3. Those are what we'll use as our benchmarks to

determine whether or not there is a care component in order to meet this

accountability we have.

There are

two sides to it. One is that we obviously have a political accountability back

to the voters of B.C. based on the new-era commitment we put forward around the

5,000 net increase in beds, based on

definitions that were in place in 2001 for

intermediate long-term care. When it comes to meeting the needs of individuals,

we want to be driven by future needs and future

definitions, but we also

appreciate the fact that when it comes to our political accountabilities, we are

driven by what was in fact in place and understood in 2001.

J. Kwan:

That's good clarification. What the minister has just admitted, then, is that

they're aiming to meet both tests — that is, the political commitment that was

made during the election in the New Era document and what the assessment

of the communities' needs is. There are two tests, really, that the minister and

this government must be held to account for.

I certainly

appreciate that, and as an opposition member that's exactly what I'm trying to

do here, which is why we're going through these

definitions in quite a bit of

detail and making sure we're not mixing up apples and oranges. We are also

clarifying the record of what the former minister of state for seniors had put

on record, which turned out to be wrong and corrected by this Health minister

today.

Now we're

clear about the rent supplements here — that they must have the care component

— and the information that was obtained from the former minister of state for

seniors advised that it was 479 rent supplements. Is there any update with

respect to that number, or has that number stayed static at 479?

[1640]

Hon. C.

Hansen: I don't have that with me. That actually is a question she may want

to put to the Minister of Community, Aboriginal and Women's Services,

[ Page 8960 ]

who is responsible for the Independent Living B.C. program.

J. Kwan:

Okay, then I will put that question to the Minister of Community, Aboriginal and

Women's Services around that, with the exception that the former minister of

state for seniors provided that information in estimates debate as part of those

5,000 beds. So one would assume it would be logical to ask that question for

that update here with this particular minister, because that does fit into that

5,000 new extended and long-term care bed commitment. But I'm fine with asking

the other minister for that.

Can the

minister clarify the independent supportive-housing units — the 173 to 288

that are now in place? Could the minister advise that those independent

supportive units…? Am I right in assuming that those units also have the care

components or the three conditions we talked about?

Hon. C.

Hansen: First of all, when it comes to the rent supplements, I'd be pleased

to try to get that information for the member, if she would like it, from

Community, Aboriginal and Women's Services. I just don't have it at my

fingertips today. I think the other thing that's important to underscore is that

the 5,000-bed commitment is a commitment by this government. It is not a

commitment specifically by the Ministry of Health Services. We obviously have a

role to play. We have an important partnership with the other agencies and

not-for-profit organizations, community organizations and the not-for-profit

providers to make sure that goal is achieved. If she would like, I would

endeavour to get that information for her, if she would prefer it before those

particular estimates come up.

With regard

to the independent housing, those units would only count towards the 5,000

commitment if, in fact, there was a care component to them. The number I read

out, the 288, is simply those facilities for which B.C. Housing or the health

authorities may be somehow involved with. We recognize that there's a whole

bunch of independent housing that is being built around this province, and when

it comes to our commitment of reaching our 5,000-bed commitment, that only gets

factored in if, in fact, there is a health care component to it. If the question

the member has is if those 288 beds are all being included towards the 5,000

commitment, probably not, because we still have to make sure we do proper

assessment as to which of those units do or do not include a health care

component.

J. Kwan:

Thank you for that clarification. Again, that differs from what the former

minister of state for seniors had provided. In last year's estimates the former

minister of state had provided that of the 5,000-bed commitment, it included the

173 independent supportive-housing units. Now it appears that independent

supportive housing units…. The minister may not necessarily have known how

many of those units actually have the care component that would allow it to be

counted towards the 5,000 new bed commitment. If it doesn't have the care

component, it should not be in the list of numbers she provided. She gave a

total of 3,833 units that have been met towards the 5,000 new intermediate and

long-term care bed commitment, so that's wrong. That's wrong information that

the minister of state for seniors had provided. I need to get this information

from the minister — that is, of the 288 units the minister advised are the

independent supportive housing units, how many of those have a care component?

Does the minister know?

[1645]

Hon. C.

Hansen: I don't have that information at this time. It may well have been

that the former minister had more detail at that time around what were then the

173 units. Just to put this debate into perspective, you know, as we said

earlier today, this is about a target we have set that we will meet by the end

of 2006. When we look at the mix of…. I've given you lots of examples of

progress to date and a snapshot in time, and if the commitment was deliverable

by March 2004, obviously we'd have a lot more refined numbers today at our

disposal around that target.

As we get

closer to our target, I certainly want to give evidence that we're on track to

getting there, which I think I've done today. As we get closer to the end of

2006, we will take our accountability seriously. We have to be able to show or

to demonstrate to what I know is always a very skeptical public that in fact we

lived up to the obligation we made to them in 2001, and I know we'll be able to

do that.

J. Kwan:

It seems to me that the minister is getting a bit defensive about these numbers.

There's no need to get defensive about it, Mr. Chair. I'm not suggesting the

minister or the government had said that by 2004, X number of units will be

built. What I'm saying is that the government made a commitment in the New

Era document that by 2006, they will have 5,000 new intermediate and

long-term care beds built in British Columbia.

