Manitoba Committee Hansard — 9 June 2004 (Social and Economic Development Committee, Sitting 05, 38th Legislature, 2nd Session)

38-2-sed05

Manitoba — Debates (Hansard)

Second Session - Thirty-Eighth Legislature of the Legislative Assembly of Manitoba Standing Committee on Social and Economic Development Chairperson Ms. Marilyn Brick Constituency of St. Norbert Vol. LV No. 5 - 6:30 p.m., Wednesday, June 9, 2004 ISSN 1708-6698

MANITOBA LEGISLATIVE ASSEMBLY Thirty-Eighth Legislature Member Constituency Political Affiliation AGLUGUB, Cris The Maples N.D.P. ALLAN, Nancy, Hon. St. Vital N.D.P. ALTEMEYER, Rob Wolseley N.D.P. ASHTON, Steve, Hon. Thom pson N.D.P. BJORNSON, Peter, Hon. Gimli N.D.P. BRICK, Marilyn St. Norbert N.D.P. CALDWELL, Drew Brandon East N.D.P. CHOMIAK, Dave, Hon. Kildonan N.D.P. CUMMINGS, Glen Ste. Rose P.C. DERKACH, Leonard Russell P.C. DEWAR, Gregory Selkirk N.D.P. DOER, Gary, Hon. Concordia N.D.P. DRIEDGER, Myrna Charleswood P.C. DYCK, Peter Pembina P.C. EICHLER, Ralph Lakeside P.C.

FAURSCHOU, David Portage la Prairie P.C. GERRARD, Jon, Hon. River Heights Lib. GOERTZEN, Kelvin Steinbach P.C. HAWRANIK, Gerald Lac du Bonnet P.C. HICKES, George, Hon. Point Douglas N.D.P. IRVIN-ROSS, Kerri Fort Garry N.D.P. JENNISSEN, Gerard Flin Flon N.D.P. JHA, Bidhu Radisson N.D.P. KORZENIOWSKI, Bonnie St. James N.D.P. LAMOUREUX, Kevin Inkster Lib. LATHLIN, Oscar, Hon. The Pas N.D.P. LEMIEUX, Ron, Hon. La Verendrye N.D.P. LOEWEN, John Fort Whyte P.C. MACKINTOSH, Gord, Hon. St. Johns N.D.P. MAGUIRE, Larry Arthur-Virden P.C. MALOWAY, Jim Elmwood N.D.P. MARTINDALE, Doug Burrows N.D.P. McGIFFORD, Diane, Hon.

Lord Roberts N.D.P. MELNICK, Christine, Hon Riel N.D.P. VACANT Minto MITCHELSON, Bonnie River East P.C. MURRAY, Stuart Kirkfield Park P.C. NEVAKSHONOFF, Tom Interlake N.D.P. OSWALD, Theresa Seine River N.D.P. PENNER, Jack Emerson P.C. REID, Daryl Transcona N.D.P. REIMER, Jack Southdale P.C. ROBINSON, Eric, Hon. Rupertsland N.D.P. ROCAN, Denis Carman P.C. RONDEAU, Jim, Hon. Assiniboia N.D.P. ROWAT, Leanne Minnedosa P.C. SALE, Tim, Hon. Fort Rouge N.D.P. SANTOS, Conrad Wellington N.D.P. SCHELLENBERG, Harry Rossmere N.D.P. SCHULER, Ron Springfield P.C. SELINGER, Greg, Hon. St. Boniface N.D.P. SMITH, Scott, Hon.

Brandon West N.D.P. STEFANSON, Heather Tuxedo P.C. STRUTHERS, Stan, Hon. Dauphin-Roblin N.D.P. TAILLIEU, Mavis Morris P.C. VACANT Turtle Mountain WOWCHUK, Rosann, Hon. Swan River N.D.P.

207 LEGISLATIVE ASSEMBLY OF MANITOBA THE STANDING COMMITTEE ON SOCIAL AND ECONOMIC DEVELOPMENT Wednesday, June 9, 2004 TIME – 6:30 p.m. LOCATION – Winnipeg, Manitoba CHAIRPERSON – Ms. Marilyn Brick (St. Nor- bert) VICE-CHAIRPERSON – Mr. Bidhu Jha (Radis- son) ATTENDANCE - 11 – QUORUM - 6 Members of the Committee present: Hon. Ms. Allan, Hon. Messrs. Chomiak, Sale, Selinger Ms. Brick, Mrs. Driedger, Messrs. Faurschou, Jha, Mrs. Mitchelson, Ms. Oswald, Mr. Schuler APPEARING: Hon. Jon Gerrard, MLA for River Heights Mr. Leonard Derkach, MLA for Russell WITNESSES: Bill 39–The Residential Tenancies Amendment Act Ms.

Debbie Penner, Manitoba Park Owners Association Bill 48–The Human Tissue Amendment Act Mr. Christopher Snow, Director, Quality Management, Research and Development, Tissue Bank of Manitoba Bill 43–The Personal Health Information Amendment Act (Spiritual Health) Ms. Susan Skinner, Association for Healthcare Philanthropy Ms. Val Coward, Executive Director, St. Boniface Hospital and Research Foundation Mr. Andrew Ogaranko, Faith Coalition, Interfaith Health Care Association of Manitoba, Manitoba Interfaith Council, Canadian Association for Pastoral Practice and Education Ms.

Kathleen Rempel Boschman, Director of Spiritual Care, Bethania Mennonite Personal Care Homes Inc., Concordia Hospital Bill 45–The Engineering and Geoscientific Professions Amendment Act Mr. Dave Ennis, Executive Director and Registrar, Association of Professional Engineers and Geoscientists, Province of Manitoba Ms. Veronica Jackson, Manitoba Association of Architects Mr. Terry Danelley, Private Citizen Mr. Don Oliver, Private Citizen Mr. Guy Prefontaine, Gaboury, Prefontaine and Perry Architects Mr. Andrew Bickford, AGB Architecture Mr. David Penner, Private Citizen Mr. Arnold Permut, Private Citizen Mr.

John Woods, Private Citizen Mr. Steve Cohlmeyer, Private Citizen Mr. Brian Stimpson, Faculty of Engineering, University of Manitoba Mr. Raymond Wan, Raymond S.C. Wan Architect Mr. Kelly Baumgartner, Private Citizen Mr. Francis Pineda, Private Citizen Ms. Judy Pestrak, Private Citizen MATTERS UNDER DISCUSSION: Bill 39–The Residential Tenancies Amendment Act Bill 43–The Personal Health Information Amendment Act (Spiritual Health) Bill 45–The Engineering and Geoscientific Professions Amendment Act Bill 48–The Human Tissue Amendment Act *** Madam Chairperson: Good evening.

Will the Standing Committee on Social and Economic Development please come to order.

208 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 This evening, the committee will be considering the following bills: Bill 39, The Residential Tenancies Amendment Act; Bill 43, The Personal Health Information Amendment Act (Spiritual Health); Bill 45, The Engineering and Geoscientific Professions Amendment Act; Bill 48, The Human Tissue Amendment Act. We do have presenters registered to speak to Bills 39, 43, 45 and 48. It is the custom to hear public presentations before consideration of the bills.

Is it the will of the committee to hear public presentations on this bill? [Agreed] I will then read the names of the persons who have registered to make presentations this evening: On Bill 39, The Residential Tenancies Amendment Act, Debbie Penner, Manitoba Park Owners Association. On Bill 43, The Personal Health Information Amendment Act (Spiritual Health), Susan Skinner, Association of Healthcare Philanthropy; Val Coward, St.

Boniface Foundation; Andrew Ogaranko, Faith Coalition (Interfaith Health Care Association of Manitoba, Manitoba Interfaith Council, Canadian Association for Pastoral Practice and Education); Rev. Kathleen Rempel Boschman and Henry Tessman, Concordia Hospital.

On Bill 45, The Engineering and Geoscientific Professions Amendment Act, Dave Ennis, Association of Professional Engineers and Geoscientists of Manitoba; Veronica Jackson, Manitoba Association of Architects; Terry Danelley, private citizen; Don Oliver, private citizen; Guy Prefontaine, Gaboury, Prefontaine and Perry Architects; Andrew Bickford or Arnold Permut, AGB Architecture; David Penner, private citizen; Allan Silk, private citizen; John Woods, private citizen; Steve Cohlmeyer, private citizen; Brian Stimpson, professional engineer, Faculty of Engineering, University of Manitoba; Ray Wan, Raymond S. C.

Wan Architect; Kelly Baumgartner, private citizen; Richard Prince, private citizen; Francis Pineda, private citizen; Mike Fritschij, private citizen; Judy Pestrak, private citizen. On Bill 48, The Human Tissue Amendment Act, Christopher Snow, Tissue Bank of Manitoba. Those are the persons and organizations that have registered so far. Is there anyone else in the audience that would like to register or has not yet registered and would like to make a presentation? Would you please register at the back of the room. Just a reminder, 20 copies of your presentation are required.

If you require assistance with photocopying please see the Clerk of this committee. I understand we have some out-of-town presenters in attendance th is evening. These names are marked with an asterisk on the presenters' list. Is it the will of the committee to hear from out-of-town presenters first? An Honourable Member: Yes. Madam Chairperson: I would like to inform presenters in accordance with our rules, a time limit of 10 minutes has been allotted for presentations and 5 minutes for questions from committee members.

As well, in accordance with our rules, if a presenter is not in attendance, their name will be dropped to the bottom of the list. If the presenter is not in attendance when their name is called a second time, their name will be removed from the presenters list. I would also like to advise all in attendance in accordance with our rules if there are fewer than 20 persons registered to speak at 6:30 the committee may sit past midnight. I would like to advise that as of 6:30 there are 22 persons registered to speak. Therefore, unless unanimous consent of the committee is given, the committee must rise at midnight.

Is there unanimous consent for the committee to sit past midnight? [Agreed] Just prior to proceeding with public presentations, I would like to advise members of the public of the process when it comes time for ques- tions from committee members on your presentation. The proceedings of our committee meetings are recorded in order to provide a verbatim transcript. Each time someone wishes to speak, whether it be a member of the committee or a presenter, I have to first say the MLA's or the presenter's name. This is the signal for the Hansard recorder to turn your mike on and off. Thank you for your patience.

We will now proceed with public presentations. Hon. Dave Chomiak (Minister of Health): I am just wondering if there might be leave of the

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 209 committee. I notice we are going in numerical order of the bills. I notice the last bill has only one presenter. I wonder if, in sofar as it might expedite matters, whether it would be appropriate to have the Bill 48 presenter moved ahead of Bill 45 insofar as there are 15 presenters, so the individual does not have to wait until the very end. I assume I am looking for leave to do that following out-of-town presenters. Mrs. Bonnie Mitchels on (River East): I was wondering if we might extend that a bit.

I notice there is only one presenter, which is an out-of-town presenter, on Bill 39 and one on 48, whether we could go 39, 48, 43, and 45, just to try to expedite the process and not hold anyone any longer than they need to be here. Thanks. [Agreed] Madam Chairperson: That being the will of the committee, we will then proceed with Bills 39, 48, 43 and 45. Bill 39–The Residential Tenancies Amendment Act Madam Chairperson: The first bill we will be hearing is Bill 39, The Residential Tenancies Amendment Act. Debbie Penner, Manitoba Park Owners Association. You may proceed, Ms. Penner. Ms.

