MADAM CHAIR: Good evening, welcome. I think we will get started. There may be another person joining us on the committee this evening.
My name is Maureen MacDonald and I am the Chair of the Standing Committee on Community Services and the MLA for Halifax Needham. This is the 11th public meeting of the Standing Committee on Community Services. We started in mid-September in Sydney and we have been in Sydney, Port Hawkesbury, Guysborough, Stellarton, Truro, Kentville, Bridgewater, Yarmouth and Preston. This is the second of several evenings that we have been in Halifax, so it is good to be here.
The process we use is that we have an agenda of people who have come forward indicating that they would like to make presentations. We call people in the order in which we have them on our agenda and then we open the floor up for further presenters. If you are not on the list and you would like to be, you could speak to Kim over here, the woman in the front row with the yellow cardigan on, and she will make sure you will get on the list. We try to keep things as informal as possible.
Hansard is here and all of the presentations are taped by them. Tonight we have a student from the Kings School of Journalism who is doing a news item for his news program which airs on cable television, and we also have other members of the press here tonight, so people should be aware of that. We operate with the same rules that we use in the Legislature, so everything is public and is accessible to the news media and the public through the news media.
I think what we generally do before we call our first presenter is have members of the committee introduce themselves.
[The committee members introduced themselves.]
MADAM CHAIR: Thank you. Our first presenter tonight is from the Huntington's Society of Canada, Linda Geyer.
MS. LINDA GEYER: My name is Linda Geyer and I am the Director of the Huntington's Disease Resource Centre for Nova Scotia and Prince Edward Island. That is one of the reasons I am here, but the biggest reason I am here is because I have been a social worker for 20 years and I have been waiting for this opportunity and it has been bugging me for a long time, so I am really happy to be here. Although I am representing people with Huntington's, I have a few other things to say about social assistance for people with disabilities. I wasn't expecting microphones and recordings and all of that, so if you will give me a few minutes to get my sea legs.
I guess I worked more than 10 years throughout the health system with people with cancer, cardiac disease, MS, all kinds of progressive diseases, ALS, and about five to six years in mental health and that is why I am here. I am here because I have had so many people parade into my office, desperate because of their financial situations. I know that you have probably heard every sad story that you could possibly hear, so I am not going to talk too much about that because I figure lots of people will tell you that, and I hope that they do, but I will tell you a few and the ones that are most recent in my mind.
I do appreciate this opportunity to say to the government what I think about social assistance. I always use overheads because I have a bad memory and I can't speak off the cuff. So that is my name and I work with people with Huntington's and their families all over Nova Scotia and Prince Edward Island. I work only 25 hours a week and I made that a conscious choice so that I could spend one day a week doing things like this.
Aside from talking about people with Huntington's, I would like to focus on social assistance for persons with disabilities, Huntington's disease being one of them, and severe mental illness and progressive diseases. Why would I want to focus on people with severe disabilities? I know that the issue of social assistance is extremely complex, and, in one-half hour, I am not going to comment on all those other things. I have worked with single parents and I have worked at Bryony House, and I will let other groups speak to that, but this is the area that I know best.
I think that there is a special case to be made for people with severe and progressive disabilities. I have made the point of separating it out from people with disabilities that they are born with or something that is not progressive and life-threatening, not because I think they are less important, but because I think it is a different set of problems.
What is Huntington's Disease? When I read a letter later, it will give you the detail about what Huntington's is, but I gave you pamphlets and, anyone in the audience, I would be very happy to share information about Huntington's with you. Why the other diseases is mainly because I did work in hospitals and I had so many people with severe mental illnesses that I dealt with, and I really felt that people didn't understand what was happening to them, in the general public.
I think, my own personal belief - and I don't know if you have heard this before - is that the average Nova Scotian really cares about people with disabilities and they have an assumption that our system helps them; they assume that people are being well looked after and I don't think that is true.
I am going to give you a real-life example. This lady gave me her permission to tell her story, just a little bit, and this is not her name. Alice, a 37 year old mother with Huntington's. She gave custody to her husband of two children, a great act of love, because she knew she couldn't look after them well enough because she is very sick. She receives $657; $544 is from Canada Pension, because she worked for many years and did a good job, so she only gets $113 from family benefits. That leaves her with $200 for food, clothing and miscellaneous. When I last saw her last month, she was severely underweight. She is very, very thin. People with Huntington's need more calories - which I will read to you in a minute - so I said to her, look, you really need to eat more food. She said, I can't eat more food.
I wrote a letter to social assistance, and I called them and I asked if she could get some more money for food - you have to realize that this woman's whole family has been devastated by Huntington's Disease. Her father died of it; he was misdiagnosed. All of her family, except one. She has six siblings and five have been afflicted with Huntington's - so I wrote this letter to the municipal assistance worker:
As you probably know, Alice has Huntington's disease. Huntington's disease is a hereditary brain disease. It causes progressive deterioration with varying symptoms which may include involuntary movements, speech impairment, and cognitive and emotional changes. The disease usually begins between the ages of 30 to 45 and death usually occurs 15 to 25 years after the initial onset - this lady has had Huntington's for about 10 years and she won't be in the community for more than another five years, probably. When I visited Alice this month, I told her she should try to gain 15 pounds; she is definitely underweight. In order to do that she should be eating more cheese and meat and drinking lots of milk and eating ice cream. If she gains weight, her balance may improve and her movements may decrease. People with Huntington's fall all over the place. They split their heads open; they break their bones. It is pretty awful. She is so thin that this happens to her more.
I went on to give some other detail and I quoted from the Physician's Guide: "For reasons not fully understood, patients with Huntington's typically require up to 5,000 or 6,000 calories per day to maintain their body weight. They may require additional caloric
supplements such as Ensure. Maintaining adequate weight and, in fact, gaining weight, particularly in the late stages, has been seen to result in improvement of chorea, as well as alertness and responsiveness."
I don't know how much this means to you, but this lady was starving. She is eating one-third of the amount that she should be eating. So I wrote that letter to a very nice social assistance worker who, I thought, was brand new to the business, and I found out later he was in 20 years, so I was pretty impressed. Anyway, he was very sympathetic but said, look, she has a surplus in her budget of $79. I said, really. She has a surplus, well, you know what that means; you have heard that before. She has a surplus because we have to go from Community Services to apply to the municipality, plus we have to drag her through the embarrassment of telling people she is starving.
Here is another example of somebody with mental illness. A single woman with severe mental illness, assisted by her brother, she receives $714 - $560 is from Canada Pension and $154 from family benefits. After rent, she has $229 for food, clothing, power, transportation, laundry, et cetera. She cannot afford haircuts, presents, trips to the mall or food. She applied for dental hygiene related to her condition. Now, if you have a mental illness that is very severe and you have a bad bout of it, you are going to be out of it for a few months and your teeth are going to be in really bad shape.
It is a necessary health thing. We applied for dental hygiene, related to her condition, moving expenses because she was living in a hovel, and carpet cleaning, furniture. She was denied. She had a surplus and these items were not covered, such as carpet cleaning, even though the landlord requires it. She has virtually no furniture and no winter clothing. She is paying an ambulance bill. Unfortunately, she got sick and went to the hospital and she has to pay $75 for her ambulance out of her food allowance.
Recently she received Canada Pension, it was approved. She got $18,000 sent to Community Services to pay for the money that they had paid for her, and she was able to retain $2,700 because, if you are on family benefits and you are disabled and you are 20-something or 30-something, you can keep up to $3,000. Presumably to bury you, right? That is really good for her because she is 39 and she is not anywhere near dying. She is able to keep $2,700. She was really excited and she said to me - this is the pitiful part - I really had a good week. I drank milk every day and ate bananas.
We could tell you lots more stories like that. What do we need to do? We need to ensure that the financial needs of persons with severe, chronic and/or progressive illnesses are met. We need to institute financial assistance programs that are simple, accessible and standard. This is what I think Nova Scotians don't know, and I wish I had time to talk to you folks, because maybe you know all this. I don't know. I read in your report there are only 15,000 people on disability and I don't think Nova Scotians know how few people are on
disability family benefits. If you notice what I said, a lot of those people are getting Canada Pension, so we are not even paying a whole lot for them.
People with Huntington's, served by the resource centre in Nova Scotia, are only about 75 people. Many more are affected, of course, but 75 people and only 12 of those are on family benefits and most of them have Canada Pension. So, I really do not like spending two days trying to beg for a few dollars for food, because she is paying most of her way.
Some people with disabilities receive most of their income from Canada Pension. The amount of money a single person receives is approximately $719 - somebody else here might have the exact figure - rent, food and clothing. Telephone costs are not covered by family benefits, even if the disabled person has a life-threatening illness. I understand you can go through a process and if you don't have a surplus - but I don't meet people who don't have a surplus, I don't know where they are, but I don't meet them - they always have a surplus, anyway, I have worked with all kinds of people with heart conditions, unstable angina, and you cannot get a telephone for them. It is ridiculous. Ambulance costs are not covered. I don't think Nova Scotians know that. Do you?
MADAM CHAIR: They are learning.
MS. GEYER: Good. That is why I was interested in the press.
Okay, more things Nova Scotians don't know. If a person with a disability finds lower cost housing, they cannot keep the money they save. Maximum rent is $525. If they find a place for $475, they cannot keep the savings. This causes, in my mind - and I am not an economist or a social policy expert - what I see in my practice is people whose landlords charge the maximum rent, so we are paying a lot of money in family benefits to landlords. I don't understand that. I have a recommendation for that. If a person with a disability could keep, let's say 50 per cent of the savings, that would give them an incentive to find a lower rent, the landlord would not be anxious to charge the maximum rent, and we would both win, the taxpayers and the other people.
These are other things. My neighbours that I talk to, I have worked with people on assistance for a long time and I think they don't know this, that if a person with Huntington's or a mental illness is admitted to a hospital for more than 30 days, their shelter allowance must be discontinued and this often results in people losing their home, further illness, and they stay in the hospital for months. I think people don't realize that, but we're spending millions on this silly rule.
Non-emergency dental work is not covered. This includes hygiene and fillings even if it is related to their condition, as I said if they are so sick that they can't take care of their teeth. People with Huntington's need more dental visits, and that is not covered. Emergency dental work, if you can get yourself through the maze of social assistance and get it - I once
had a patient who was at risk for pericarditis which is a heart condition, a life-threatening heart condition, and it took me six months to get him dental care and I worked at it, believe me. So if he was on his own, he wouldn't have gotten it - it is very difficult to obtain.