I'm trying

to assess…. A normal person — some would argue that I'm not that

particularly normal, but anyway, whatever — would be able to assess how the

government is doing by determining that we are now at 2004. Of those 5,000 new

beds that have been committed, what percentage of those beds is actually

existing in our community? Then perhaps a person would be able to gauge by 2006

whether or not the government will realistically meet those commitments. That's

all I'm trying to do.

There's no

need, Mr. Chair, to get all defensive about these numbers of what the former

minister of state for seniors had stated, because that's what she said on the

record…. Earlier this morning we were able to establish, through the

discussion and the debate, that the minister of state had made a number of

errors. I will be generous in casting that it was in fact an error and that it

was not intentional to mislead or to purposely provide wrong information in this

House. I'll be

[ Page 8961 ]

generous in suggesting that it was simply wrong information that was

provided. That's what I'm trying to assess here. Of those independent supportive

units, how many can actually be counted towards the new-era commitment of 5,000

new beds?

The former

minister, I think, took in the entire 173 to be counted towards that, because

she gave a grand total of 3,833 units to be built. By today's discussion, I can

only come up with, definitively, how the government is doing on this file with

respect to meeting that commitment towards 2006 — that there's only been 1,553

units that can definitively be used towards that 5,000 new-era commitment.

There's less than two years for the rest of the units — almost 3,500 of them

— that need to be built and developed for the government to say that they

actually honour their election campaign commitment. So we can assess, in

reality, how close we are. That's the intent of these questions.

As I say,

I'd be happy to ask the minister of CAWS for the rent supplement breakdown. But

if the minister can provide that tomorrow, I can add that to our list in terms

of the updates of the information I know the minister is getting for tomorrow's

debate. Also, if the minister can, for tomorrow, advise this House how many of

the 288 can actually be counted towards this New Era document, that would

be useful as well.

[1650]

Let me ask,

then, this question of the minister — again based on what the former minister

of state for seniors had said, which is that 1,941 more independent living units

are requested but are not yet ready: is that number still the targeted number?

Is that number still valid today?

Hon. C.

Hansen: Again, I just want to underscore that the numbers we've been talking

about this afternoon are just the work that is being done either by or through

our health authorities — with our health authority involvement. Clearly, B.C.

Housing is one of those partners. This is part of that whole puzzle — part of

the whole goal or process of leading towards the 5,000 beds. These numbers that

we're talking about this afternoon are just those that are, at this stage,

directly involving the health authorities.

As I

mentioned earlier, under the category of "Opened since June of 2001,"

we had assisted living, 668; independent housing units, 288; and total

independent living units, 956. What we have also, as of February, are those that

have been tendered — those that are in process and are near completion, so

they're not yet actually open: assisted-living units, 1,219, for a total of

1,887. We have 303 independent housing units that have been tendered, are in

process or near completion, for a total of 591. The overall total there is

2,478.

Again, when

we talk about the independent housing units, we still need to determine which of

those have a care component. I'm not sure. That is a work in progress. I can't

promise the member that we can give her a definitive number by tomorrow, but

we'll certainly see what kind of information is at our disposal in that regard.

J. Kwan:

I'm sorry. The numbers that the minister just provided differ from the numbers

that he provided just moments ago, so I'm confused. The minister had advised

that assisted-living units, from the October 2003 update…. The number had

moved from 429 to 668, and I think I just heard the minister…. Maybe I heard

him wrong. He said that there are now 1,219 assisted-living units. Anyway, maybe

the minister can just tell me these numbers again. I'm thoroughly confused —

I'm sorry — with that last answer.

Hon. C.

Hansen: My apologies. I will read these columns vertically, and that might

make it more clear. Opened since June of 2001: 668 assisted-living units. Those

that have been tendered, which means they are in process or nearing completion,

are 1,219. The total that are opened or tendered at this point is 1,887.

Independent housing units, as I had indicated earlier, opened since June of 2001

are 288, and those that have been tendered — i.e., in process or near

completion — are 303, for a total of 591. The total of those independent

living units is 2,478.

J. Kwan:

Could the minister give that last number again?

[1655]

Hon. C.

Hansen: The total of either opened or tendered assisted-living units and

independent housing units is 2,478.

J. Kwan:

Okay, so that clarifies it. The minister will endeavour to find out how many of

the independent supportive-housing units in fact have the health care component

within them, and we'll await that information — and also the rent supplement

side.

Now, the

question earlier was about how many more independent living units are being

requested at this time. The former minister of state had advised it was 1,941.

My question to the minister is: what is that number now?

Hon. C.

Hansen: The degree of certainty that we have is around those that are,

obviously, open and those that have been tendered and are actively under

completion. For those that will be rolling out, there is no hard definition now

to say there's going to be X number of a certain number of units. That is part

of the flexibility that the health authorities are still working with.

I know of

cases, for example, where they have gone out for an expression of interest

around the building of an assisted-living unit only to find out that somebody in

the community has a facility that would lend itself to conversion. They need

that kind of flexibility, because at the end of the day it's not just about

building buildings; it's about making sure the needs in the community get met.

That's what's driving the health authorities in this planning process.

I don't

have a hard number for how many units aside from those that are tendered are in

fact going to

[ Page 8962 ]