Debbie Penner (Manitoba Park Owners Association Incorporated): The Manitoba Park Owners Association Incorporated is a provincial association that represents the interests of many Manitoba-based mobile home park operations. Parks throughout Manitoba f ace a number of regulatory problems that led to the creation of this association in order to be able to present a united front to the government in seeking fair and equitable resolution of the problems. We appreciate the opportunity to speak to you today regarding Bill 39, The Residential Tenancies Amendment Act. * (18:40) My comments today are primarily directed to

section 1, 1.3 to 1.6. These changes to The Residential Tenancies Act are the first step in the right direction in creating a fair resolution for park owners. I would like to express our appreciation to the Honourable Greg Seli nger for analyzing the circumstances and being committed and making these proposed changes to better mobile park operations. The changes allow park owners to pass on the property taxes, licensing fees for mobile homes not owned by the landowners and to have a regulated way to obtain judgements if these amounts are not paid.

We have 21 parks as members of our association, 4 of which are being assessed. The remainder of the parks are still on licensing fees. The municipalities who have by-laws allowing them to increase the licensing fees are increasing the licensing fees every year, which currently, from the examples I have seen are over the allowed rent increases amount, leaving the park owners nothing for the inflation increase allowed annually through Residential Tenancies Branch. The parks that are currently being assessed, the taxes change with every municipal budget and, in some cases, have increased as high as 7 percent.

With these proposed changes, we will be able to separate rent from taxes and apply the increases for property taxes, licensing fees directly to the homeowners. We are in favour of Bill 39. Madam Chairperson: Thank you very much, Ms. Penner. Are there questions for Ms. Penner? Mr. David Faurschou (P ortage la Prairie): I would like to know how many jurisdictions or how many municipalities are still linked to the licensing avenue for garnering revenues for mobile homes parks. Ms. Penner: Right now, we have 17 that are part of our association that are still under the licensing fee system.

I am not aware of how many are throughout Manitoba. I just know from the members who are part of the association at this point. Mr. Faurschou: Is there indication these municipalities are going to change their way of assessment from licensing to property-based assessment for the revenues taken from the park owners? Ms. Penner: From what my understanding is, Intergovernmental Affairs will and are encouraging all the municipalities to change over to assessment. I think there is a bill right now that is being heard tonight also. I cannot comment on what the municipalities plan on doing in the future.

210 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 Mr. Faurschou: I was just trying to garner a trend line as to whether that is the trend, whether more municipalities have been changing over from the licensing aspect to an assessment-based assessment for garnering fees of operat ion. Further to that, I was wondering: Is this the greatest impediment to expansion within your industry? I know it is a slow growth industry as far as mobile home parks throughout the province and has this been the primary impediment to th at establishment of new parks? Ms.

Penner: Well, my comment would be, I think, because now the mobile home or the manufactured housing industry has come up to age, the homes are built the same as site-built homes, and it is becoming more of an affordable housing and alternate living solution for a lot of people. The changes in the legislation, I cannot comment on that. I basically represent the park owners and what they do with the legislation, I do not know the background on why they are doing this or what the ultimate plan will be. Madam Chairperson: Thank you very much, Ms. Penner. Hon.

Greg Selinger (Minister of Finance): I would just like to thank you for coming out tonight and making a representation on this. I know this is not the whole solution to some of the issues you face, but it allows for at least the pass through of taxes and licensing fees and gives you a remedy in case they are uncollectible. I know you work closely with our staff on that so I appreciate that. I think we have a solution that at least makes things a little easier for your association. Thank you. Ms. Penner: Thank you very much.

Bill 48–The Human Tissue Amendment Act Madam Chairperson: We will now hear public presentations on Bill 48, The Human Tissue Amendment Act. Christopher Snow, from the Tissue Bank of Manitoba. Thank you very much, Mr. Snow. Do you have copies of your presentation to distribute? Mr. Christopher Snow (Director, Quality Management, Research a nd Development, Tissue Bank of Manitoba): Yes. Madam Chairperson: Please proceed whenever you are ready. Mr. Snow: My name is Christopher Snow, Director of Quality Management, Research and Development for Tissue Bank Manitoba, and I wish to speak in favour of the legislation.

Approval of organ and tissue donation is almost unanimous among Canadians. A recent Environics poll has shown 93 percent of Canadians either strongly or somewhat approve of it. The poll also reports 40 percent of Canadians say they have signed their donor cards or registered as an organ donor, and a large majority, 88 percent, say they have discussed their wishes with their family. However, actual donation rates particularly in Manitoba, are not consistent with these numbers.

Consequently, Canada continues to face a shortage of organ and tissue donors in relation to the number of recipients in need of life-saving and life-enhancing donations. In our opinion, one of the main reasons for low donation rates in Manitoba has been the lack of resource allocation to organ and tissue donation efforts. While most Manitobans are in favour of organ and tissue donation, and many of them would be eligible for one or more donation options, very few potential donor families are actually given the opportunity to consider donation at the time of a loved one's death.

Family opinions are important because even if there is signed documentation indicating a person's wishes, such as a donor card, it is common practice for the next of kin to have the final say on donation. It is they who must sign the consent for donation. That is why those who have made a decision about organ and tissue donation should share their decision with their family. Another reason for low donation rates is the current, outdated legislation governing donation.

Current legislation puts the onus on the attending physician to consider donor eligibility and to approach families for consent, but this rarely happens, at least in the case of tissue donation, and is indeed inappropriate in most cases because of the numerous and significant changes that have occurred in the organ and tissue donation fields over the last decade which now require specially trained personnel to perform these functions adequately and for consent to be informed. * (18:50)

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 211 In order to help solve the first problem of lack of resources, the Winnipeg Regional Health Authority, in April 2003, created a new human tissue gift agency called Tissue Bank Manitoba, with a vision of relieving human suffering by providing human allograft tissue to restore health, and with a vision to provide accessible, quality allograft tissue for transplantation, education and research. When we talk about tissue, we mean skin, bones, tendons, ligaments, heart valves, veins and arteries.

Allografts are components derived from tissues which have been processed and prepared for transplantation according to predefined specifications. A recent report from the Canadian Institute for Health Information estimates the annual demand in Canada for allografts to be from 34 000 to over 62 000 grafts.

The establishment of Tissue Bank Manitoba builds on the already established human tissue gift agencies in the province, those being the WRHA's organ donation and transplant program, and the Lions Eye Bank of Manitoba and Northwest Ontario, by increasing the number of donation options available to Manitobans and by increasing the likelihood those Manitobans who wish to donate will be able to do so. The second problem would be solved with the passage of these amendments to The Human Tissue Act, which are now before you.

These amendments will ensure that as many Manitobans as possible will be considered for the option of tissue donation in a timely manner, and families of eligible donors will have their donation options explained to them by appropriately trained and qualified health care professionals. Madam Chair, these amendments will also provide clarification of the issue of remuneration and recovery of expenses as it relates to human tissue gift agency operations, including the cost of education, research and development.

Tissue Bank Manitoba is committed to working closely with the other two human tissue gift agencies and designated facilities to ensure optimal co- ordination of donation efforts. We are also com- mitted to increasing tissue donation awareness in the general public and health care providers through our education and promotion programs. In this context we encourage all of you and all Manitobans to sign your donor cards and even more importantly to share your decision with your family. Thank you. Madam Chairperson: Thank you very much, Mr. Snow. Does the committee have questions for Mr. Snow? Mrs.

Myrna Driedger (Charleswood): Thank you, Mr. Snow. I appreciated the presentation. Two questions, I guess. I realize that donation rates are not anywhere near what we would like to see across this whole country and it has been a problem for some time and that it is very difficult for doctors and nurses to be in positions of making the ask. I like how this has been streamlined in order to address that. Two things, would you recommend anything else that maybe could be or should have been looked at or could be down the road to strengthen this bill even further?

The second question is are there any problems that you still see in the bill the way it is set up? Mr. Snow: Well, nothing is perfect. You can always refine things, but as far as we can tell there is nothing significant that needs refinement in the bill with the amendments at this time.

Certainly, down the road there are more aggressive op tions to look at if these particular amendments are not as effective as we would like, but other jurisdictions have found that the step of routine referral which will be brought forward with these amendm ents has a significant impact in increasing the number of families that can be offered the option of donation. That might be suffice One of the things that we are looking at for the not-too-distant future is a donor registry which has been used successfully in other jurisdictions, especially if it is an online registry where people at any time can sign up.

Obviously, if the health care system has the necessary information technology to access that information quickly, that would certainly be a useful tool to add. I do not know, necessarily, that we would need legislative changes to do that, but there would be a cost to that, for sure. Hon. Dave Chomiak (Minister of Health): Yes. I just wanted to thank you for coming out and making the presentation.

I want to thank the Lions Bank, the WRHA and the Tissue Bank fo r your efforts to put this together and take this through the process and also my people in the Legislature for helping expedite this matter because of the significant impact it has on all Manitobans. So thank you and I thank my colleagues in the Legislature as well.

212 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 Madam Chairperson: Thank you very much, Mr. Snow. Bill 43–The Personal Health Information Amendment Act (Spiritual Health) Madam Chairperson: The next bill the committee will be hearing presentations on is Bill 43, The Personal Health Information Amendment Act (Spiritual Health). Our first presenter is Susan Skinner, the Association of Healthcare Philanthropy. Ms. Susan Skinner (Association of Healthcare Philanthropy): The presentation is actually a joint presentation of Val Coward and myself.

I wonder if the piece that I am handing out includes both pieces, and I am wondering if– Madam Chairperson: Is Ms. Coward here? Ms. Skinner: She is here. Yes. Madam Chairperson: She could come up beside you. Ms. Skinner: We could do that as a joint trade-off at some point and the questions could be held until it is complete. Is that all right? Madam Chairperson: Absolutely. Do you want it as a joint presentation, or do you want it as separate presentations? Ms. Skinner: A joint would be fine. She will do one piece of it, but I happen to be the biggest piece.

Madam Chairperson: If that is the will of the committee to hear this as a joint– [Agreed] Agreed. Thank you. So I will be recognizing you each sort of separately so that Hansard has that documented accurately. Ms. Skinner: Thank you. Okay, we will stop when she comes on, but mine will probably be a little bit longer. Madam Chairperson: Okay. Ms. Skinner, you can proceed whenever you are ready. Ms. Skinner: Thank you so very much. Thank you for the opportunity to present to this committee representing the people.

I first would like to introduce you to the Association for Health Care Philanthropy and tell you who we represent. It is a not-for-profit organization with more than 3500 members. More than 1900 are from the largest health care facilities in the United States and Canada. Headquarters is located in Washington. There are over 400 members in Canada and Manitoba, of course, has repre- sentation. I sit as the prov incial representative on the AHP Cabinet.

AHP members in Manitoba respect the confidentiality of private information through the AHP Statement of Professional Standards and its companion Donor Bill of Rights which are endorsed by members when they join our association. They are appendices in the piece that we have given you. AHP Manitoba commends our Manitoba government for moving forward with specific emphasis in ensuring that protections are in place for personal health care information.

This kind of legislation is critical for patients, providers and institutions to protect the privacy of personal information with which data custodians are entrusted and serves to inspire pu blic confidence in the information management practices.

While we support the principles of health privacy legislation for the province of Manitoba and specifically Bill 43, as amended, to represent holistic health care and the importance of the spirit in healing and wellness, we welcome a process of consultation in order to improve the legislation to allow the relationship of health facility and donor to continue to grow in order to advance health care in Manitoba. Central to this effort is the "grateful patient" program, and we will refer to that later. For your information, I have just come back from a conference about one o'clock a.m. eastern time, in the morning.