Why are we starving people with disabilities? I do think we are starving people with disabilities - I am not going to mince words or apologize for myself - I think we are starving people and I wish that you could see all the people that I see who cannot buy milk, bread and cheese. It is ridiculous, in this country. I think that there's a lack of a specific program for persons with severe, chronic or progressive disease. Everybody is so obsessed with cutting back on cheaters and all this kind of stuff. It is a totally separate issue and we shouldn't be penalizing people who are disabled. There is no mechanism for recipients, community groups and citizens to have input into social assistance programs.
Recommendations. Create a separate program for persons with severe, chronic, progressive diseases, increase food allowances. A standard $200 extra for food for persons with Huntington's would cost about $5,000 a year for everyone on family benefits. I called somebody today, a social assistance worker, and they said the maximum extra diet is $68 a month. That's really unacceptable. That's for somebody with AIDS, I think.
Increase clothing allowance for persons with disabilities, allow a telephone at least for medical reasons, with a physician's letter if you need to, without applying to municipalities; and encourage the development of housing co-ops. I think if we had housing co-ops, people could spend one-quarter of their income on housing and have the rest for their food and everything. We would be creating jobs; we would be creating housing; it would have social benefits, and I could go on.
I think we should cover ambulance costs, cover necessary over-the-counter medications and supplies that are medically necessary. We don't do that. Even if people have severe side effects from medications, they do not get those costs covered. Cover eye-glasses, dental care, allow people to keep up to $5,000 in savings from Canada Pension or other. That is just so that people can have a little peace of mind, just so they can have something, especially if they have earned it. If it is Canada Pension that they've earned, allow them to keep some in the bank, because we keep them just at a subsistence level. There is no money there for any emergencies and it would result in better mental health and functioning.
Allow people to keep any monies they inherit. I am told Revenue Canada doesn't consider inheritance as taxes - I don't know because I will never inherit any money - but we consider it income. I have had clients and patients who have very severe illness and their mother dies and leaves them $3,000 and we take it, every cent. We take away their sense of security, their inheritance, what their mother left to them because they had an illness.
Allow persons with disabilities to retain half of any savings they realize on rent. Increase the amount of earnings people with disabilities can retain because people with disabilities sometimes can work. With Huntington's it is almost impossible, but with other mental illnesses people can work and we should allow them to keep what they make, or at least a higher portion of it. Institute a special transportation allowance, and eliminate the need for people to apply to their municipality for special needs.
This last one has got to go; it is a big waste of energy, time and money. For anybody here who doesn't know, you do have to, anything extra, dental work, anything, you have to go to the municipality. They have to take an application. They have to do an assessment. It is just silly.
MR. JERRY PYE: . . . not anymore.
MS. GEYER: (Interruption) Yes, it is.
MR. PYE: Not to the municipality. It is called an IAP Program.
MS. GEYER: Okay, but they have to apply to the other program which . . .
MR. PYE: That's right.
MS. GEYER: . . . uses different criteria for how much you are allowed to keep and you always have a surplus.
MR. PYE: Yes.
MS. GEYER: So it is two workers, whereas if you had family benefits get rid of all that foolishness, then you could just go right to family benefits and you say could I have some glasses, please, and they would say yes. Right? We could save all the money of the workers, and they could do something better, because they are good; they work hard.
Employ social workers in municipalities instead of people who are not social workers. Monitor the quality of service to eliminate insensitive punitive attitudes of workers and inconsistencies. I am worried about running out of time, so I am not going to give you examples, but I could give you lots.
I had a very nice discussion with somebody from Cape Breton today. I spent probably about an hour and one-half on this case and the person, it was all over $50 and how they had to move their doctor's appointment in Halifax to save $50, in the Municipality of Cape Breton. Now, they said, they weren't even paying for it but they were worried about paying this $50. I am getting carried away here, sorry.
Recommendations. Create a volunteer advisory board to advise the Department of Community Services. The only other specific thing I wanted to address in your initiative there is don't make parents of people with disabilities pay. They already pay a lot. If they weren't already supporting people with disabilities, those people would be dead or starved. I think anybody who has some real money, I have never met anybody in 20 years who has a disabled relative who is begging the province to pay for their relative; I mean it doesn't happen, not in my experience.
Dealing with costs. Reduce required home visits to persons with disabilities to every three years. We don't need to visit them every year; it is a waste of everybody's energy and money. Less employee costs in municipal units if you got rid of that whole thing. Look to the Pharmacare Program to reduce costs. I had a conversation with a lady about two weeks ago whose husband was dying of brain cancer. The doctor prescribed a nice little pill and the pill cost about $200 and they prescribed 30 of them. I have worked in hospitals a lot and if we just looked at Pharmacare and stopped giving people trials of 30-day prescriptions, we could save enough money to pay for the costs I am talking about, I am sure; I mean we could save a lot anyway. I know it is a different program, right, it is Health, but still it is coming from the tax dollars.
Save on emergency visits and hospital beds. I don't know how much I work in the emergency room of the QE II and I spend a lot of time talking to people who get morphine shots for dental pain and all kinds of foolish things. We give out meals at the QE II because people are starving there, too. So we do that and that's a waste of money.
Save on social programs that provide meals and support to people due to their poverty. I have nothing against food banks, suppers and all that kind of stuff, but I would rather give the money to the people so they could buy their own food.
Save on food banks, the people I deal with do not go to food banks. They do not go to food banks, very rarely. Part of my work was trying to convince people to go and get some food at the food bank so that they wouldn't starve, but they wouldn't do it, a lot of them. One girl, I remember very clearly, living on her own with a disability, a mental health disability, and she - very, very frugal, if you or I could ever live on what she does - said the only way she did it was to eat breakfast and only one, a supper or lunch, she couldn't eat both.
Save on family benefits by reducing shelter costs, and that's it. Do you have any questions?
Thank you.
MADAM CHAIR: Thank you. We will open it to some questions.
MR. PYE: Thank you, Madam Chair, I will go first. I usually sneak in first here every once in awhile.
Linda, the question I have for you. You indicated the kind of impoverished conditions that persons with disabilities in Nova Scotia have to live under, particularly if they're on a CPP disability and supplemented by the provincial social assistance programs, you represent the Huntington's Society of Canada, and I believe the Atlantic region might be more specific unless you're going across Canada, and I am wondering, how you rate Nova Scotia with respect to providing services such as special needs, such as income supplements, to individuals with disabilities compared to other provinces? Can I ask you that question, and have you done any statistic measurements on that?
MS. GEYER: I can't really answer that question because I cover Nova Scotia and Prince Edward Island. We only have a couple of people on the Island and I have been very impressed. I decided actually to stop going there more than once a year because the services there are quite good. I just found a difference, and maybe it is just the three people I had, but I can't really comment on the rest, I can't really on New Brunswick or so on.
[7:30 p.m.]
MR. PYE: I want you to know as well that we can relate to the stories that you have brought to us because of the 11 meetings we have had across this province. We have heard those very stories as well. There is one clarity, though. When you say the municipal assistance program is no longer, it is an IAP program within the Department of Community Services and they continue to tell us that is only there until they merge the Community Services Department together, so there is one program that is provided. You are absolutely correct with having to shift out of family benefits into the IAP to grab a special need and then to come back out again. It is totally uncalled for; it is not the way a government should operate. I tend to agree with you. Thank you.
MADAM CHAIR: Mr. Muir.
MR. JAMES MUIR: Linda, one of the things you did not mention in your presentation was any type of respite care particularly. Some of the people, whom I know, who have Huntington's have constant caregivers, and I can, indeed, remember going into a home and it was quite an eye opener for me to see.
MS. GEYER: It is quite amazing.
MR. MUIR: Is that readily available? For example, if a family is on benefits, is that included in the benefits package?
MS. GEYER: No.
MR. MUIR: Okay. Secondly, how many people in Nova Scotia are there with Huntington's, do you know?
MS. GEYER: Right now, the resource centre has only been open for two years, and 25 hours a week, so I have been slowly going around the province and we have been contacting more and more people. I have contact with 72 people with Huntington's, but in the last five years we have lost 13 people to Huntington's, so that is 85 I have had contact with, plus we have about 15 people who are gene positive, who will develop the disease. We have many people at risk, but those are the numbers. We probably have at least 100 people in Nova Scotia. That is statistically the norm, but I think we have many more than that.
MADAM CHAIR: Ms. Atwell.
MS. YVONNE ATWELL: In one of your recommendations, you mention an advisory board or committee to Community Services. Can you elaborate a little bit on your thoughts on that?
MS. GEYER: I did not spend a lot of time figuring out what kind of structure, because I know some people have talked about it and I figure they will come up with some more clear ideas. I just know that there has to be some mechanism that people can go to; for example, this simple little thing about food, about Huntington's, there should be a mechanism to go and say, look, we have a little glitch here, we have a problem, let's deal with it. There is no mechanism for the community to speak and, particularly, for people on family benefits, and there needs to be a mechanism, but the one thing I did specify was "volunteer". I don't think it should be government paid.
MADAM CHAIR: Linda, I have a couple of things. One is just a clarification. When you were doing your presentation, you made, I think, reference to the discussion paper as our report. Just for clarification, it is not our report; it comes out of the Department of Community Services. The other thing is, at the beginning of your presentation, you said you have been waiting 20 years to do this, so my question is in that context. What communication has your society had with the department? Have you made representation in the past with respect to some of the things you are giving us tonight and to what effect, if you have done that, what has your experience been?
MS. GEYER: Okay. Actually, as I said at the beginning, there are lots of things I could comment on, but I figured I would narrow it down to just very specific things that were actionable for people with disabilities rather than going on about what social workers have or have not been listened to or whatever. I feel I have voiced my concerns to individual workers, to supervisors, whatever, any time that I could and, in terms of the Association of Social Workers, I was on the Social Action Committee briefly, and I thought that they would be presenting and saying something to you but, to my understanding, we had quite a difficult
time getting a hearing with the Department of Community Services. That was my understanding as a social worker in the association, which I find very frustrating.
I think a lot of social workers - and that report, I am sorry, I didn't mean your report, the Community Services report - one of the things I notice is I have a lot of friends who are social assistance workers and they are very concerned about their clients, and they all say that everybody, every social worker that you speak to knows that the rates are way too low. I know that they were in focus groups and they said that, but I don't hear it loud and clear in that report. I hear a lot of other stuff, but I don't hear that about the rates. They said it, and I don't know where it is.
MADAM CHAIR: Are there any further comments or questions for Linda?
Mr. [Charles] MacDonald.
MR. CHARLES MACDONALD: Just for clarification, Linda. You say there are roughly 100 people in Nova Scotia who have Huntington's, and 12 of them are on social assistance. So that is the 12 that you would come in contact with, normally?
MS. GEYER: Oh no, I have come in contact with all of them.
MR. CHARLES MACDONALD: With all of them?
MS. GEYER: With all of them, but I am particularly concerned about that small number who are on family benefits, who can't eat.
MR. CHARLES MACDONALD: Okay. Who do you work for in particular? How are you set up? Are you set up with the Huntington's Society, do they pay you?
MS. GEYER: It is the Huntington's Society of Canada, yes. Most of our funding comes from the society and it is money raised by volunteers. We do get a small amount of money from the Department of Health, which we are very grateful for.
MR. CHARLES MACDONALD: Thank you. That is all.
MR. PYE: Do you mean the Department of Health, federally or provincially?
MS. GEYER: Provincially.
MR. PYE: Provincially. Also, can I ask you if it is possible for you to provide this committee with information with respect to persons with disabilities, particularly individuals with Huntington's disease across Canada? How their provincial governments assist them? Is it possible to get that information for us . . .
MS. GEYER: Sure. Yes.
MR. PYE: . . . so that we have some working material, that we can say that this is what is provided in other provinces and we can measure that with the Province of Nova Scotia.
MS. GEYER: Yes. I know that Quebec - my brother is a social assistance worker in Quebec - has a whole system where people with a severe mental illness, for example, or Huntington's, there is a set standard. If they have that disability, they get this amount of money and no questions asked.
MR. PYE: That is the kind of information I would like to receive.
MS. GEYER: Okay. Sure.
MR. PYE: Thank you.
MADAM CHAIR: Thank you very much. Before we proceed any further, I would like to introduce two members who joined us in the last few minutes: Murray Scott, Cumberland South, and Paul MacEwan, Cape Breton Nova. In our audience is Howard Epstein, Halifax Chebucto.
Our next presenter is Paul O'Hara from the North End Community Health Centre.
MR. PAUL O'HARA: Good evening everyone. My name is Paul O'Hara. I work as a community social worker with the North End Community Health Centre, which is located on Gottingen Street in Halifax. Our organization is funded primarily by the provincial Department of Health. Our health centre is committed through service, education and advocacy to play a leading role in concert with others in promoting healthy communities, and in particular, the north end of Halifax. Our programs consist of primary-health-care-related services, including physician, nursing and social-worker related services.
We are committed as an organization to including broader determinants of health in our work. These determinants include: employment; education; environment; income; shelter; food; social justice and equality; family, friends and social supports; peace and safety; cultural and rights relations; and other factors such as language; learning; meaningful work; literacy; recreation programs; self-esteem; and personal control. These are factors which we acknowledge as contributing to well-being.
Recognition of these terms of health is essential in any effort to improve community and individual health in order for them to be successful. Poor health is both an individual and collective problem and to problem solve effectively it is necessary to look behind the symptoms and illnesses in our communities to try to understand and, whenever possible,
address the underlying causes and contributing factors that result in poor health. Effective partnerships with community organizations and government agencies is an essential component of sustaining a healthy community.
On a practical level, in our health centre, this has meant: supporting the community and addressing proposed school closures and issues about meaningful access to employment- related services; we have been actively involved in advocating for licensing of rooming houses and for the provision of alternative housing for low-income, single people; our health centre provides direct services such as translation service for new immigrants to Canada; we offer cooking classes and prenatal programs; we have provided leadership in developmental work on a proposed health centre for our community; we have worked with government and community organizations on program proposals related to addiction issues; and we have initiated health-related programs specific to Black women in the metro area.
Our relationship to the Department of Community Services and to social assistance restructuring relates to the high volume of health-centre users who are recipients of social assistance programs. It is our experience that the health status of users of our services is heavily influenced by circumstances and living conditions to which they are exposed. We are concerned that the present social assistance restructuring process does not give adequate consideration to the deterioration of the health status of people dependent on social assistance; in short, there is no apparent evidence suggesting inclusion of health determinants in a social assistance restructuring initiative by the Community Services Department.
We are concerned with the reduction in shelter allowances for single, employable people. Clients have told me they give all their social assistance money to the landlord and then spend the rest of the month attempting to survive; these people eat through the support of soup kitchens and food banks. You can appreciate the barriers to health and employment with this kind of daily living experiences. We are concerned with the lack of adequate allowance for transportation needs and a telephone allowance for health- and employment-related reasons.
We are concerned with the housing and nutritional needs of single, pregnant women, particularly early in pregnancy. We believe the nutritional health of newborns is compromised by current levels of income assistance allowances. Physicians have also expressed concerns regarding smoking cessation programs, indicating several people who are trying to quit smoking do not have access to appropriate supports because the Pharmacare program does not cover them.
Income assistance is being promoted. I hope Mr. Pye is correct in his comments that once the province is fully engaged with the restructuring initiative that it will be a one-tier system and not an income assistance and family benefits one. These programs really are creating barriers for employment; they are not really helping people find employment. Basically what the income assistance program is, it is a lower allowance than the Family
Benefits Program. It places people's health, as well as their employment capacity, at risk. Something that is quite frustrating for me is seeing the income assistance program having an $18 reduction in personal allowances for each family member during the first three months the family is on income assistance; it is an unjust policy in an already severely inadequate system.
Community Services has what I would frame as an anti-family policy, which terminates allowances for dependent children who have reached 18 years of age and are not in school. The policy further charges board income of approximately $80 monthly while that dependent child is still in the family. It is really discouraging when people come to me and say that their family benefits allowance has been cut $250 because the oldest child in the family has just finished school. Their children are actually encouraged to go and apply for welfare themselves. Now, what is that for a Community Services Department?
Special needs items are dealt with through the Income Assistance Program even if the clients are actively family benefits recipients, and the last speaker spoke to some of that stuff through specific programs. All the health care needs that people have, the money for it actually comes out of the food budget even when the department will supplement to a certain degree. I will try not to get too anecdotal in my comments, but someone came in today - or called me today, rather - who just had a tumour on her throat, her esophagus, and the specialist told her she had to go on a liquid diet, starting right now, today. She will not qualify for the $68 on the Income Assistance Program because she is in the Family Benefits Program and she is overpaid. So, people do not have access to something as needy as that.
The Department of Community Services' implementation of the federal-provincial National Child Benefit Program is a little discouraging social policy. In 1996, Nova Scotia had a child poverty rate of 23.5 per cent. The new Nova Scotia Child Tax Benefit means families on social assistance are supplementing 60 per cent of their recent increase in the federal program, giving the money directly to the Department of Community Services for programs to create employment opportunities, presumably. Some family benefits families may or may not benefit from these programs.
Interestingly, New Brunswick and Newfoundland have not adopted this approach. Recently in the City of Toronto, one of the councillors there has put forward a resolution to council to redistribute the clawback from the Community Services directly to social assistance recipients. So there are efforts all across the country to change the National Child Benefit. The fact that the Department of Community Services implemented the Nova Scotia Child Tax Benefit Program without any community consultation, reinforces concerns in the larger community that any consultation process is going to fall on deaf ears.
I recently learned that the Governments of New Brunswick and Newfoundland have asked community groups to come to the table to help find a process for social assistance restructuring initiatives there. People I spoke with are not jumping for joy, they are very
cautious but again, the Department of Community Services in our province has a pretty bad track record in engaging people in the community in trying to develop their program initiatives. Our health centre is a member of the Community Advocates Network who are going to speak a little later and it is discouraging that it took an application under the Freedom of Information Act before Community Services made their discussion paper public information.
Physicians at our health centre are regularly asked to complete medical forms assessing employability of social assistance recipients. With few exceptions only clients with permanent disability are eligible for a higher allowance. This has forced physicians to identify clients as permanently disabled. That has a negative consequence on the self-esteem of the clients and places the physician in a conflict presenting inaccurate medical information. A physician report often requires a physician visit and presents an unnecessary cost to the health care system. All social assistance recipients, regardless of employment-ready status, have similar basic shelter and personal allowance needs.
In the presentation by the previous presenter it was mentioned that maybe just a letter from the physician is all people need in order to be supportive. Well, we don't need letters from physicians, people don't need to go to their family doctors. Social assistance workers can dig up the information, there can be all kinds of collaborative professional and community involvement in order to get the required information. It is creating more cost on the health care system by being very medically orientated in terms of eligibility requirements for social assistance. You have got bright, well-educated, very effective and efficient professionals working for your department; give them some space to do their work.
Most short-term disability could be adequately documented by social workers and related professionals. Again, this emphasis on medical reports and rehabilitating social assistance recipients and breaking the cycle of poverty begs the question on the causes of poverty. Although medical and behavioural approaches have their place, socio-environmental models demonstrating health promotion initiatives are lacking in our community.
Leadership from the Department of Community Services in supporting models encompassing community economic development and related activities at the local level would be well received. Such initiatives could go a long way in supporting social assistance recipients in their quest to become independent.
Health centre staff involved in community initiatives expressed concerns about the lack of collaboration among government departments, particularly as it relates to women attempting to become employable. Student loans and social assistance, even subsidized housing are not coordinated. So you have the Department of Housing, the Department of Community Services and the Department of Education obviously not working together in the way they develop their programs. It really puts social assistance recipients in a disadvantaged
position and I could give you all kinds of examples. The options in child care are also very limited for people attempting to find employment.
At your November 10th hearing, Mr. Pye asked Carol Isenor of the Canadian Mental Health Association if disabled people had reported any decrease in benefits as a result of changes in eligibility due to the provincial takeover of social assistance. That same day a young pregnant woman came to my office stating she had no food to eat and her disabled partner on family benefits was told by his worker he would have to reapply for the lower benefit program of income assistance if his pregnant girlfriend moved in with him. The couple now attempt to live in the same rooming house renting different rooms at a higher total cost to the system than if they were sharing the same apartment.