In 1967, there were 35 000 charities registered. In 2003, there are 80 819. The not-for-profit business and charities is a significant factor and I think that is part of our issue, the recognition of the charitable sector. In the United States, it represents 800 000 charities. Twenty percent of the individual support from Canadians is for health care. In the U.S. that represents 240 billion. We do not have the U.S.

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 213 numbers. I think it is a sector worth considering. Fundraising is a critical component of health care in Manitoba. We believe the legislation should address the role of the charitable sector. AHP understands and respects the principle of ensuring that confidential health care information remains private, however legislation which deals specifically with privacy and protection of an individual's personal health information has significant impact on fundraising activities in health care organizations.

The Personal Health Information Act, PHIA, impedes the functioning of foundations and government in their mutual quest to increase private funding for the advancement of health care. * (19:00) PHIA was drafted, Madam Chair, without consultation or consideration of the impact on philanthropy, specifically patient solicitation. Yet patient solicitation is a major source of non- governmental revenue for hospitals and health care organizations across Canada. Without patient financial support, governments and hospitals will face a crisis in health care funding.

Increasingly, fundraising initiatives are critical in supporting increased health care funding and needs to meet and promote a better co-ordination of care and wellness and enhance and sustain quality health care. We believe legislation should not be constructed in a manner that places unnecessary roadblocks in the way of philanthropic efforts that are desperately needed to pave the way for an improved and stronger system.

We believe there is a way to amend or, and I would like to say, reinterp ret or clarify the current PHIA legislation and to maintain the original focus and intent while acknowledging and addressing the unique role of the non-profit sector and the unique needs that charities have in their funding requirements. Existing PHIA legislation creates a barrier to connection with key constituents, the individuals and families who use health care services. These barriers must be lifted in order fo r health care facilities to develop and maintain these relationships.

Val will talk to you about our response to tell us what you think. I thought it would be interesting for you to know that regarding PIPEDA, the Privacy Commissioner of Canada has released a fact sheet that confirms that fundraising is not considered a commercial activity and therefore subject to PIPEDA. In Manitoba, the he alth care system has benefited through philanthropy for well over $25 million a year. It is a vital component. As fiscal challenges for health care services increase, so does the need for alternate sources of funding. To augment resources for health care in Manitoba is critical.

It is critical that the public and private sectors work in tandem. Philanthropy is a lynchpin to enabling health care changes to occur in a seamless and smooth fashion. Rules and funding formulas are changing. Communities and their health care facilities, privately, are being asked more and more to make up the differences in major project costs, a new approach. Demands upon health care fundraisers continue to increase while present PHIA legislation has hampered the efforts of health care foundations to achieve much-needed fundraising targets.

Tools have been removed while targets and the need for co- operation increase. We believe that legislation should not be constructed in a manner that places unnecessary roadblocks in the way of philanthropic efforts that are desperately needed to pave the way for an improved and stronger health care system. The impact of philanthropy in health care goes well beyond bricks and mortar. In teaching hospitals, partnerships have flourished with various faculties of health sciences. Other funds are at work in community hospitals, providing seed money for new programs.

Community outreach, educational and preventative seminars on health care issues are often hosted by foundations. Requests to support research infrastructure is increasing at a time when we should be supporting the work of scientists and clinicians. Communications from development offices and related foundations seek to both educate the community as well as generate– Madam Chairperson: Ms. Skinner, can I just stop you for one moment? Can I have leave of the

214 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 committee to allow this presentation to go longer than 10 minutes in consideration of the fact that it is two presentations in combination? [Agreed] You can continue. Ms. Skinner: Thank you so much. Through health care development programs, the community is afforded a viable partnership with the health care system. The effects of privacy legislation: Successful philanthropic programs are donor-centered. This means that charities seek to develop long-term meaningful relationships with their supporters. True philanthropy is not transaction-based. It is

an act of caring through sharing and is relationship-based. Philanthropy is based on values and development which often our departments are called uncovers those values. Barriers to relationship development have been detrimental to the philanthropic sector resulting in significant and increased admin. costs, greater costs per dollar raised, and lower net funding to health care programs. Grateful patients and their families create the largest single pool of health care supporters. Just by way of clarification on that, it makes sense that you would talk to the people who have been using your services.

They would be most inclined to support you, as opposed to a general mail-out to the entire province. There are people who are linked more closely to one institution. There is a definition of grateful patient. It is in the piece that I have given you. I will not get into it. It obviously means people who use the system. It is important to note that good practices affect us to in fact eliminate people without mental capacity, abortions, significant issues that may be emotional and/or difficult, so those people are not considered when solicitations are involved, or children.

There is a piece that ha s the legislative overview. The bill was passed in 1997. The night before the bill was passed, or the day before, we spoke with the minister, who recognized at that point an amendment would be necessary and required. The philanthropic sector was not considered. Consideration was given there. We did, in fact, employ several methods afterwards of working through the system. Consent is one. We will tell you it does not work. We feel it is not ethical to ask for consent upon entry into the health care system. People are already under duress. It is a very, very difficult time to ask people.

They feel like they will not be treated fairly unless they sign. During treatment is also inappropriate and puts stress on the health care provider as well as the patient who is there. Madam Chairperson: Ms. Skinner, I would like to inform both of you that you have now reached 10 minutes, just so you are aware. Ms. Skinner: Thank you. We feel discharge is equally bad. Especially with the advances in medicine now, we are shooting people out of our health care facilities very, very quickly. They are not necessarily completely healed.

Also, having a system uniform and consistent would be difficult among the various institutions. I will conclude that, while we strongly endorse the need to protect the privacy of our patients and foster the development and implementation of clear policies in this regard, we also must underscore the need to ensure that our ongoing efforts to support our health care system are not jeopardized by unworkable laws. We have several guiding principles. We believe the intent of PHIA legislation is to protect an individual's right to privacy, not to prevent their basic right to choose.

We believe all Manitobans have a basic right to express their appreciation for treatment received at our health care facilities in a tangible fashion. We believe legislation should acknowledge and address the unique role of the charitable sector and the unique needs charities have, in order to respond to community needs. There are several recommendations: One, that an amendment should be enacted to allow hospitals, health centres and long-term care facilities to extend to patients, residents and their families the freedom to choose to provide support to a health care facility.

Secondly, that creating provision for ethical first contact with a potential donor by health care facilities and/or their charitable foundations, while maintaining the integrity and conceptual focus of privacy legislation, is possible. Next, that an amendment to the legislation be approved that removes the penalty for hospitals using

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 215 the names of former patients for charitable purposes of donating and supporting health care in Manitoba as an expression of one's choice where a relationship is evident. Next, that charitable pur poses be considered an acceptable use for basic information for a health care institution and their foundation. Next, that demographic information be approved for purposes of fund raising. I am now going to pass this over to Val Coward, and we will entertain questions following her piece. Hers is responding specifically to the PHIA. Madam Chairperson: Thank you very much.

Ms. Coward, do you have information you would like to distribute? Ms. Val Coward (Executive Director, St. Boniface Hospital and Research Foundation): It is included in the package. Madam Chairperson: Thank you. Please proceed. Ms. Coward from St. Boniface Foundation. Ms. Coward: Thank you very much. I welcome the opportunity to present to you today. Susan stole most of my thunder, so my comments are going to be very short. I wanted to say we believe, as part of philanthropy, that we are partners in the health care system in Manitoba, and we are proud to be partners.

Philanthropy is an expression of a civilized society. We work closely with individuals who either volunteer to support health care institutions and the donors who are very grateful for the services that they get. As Susan indicated, in December 1997, PHIA was passed into legislation without direct consul- tation, actually I believe, honestly not realizing what the impacts were going to be on health care philanthropy. * (19:10) I want to just touch on a couple of points in the scope of the questions: What do we think? Do we feel the definition of the personal health information is appropriate?

Personal health information as described in PHIA is reco rded as information about "identifiable" individual that relates to: (1) the individual's health, health care history, including genetic information about the individual; (2) the health care provided to that individual and payment for health care provided to that individual. The question of what makes individual identifiable is at issue here. Clarification also is required on the second point.

Fundraisers require only basic information regarding an individual (name, address), not identifying information about their health complaint or services they received. The division of the information under The Personal Health Information Act, under demographic or diagnostic, is very much supported by AHP and all our colleagues because, as good stewards of privacy with our own donors, we do not believe it is our responsibility to have any of that information. In fact, in the system that is used under a grateful patient program, our other foundations do not see the information until the donor has made a donation.

So that information is only passed on to us once there has been consent given through a cheque, through a donation. The elements of consent from the trustee's perspective, collection of consent for charitable purposes at entry, have just proven to be dismal. Our hospital, for instance, would not even entertain the concept of asking a patient on admittance whether we could ask them for a charitable gift following, and most institutions were the same. Those who attempted it through the entry process found that it just was not workable, not comfortable and did not meet our ethical guidelines.

We believe that a grateful patient program offers an automatic consent or an opt out. A person can always file a request under G. I think the general role of the Ombudsman is the other point that we wanted to really restate. Well, the statement is that the role is not to respond to complaints, but to avoid breaches in assisting trustees and assessing and monitoring their own health information policies and practices. We feel that the Office of the Ombudsman has been forced to take a role in interpreting the legislation, and we ask that you attempt to clarify the legislation.

Clarification of this act regarding philanthropy, use

216 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 of the information, is also required and is stated rather than an expressed one. Exercising the Rights of Another Person. Within the health care institution, those who are minors, who have mental incapacity, abortions, aged, those who are otherwise incapable of making sound decisions are excluded from any solicitation by the trustee itself. For many years it has been a practice of the solicitation of the grateful patient model to a lot of success for our institutions. Madam Chairperson: Thank you very much. Hon.

Dave Chomiak (Minister of Health): I want to thank you both for the presentation. I have a comment and a question. First is the comment. Perhaps all the members of the Legislature should be made aware of the fact that there was a mandatory five-year review of PHIA that was undertaken. I have just looked through the list of presenters, and I take it that the presentation you have made today by both of you has also been made to the PHIA committee. Am I correct in that? Ms. Coward: That is correct. Mr.

Chomiak: I also take it that, notwithstanding that presentation, your recommendation today is to further amend PHIA in line with the recommendations you made to both the committee and your presentation today, although you are supportive of the amendment that we are making today which is Bill 43. Is that correct? Ms. Coward: That is correct. Mr. Chomiak: I just wanted to provide that for members of the committee so that there is a rubric under which they can understand, perhaps will guide members in terms of posing their questions in this regard.

I will close by saying that the point made by you in terms of the gifting program, in terms of the consent or non-consent, et cetera, is similar to some other issues raised by other groups who have concerns with PHIA legislation, and we saw a fairly significant number of presenters. Now I guess that is not a question to you but I am just making an assertion for members of the committee. Thank you. Mrs. Myrna Driedger (Charleswood): Thank you very much, Val and Susan.

I do want to commend the work of hospital foundations and other foundations for the value of the work, the valuable contributions that are made to health care. It really has become a significant segment of health care, especially as health care funding becomes more and more challenged down the road you are going to continue to face formidable challenges in the future. I think that your requests today and your suggestions are very reasonable and I hope there is an openness for a consideration of all of that. I would like to pose a question to you. You have been living now with the PHIA legislation for some time.

What kind of decreases in donations have you seen over the past few years? Have you been able to put any price tag on that and, therefore, the effect that might have on what you are not able to do? Ms. Coward: I can answer for our foundation. All foundations have looked at this. I took an example of two years, 1995 and '96, complete years before the legislation came into effect, and the long-term effect of those past patients to that solicitation to our hospital. The gifts from those patients, I want to be really clear that I am not overstating this, is $560,000 from two years, from 800 past patients.