This would not have been the case prior to the Department of Community Services takeover of municipal social assistance. A second disabled client was in my office yesterday with a very similar problem, so this stuff is happening, ongoing and, again, it is an anti-family kind of approach to community services. It really has no place there. In meetings with senior bureaucrats within Community Services, we have been asked not to provide anecdotal comments. These are daily experiences of those of us dealing with people rejected by social assistance.
Harold Crowell pointed out, on November 10th, the Department of Community Services is working against its intended objectives by having a two-tier benefit system. The present system creates barriers from health, employment and family perspectives. Bureaucrats have also told us, as advocates, that it is difficult to get support for social programs because of the negative attitudes in the general public. My question is, where is the department's commitment to address poor-bashing? What statistical information is available from the Department of Community Services? The web page on the National Child Benefit is misleading; it contains elements of poor-bashing. Readily available and accurate information could be used to counter the attitudes; it could also be used to guide program development by community agencies.
We don't get it - Linda Geyer said that she had been waiting 20 years. Well, I have been talking 20 years and I will continue to talk and raise my voice and go to rallies and do what I have to do to try to represent the interests of the people that I work with - it is really discouraging. I really hope that the Department of Community Services gets the message that there are lots of people in the community who have things to say, positive things. We want to work with them, but we're shut out, and that needs to be addressed.
A special service to social assistance clients at the health centre is referred to as a trustee program; this is intended for recipients who, for a number of reasons, are unable to manage their finances. Other community agencies also provide this service. The demand in the community for a trusteeship is increasing, and this is in part because of the Department of Community Services takeover of municipal social assistance. Organizations in the
community have asked for a coordinated approach to a trustee program with a community development component middle-management staff of the Department of Community Services recently suggested we make submissions to yourself regarding a need for a trustee program.
We have been asking for this for about three years now and it falls on deaf ears. The Minister of Community Services has acknowledged our concerns, but we are not encouraged and we are not asked to develop specific proposals. Again, this is in writing, this is at meetings, this is in all kinds of ways that we would have to make our concerns known. We believe, for example, a community development approach to a trusteeship can have a significant impact on the rooming house problem in North End Halifax.
The Department of Community Services does not appear to appreciate this responsibility to actively participate in the resolution of the rooming house issue. I am aware of one landlord of run-down rooming houses in North End Halifax whose gross monthly income is close to $10,000, from social assistance shelter allowances paid by the Department of Community Services, and the Department of Community Services washes its hands of this issue.
In closing, the one thing the Department of Community Services could do to improve the quality of life for people on social assistance would be to incorporate the determinants of health and social policy development. Such a commitment could be implemented in a demonstrable way through programs and services in the community. I appreciate this would be most challenging, given the inherent difficulties of managing such a large bureaucratic institution.
Small initiatives within specific programs and legitimate support for staff time to these initiatives would prove most rewarding: it would advance meaningful relationships between community organizations and the Department of Community Services; it would provide recipients of social assistance an opportunity to actively participate in defining their own needs; it would advance their capacity to improve their quality of life; it would acknowledge the contribution social assistance recipients wish to make to the health of their communities; and it would provide a strong sense of personal self-esteem and go a long way in enhancing job readiness.
Thank you for the opportunity to present before this committee, and the interest of the elected representatives in the complex issues associated with ensuring a just and equitable social assistance program.
MADAM CHAIR: Thank you, Paul.
Mr. Balser.
MR. GORDON BALSER: In the bold type on the inside, second page, you list 10 items and you make reference to those in your summation; that is, employment, education, environment and so on. The difficulty I think - certainly that I am having - is trying to unravel the ball of string. If you could make one recommendation, or you see one particular area where, if the restructuring was to focus attention, it would have the most significant impact, that is if we were to come away with a recommendation to target employment because that would trickle down into the other areas, or something of that nature, could you speak a bit about that?
MR. O'HARA: I think I tried to do that in closing. I believe that a community development approach needs to be enhanced within the Community Services Department, particularly a social assistance program to help people. Self-esteem is a real issue for people on social assistance and it is a very dehumane - I don't know if that's a word - it is a very . . .
MR. PYE: Dehumanizing.
MR. O'HARA: Thank you. Dehumanizing process for people who are constantly rejected and feel frustrated. I think that the staff, in particular in social assistance programs, need to be given some opportunity to do their work in a different way, to define ways of working with people as opposed to just kind of shutting them out. So if you have a large number of people on social assistance in a particular area, or single employables, find a way to bring those people together to work with them through the employment support program, or whatever, get out of that hierarchical way of delivering programs and get into bringing people together to identify some of their own needs and some of the ways that they think that they can get those needs met, and help them do it.
The Department of Community Services is not going to solve the unemployment problem. Figure out what it is that you can do and start doing it. Find out what the strengths are of the people who are on social assistance. Find out how the department, in its capacity and its resources can work effectively with those groups. It is a way of thinking. It is moving away from this medical motto or this behaviourist motto, saying we have got to break this cycle of poverty or we have got to rehabilitate these people so that they can go to work. Get to know people for who they are and what they are, and find out where their strengths are and help them advance those strengths. To me, it is a philosophical and a different way of approaching a problem. We are too stuck at welfare, you know, poor-bashing and looking at people and let's try to motivate them or change them somehow so they won't be so lazy or lack incentive or be dependent on the state.
That whole thinking is what needs to change and no politician of any political stripe has demonstrated to me that they are committed to that. I haven't heard anybody make strong statements. I don't think, from an MLA perspective, but from a leadership perspective. The Premier or the Leader of the Opposition or the Leader of the Progressive Conservative Party, I don't hear them say these things. They are all afraid of it I think. Like we can't say anything
to say we want to support people on welfare because there's a negative connotation to that and it drifts all the way down through the system. We have to change that whole concept of the way we view people in our communities, and how we need to make our communities more healthy. I can give you 1,000 examples of how that plays itself out. I don't know if I have answered your question or not.
MR. BALSER: We certainly have heard the issue of people who are directly involved becoming desensitized over time. I think that's what I am hearing, that there's a need to make the system more sensitive to the issues, and take a more holistic approach to the problem I guess.
MR. O'HARA: For sure, and to initiate programs that are developmental in nature and not to find a way to push people off welfare.
MR. BALSER: Thank you.
MADAM CHAIR: Ms. Atwell.
MS. ATWELL: Thank you, Madam Chair. I don't really have a question, just a comment. When I worked at the African-Canadian Employment Clinic, we watched the North End Community Health Centre grow in terms of involvement in the community. In my opinion, it has been a centre that has worked very closely with all elements of the community and is very progressive and has taken into consideration that health is just not about critical health, it is about a healthy community.
So when I looked at all the different areas that you are involved in, it was very encouraging because I think that is a way for us to deal with health in our communities, in a more holistic way and to see things like a health program for teens, I think that is quite exciting. The Black women's health program that I have been involved in, I just wanted to make a comment that the clinic is in an area where we know that there are many problems within that community, but it continues to grow and I think it is really important that government support these types of initiatives in the best way that they can and to listen to those people who use the services. Thank you for that.
[8:00 p.m.]
MR. O'HARA: Thank you very much. We hope the Department of Community Services learns that some day, because there are glimmers of hope in that within Health, and we get support from Health that allows us to move in that direction. That is the point I am trying to make here, which I am not making very well I guess.
MS. ATWELL: No. You are doing fine.
MADAM CHAIR: Mr. Pye.
MR. PYE: Paul, my question to you is, do you keep stats, records, information on when clients come to the North End Health Clinic, what their particular needs are, and if in fact there is a set pattern across the board with respect to that statistical information, and in fact, the needs that are not met by the Department of Community Services and/or the Department of Health, because both of them are in your domain?
MR. O'HARA: Well, I couldn't pull out a book with statistical information. I guess I try to do my work in relation to what I experience every day, and for me, it is the problems that are presented to me by the people I work with. I try to develop them in relation to social policy or health policy issues, and then work in concert with others, the community advocates network in relation to the social assistance restructuring. My connection to those issues is through the stuff that I talked about here and through groups like the Community Advocates Network.
People who come to me with rooming house issues, there is a good example, and we are trying to get people into detox all the time, but if it is not just at the detox level, then there are problems, it is just like a revolving door. What is it that brings people to the need to go to detox, and what are the alternatives, and how can we provide better services and more supportive situations for people so that they are not dependent on detox services.
MR. PYE: The reason for my asking you that question is that you brought up in your presentation on November 10th, my comment with respect to the individuals on family benefits who are in fact being shifted to the IAP program. I am just wondering if in fact there is a set pattern, because I have noticed in the number of calls through my office and so on, that in fact there seems to be a pattern in the Department of Community Services, as you know, persons on family benefits are usually long-term disabled people, and they are never going to be off family benefits. What they do is they encourage them to get into the IAP program for a special need and they are left there, without getting back into family benefits. That is one way of reducing the number of family benefits clients. During the budget estimates in June, the Minister of Community Services, I do believe, made the comment that the number of people on family benefits had decreased. So that is the reason why I wanted to get that kind of statistical information, so that the committee could be aware of that information.
My final question to you is, do you believe, and I have had a conversation with my colleagues this afternoon about this, the political will of any political Party is out there to dispel the myth of people on social assistance, and that in fact there is the political will to truly address the problem?
MR. PAUL MACEWAN: That is politics.
MR. PYE: It is not politics at all.
MR. MACEWAN: It is. It is terrible.
MR. PYE: I asked if any political Party, Madam Chair, you can rule on that.
MADAM CHAIR: Just one moment. The question has been put, and it is up to the presenter whether or not he wishes to answer it.
MR. O'HARA: Well, I think that in Nova Scotia that needs to be demonstrated, and demonstrated clearly. None of the political Leaders, from my perspective, have demonstrated it. Here, as I said in my presentation that in New Brunswick and Newfoundland, there is some hint of that, that it is there. I would really like to see it louder. That is how I will choose to answer.
MR. PYE: That is simply my reason for asking you that question, that you made reference to it.
MR. O'HARA: There were points that you raised around statistical information, the Department of Community Services should be made to keep some record of who they are refusing and the reasons why they refuse them. People get turned down every day on telephone calls, and they think that there is nothing they can do and they don't do anything and they go without. So I think it should be incumbent on the Department of Community Services to keep some record of how their policies are impacting on people who don't get access to services and why.