In five years I could easily project that we are down about a quarter of a million dollars a year in revenue to the St. Boniface Research Foundation because of that. Mrs. Driedger: How are you managing to raise donations now if you are not able to solicit your clients? Madam Chairperson: Ms. Coward, and just to be respectful of the process, you have about 45 seconds to answer. Ms. Coward: What we have to do now is solicit the masses so we use household mailings which are extremely expensive, drop a letter to the entire community and actually lose money on that to be able to obtain donors.

We have not been able to develop anything that we believe is ethical to be able to do within the institutions ourselves. Madam Chairperson: Doctor Gerrard, and you will have to be really brief. Hon. Jon Gerrard (River Heights): Thank you. I have had an opportunity to meet with you before and

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 217 certainly am supportive of your effort. How urgent would you say this is? Ms. Skinner: We are behind already. We have lost a lot. In trying consent I think, to date, I have 800 to process– Madam Chairperson: At this point, I am sorry I will have to conclude the questions. I thank you very, very much for your presentations. Mr. Ogaranko from the Faith Coalition of the Interfaith Health Care Association of Manitoba, the Manitoba Interfaith Council and the Canadian Association for Pastoral Practice and Education. You may proceed, Mr.

Ogaranko, whenever you are ready. * (19:20) Mr. Andrew Ogaranko (Faith Coalition, Interfaith Health Care A ssociation of Manitoba, Manitoba Interfaith Council, Canadian Association for Pastoral Practice and Education): Good evening and thank you so much for giving us this opportunity to present to this committee our support for Bill 43. I am here this evening on behalf of the Interfaith Health Care Association of Manitoba, the Manitoba Interfaith Council and the Canadian Association for Pastoral Practice and Education. With me as well this evening is Rev.

Douglas Longstaffe, who is representing MIC and CAPPE in these proceedings here today. This group has come together as a national faith coalition. Its purpose was to provide a unified position on how spiritual care and religious care issues should be addressed in the context of the health care system.

You should be aware that the coalition represents all of the faith-based hospitals, personal care homes and primary care facilities in the province and with that all major faith groups in the province including Hebrew, Catholic, Hindu, Muslim, Lutheran, United, Pentecostal, Presbyterian, Orthodox, Mennonite, Anglican, Buddhist and Aboriginal. The coalition has been working long and hard for changes to PHIA legislation. It has sought and received the endorsement and support of a very broad base of individuals, churches, religious organizations, facility boards and religious leaders.

In fact, as part of th eir efforts prior to the commencement of the PHIA review process, over 7500 persons, we have 7385, there have been petitions and letters subsequently, well over 7500 individuals have lent their support to the advocacy that the faith coalition has been doing. So what is the objective? Mainly it is to make it clear in PHIA, as contemplat ed by Bill 43, that there is some recognition that spiritual health is an integral part of health.

The objective of the amendments would be to conclude a debate that has arisen lately where spiritual care worker s who are employees and agents of facilities can continue to access patient information on the same basis as other employees or agents, such as physicians, nurses or allied health care professionals. That on the one hand, and on the other hand is to provide that religious visitors, clergy persons designated by a particular faith can, unless the patient objects, receive the basic information that they need so that they can provide the religious services that the patient may require or want.

So the issue is how privacy laws and, in particular, PHIA affects, on the one hand, the ability of these spiritual care work ers, who are very highly trained professional individuals from all faiths and cultures, to access patients and how they can provide spiritual care to those patients, and, on the other hand, the ability of religio us care workers such as clergy or visitors designated by denomination to access patients of their own denomination and provide religious care. The Minister of Health (Mr.

Chomiak) and his deputy, in letters to regional health authorities and health care facilities and administrators, have acknowledged that the Department of Health is definitely committed to the concept of holistic care in the province of Manitoba as an approach to health care. There is a recognition that spirituality is a very important dimension of that health care, that spiritual care workers are integral members of the health care team. They have gone so far as to commit resources to training and establishing a spiritual care co- ordinator position. However, the regrettable

part is that the government's sentiments are not universally accepted. Spiritual care is not expressly and

218 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 distinctly mentioned in PHIA. It is recognized only implicitly as a subset of either physical health on the one hand or mental health on the other hand. In other words, it is a care or service which is offered to treat mental or physical health as the act currently is. It is not considered as a component of health in its own right, and even this implicit recognition has been challenged on some occasions as we have had with a very narrow and troubling

interpretation of the legislation in this regard from the Ombudsman's office. Although we believe the Ombudsman is mistaken in law, nevertheless, there was a signal sent with the

interpretation that came out of that office to the RHAs and facility administrators which resulted in an environment of what we consider, PHIAnoia. It is a situation where privacy officers are the ones who are dictating to physicians and other health care workers what health information they require or make available to them in order to manage the risks of patient care which can result from such interference. In our view there is no necessary conflict between a robust protection of individual privacy and insuring the access of patients who want it to spiritual care.

There is much controversy, we believe, due to confusion over terminology, spiritual care versus religious care. It should be clear religious care is not spiritual care. Spiritual care deals with the chaplaincy of patients by highly educated and specially trained professional s.

It includes activities such as grief and loss care; risk screening of individuals whose religious conflicts may compromise recovery; helping patients and their families to find meaning, dignity and comfort; assisting patients and families who must address ethical issues such as those connected with organ donation or foregoing treatment that may prolong suffering; improving the ability of patients to access other potential caregivers such as social or religious care givers.

Religion, it should be pointed out, is only one of the factors a spiritual care provider considers in attempting to understand the patient's psyche. They assist patients to come to terms with decisions they must make about themselves and their interactions with their families, work colleagues and hospital staff generally. They can assist individuals from different faiths and religions. They are not confined to assisting co-religionists. It is not about being a religious care provider.

Religious care, on the other hand, means assisting a patient to connect with rituals, texts, beliefs and liturgy of a particular faith. That is a very distinct service that is provided within the context of the health care system. It is the confusion between these two that we believe is a great source of the problem. The WHRA policy has indicated the release of personal health information, for example, to a spiritual care worker is predicated on the religious affiliation of that patient.

The Ombudsman has taken religious affiliation issues pertaining to religious visitor lists which deal with disclosure of personal health information and applied the same principles to spiritual care workers who are health care professionals within a facility and should have the ability to use the information based on the discretion of the trustee. If the spiritual care worker is an integral part of the health care team, it is personal health, not religious affiliation that should be the governing consideration.

Bill 43, which provides that PHIA be expressly amended to recognize the spirit, as well as the body and mind, is an integral dimension of health, is a most welcome and timely clarification which the faith coalition believes is going to settle some of this confusion. It is very important for members of the Legislature to recognize that spiritual care has been recognized by other Manitoba statutes as an integral part of health care. The Workplace Safety and Health Act and The Sustainable Development Act both define health as the condition of being sound in body, mind and spirit.

The World Health Organization defines health as a state of complete physical, mental, social and spiritual wellbeing, and not merely the absence of di sease and infirmity. It is important to recognize that definition has essentially been adopted by the Canadian Council on Health Services Accreditation, wh ich is the accreditation body for all the health care facilities in the province. Bill 43, we believe, will make that definition consistent with other legislation and what is happening elsewhere in the health care– * (19:30) Madam Chairperson: Mr. Ogaranko, you have about 20 seconds left to sum up.

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 219 Mr. Ogaranko: Thank you. We submit this change would actually then recognize spiritual care provid ers as part of the core team and will enable the delivery of spiritual care to those people that want it. It is not only timely but, we believe, long overdue to have this clarification put in place. We strongly urge you to expedite the processing of this bill and passing it into legislation. Madam Chairperson: Thank you, Mr. Ogaranko. Would the committee members have questions? Mrs. Driedger: As a nurse that worked at St.

Boniface Hospital for 20 years, body, mind and spirit, holistic care, was an integral part of what we did, and there was never really any question about it. It was just there and it was something that happened all the time. I certainly came to value the significance of this. I guess as a nurse, I was trained to look at patients in a holistic way. My question, I have a couple, I guess, is do you think this bill, in and of itself, is going to help you clear any hurdles.

It is changing the definition, but are those hurdles still there, left to be jumped because the processes and policies out there are obviously going to have to be put in place? Do you see this bill helping to get past those hurdles? And my second question is are you asking for access to lists or access to information that is in the charts. Mr.

Ogaranko: In response to your first question, this bill is going to go a long way in assisting the industry and clarifying wh at has to date been, we submit, a gross misinterpretation of how the act reads today because it is not recognized in PHIA that health care and health is a holistic notion. It was very restrictive, restricted to physical and mental, and there was no mention of spiritual.

When facilities or health authorities were looking at the legislation as it currently exists, they did not see the word "spirit" in there, so consequently policies were prepared and procedures were developed which would have avoided any reference to that except with hurdles patients would have to go through or spiritual care workers would have to go through in order to receive that.

We think the amendment would give credibility and validate the notion that spirit is very important and the spiritual care workers are an integral part of the health care team and should be treated as such, insofar as use of information is concerned, as distinct from disclosure. Referring to the disclosu re of information, we are also very interested in having lists made available to clergy or designated religious visitors on an implied consent basis. We have made that submission to the review committee together with some proposed language we feel would work.

It is consistent with what is happening in the United States with HIPAA. It is the type of process that has been adopted by facilities like the Mayo Clinic in their regime. We believe it is a concept that is eminently workable in Manitoba and in fact is the historical practice that has been in existence here up until the introduction of PHIA. Mr. Gerrard: I just want to thank you for a pretty clear presentation. Mr. Ogaranko: Thank you. Mr. Chomiak: I concur. Again, thank you for taking the time for a well-crafted presentation. Madam Chairperson: Thank you very much, Mr. Ogaranko. Mr. Ogaranko: Thank you.

Madam Chairperson: The last presenters we have on Bill 43 are Rev. Kathleen Rempel Boschman and Henry Tessman from Concordia Hospital. Ms. Kathleen Rempel Boschman (Director of Spiritual Care, Bethania Mennonite Personal Care Homes Inc., Concordia Hospital): Henry Tessman, our CEO at Concordia Hospital, is regrettably unable to make it today. Madam Chairperson: Okay. Do you have a presentation? Ms. Boschman: Yes, I do. Madam Chairperson: You may proceed whenever you are ready. Ms. Boschman: Thank you very much for the opportunity to speak to you here this evening. My name is Rev. Kathleen Rempel Boschman.

I am the director of spiritual care for Bethania Mennonite Personal Care Homes. Bethania supplies chaplains

220 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 for a variety of personal care homes as well as Concordia Hospital. Health professionals are becoming increasingly aware of the linkag e between spirituality and health. Over the next few years, the National Institute of Health in the United States plans to spend 3.5 million on mind-body medicine. According to Newsweek's cover article, dated November 10, 2003, entitled "Spirituality and Medicine," over half of the medical schools in the U.S.A. now offer a course by the same title.

Last week, I attended the Third North American Multidisciplinary Confer ence at the Faculty of Medicine, University of Calgary. The topic was spirituality and health, and the purpose of that conference was to examine and explore the following themes. I will read the first bullet only: the science and research that validates the effect/impact of spiritual practices on health and well-being. Much of the research th at is being reported at conferences such as the one mentioned empirically demonstrates that spiritual care makes people healthier.

Spiritual care workers help patients or residents come to terms with the decisions that they must make about themselves, their work and their relationships. Spiritual care has empirically been shown to reduce the demand for pain medications, shorten hospital stays and other evidence as listed. Keeping people healthy spiritually may also require access to religious care. Religious care is specific to a person's own belief system.

It helps a person maintain connections with their religious community, draw upon the resources of their faith tradition to understand and cope with their illness, pray and worship in a way that has meaning for them, participate in significant healing rituals of their faith tradition and prepare for death in a way that has meaning for them and their family. The impact of PHIA on spiritual and religious care. As PHIA has come to be interpreted and applied to spiritual and religious care within facilities, many people have been denied access to these services.

At present, upon admission, all patients are to be presented with the notice to collect information on religion. This is the disclosure piece of PHIA. Eighty percent of admissions to Concordia Hospital are through emergency. Many admissions are swift. As a result, the notice to collect information on religion is not presented to the patient or next of kin, and I can testify to that. It happened to me last year. On the other hand, some patients do not expect that they will be admitted to the hospital, and therefore they pass on the question.

Following their admission, there is no mechanism for them to give consent. They are therefore denied access to a service they may wish to receive. The underlying assumption of the notice is that chaplains visit only people who are overtly religious. As chaplains, we find that many people who state their religion are part of a religious community and receive exceptional religious care from their reli- gious community. Our training specifically allows us to visit all people and to determine whether or not spiritual care outside of religious care is appropriate and beneficial to a patient or resident.

The second aspect of PHIA with respect to spiritual care is the aspect of youth. The notice to collect allows the facility to collect patient or resident religious affiliation and to compile a religion list. The PHIA subcommittee on spiritual care informed us that such information would be available only to chaplains who attended ward rounds for the patient or resident under consideration. This restriction stems from the fact that, in the act as it is presently written, spirit is not in the definition of health.

At a faith-based facility such as Bethania/Concordia, chaplain s are considered to be part of the health care team. Furthermore, we greatly value the care that is provided by community clergy and lay religious volunteers. In order to continue the service of spiritual religious care, as well as to comply with the act, Concordia has asked that all community clergy and lay volunteers who wish to see the denominational list go through a process of orientation whereby they become volunteers of the hospital. They are oriented to PHIA.

In addition, they sign a legal contract with the hospital entitled "Spiritual Care Agreement." This agreement has been lifted out of the act and adopted for spiritual care allowing them to become PHIA trustees.

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 221 As the director of spiritual care, I am pleased to know the exact number of volunteers that are coming in and out of the hospital and to have references from their superiors. At Concordia Hospital I have a team of over 100 volunteers that come weekly to bring prayer, holy communion and spiritual support to members of their own denomination. This community support in the role of healing should not be underestimated. Without it people enter hospitals afraid, anxious and often very alone.

Religious and spiritual support of patients helps to significantly eliminate these emotions and thereby promotes physical healing. * (19:40) When the volunteers go through the PHIA orientation and sign the agreement, they ask many questions, such as: Can I tell our parish priest or pastor that I have visited our church member? Can I place the person's name on our prayer list of our church? Can I say the person's name when we meet to pray for one another? Well, the correct answer is always to ask the person if that is their wish. Sometimes a person is not corpus mentus and cannot respond to the question.

The volunteers are becoming afraid to share information that could be shared in the confidential and respectful manner for the benefits of the patient or resident. Existing volunteers tell me that they are finding it hard to recruit new volunteers from their churches as they fear breaking the law. If I lose my volunteers, I lose an important source of healing for the patients and residents, and we as a society lose the faith community support for our health care facilities, which is very important to the fabric of our society. With all due respect to the Ombudsman, I would like to make a response to the

article which appeared in the Winnipeg Free Press on Saturday, April 17, and specific to the quote: People have a right to spiritual care, but that does not mean that spiritual care staff should automatically have access to people's medical records. The Difference between Hospital Staff and Community Clergy. Community clergy are not allowed to read medical reco rds. I have spoken with nursing staff at all levels, program managers, clinical resource nurses as well as front line nurses since I have read this article.

I asked them the question: At any time in your career have you ever seen a community clergy come into a hospital, open a patient's chart and read it? Nobody at any level has indicated that they have seen it happen. I myself have practised as a chapla in for almost 20 years and have never seen this happen, and it should not happen. I have also been a community clergy for six years. Since PHIA was implemented I was made aware of the fact that I will receive no information about my parishioner's health when I came into a hospital.

I knew that the only people I would gain information were the next of kin or my parishioner, him or herself. The Training of a Hospital Chaplain. Hospital chaplains are specifically trained to be members of the health care team. While I do not speak for all facilities, I do speak for Bethania and Concordia Hospital. Our hiring criteria require that a chaplain have an undergraduate degree. For example, myself, I have a B.Sc. in Physiotherapy from the University of Manitoba. As well, we must have or be working towards completion of a Master's degree in Divinity or Theology from an accredited seminary or university.

Following this course of studies, a chaplain requires accreditation from the Canadian Association of Pastoral Practice and Education, which offers clinical training as a member of the health care team. In the Winnipeg Regional Health Authority training is offered at the various sites listed there. In addition, a chaplain must demonstrate endorsement from his or her religious tradition, such as ordination or commissioning. I received my training for ministry in Chicago at the Theological Consortium.

In the state of Illinois there is a law which requires all clergy to keep all matters entrusted to them confidential unless the matter will cause the person harm or another person harm. This is the training I received in my chosen profession. I am glad that all disciplines in the health care field are now required to keep matters of personal health information confidential. I believe PHIA is a necessary legal requirement. In some respects, however, the implementation of PHIA with respect to spiritual care has been to the detriment of patients and residents. Therefore, I welcome this review.

222 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 I conclude this

section by stating that a chaplain is a highly trained and skilled member of the health care team requiring access to the patient's medical record for information on a need-to-know basis as per any other member of the health care team. My recommendations: That as proposed in the amendment, Bill 43 "spiritual" becomes a part of the definition of health in the act. Two, that as per other health care disciplines, patients and residents be given the option to opt out if they choose.

A standard, large-print document such as the following posted on the walls of waiting or admitting rooms in all facilities could be used. This service provider practices holistic care. During your stay here you will be seen by a number of health care staff from various disciplines. Additionally, your service provider welcomes the involvement of your community clergy or designated visitors while you are here. Should you choose not to have a visit from the latter, please inform the admitting clerk.

Three, that community clergy and lay religious volunteers have access to the total patient religion list as occasionally the parishioner is not classified in the correct category; and, four, that chaplains, community clergy, and lay spiritual care volunteers requiring access to these denominational lists be required to receive training in PHIA. Once again, thank you very much for your time and attention. Madam Chairperson: Thank you very much, Ms. Rempel Boschman. Mr. Ron Schuler (Springfield): Reverend, first of all, I would like to thank you for coming to this committee.

We appreciate you coming and making your presentation. On page 2, you have a really incredible quote, and I would like to read it. "This community support in the role of healing should not be underestimated. Without it, people enter hospitals afraid, anxious and often very alone. Religious and spiritual support of patients helps to significantly eliminate these emotions and thereby promotes physical healing." I can tell you I have had family work for Concordia Hospital.

I have had numerous broken bones taken care of in your fine institution, family members provided for, and we have seen loved ones pass away in Concordia Ho spital. In all of these experiences, I have found Concordia Hospital and Bethania to treat all of our loved ones, myself included, with utmost respect, and I have always found the care provided, whether it was some spiritual counselling or otherwise, has always been tremendous. We certainly appreciate both of those facilities. On page 3, you talk about the difference between hospital staff and community clergy.

I think that is really important for the committee to take to heart that at no point do community clergy have access to medical records. I think there is a real misunder- standing out there that somehow a person comes in and gets access to personal records. That, of course, has never been the case, certainly not where I have been involved. We appreciate your presentation and we really appreciate what you do as a hospital, as a faith-based hospital. That is how it started out. Our community backed it way back then when it was a small building, and it has grown to what it is today.

I agree with you it has a very important component, and we would like to see it continue to be done in a proper fashion like you do. We certainly appreciate you coming forward and making a case. Thank you very much. Madam Chairperson: Thank you very much. Mrs. Driedger: Thank you, Reverend Boschman. You have certainly cleared up a lot of points with the clarity of your presentation and I thank you for that. I have one question. I am assuming pastoral care workers, perhaps in th e city, get together or there are organizations and groups that get together.

Would hospitals and personal care homes, for instance, in Winnipeg, all be working under the same protocols as you have described carried out at Concordia, or would different facilities have different protocols in terms of how this is managed. Might rural Manitoba be very different, and might that be where Barry Tuckett, perhaps is hearing some of the issues he is hearing? Ms. Rempel Boschman: Yes, I believe that could be where confusion is developing.

As I mentioned, Concordia, in order to be in compliance with the act, with the desire to still deliver spiritual and religious care, developed their own recommendation, which was to have the volunteers come through volunteer services and then sign a spiritual care agreement

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 223 which was lifted out of the act. We are the only hospital in the Winnipeg region that went to that extent. Other hospitals have managed the situation differently, according to their understanding of the act. So there is confusion going from hospital to hospital about what is the exact limit to which community clergy can receive information, or a chaplain can receive information.

I cannot really speak knowledgeably about the rural areas but I do know this much, that in rural areas where there are not funds or someone available to be hired as a chaplain, there can be an agreement between hospitals and community cl ergy that the community clergy would act in the role of a chaplain in the facility and so, in fact, without pay that community clergy may be receiving personal health information. * (19:50) Madam Chairperson: Mr. Gerrard, and there are only about 30 seconds. Mr. Gerrard: Just to say thank y ou.

I worked for a number of years as a team and part of the time as a leader of the team looking after children with cancer. We had a chaplain as part of our team and she was treated as an integral part of the team. Mr. Chomiak: I have some comments but because we are running out of time I will make them to Committee as a Whole regarding the recommenda- tions.

I am assuming the members of the committee should know that this amendment deals with recommendation 1, but your recommendation 2, 3 and to a certain extent 4 were made, I assume, to the PHIA committee and are not necessarily part of this particular amendment but clearly recommendation 1 is. Madam Chairperson: You can answer that orally, if you do not mind. Ms. Rempel Boschman: Yes, that is correct. Madam Chairperson: Thank you very much, and thank you for your presentation. Ms. Rempel Boschman: You are welcome. Thank you.

Bill 45–The Engineering and Geoscientific Professions Amendment Act Madam Chairperson: The committee will now hear public presentations on the remaining bill which is Bill 45, The Engineering and Geoscientific Professions Amendment Act. Our first presenter is Dave Ennis of the Association of Professional Engineers and Geoscientists of Manitoba. Once again, I would just like to remind all presenters there are 10 minutes for your presentation and then the committee has 5 minutes to pose questions. Thank you. You may proceed, Mr. Ennis. Mr.

Dave Ennis (Executive Director and Registrar, Association of Professional Engineers and Geoscientists, Pr ovince of Manitoba): Thank you. Madam Chairperson, ministers, committee members, I am the executive director and registrar of the Association of Professional Engineers and Geoscientists of the Province of Manitoba, for short APEGM. I am also a professional engineer. Needless to say, I speak in favour of the bill.

The purpose of the bill is to clarify APEGM's ability to firstly, sponsor a range of initiatives that are in the public interest; foster public awareness of the significance of the professions of engineering and geoscience and their advantages as career choices for young Manitobans; and thirdly, to be in a position to participate in and add value to public and government consideration of safety related and other public-interest issues by drawing on the expertise of its members.

With all that, of course, as stated in the bill, "In a manner that is in the public interest." It is worth noting that the term the "public interest," the Legislature has had the foresight to define the term in The Engineering and Geoscientific Professions Amendment Act. It is defined as "the well-being, convenience and concern of the public at large." Some may wonder why such an amendment is needed, so I will comment.