MR. MUIR: Just one quick question for you, Paul. How many separate agencies or community services are located in the North End Community Health Centre, in your building or whatever it is?
MR. O'HARA: Well, we own our building. We are a non-profit organization. It is a citizen organization. We have a board of directors. We own the building that we are in. We have a mortgage on it. There are no other groups. It is just us.
MR. MUIR: For example, do you have family physicians come in? Do you have a medical clinic, I guess that is the type of thing or Drug Dependency?
MR. O'HARA: No, we have about three and one-half physicians who are on salary with us. We have four or five nurses. I am the only social worker and we have other support staff. We have specific programs that we receive funding from various groups to run now and again.
MR. MUIR: So you actually run the programs as opposed to having four services yet there are four more that you provide space to? Everything is under you, you administer it.
MR. O'HARA: We run our own program.
MR. MUIR: Yes, I understand now. Thank you.
MADAM CHAIR: I have a couple of questions. One of my questions is about the trustee program. Rather than have you explain it, because it may be a relatively detailed explanation, I guess my question is, have you a written proposal that sort of outlines what it is that you are looking for in terms of trusteeship and if so, can we have that?
MR. O'HARA: The closest I could come to that is a letter I have written to the Minister Francene Cosman a while back saying that we needed it. It wouldn't be hard to put it together. We ask for meetings to talk about it. We try to get some sense of the will to do it and it hasn't presented itself as of yet. So, no, we haven't been encouraged to submit a proposal so we don't have one.
MADAM CHAIR: And there are other organizations that are looking at this issue besides the North End Community Health Centre?
MR. O'HARA: There are a couple of agencies. Veith House, for example, provides a similar service as the health centre does, Metro Turning Point Centre and Brunswick Street United Church.
MADAM CHAIR: My last question is with respect to your comments about having been asked not to provide anecdotal comments when you meet with Community Services at this senior official level. Does the department provide money to community groups to do research so that you are not in a situation where you have to provide anecdotal information or do they give you access to their data so that you can, in fact, develop sort of more empirical recommendations?
MR. O'HARA: No, there is no encouragement at that level at all. It is really kind of demoralizing and we are not sure of the reasons. I am not trying to badger people who work for the Department of Community Services. There are all kinds of good people within that system who work really hard but I want just clearly to say what my experiences have been and I would really have appreciated a health promotion strategy within Community Services. There are community health centres all across Ontario who collaborate with the Department of Community Services and do receive funding to develop specific programs. We are a small province. We have a small tax base but there has to be some kind of a vision or a sense of commitment of doing things a little differently. Whatever the reasons are, it is not happening. I think the political will needs to come and the Minister of Community Services needs to get support in caucus, needs to get support in Cabinet. I don't see it from politicians.
MADAM CHAIR: Are there any further comments or questions?
MR. CHARLES MACDONALD: One, Paul, on your housing. You talk about shelter and I think Linda talked about it in her presentation as well. I am not from the city. You do have low rental housing in the city?
MR. O'HARA: Yes, it is there and I would like to see Community Services tell us, how many people do they provide assistance to who are in low rental housing. I would guess it is not a lot. I believe that at least 60 per cent, and probably more, of all social assistance money goes to landlords.
MR. CHARLES MACDONALD: You are a landlord, in your own right, in that you own the building that you are occupying now and you operate out of. Do you ever look beyond that to the point that you may, in fact, get into tenancy itself? It has been done in other areas.
MR. O'HARA: Part of my work is supporting the development of non-profit housing and I am very active with an organization called Metro Non-Profit Housing Association. That is how I have developed that part of it and right now we own four buildings, two in Dartmouth and two in Halifax, where we are providing housing for low income single people and we have a development proposal for the Gottingen Street area for another building for 19 units. So we are very active on that issue and we have tried really hard to get Community Services to play a role in it and they step outside of it. They say we can make no decision on where people live and if they live in these run-down rooming houses, there is nothing we can do about it.
Now I need to qualify that because two or three years ago, the department did give us about $15,000, actually, to do research, cost-shared with the Department of Housing and we did a very clear and specific report and we are acting on the recommendations from that report now. We get support by the provincial Department of Housing to do some of the work that we are doing. We need the support of the municipality right now for the piece of property on Gottingen Street that we want to do the development on and we are not sure if we are going to get that. So anybody who knows Graham Downey in this crowd tonight, if they would go and talk to him and say, Mr. Downey, we believe that the rooming house situation in the North End of Halifax is disgraceful and we think you should support the efforts of anybody who is trying to do something about it. We would really appreciate that.
MR. CHARLES MACDONALD: I am glad to hear that, that you are ongoing on that side.
MR. O'HARA: I will give you one of my pamphlets before I leave tonight that will explain a little bit about that particular initiative.
MADAM CHAIR: Thanks, Paul. Our next presentation is from Halifax Drug Dependency, Bill MacNeil, Chris Willett and Edith Short. Is there anybody here from the Disabled Individuals Alliance, Peggy Brown and Lorne Ryan.
MR. LORNE RYAN: I am currently the Chairman of the Disabled Individuals Alliance.
MADAM CHAIR: Thanks, Lorne. Just speak into the microphone and we will get it all down for Hansard. Thank you.
MR. RYAN: I will just give you my card so you will spell my name right.
MADAM CHAIR: Good evening.
MR. RYAN: Good evening, ladies and gentlemen. My name is Lorne Ryan. I am currently the Chairman of the Disabled Individuals Alliance and I do have a written submission for you to read but I am going to be canny and hold on to it until I am through talking. If I give out printed matter in advance, I find people have a tendency to look at what is printed rather than listen to what I am saying. I am sure you have all had that experience so I am going to hold onto my information until I am through but I would ask you, if you have any questions, please to wait until I am through talking. How much time do I have, just so I don't go over?
MADAM CHAIR: Well, we have asked individuals to take about 20 minutes, if they can and then we will have 10 minutes for questions.
MR. RYAN: I have got time for a sermon, then. (Laughter) I base my comments and observations on the draft discussion of the Community Services Action Paper dated June 26, 1997. So there may be changes in page numbering and wording but my understanding is that the White Paper, as circulated, bears a very close resemblance to the draft paper of June 26th. If there are any problems, because I am using the earlier version, I apologize for this in advance but on the other hand, you may find it interesting to see where it differs from what was actually distributed. So if there are any differences, I would ask you to make note of that. What I am going to do is go through the paper systematically making comments, as they appear appropriate, I will refer to the page which that comment is derived from, so you can check it out. This will be in my written version so you don't have to bother being sure whether I said three or five.
To begin with, the paper on social reform states that it is seeking to update social assistance policies and regulations for the needs of today which will make the system more flexible and responsive to the people who need it. That sounds very nice. People involved do not feel this is true.
A survey done by a group dealing with social assistance called the Community Advocate's Network surveyed some 211 people who were on family benefits. A very large majority felt the system was not dealing with their responses, with their needs, and only 1 per cent of them were aware that you were trying to change the system in any way, shape or form. So if 99 per cent of people are unaware that anything is going to change, you don't have a lot of input from the people who are involved. The paper says that we need a system which will allow people to move toward independence. That is Page 4, Paragraph 5.
How are you going to be independent when you have a travel allowance of $18 per month, per family. That comes from the family benefits manual, reference Page 03-01-02. You don't have to write that down, it is in my notes. That comes from the 1991 family benefits manual. So that is the 1991 figure. It is seven years old but I don't think they have changed that figure in 20 years so it is probably still relevant. So $18 a month for an entire family to travel. You can't even get a tank of gas for $18.
Now I understand that this has been amended. I made comments on this before. I understand this is now up to $100 per month travel allowance for those seeking work. So if one member of the family is seeking work, then presumably the family allowance is up to $100 per month. But if nobody in the family can afford to work, they are still at $18 a month and you can't get a bus pass, even in the City of Halifax, for $18 per month. What it is for people unable to work or not is something you should really check on. What is the current travel allowance? Let's remember something. This is something I am going to refer to later. There are only two places in the entire province where there is public transit. Halifax-Dartmouth and Kentville. Any place in between, good luck.
What about the rest of the province? Many people looking for work in an area, and I am referring to work because it talks about independence and one of the best ways of being independent is to work, one of the ways of finding a job is simply to go to an area and drop off a bunch of résumés. I have done it, hundreds of other people have done it, thousands of them. How do you get to that area if there is no public transit and you have to get somebody to drive you and you have to pay them to drive you, pay them to drive you back? I don't know what it is outside of Halifax but I know that to go a very short distance in Halifax, you are looking at $5.00 to $10 for one way, and across from Agricola Street to Brule Street in Dartmouth is $14 and one trip blows your family budget for the month. So how do I drop off my résumés?
Many people looking for work look for work in the newspapers. What if you can't afford a newspaper subscription? A good way to look for work and be independent is to use a telephone but Community Services regard a telephone as a luxury. It is not part of the family benefits package. If you have an application in, the simplest way to check and see if they want to really see you is to call. On the other hand, if they want to see you, they usually call and make an appointment but if you are not there to answer the phone, on to the next applicant. So you lose the job. Most jobs have 300 people applying for them. If you are one of the lucky
10 or 15 that are chosen and you don't answer that phone for the appointment and they can't schedule you in, good-bye, onto number 299. You are out of luck. So because you don't have a telephone, you are out.
Let me go on. How do you call for medical advice? You are supposed to have call-in centres. The government is promoting this call-in advice. How do you do that if you don't have a phone? Your son is down sick, it is 10:00 o'clock at night, there is no public transit and you need advice. What do you do? Do you take him into the emergency room, wake up your neighbour and get them to drive you in? How does the doctor call you back to tell you that your appointment has been changed? You have no telephone. Your child is in school and they become sick, how does the school call you to tell you to pick them up. They have a problem and I need your advice on what to do with this child. You can't, you don't have a telephone. So what do you do?
How do you call your social worker if you don't have a telephone or how does your social worker call you and say look, I want to see you about your last report? They don't have a telephone. Are you going to supply everybody with cell phones? I don't think so. City council might but not Community Services.