The background is that APEGM recognized, through the recent completed Building on Strengths campaign, the University of Manitoba's need for financial assistance in replacing the Engineering Building. It then decided to make a contribution in its own name and to facilitate contributions from the APEGM membership, approximately 70 percent of whom are Manitoba engineering graduates. The vehicle that was chosen to make the contributions is a separate corporation, APEGM

224 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 Foundation Inc., which is a charitable organization, which has charitable organization status, so that the contributing APEGM members can be issued with receipts for tax purposes. However, in engaging legal assistance to establish that foundation, we were advised that the APEGM did not have the authority in the act to give away money, even though it had been given out cash scholarships and other prizes for many years.

Also, the authority to undertake public awareness, to promote the value of their professions and to provide a position on issues, could be debatable. So, to facilitate the cash contribution and to provide for a greater certainty, the amendment was requested. Incidentally, the pledge to the university is not insignificant and is directed to support both engineering and geoscience, and not just at the University of Manitoba, there is Brandon University too.

The overall pledge is $370,000, with $350,000 of that going to the Engineering Building, money that the taxpayers of Manitoba will, if the bill goes forward, not have to come up with.

So, then, among the funding initiatives and public awareness activities that APEGM wishes to be able to continue to support, both financially and in- kind, are: supplementing the needs of the engineer- ing and geoscience facilities and departments at Manitoba universities; scholarships for students in engineering and geoscience programs at Manitoba universities; student governance activities at those same universities; programs such as the Engineering Access Program or ENGAP at the University of Manitoba, which is designed to assist the students of Aboriginal ancestry to have access to the Faculty of Engineering and to provide appropriate supports that enable these students to obtain a Bachelor of Science degree in engineering; North America's largest science fair, the Manitoba Schools Science Symposium; individual school initiatives in science and technology, for example the 2003 Sisler High School team, which won a national competition in robotics in 2003; our own provincial engineering and geoscience week activities, which focus on career choices and publicizes accomplishments in engineering and geoscience; and our Spaghetti Bridge building and testing program that has provided outreach and career awareness to some 100 Manitoba schools.

In the other area, the types of issues we believe that APEGM can add value to Manitoba for Manitobans by providing comment and putting forward the position of our professions are: avoidance in Manitoba of the circumstances that led to the August 2003 electrical blackout in eastern North America; the regulation of evolving technologies such as nano-technology and its application in biomedical engineering; geoscientific issues involved in resource development and their associated investments; a ssuring the safety of the province's water supply; assuring safe implemen- tation of alternative energy supplies, such as wind and bio-gas; infrastructure issues in general; and the significant progress of projects such as the Winnipeg floodway.

We see these activities as the promotion of the professions of engineering and geoscience and their continued development as stated in the bill, bearing in mind all the time that the public interest is not to be compromised. In that regard, APEGM has consistently endorsed the principle enunciated in the 1994 Law Reform Commission report on regulating professions and occupations, namely, the purpose of occupational regulation should be to protect the public from harm resulting from improper performance of an occupational service. It should not be used to benefit or reward practitioners.

The public of Manitoba has the right to have the benefit of the knowledge of APEGM members and their willingness to contribute to the public interest and the Manitoba economy. With that, I will take questions. Madam Chairperson: Thank you very much, Mr. Ennis. Mr. Ron Schuler (Springfield): Thank you very much for coming to the committee. Certainly, over the years, I have appreciated working with both you and your organization. On May 10, I had the opportunity to send a letter and the legislation to you and your organization, amongst others. I would like to thank you for coming out.

We met May 27 and then June 7, again, and certainly appreciated the documentation and all the information that you gave us. * (20:00)

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 225 I have three questions. The first one is I understand you were in close contact with the department. You have been working on this for a while. How long have you been working on this particular piece of legislation? Mr. Ennis: I believe the first approach was made to the Department of Labour and Immigration towards the end of September of 2003. Mr. Schuler: On page 2, you mention, amongst other things, you certainly have quite a list of things and causes you would like to donate to. You say there is a $350,000 pledge going to the Engineering Building.

Is that time sensitive? Is that something that has to be forwarded shortly, or is that something you see being done? Is it over several years? Is it something that will be done at the end of the year? When is that supposed to be transferred over? Mr. Ennis: Yes. The

schedule of funding is over a six-year period. We are rapidly reaching the end of the second year. At the moment there is roughly $200,000 waiting to be passed to the university. Mr. Schuler: I thank the committee's patience with all my questions. Mr. Ennis, I was wondering if you could tell the committee: In the last week or so have you been approached in regard to any amendments to the legislation that is before us? Perhaps you have not, but in either case would you be supportive of any amendments to the bill that is in front of us right now? Mr. Ennis: I was not approached as to any particular amendments.

I was aware from the department that the Manitoba Association of Architects may be suggesting an amendment. I had some speculation as to what the nature of, what would have promoted or caused the amendment. I did at one point suggest to the department a possible amendment, but I really think that the way it stands right now is the most appropriate wording. It is the wording which was provided to us by the Legislative Counsel. The very first text we sent to the government was, I think, not exactly the same as what the Legislative Counsel provided.

I remarked to our association that the Legislative Counsel managed to say the same thing with much fewer words. I think it is pretty good. Hon. Nancy Allan (Min ister of Labour and Immigration): I would just like to thank you very much for taking time this evening to come and make your presentation. Thank you. Madam Chairperson: Thank you, Mr. Ennis. Veronica Jackson from the Manitoba Association of Architects. Ms. Jackson, do you have written presentation? Ms. Veronica Jackson (Manitoba Association of Architects): I do, thank you. Madam Chairperson: You may proceed whenever you are ready. Ms.

Jackson: I might say at the outset that I am here on behalf of the Manitoba Association of Architects. What has been distributed is really my speaking notes, but for something for the committee to follow along with. You will note that there is a reference to my making four points. As I was writing, I actually decided I would be making six. So I have scratched out four points. I am here to speak against the bill as presented.

I am mindful that my time is limited, and there are others, I know, who will be speaking about some of the specific issues relating to the practice of architecture, but I will be making some general overview comments. First, let me briefly make a comment about the lack of consultation and communication with architects in this province regarding this bill. Until the honourable representative from Springfield mentioned just now and inquired as to how long this issue has been with the Department of Labour, we did not know that it has been discussed for several months, since September of 2003.

At no time did the Association of Professional Engineers and Geoscientists of Manitoba ever bring these proposed amendments to the attention of the Manitoba Association of Architects. That is completely different than the way proposed legislative changes have been dealt with in the past. In fact, these amendments have only been brought to the attention of the Manitoba Association of Architects by the correspondence of the Labour critic for the opposition. Architecture and engineering are very closely connected professions. They share involvement,

226 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 albeit very different types of involvement, and functions in the construction of buildings, and because of their close relationship, the two professions share a legislative joint board. They have in the past, as I say, when proposing changes, given each other the heads-up so that anything that can be agreed upon can be agreed upon in advance.

Not only did the APEGM not consult with the MAA on these proposed changes, we did not even know that they were being put forward, and I can tell you, on behalf of the Manitoba Association of Architects, we have some significant concerns about the language and the purpose of these proposed changes. I can tell you, and you will hear from others, that architects in this province are extremely upset about, as I say, the lack of consultation, and that said, I want to turn to the substance of my presentation.

You will hear from another member of the architectural profession how engineering and architecture are different, and they are very different. But let me just say this as a layperson: Architects are not artists who make buildings look pretty. There is far more to the practice of architecture. Architects are, by analogy, like a physician, a treating physician who is given assistance from other specialists, like radiologists and neurologists, lab technicians, but they see and they oversee the big picture, because that is what their training, their education and their expertise allow them to do.

You will be hearing, as I say, about the difference between architecture and engineering, but all this committee needs to know is that that issue has already been decided and they are separate professions regulated distinctly by separate pieces of licensing legislation. The MAA is the regulatory body for architects. It is created by statute, and it is the body which has been given the responsibility of deciding who in Manitoba is qualified to safely do the things that are the practice of architecture.

By saying, "not everybody should be allowed to do this," the government is saying, as it says for doctors and nurses and accountants and lawyers, that the public needs to be protected from people undertaking these acts who are not qualified to do them. The APEGM is the regulatory body for engineers, and it decides likewise who is qualified to practise engineering, and I just want to say a role about the regulatory body. The mandate of a regulatory body is to make sure that only people who have the requisite education, experience and skills are licensed and permitted to carry on a certain profession or occupation.

The Legislature, as I said, in passing licensing legislation and giving that responsibility to the MAA, has determined that architecture is such a profession. I am quoting, as did Mr. Ennis, from the 1994 Manitoba Law Reform Commission report on regulating professions and occupations, and it said, "The purpose of regulating members of a profession is to protect the public from preventable harm." That is a regulatory body's mandate, and it is a regulatory body's only mandate. It is currently the only mandate of the APEGM.

Again, I am quoting from that Law Reform Comm ission report, "Indeed, its purpose," and its purpose is referring to occupation regulation, "should not be to serve the interests of practitioners at all but should only be implemented when it is in the public interest to do so." I have made reference to the other provinces, which include Alberta, Ontario, B.C. and Québec, who have followed the same policy. The Legal Profession Act was recently redone. That is the regulating licensing regulation for lawyers.

Its purpose is very clear and it is consistent with what the government has attempted to do to avoid a conflict of interest where one body is looking after what is in the public interest and what is in the profession's interest, because there is often a conflict. * (20:10) The Law Society's purpose is very clear. The purpose of the Law Society is to uphold and protect the public interest in the delivery of legal services with competence, integrity and independence.

In pursuing that purpose, the Society must establish standards for the education, professional respon- sibility and competence of persons practicing or seeking to practise law in Manitoba and regulate the practice of law in Manitoba. The architects' legislation is similar. The engineers are, I am suggesting, attempting to do much more. A regulatory body should not be the advocacy arm of a profession. It should not be the advocacy for a profession and it is not to promote the profession

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 227 and it is certainly not to promote its members. It is provided by government to act strictly in the public's interest. Now I am not suggesting and MAA is not suggesting it is not appropriate for engineers to contribute as do other members of professions to works such as the University of Manitoba Faculty of Engineering Building, but you do not do that through your regulatory body. You do that through the foundation that Mr. Ennis has already indicated has already been set up. You promote the profession through that organization.

The Law Society restricts its operations to regulating the profession and making sure that the public is protected from people who are not qualified to be lawyers. It is the Canadian Bar Association and the Manitoba Bar Association that acts and promotes the profession of law. Likewise, it is the Manitoba Medical Association that promotes the interest of doctors. The College of Physicians and Surgeons has one mandate, and that is to act in the interest of the public. Now we have been advised by the Deputy Minister of Labour, Mr.

Parr, that APEGM has submitted the proposed amendments and has described in doing so that these are merely financial in nature and Mr. Ennis has made references to that. With the greatest of respect, we disagree that that is the extent of the impact of these amendments. The amendments go far beyond simply allowing the gifting of money by APEGM, and, in fact, APEGM current legislation expressly permits them to do that. Madam Chairperson: Ms. Jackson, I just want to tell you that you have a minute and a half left in your presentation. Ms. Jackson: Thank you very much.

The current provisions, and I have cited them and they are in the current legislation, permit the APEGM to give money in anyway it is used and there is no restriction at all. As Mr. Ennis, says they have been doing so for some time. The real agenda is that APEGM is establishing a framework using very broad, very vague language and increasing its purpose to include the promotion of its association and its members to encroach into the area of architecture. This has been something that engineers have been doing for 12 years and architects have been continuously battling against it. The legislation is very clear.

Architecture is an exclusive practice. It is only done by architects in Manitoba and there is a reason for that. Engineers, their legislation says this is the practice of engineering, and defines what that is, and it makes it very clear that nothing in the engineering legislation takes away the ability of any other regulated profession– Madam Chairperson: Ms. Jackson, you have 15 seconds to conclude. Ms. Jackson: –including architecture to practise theirs. It is a restricted scope, it is not exclusive. So I am suggesting the solution that we are asking is the tabling of this legislation.

The Manitoba Association of Architects believes that the legislation can be crafted and word-smithed in such a way to achieve the goals that APEGM wants to achieve, the concerns that the MAA has, in such way that the public interest is still protected by making sure– Madam Chairperson: Ms. Jackson, I am sorry I am going to have to interrupt you so that we have respect to the other presenters who want to be here. I will now entertain questions. Mr. Schuler: Thank you very much, Madam Chair. It is with great difficulty that I take on this issue. On May 10, I sent the legislation out to all the stakeholders.

In this case there were three, far easier than some of my other pieces of legislation where there are 750 different stakeholders. On May 18, I received a letter from your organization asking for a meeting and laying out a lot of concerns and June 1 we met and, until that point in time, I thought what was normally done, and it has always been done when these types of changes are made to an organization's act, and far be it for me to correct you, but I have always been under the impression it was the government's role to see to it that all stakeholders saw the legislation.

In fact, it is not the association's role, because legislation, until it is tabled, is actually not supposed to be out in the general public. On June 1, and I tread lightly here, to my horror I found out from three individuals from your organization, that you had, in fact, not seen the legislation. Until that point in time, I had indicated to

228 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 the opposition caucus, my leader, and my caucus members, that this was general housekeeping, clearly everybody would have been informed, and that was not the case. I take it the first time you heard about this was when you received my letter, and secondly, since June 1, have you had a meeting with the minister, and then I will ask my subsequent question? Ms. Jackson: The Manitoba Association of Architects requested a meeting with the minister and we were denied that opportunity. We were allowed to meet with the Deputy Minister, Mr. Jeff Parr, and we did that. Mr.

Schuler: Well, I am sure I speak for committee members. That is terribly disappointing to hear, because any time that we have this kind of legislation, there should be an opportunity for all stakeholders to meet with the minister. I have to tell you that in your presentation–and I suspect we are at 16 presenters right now, so we are going to hear more of this. On behalf of the committee, I am appalled that we have two of our finest organizations who helped to build this city and this province, are at each other's throats, and– Madam Chairperson: Mr.

Schuler, in respect to the other committee members who also want to pose questions, if you do have a question, I would ask you– Mr. Schuler: Well, we will give leave; perhaps then they can ask, too. This is very serious, Madam Chair. Thank you. I am appalled at even the kind of language and– Madam Chairperson: Mr. Schuler, Ms. Allan has a question. Thank you. Mr. Schuler: Okay, I will finish my question and then I will move on. My question to you is is there any way that we can bring the groups together and reconcile some of the differences we have.

Madam Chairperson: If you could keep your answer brief, to 20 seconds, 30 seconds, I would appreciate it, as the Chair. Thank you. Ms. Jackson : The Manitoba Association of Architects believes that there is the potential to come back and provide input to come up with a resolved or a reconciled proposed ame ndment. We believe that that is absolutely possible, but not at the eleventh hour. Madam Chairperson: Thank you. Ms. Allan: I just want to comment on the misunderstanding, apparently, that the organization has in regard to the fact that you were denied a meeting with the minister.

I think it is very important to clear up that misinformation. My understanding is that we received a letter from you. You are the lawyer for the association, and this was the first time that we realized that there were some concerns with regard to the scope of jurisdiction. When I received the letter, of course, we wanted to look into it right away. I forwarded it to officials in my department. They wanted to meet with you right away to get some sense of how serious this was. This was a scheduling issue. No one has ever been denied a meeting with me.

In fact, my understanding was that you were having an initial meeting with officials in my department in preparation for a meeting with me. So I certainly would not want people to think that you were being denied a meeting. Madam Chairperson: Ms. Jackson, did you want to respond? * (20:20) Ms. Jackson: Well, I will just respond. The information is that we requested a meeting with the minister and were denied that opportunity. Madam Chairperson: Thank you very much. Our next presenter is Terry Danelley, private citizen. There was another question. I do not know whether that is going to be allowed? Is there leave?

Actually, there is no leave. At the beginning, we were beyond our number of presenters. I will apologize for that. We are at 22 presenters, which takes us beyond midnight, which means the committee, in all honesty, will be probably be here until 3 o'clock in the morning. So, as the Chairperson, I am going to respectfully suggest that we hear our next presenter. Thank you very much.

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 229 Floor Comment: I appreciate that there are a number of people that want to speak. Thank you, Madam Chair. Madam Chairperson: Terry Danelley, private citizen. Mr. Danelley, you have a written presentation you would like to distribute? Mr. Terry Danelley (Private Citizen): Yes, it is being distributed now along with actually a letter– Madam Chairperson: You know what? We will wait until the presentation is distributed. Okay? Mr. Danelley: What you have in front of you are 75 to 80 letters from our members, opposing this particular Bill.

I have to say– Madam Chairperson: At this point, you know what? I will recognize you. We will go on the clock if you do not mind. So please proceed with your presentation. Mr. Danelley: Thank you. So you have there in front of you 75 to 80 copies of a letter that was sent in by our membership on extremely short notice. Why we wanted to distribute this was really to indicate the level of frustration by our membership with respect to this particular bill, but also the longstanding disagreement between our respective associations. I hope that does reinforce the message.

This was issued less than 24 hours ago and that is the response that was received. Over half of our membership responded by submitting that letter to you. I am before you this evening as an architect to voice my opposition to Bill 45 and to make you aware of its hidden agenda and the concerns of the Manitoba Association of Architects. I must also express my indignation with respect to the lack of consultation by APEGM, or by this legislative body with the MAA, on this important issue which has the potential, if implemented, to have serious reper- cussions on my profession.

APEGM is promoting these amendments to their existing governing legislation on the premise that they are necessary in order for them to further their philanthropic endeavours. However, Bill 45, as currently written, is simply another attempt in our opinion on the part of the engineers in this province to expand their scope of practice to include the practice of architecture and in direct contravention to The Architects Act. There is nothing more, nothing less. It is consistent with their actions over the past 12 years and is in direct response to the MAA's successful legal challenge of the Denoon case in 2000.

In that case, Justice Monnin, now the Chief Justice of the Court of Queen's Bench of Manitoba, determined that the engineer in question had in fact contravened The Architects Act by practising architecture when unlicensed to do so. The engineer was convicted and fined. In 1998, the APEGM, after consulting with the MAA, as has been the history of the two professions when proposing changes to their legislation, put forward amendments to their act.

At that time, APEGM assured our association and the Minister of Labour that the proposed amendments were more restrictive, and I underline that, relative to their scope of practice. This representation was the basis upon which the MAA agreed to the proposed amendments. It was agreed between the Minister of Labour, the MAA and APEGM that this repre- sentation about the intended restrictive nature of the new practice definition of the practice of engineering would be read into the Hansard record by the minister as background to the legislation.

Shortly thereafter, when our association notified the authorities having jurisdiction of the Monnin decision and the requirement that architects must be involved on all

part 3 buildings and certain

part 9 buildings, APEGM responded with a letter to those same authorities indicating that recent changes to their legislation made the Monnin decision irrelevant. This is not true, and it illustrates the tactics that APEGM is prepared to utilize to further their own agenda. Such actions fuel our mistrust of the intentions of APEGM and these proposed amendments to their legislation. They are attempting to repeat history with Bill 45, which is so broadly written that we have no doubt it will be utilized to advance their self-serving interests.

Please do not be manipulated or duped by their stated philanthropic intentions. APEGM knows exactly what they are doing, and the language of Bill 45 has been left purposefully broad with the intention of allowing them, finally, with the legislated authority, to practise architecture, for which their members have no formal education or training.

230 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 A case in point: Our firm recently completed a $3.5-million addition to an existing elementary school, completed by an engineer in the late nineties, with no involvement by an architect. The engineer in question was a former employer of mine, a senior engineer with over 30 years of experience and was at one time a partner in a large, local, multidisciplinary engineering firm.

When I asked him why he chose not to pursue the second phase of the project, his response to that was that his experience on the first days had not been good, that he felt he may have been in over his head, and, further, that he thought the project would be more appropriate for an architect to undertake. The point here is that you cannot dabble in architecture. Buildings are complex entities and growing more complex with each passing year. They require the specialized skills, knowledge and training that only an architect possesses.

Our education, our internship program, our registration requirements, our continuing education program and our associ- ation, which regulates our profession, are all focussed on providing the necessary skills, knowledge, and support to our members directly related to the practice of architecture. The same cannot be said of the education, training and regulatory support of the engineers. It would be akin to saying that a general practitioner in the medical profession is capable of successfully doing brain surgery. He or she might be, but would you be willing to take the risk?

The fact that this bill was introduced to the House without consulting the allied professions who would be affected by it or providing them with adequate time to fully understand the implications of the amendments and respond accordingly must surely underscore the motivation of APEGM to sneak this bill through the House and thereby circumvent the democratic process. What other possible explanation can there be? This action only seeks to heighten the growing atmosphere of mistrust between our respective associations.

Our frustrations grow daily as our members continue to see ever larger and more complex public buildings being completed by non- architects, with the increased associated risks to the public who unknowingly occupy and use them. This has to stop. You cannot, as our elected representatives, sanction this practice. I implore you to table Bill 45 so that it can be properly reviewed to accurately reflect its purpose or acce pt the changes that our association has brought forward to restrict its

interpretation and meaning. Finally, enforce the laws of this province with respect to who can practice architecture. The legislation is clear and has been interpreted as being so by the justice system. There is no gray area here. You have a moral and a legal responsibility to do so. The law is being flagrantly violated and yet it continues to be sanctioned through the Department of Labour. Will it take the loss of life when a building fails to have you uphold the law of the land? I sincerely hope that it will not come to this. Thank you. Madam Chairperson: Thank you very much, Mr. Dannelley. Point of Order Mr.

Schuler: I would like to just, on a point of order, ask the committee if they would agree to recess for 15 minutes and perhaps the minister would like to meet with the two gr oups and see if there can be some kind of resolution. Or is it the intent to continue to go through this process? Madam Chairperson: Mr. Schuler, I am sorry, but we did at the beginning ask for leave to go beyond our normal sitting time, which would take us to midnight. We have 22 presenters. Mr.

Schuler: I asked if the Chair would please canvass the committee to see if there is leave to give the minister and her department an opportunity to meet with both groups– Madam Chairperson: Just a moment. Is there leave from the committee to briefly recess? Is there leave from the committee? Some Honourable Members: Yes. Some Honourable Members: No. Madam Chairperson: Leave has been denied. * * * * (20:30)

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 231 Mr. Schuler: Well, Mr. Danelley, I thank you very much for coming to committee. I also had an opportunity to meet with you, and I expressed at that time my concern that you, as architects, had not been consulted. This is not about engineers and I do not think this is about architects. This is about a government that has bungled a process. My question to you is very straightforward.

How do we get out of this without having two fine organizations, great organizations, with tremendous people who help to build this province– how do we get the government out of this mess? Mr. Danelley: Mr. Schuler, there are two solutions to this problem. Madam Chairperson: If you could just speak up, even I am having a hard time to hear. Mr. Danelley: There are two solutions to this problem. Table the legislation.