Let me just mention something that you might want to take under advice. I have discussed this with a member of MT&T. It wasn't a formal discussion, it was informal. He indicated that due to the fact that Community Services has got over 20,000 people on its books, MT&T might be willing to give Community Services a break on the basic phone bill if they were willing to sign a group contract so that anybody on Community Services would get a special rate. And why not? You have 20,000 guaranteed customers. How many companies would not be willing to give a break to somebody who could supply them with 20,000 guaranteed customers. I think there are very few that would turn it down. Give them a special rate. Now I grant you, you have to pay for call waiting and all the other little frills that people like to sell you but just having a basic telephone so you could call and say, listen, what time do you want me to come in for the job, that should be covered by your local exchange.
So that is something that could be considered and discussed with MT&T. I am sure if there are business people there at all, they would be willing to discuss it if there was a potential customer with a $20,000 additional customer base or more.
Now let's take a look at the basic living expenses of one person and please tell me if I am starting to get long winded here. Under the guidelines of 1991, which is what I had to work with, and I believe they are still in effect, a single adult receives a maximum allowance of $700 per month or roughly $175 per week. Now you can talk about rooming houses but they work out to about $75 a week or you can talk about one bedroom apartments and that works out to about $300 per month, minimum, for a one bedroom apartment that is anywhere
decent. This just gives the person four walls, a roof, a floor, heat and hot water, a stove and fridge. A person now has $400 a month to deal with the other necessities of life.
For example, in the apartment just described, there is no light. It is dark out right now. He would like to see what is in his apartment. He has to pay for that, that is an additional cost. Electricity will cost $18 to connect plus a deposit if you do not already have credit. Now the person can stand naked in the light and see the empty food cupboards, empty closets, lie or sit on the floor, since they don't have a bed or a chair. Once connected, the average electric light bill will be approximately $30 per month plus, of course, HST, which brings it up to $34.50. We now have $365.50 for other things like food, like clothing.
Of course, if the person is seeking work, the easiest way to do this is to have a telephone which costs $30 to connect plus HST, bringing it up to $34.50 and a base rate right now, no deal, $26 per month plus HST to $29.95. Leaving the person still naked and with no food but with a telephone and lights and $335.60 a month to get the other necessities of life. If they live in Halifax and want an economical way to travel, they should get a bus pass, currently $55 but soon to go up plus HST for $63.25, leaving them with $272.35 a month or $68 a week for clothing and food, furniture, light bulbs, toilet paper and so on.
Since most people on family benefits cannot afford a washer and dryer, they have to go to a laundromat and pay so much for each load to be washed and again for each load to be dried. Then, of course, there is laundry detergent to be bought and something to carry the laundry into the department to where the washer and the dryer are located. Of course, if they have a job interview, the person would like to get a haircut and this, again, has to come out of their food budget. They are not having a lot left, are they, by the time we get down to this point. Not a lot at all.
I would like to point out that the majority of single adults do not get $700 a month and I am sure there are many here who can answer you what the average is. My understanding is it is between $400 and $500. (Interruption) $469?
MR. PYE: $225 for the . . .
MADAM CHAIR: $369.
MR. RYAN: Well, that is fine, just take it out of the food budget. (Laughter) That is what you have to do, people. You only have so much to work with; $369, okay, so after you pay your rent of $300, you have $69 a month to do with for everything else. I invite anyone in this room, and I would think the majority of us are not living on $369 per month less, of course, the HST which has to be taken out. So, ladies and gentlemen, I think seriously you have to take a look at what is being paid.
Let me not forget this, that we have something else we are overlooking here. We are overlooking a nutritious diet. We are supposed to have five kinds of fruit and vegetables a day, cereal, a dairy product and protein. Bananas are 69 cents a pound. How many bananas do you get in a pound? One banana, two banana, three banana, four, five banana, six banana, seven banana, more? I don't know. I bet probably two to three. So one banana a day, how many do you go? How many apples to a pound? On $68 a week and you are correcting me and telling me I am way too high by about $400, how are you going to have a nutritious diet? If you don't have a nutritious diet, you don't have good health. If you don't have good health, off you go to the hospital. Up goes your hospital cost. The cost in the QE II, I understand, is about $1,000 a day. (Interruption) $1,100, I stand corrected. I seem to be hitting things either high or low here. Thank you for correcting me. The point is, gentlemen, that one day in that hospital would make a big difference to a lot people's food diet and giving that money to them in a food diet might save a lot of hospital beds, prevention.
Now I have probably taken longer so I am going to hit one other point here and you can read the interview in the pages. I am sure you have many exciting things to do and many other submissions to read and if you have trouble going to sleep at night you can read these submissions. I still have seven minutes and I have time to do the question that struck me as most interesting. How can the system formally weigh the cost of prevention programs against the cost of paying for them? Well, I have a suggestion for you. I will give you an example which I used here. Let us take a look at the criminal justice system, or the cost of keeping a prisoner. The number of prisoners multiplied by the number of years spent in prison out of each person's lifetime could be calculated. Programs which prevent such things such as education would then be shown to save the cost of keeping the person in prison over their entire lifetime. In addition, there would be reduced costs in terms of policing, legal defence, transportation to and from jails, et cetera. The cost of saving even one individual from prison would be tremendous.
Let me go into more detail. The provincial government here in Nova Scotia spends between $20,000 to $25,000 per person per year to keep a person in jail, sitting on their rear end, looking at the bars, waiting for time to pass. The maximum sentence they can have here in Nova Scotia is two years less a day. Two years, plus a day, they go to a federal penitentiary. The cost then climbs to $50,375 per prisoner per year. So let us look at one individual, a 20 year old criminal, commits his first offence, goes to jail for the maximum provincial term. It costs us $40,000 to $50,000 for that term. He is out in two years. He is 22 years old now, probably, and between 20 and 65, I don't know what the criminal retirement age is, but let us say 65 so we are talking the same as everybody else, he has a chance to do a number of things. He can be in jail 22 times in that time span but let us be generous and say he is only in for 15 times and that is possible. Many criminals are repeat offenders, talk to anybody in the justice system, 15 times makes it easy to calculate and it will allow him some time off between trials. Although I do know of one case of a guy who was charged with armed robbery and while waiting for trial committed another armed robbery while he was
waiting for the first trial, he was caught on both cases. So criminals are not the brightest people in the world.
[8:30 p.m.]
So let me go on and I will just say that over that 40 year period it is going to cost between $600,000 and $750,000 to keep that one person in jail. Any prevention program that stops that one person saves us from $600,000 to $750,000. Now that is not including the cost of 15 criminal investigations, it does not include the cost of 15 trials, it does not include the cost of 15 lawyers to defend him, it does not include the cost of 15 persons to prosecute him, it does not include the cost of transporting him to and from jail 15 times, it does not include the cost of any transportation and medical services he requires during the time he is waiting for trial and on trial. All those are over and above that $600,000 to $750,000. So we are talking about a huge sum of money to keep one person in jail. Any program that prevents that saves us that amount of money. Most important, it does not include the psychological impact to the victim of coming home and finding their door kicked in and their property stolen and maybe something worse. So any program that prevents criminals is saving us millions of dollars, literally.
To estimate formally what a prevention program would save you would have to estimate the total costs of the above factors and more which is possible, it could be done and you would have some idea of what the cost is to the province for one criminal. Any prevention program that prevents that is saving you that much money. This could be done for other programs.
I would like to mention just one other point here and I left my name and phone number here if you want to discuss this with me further. One other question was raised in this report and that is should private funding be involved in Community Services? The extent to which a program depends on private funding, the extent to which this government depends on the program or the program depends on private funding to my mind has been measured by this government or any other government who abdicates its responsibility to its citizens as a whole.
These are only some preliminary observations, ladies and gentlemen, if you have any questions I will be happy to answer them. I do have this in writing so you can all read it at your leisure or in your bathroom whichever you feel is appropriate, I do a lot of reading there. Thank you.
MADAM CHAIR: Thank you Lorne. Are there any questions or comments. Mr. Pye.
MR. PYE: Thank you, Madam Chair, to Lorne, you said that any prevention program would save $600,000 to $750,000 over the life of that individual being in prison. You didn't measure into that equation the cost of the programs, did you?
MR. RYAN: No, I did not because I was doing a comparison here between the cost of the program and the cost of the money that would be saved. The point is, and let me specify I was referring there to a criminal prevention program, there are others. No, I did not because what we were doing was comparing the cost of the program to the cost of what it saved and therefore you would have to take that comparison over the time that it would take to affect the individual, to prevent them from becoming a criminal. The other thing you would have to look at is how much extra that program is, over and above things.
A good example of one case that I will give you, I don't know if you remember a case of a few years ago of a fisherman who was charged with five counts of sexual touching. The judge dismissed the charges because nobody could talk to him. He was deaf, he was unable to speak, and no one could ask him a simple question. How do you plead? Are you guilty or not guilty? So all the charges, all the effort that went into bringing that man to trial were thrown out because nobody could talk to him. He was 50 or 55 years old when that charge was laid.
If he had been in the school system, and if a way would have been found to communicate with him at that time, how much would it have cost? I don't know. But I am sure it wouldn't have affected just one person; you have to also say, not just one person, but you are talking about a program you have to divide by the number of people that will be affected. Usually it is not just one person. It is not a simple equation by any means, but it could be done. If you want to pay me for it, I will be happy to charge $1.5 million to draw up a report.
MR. PYE: No. That is sufficient. That wasn't meant to diminish the thrust of what you were presenting. It was just a matter of bringing the equation closer together.
MR. RYAN: Yes. I am quite happy to answer that question. I didn't mean to be sarcastic.
MADAM CHAIR: Are there any other questions or comments for Mr. Ryan? Thank you, Lorne.
MR. RYAN: Thank you. Who could I leave this with?
MADAM CHAIR: Kim. Thank you.
MR. RYAN: Thank you for giving me your time.
MADAM CHAIR: Thank you very much. Our next presentation is from a committee, the Vocal Committee, Chris Fyles and Brenda Delorenzo-MacKean.
MR. CHRIS FYLES: We are presenting from a committee which is called Vocal. I think you have a copy of our report. It is a group composed of mental health consumers and service providers, providing employment services to mental health consumers. I work for Lake City Employment Services Association in Dartmouth. Brenda is involved with the Connections Clubhouse in Halifax. We are representing the group.
The purpose of our committee is to improve access to a range of employment opportunities for mental health consumers, which would include issues relating to the social security system. Over the years, our committee has made several attempts to meet with the Department of Community Services to make presentations on how we feel the system could be more responsive to mental health consumers in the system for them to be involved in employment and access employment and made written presentations and have had sort of mixed response as to whether it actually gets us anywhere. We were pleased when we heard there was an opportunity to make this response to this committee. We have written to the department as well and sent in a written response by the October 31st deadline.
Part of our mandate is also to provide information to consumers and service providers about existing training and employment programs, so that the programs that are available within the community, so that we all know about what is available, so that we can help people access those programs, so that the mental health consumers can find the information themselves, and to promote cooperation between the various service agencies, because they are and have been quite isolated, working on their own in their little field of expertise, and have not necessarily been connected all that well together. We are trying to promote cooperation and better access to the consumers in that way as well.
Also part of our mandate is to be informed about government policies and regulations affecting employability of mental health consumers and to provide education to mental health consumers and service providers regarding how these policies affect the employment of individuals. An example of that came up for me at a conference that I was attending, there was a group there from Cape Breton. Actually, there were a number of groups, they were all employment service groups. One of the groups that was assisting mental health consumers to access employment were telling their mental health consumers that if they were on the Canada Pension Plan that they couldn't work and keep any of the money that they earned. I was able to, which is kind of unfortunate, because we have discovered and it was not easy that you actually can work while you are on Canada Pension and keep some of the money up to a certain limit and the trouble is that they do not have that written down anywhere. In order to find it out you have to phone a lot of places until you get to the right place and you do find it. Even when you get there, they do not tell you exactly what the rule is. They will only tell you on this particular individual, on this particular case, this is what you are allowed to do.
You want to know the rules so that you can use them with the other people you are working with and they will not tell you. It is not surprising that the individuals don't know if the service providers don't know. We are working to try to educate ourselves and the
consumers that we are working with so we know what the rules are, so we know what the marching orders are and we know how to proceed. That is the group that we are representing. On the next pages we are talking about some issues that we want to discuss.
MS. BRENDA DELORENZO-MACKEAN: Individuals living with mental illness face many challenges on a daily basis. Due to an early onset of the illnesses, basic social and day-to-day life skills acquired may be at a minimum level. Quite frequently, individuals do not complete Grade 12 and have little or no work experience. Due to the severe and persistent nature of some of these illnesses, they are often in need of long term income assistance, while the greatest challenges they face in coming to terms with their mental illness is living within the income assistance system. I was very lucky to go back to school as a disabled student. When I turned the age of 40, I went back to school. My education was interrupted by mental health problems, but I was able to go back to the Nova Scotia College of Art and Design. I did not quite finish because I got sick again, but due to these illnesses, in order to get a job, with Grade 9 or Grade 10 education, it is hard to get a job because the illness affects you and you cannot complete your education.
MR. FYLES: But at the same time, many people do want to go on and do something to further their education.
MS. DELORENZO-MACKEAN: They want to go to community college or do their GED program and get their Grade 12, or go back to university and complete their course and go on and do jobs. People with mental illness can work and it is proven, because we have temporary employment jobs at Connections Clubhouse where people go out and work for six months. They do maybe four to six hours a week at a job and get paid so much money. It boosts their self-esteem and it shows that they can work and that they can contribute to society, and that they do not have to always live on social assistance. There are people who can go out and work with mental illness.
These challenges are: meeting basic needs of daily living; accessible, decent, affordable housing; affording adequate food and clothing; achieving a reasonable lifestyle; access to eye and dental care. We have food banks, secondhand clothing stores. While food contributes to your health, for good mental health, one needs to have healthy food. I am not talking about prime rib or expensive meals, I mean fruit and vegetables and these sort of things to buy. I am a very lucky person because I attend Connections Clubhouse and I can get a high value for my dollar. So I am one of the lucky ones where I do not have to spend a lot of money on groceries and I can eat at Connections Clubhouse for $1.00 a day and we eat nutritious meals. What about those people who cannot eat nutritious meals and in order to have a good mind and healthy body and for your healthy body and mind and spiritually and a good sense of quality of life, you need good food. So meeting employment needs, accessing training and employment programs, we have the TEP that I just mentioned - temporary employment jobs at Connections Clubhouse - we have Lake City Woodworkers of which Chris is the coordinator, we have Dartmouth Work Activity, we have the Bloomfield School where they
have the options program, we have Stone Hearth Bakery. These are all important because they help people with their self-esteem and they know getting back to working helps with their self-esteem and they say, yes, I can work, even though I have a mental illness. It improves the quality of your life.
Dealing with disincentives built into the system, well, you are only allowed to keep so much money so why would you want to work, if you are only allowed to keep so much money. So you stay on the system. Can you explain for me, Chris?
MR. FYLES: We have actually a whole couple of pages at the end about that. Let's just keep on going. One of the things we are trying to discuss here is the needs above that we mentioned, how they are affected by the different types of social assistance that we have right now. What I am calling social assistance, I guess is what you would call income assistance. In our view, if you are receiving IA at this point in time, it is basically impossible or almost impossible to meet your basic needs. That is our experience, anyway. If you are receiving family benefits, then your ability to meet these needs is somewhat improved. We have mentioned the example, and there are probably a bunch of them there, that you can afford to rent the apartment, but they will not give you the damage deposit. It is just a requirement in Nova Scotia law that the landlord is allowed to charge a damage deposit. Well, it is the same government that set that policy that is paying these people and I don't know why they cannot come up with the damage deposit.
If you are involved with the community supports for adults, then probably you could meet your basic needs a little better, but the government has put a limit on how many people they will accept within that program and it is not based on whether anybody has more need or not. It is just based on the fact that they are not taking any more people on that program. I guess because they don't have any more money or something.
Then there is the issue of the training and employment programs which is somewhat separate to the welfare reform issue to some degree, because these programs are funded separately. It is something that needs to be addressed. Also mentioned within the document they are saying, should we be putting more money into hiring staff within the Community Services Department to provide a higher level of service. I know that a number of people we have talked to about it basically said, no, they should not be hiring more staff. What they are looking at when they are talking about hiring more staff is policing, I think. That is the sense that we get from it.
What they should be doing is employing people within the Community Services local community network, like at the North End Community Clinic and community partners that are going to provide direct service on the ground for the people who need it as opposed to hiring more police. There are a couple of things that we do recommend here where they may need a few staff, but not just increasing the number of staff in the Community Services Department.
Our conclusions and recommendations are that there should be a separate, legislated, income support program for persons with disabilities and for persons who need to be on assistance on a long-term basis, one year or more. It is not acceptable to label a person with disabilities as unemployable. Mental health consumers and other people with a disability can and want to work at the level that they are able. The new system must allow and enable disabled persons to contribute to their own independence and to society as well. Disabled individuals who work part time or full time pay taxes, purchase goods and services, and can decrease or eliminate income assistance costs.
The current system has too many roadblocks in place for this to happen effectively. The new system must eliminate disincentives currently built into the system. The main disincentives that we see are allowable earnings, access to Pharmacare and access to case management services. This is what we are talking about, the allowable earnings thing. We have attached a graph at the back that you can take a look at. I don't know if anybody else in the room can. It is kind of hard to see, but under the present family benefits system, a person is allowed to earn $100 and that is okay. Beyond that they are charged back 75 per cent of any earnings that they receive. So a lot of times people, and I have heard Community Services people talk about this too, that people will just earn $100 and that is that because they are allowed to keep that.
It actually can work and there is quite a philosophical leap that a person has to make to realize that they have a disability, they are getting maybe $700 from the province, and if they earn $200, they are going to pay $75 out of every $100 that they earn back to the province. Some of the people we are working with are actually doing this and feeling pretty good about it but it is a hard thing. You can imagine for yourself, you say, okay, I am out of work right now and I am going to go out and work and earn $100 and pay $75 back to the province.
It does make sense in some ways. I understand that and so do people we are working with, but if they are not involved in a program and they are just on their own, it is much easier for them to say, okay, I will just work under the table somewhere and I will get $200 and I will have some money. If it could be made a little bit more user-friendly. So we are suggesting that, for example, on the second $100, maybe they would only be charged back 25 per cent; the third $100, 50 per cent; and the fourth $100, 75 per cent; and then stay at 75 per cent after that; which would just make the transition a little smoother and help a person to get into the swing of things.
I know that under the present system with the 75 per cent charge-back, the people who were involved in our little program at Lake City Employment Services, I think the province would save probably in the neighbourhood of $50,000 in a single year from the people that we are working with and ours is only a small program. If you could achieve some buy-in on this thing, it is actually going to generate some revenue to help it go around.
One of the things that I think really needs to change in regard to that is the cultural vision of the department. When people go out and earn money, the first thing that goes off I think in some people's minds is that this person is going to get something out of the system that they are not entitled to, or whatever. So it has happened many times where a person goes out and gets a job and earns some money and the next thing you know, they get this letter, a very frightening-looking letter saying that you are in an overpayment situation and you now owe us this amount of money. They probably do not have it, for one thing, and oftentimes what it means is that the person may - we have seen it happen - lose their apartment. They, therefore, lose their job that they had. We had a guy coming into our place who we have been working with. It had taken a long time to get the guy set up in the apartment, get the job, everything done, and now he is living on the street and it is starting all over. You were going to mention that you knew somebody like that, too.
MS. DELORENZO-MACKEAN: I had a friend who worked at a hotel. She had an overpayment. It was $2,000 and it was taken out of her monthly income from social assistance. So she was living on practically nothing. It is pretty scary.
MR. FYLES: One of the things I would like to see them do, and there is a little bit more discussion on this on the next page which we can get into, is when a person gets involved in employment, and their workers recognize that and say, this is great, we are really pleased to see that you are making an effort and getting out there and earning some money and you are going to save the province a little bit of money, too; this is the way it is going to affect you. You explain the thing to the person so that they don't get into a lot of trouble and be there to help the person or at least offer some encouragement.
I have talked to the Community Services Department staff about this, and they said, well, it is just a form letter. Well, okay, change the form letter. It is not complicated. That is not a very big deal, if all it is, is the form letter, change the form letter. That is just an attitude thing. So that is the allowable earnings thing.