Give us the time and the opportunity to meet with the representatives from the APEGM to fully understand what it is they are trying to do, and to put forward then properly worded legislation that will allow them to do so. The other option is to restrict the legislation that they currently have put forward, so that it, in effect, restricts what they do to the practice of engineering and geosciences. But our preference would be to table the legislation. Mr. Schuler: Thank you very much for that, and I will keep myself very short because I know others wish to speak. Madam Chairperson: Just a second, I am sorry.

Excuse me for a moment. Mr. Faurschou, if all side conversations could be discontinued, just so I can hear. Mr. Schuler: I will keep this short. I have to tell you that this is a very disappointing evening to have to sit through this and see two organizations having to duke it out at committee because a government bungled a legislative process. It is very disappointing as a member of this Legislature. Madam Chairperson: Mr. Schuler, was there a question you were posing? Mr. Schuler: I am finished, thank you. Hon. Jon Gerrard (River Heights): Thank you.

One of the points that was brought up earlier was the difference between a regulatory body and a funding or promotional body. I wonder if you could sort of give us some words of advice in terms of how this fits into the mixture of what an engineer does and an architect does. Mr. Danelley: I am not sure I fully understand the question. I can certainly talk to you about the differences between what an architect does and an engineer does. I think the point that Veronica was trying to make was that it really is not the position of a legislative body to necessarily promote the interests of its membership.

The purpose of a legislative body is to protect the public. So we are ques tioning these amendments, which in our opinion are not necessarily in the public's interest and, in fact, could be against the public interest depending upon how the engineers would choose to interpret their by-laws. But to speak then to the differences between the two professions, there are significant differences. One of our members is actually going to get up shortly and speak to you on those differences. But architects are trained for one thing. They are trained to design, build and implement or oversee the implementation of buildings.

We do look at the broader picture. It is our responsibility to oversee the work that is being done by the engineers in co- operation in terms of the systems of the building, and that education and that internship and our registration process are geared directly to those responsibilities. The engineers, as I stated in my presentation, their education, their training and their association's support are different. So, fundamentally, they are not trained in the same way that architects are trained and educated to build and oversee the construction of projects. Madam Chairperson: Thank you very much.

Seeing no other questions, I thank you very much for your presentation. Mr. Danelley: Thank you. Madam Chairperson: Minister Allan, just one moment. Ms. Allan: Thank you, Mr. Danelley. I would like to thank you for taking time out of your busy day to be

232 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 here this evening. I just had a couple of comments that I would like to make. The previous presen ter, Veronica Jackson, commented that the two organizations have separate pieces of legislation and are two totally separate regulating bodies. I am sorry. I have 10 seconds all night long? That is all I have? Madam Chairperson: Finish please. Ms. Allan: There is a dispute mechanism in both of your acts to resolve disputes within the two organizations, and the dispute language is exactly the same in both of your acts.

I also wanted to table two documents for the committee. You mentioned, Mr. Danelley, that this is a long-standing disagreement between the two organizations. I believe those were your very words when you started your presentation this evening. This long-standing disagreement is around scope of practice between the two or ganizations. I understand a lot of work has gone into this in regard to the two organizations. I would like to table the memorandum of intent that is dated February 20, 1997, that established the Engineering, Geosciences and Architecture Inter- Association Relations Joint Board.

I would like to table that. Madam Chairperson: Prior to allowing the minister to continue, I would like to ask how long leave is for this particular presenter. Just one moment please. How long is leave for this particular presenter? From the committee, I will put a suggestion on the record that leave is five minutes for this presenter. Is that agreed by the committee? [Agreed] Thank you. Proceed. Ms. Allan: I understand that the two organizations did a lot of work at the joint committee to resolve the whole issue around the scope of practice.

My understanding is that there was a memorandum of agreement between the two organizations. I would like to table that memorandum of agreement. It was a draft memorandum of agreement. It is my understanding that the agreement was going to be signed by both organizations and, at the last minute, the architects rejected the memorandum of understanding and walked away from the table. My department was not advised of this immediately. We just found out about this situation in March. The chair of the joint board, my understanding is, has quit. We have just had the opportunity to appoint a new chair of the joint board.

The new chair, my understanding is unanimously agreed to by both organizations; so, we are very pleased with that. I just wanted you to know that we will make the commitment, as the Minister of Labour, that we will continue to work with you in whatever way we can to facilitate the work at the joint board level. Madam Chairperson: Thank you very much. Mr. Danelley, we appreciate you coming forward to make the presentation to the committee. Mr. Danelley: Is it possible just to make one short comment in response to– Madam Chairperson: Yes, it is actually because you have leave so you can do that. Mr.

Danelley: Thank you. With respect to the memorandum of agreement between our joint boards, let me just say that this was two years in coming. It was initially supposed to be a three-month exercise which our council just kept extending and extending on the understanding that we were finally going to make some progress on this. Our members who are on the joint board negotiating with the engineers came back to us extremely frustrated and put before us what they considered to be the best deal that they were able to cut.

In fact, when we looked at the deal that was put before us, it was rejected because we felt it violated The Architects Act. Therefore, we could not sanction it. Madam Chairperson: Thank you very much, Mr. Danelley. I appreciate your presentation as a private citizen. Our next presenter on the list is Don Oliver, who is presenting as a private citizen. Mr. Oliver, do you have a presentation to distribute?

June 9, 2004 LEGISLATIVE ASSEMBLY OF MANITOBA 233 Mr. Don Oliver (Private Citizen): Yes, I do. Madam Chairperson: Thank you very much, Mr. Oliver. You can proceed whenever you are ready. Mr. Oliver : Well, I must start by saying that I am very disappointed that I have to come before this committee and voice my displeasure with this proposed legislation. The architectural and engineering professions are integrally related, and I find it unconscionable that the PC Labour critic was the one that informed us about this legislation and we are forced to have to address it here in a confrontational manner.

It has never been our way to resolve issues between ou r associations, and this makes me question what went wrong. I am upset that the Association of Professional Engineers and Geoscientists of the province of Manitoba is forcing our government into this embarrassing situation. I find it less than honourable to think that it is felt that this piece of legislation could be slid through the House without the related professions being involved or informed. Government now has a bill before it that is broad in wording and is hotly contested by the membership of the Manitoba Association of Architects.

By passing this bill, the government will be sanctioning the activities of one profession to the detriment of another. Our government should never have been placed in this situation. Their time and resources are scarce enough. Using a new minister to further one's hidden agenda is not acceptable in a democratic society. Past amendments to the architects and engineers act required sign-off by all related organizations, either professional or non-professional, which could include technologists, prior to being accepted by the government sponsor for presentation to Legislature.

In the past, this resulted in most of the contentious issues being resolved and poor, misleading, or ambiguous wording being revised. Good legislation results from proper consideration by a wide variety of viewpoints and respects the mandates of others. Mr. Bidhu Jha, Vice-Chairperson, in the Chair How are we able to give our feedback to the amendments proposed in Bill 45– Point of Order Mrs. Bonnie Mitchelson (River East): Point of order, Mr. Chair.

I am listening quite intently to the presentation that is being made, and I believe the deputy and the minister are sitting at the head of the table laughing and conversing with each other. I hope they would give the presenter the respect of their full attention. Thank you. Mr. Vice-Chairperson: No point of order. Go ahead. * * * Mr. Oliver: How are we able to give our feedback on the amendments proposed in Bill 45 in a non- confrontational manner if we were omitted from the process?

APEGM is aware of past procedures; why were they not followed? * (20:40) It seems odd that in a letter dated June 7, 2004, addressed to Ron Schuler and copied to Terry Danelley, our president, Mr. David Ennis, the director and registrar for APEGM, speaks to an issue being debated between our professions, the resolution of the wording that is now being discussed for the Manitoba building code. Mr. Ennis states, "The proper place to structure a resolution in the public interest is with the Engineering Geoscience Architects Interim Association Relations Joint Board." It has been discussed before.

Why is this bill application not being presented to the board for consideration? Every day my firm is faced with competition of non-professionals in what is supposed to be a restricted scope of practice. Drafting firms and interior designers continue to be able to practise architecture without a licence because a small number of APEGM members sell their seals to get drawings approved by the authorities having jurisdiction. APEGM supports this practice by its members, which has served to undermine the legislated intent of The Architects Act.

This activity has also been seen by an increasing number of engineers as a growth market for their profession. Why would I support APEGM's attempt to expand their mandate to, quote, "Promote the

234 LEGISLATIVE ASSEMBLY OF MANITOBA June 9, 2004 professions of engineering and geoscience and their continued development," when APEGM refuses to respect the limited scope of practice defined in The Architects Act? Earlier in Mr. Ennis's June 7 letter, he states APEGM's position related to the practice of engineering with respect to the practice of architecture. His position is shrouded in rambling rhetoric and, in practice, relates to members of APEGM being able to practise architecture as long as they call architectu ral engineering.

The government should not be put in a position to sanction the promotion of this position as it clearly does not reflect the best interests of the public. Tabling this bill will give the government the opportunity for all related stakeholders to develop a better bill in a non-confrontational manner. The result of this process would be a bill that more clearly defines the intent of the changes and will serve the engineering profession well. Its philanthropic purposes pursuits will be realized without watering down their rightful mandate as a governing and regulatory body for their profession.

I thank you for the opportunity to exercise my democratic right to voice my concerns. Mr. Schuler: Thank you so much, Mr. Oliver, for coming to committee. It take s a lot of courage to get up and state one's opinion, and especially for the record. The question you asked, basically, was how did we get into this mess. My question is how do we get out of this mess. It would please this committee to no end if the minister would take a break and see if there is any common ground to stop what is going on here tonight, but I sense there is no political will. Mr. Oliver, where is the common ground?

How do we get out of this? Mr. Oliver: We have a legislated joint board which is mandated to work through the issues that are of common interest between our two professions. That is a natural location for this to be referred to and to be able to develop more succinct wording to come forward as

an act proposal. Mr. Schuler: Again, I appreciate your contribution to committee and the fact that you came out, not just in the times that you took away from your business to meet with myself, but also the fact that you came to committee. Thank you. Mr. Oliver: Thank you. Ms. Allan: Thank you very much, Mr. Oliver, for taking time out of your busy

schedule to be here this evening and make your presentation. Mr. Oliver: Thank you. Mr. Gerrard: Just to come back to this issue of a regulatory body versus a body which would be involved in promotion and fundraising and so on. In the architects' side of things, you have a regulatory body and an association which might be involved in promotional activities from a different perspective. How does it work? Mr.

Oliver: For smaller organizations whose numbers do not warrant or cannot support two bodies, one is a regulatory body and one is an advocacy body, the organization has to be very, very careful on how it presents its members. As an example, dentists, the Dental Association has one body that represents its membership. As a regulatory body, it can promote the regular visits to its members as being something that is beneficial to the public.

It cannot promote going to your dentist and getting your teeth whitened, because that is a very fine line that is crossed in promoting the business interests of its members and the interests of its members' use for the public good. Is that an example? Mr. Leonard Derkach (Russell): Mr. Oliver, I think what we are viewing here this evening is a rather unfortunate incident of where we have, unfortunately, two organizations who probably have not been consulted adequate ly to resolve the issues here. I guess my question to you, Mr. Oliver, is has the department or the minister met with you

Document details

Collection	Manitoba — Debates (Hansard)
Citation	38-2-sed05
Type	hansard
Volume / chapter	38th 2nd hansardpdf sed05.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	efbdb078a3e012d8ec6fd618c8ed31aeb7b2dbc3

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