The next thing is Pharmacare and with mental health, Pharmacare is huge. We are hoping that a person who no longer needs income assistance can continue to receive Pharmacare services. So it is not part of the same process. If you now earn $700 you don't need the $700 of income assistance, you still need your Pharmacare. One of the people that I work with, their drug costs at this point in time were $1,000 a month. So if they earn $700 a month, they still need their Pharmacare. They can't even pay for their drugs at that point and, obviously, if they were cut off, they wouldn't be able to work, they wouldn't be able to eat, they wouldn't be able to live. So they might as well just stay on assistance, don't do anything.
I know that even within the system as it is now, they do allow for that to some degree. If you are in a deficit in your budget, you can include the Pharmacare costs in that, but we are hoping that some kind of a reasonable limit would be set, income tested, so that if a person
is maybe earning $30,000, then they would start to say this Pharmacare card has got to go, but you have to get to a point like that. If $12,000 is going out on drugs off of $30,000, after your tax and everything like that, you're down into $18,000 or whatever you are surviving on, and it is not an awful lot of money. So there needs to be some limit. Obviously, if the person is earning $100,000 year, they don't need the Pharmacare card. So somewhere there needs to be a limit set. We did not attempt to set that but that is something that needs to be looked at.
The same thing for case management services, which is, if a person is in a supportive housing situation, we have seen it happen where they get a job, they earn a certain amount of money. So they don't need income assistance anymore. So now they cut off their housing support. Well, this person needs the housing support even more when they are working than they did when they were staying home. So now they lose their job and they might as well go back on the system and forget the whole thing. We need to see the same thing where the income test comes later for some of these services. A person who is working still has a disability. The job doesn't take away their disability.
MS. DELORENZO-MACKEAN: Emotional support is very important
MR. FYLES: We have on this next page, which is an allowable earnings proposal, an example there where a person earning $500 a month would contribute about $225 a month, or $2,700 a year, back into their income assistance. If you added that up with the number of people, you would see some savings to the province and how much it costs to keep these people. At that same time, that person would have a better standard of living, be paying taxes, be contributing and helping to make the world go around.
If you looked at that graph, you could pick any point along it and say, okay, what would happen, and what happens is that the person who was earning a fair amount of money, like $900 or something like that, would still be getting some income assistance but it would be a small amount. Every time they earn a bit more they would be paying it back and this would allow a person to move and come to the level. Many of the people that have mental health concerns are only able to work part time. I know in our program we have people who work so many hours a week, volunteer work. We have other people who work full time and there is anything in between. However, they want to be involved in doing something to a level that they can. Is there anything you want to add to that, Brenda?
MS. DELORENZO-MACKEAN: I do volunteer work. I do a project-60 at a church where I volunteer 25 hours a month. I get an extra $60 a month for volunteering 25 hours a month but I do more than 25 hours a month because I enjoy it. Also, it helps with my self-esteem and I am giving something back to the community. I know that personally I cannot go back to work and work in even a part-time or a full-time job because of my illness but I can at least contribute 25 to 27 hours a month in the volunteer job which is not stressful and the people that I work with are very understanding and are very supportive.
So I feel like I am giving something back to the community and that is important for people with disabilities. People with mental illness want to feel that they can give something back. I almost feel guilty, like I am taking money from people's pockets, from people who pay taxes. I have this sense of guilt that I am taking money from their pockets because I don't pay taxes, but now that I have got this little job I feel like I am not stealing or taking money away from people who pay income tax. It is important to me as a mental health consumer.
MR. FYLES: I would just like to add one more comment and that is that the mention of having an ongoing consultation process would be terrific. We have tried to have a dialogue with the province on these types of issues over the past number of years. Just an example, I would like to know, and I have talked to people within the department about how many people there are who are mental health consumers that are within the metro region and I should be trying to look at our service and who we should be trying to service. I don't get an answer from them.
They have the information. They are asking us. This is way back where they had, I think it was called the ministers committee on - I forget what that was called. That would have been back in the early 1980's and they were asking us to tell them how many people there were in the community that we were going to serve but I know they have got all the statistics there somewhere if they would dig through them somewhere and come up with them. I would like to have an opportunity for that kind of dialogue to go on.
[9:00 p.m.]
MR. MUIR: Just one short question. In your discussion, or on Page 2, Chris, you had indicated individuals living with mental illness and so on, due to the early onset of the illnesses, what would be the typical age, if you were to give a number as to when this would happen to an individual, what age would you give?
MR. FYLES: It is a wide range and there are people from childhood until early adulthood, but teenage.
MR. MUIR: Teenagers. Thank you.
MR. PYE: Chris, just one question, you made reference to the person who is now living on the street because there was this overpayment and it was clawed back. The individual found that it was not possible, could not exist, so they went to live on the street. My question to you is that I know the numbers that you are dealing with but is there a counselling service offered at Lake City Industries?
MR. FYLES: We have worked with that particular individual. He is back in a housing situation again and he is working on getting employment and that sort of thing but starting over again.
MR. PYE: My last question to you is again on Page 2 and this is with respect to the community supports for adults. You said the number of people who are able to tap into that program is very small. Do you know how much funding is in that program and how many people take advantage of it?
MR. FYLES: No, I don't.
MR. PYE: Thank you.
MR. CHARLES MACDONALD: Just one, Chris, and a follow-up I guess, is there any way of preventing that kind of overrun or how do you see us dealing with that side of it so that . . .
MR. FYLES: I am glad you asked that because . . .
MR. CHARLES MACDONALD: It seems to me that it is something that should be taken care of fairly simply and I have heard it many times before in my own community.
MR. FYLES: Actually we even mention it in here. I was looking for what it was that I had overlooked and I couldn't find it, but one of the things that needs to happen within the system is that the system needs to be a bit more responsive. At this point in time with family benefits, income is monitored on a three month cycle. This is in the second paragraph on this allowable earnings page, on the second two pages with the graph.
What happens, I guess, is the family benefits' workers or the family benefits system does not want to spend the time to be keeping track of what people are earning on a monthly basis. It is just too much effort. So they want to do it on a three month basis. They will just do a quarterly. They will check what the income is and then they will decide, okay, that's what the person is earning, we will stick with that for the next three months. The problem is at this level of employment nothing stays the same for three months, even for one month. So if the person earns more money during that three month period, it means that they are in a big overpayment situation, or they may not earn as much money, in which case they haven't any money. I think they are probably more responsive to the no money situation than they are to the overpayment situation during that three month period.
What we are proposing is that the money needs to be monitored monthly and if it means that maybe there is another way to set it up where they could have either clerks who would just take that information from people, who could call in and say, look, I have earned this much this week and I just want to put that on my record so that you can keep track of it.
I did not work this week so I am going to need some more money in my next cheque, or whatever. So they could just be monitored on a more short-term basis, that is all.
MADAM CHAIR: Mr. Montgomery.
MR. LAWRENCE MONTGOMERY: I am just wondering what experiences you have noticed in terms of paying that overpayment back? How is it worked out?
MR. FYLES: They just take so much a month. So a person who has, all the people that tell us how little people have to live on, now have $50 less for however long it takes.
MR. MONTGOMERY: Are there extremes?
MS. GEYER: One of the things that we know is that they have one clerk in family benefits to monitor overpayments in that situation for the entire province so that means that it is very easy for people to lose track and even though they monitor on three months, frequently they don't catch up with somebody for six months to a year. So that is how the overpayment thing gets built up and that may be one case where we are saying that they could use more staff.
MR. MONTGOMERY: The other thing I wanted to ask, are there extremes in terms of the overpayment for an individual who has to pay back?
MR. FYLES: One of the worst situations that happens is there is a lack of communication between the different funding sources, like Canada Pension. One of the worst situations is where a person applies for Canada Pension and it may take three years before they get approved. At which point they then are paid a lump sum going back over the three year period. They have put that into the hands of the individual. It is like putting a saucer of milk down in front of a cat and saying, no, do not touch that, bad, bad, bad. This person has had no money for how long and they have got this cheque for $3,000 and they go out and spend some of it. Maybe they go out and spend all of it. Then they are in big trouble. Then they owe all that to family benefits because they should have had it all in the first place. That is one of the most common ones.
MR. MONTGOMERY: My experience has been that the allowances, or whatever the person can afford in terms of their own budget, about $25 a month or whatever the agreement comes to - I have not experienced the extreme that you have indicated.
MS. GEYER: May I add something to this since it is supposed to be informal? Can I just add one thing on that overpayment issue?
MADAM CHAIR: But we don't catch any of the comments on our recorder.
MS. GEYER: Do you mind? Do you guys mind? On the overpayment issue that you are talking about, the Canada Pension is one I am seeing. For example, the lady I was talking about didn't have enough food, she had an overpayment. She was paying back $33. It is confusing for people. If you have a problem of any kind, anxiety or other health concerns, you are getting money in, you have got to keep track of it and let people know properly when it is. So you can make an honest mistake - and most clients I have seen make honest mistakes - spend some money they should not have. Yes, it is true that it can be changed but like this lady I was dealing with who was very well educated and everything else, but she had got an official letter, $33 a month, that is what I have to give.
So I wrote a letter and it was reduced. But why should there be intermediate people doing that? The other concern, you are talking about, I bet one of the problems with that lady was, as I have seen so many times, people have a big overpayment and the anxiety and the stress of getting a letter saying that you have that overpayment is overwhelming. So people lose everything because they get sick.
MR. PYE: Madam Chair, I just wanted to make one comment on that. Remember that the recipient is now paid the very basic amount that is required in the first place. So to take $25, $10 and so on, is an elimination of the very basic amount that was set by the department. So remember that. That is the single most important factor.
MR. FYLES: The other thing is, if you lose your apartment due to some of these things that happen - say for one month something happens and you lose your apartment - you do not get the money for the apartment anymore. So then you can't afford to rent an apartment because you don't have one. That is how you get the snowballing effect. Also there are a lot of negative feelings toward the system out there because it is just people interfering with your life all the time about stuff. So sometimes there is some bit of overreaction which would cause this snowballing effect and if there is somebody around to say, come on, take it easy, we can work our way through this and all that sort of thing, and being positive about things, then we can gradually start to put the thing back together but that is not always the case.
MADAM CHAIR: I have one question. It is about the first recommendation you have. You say you recommend that there should be a separate legislated income support program for persons with disabilities. I am wondering if you would elaborate on that a little bit because now we have these two programs, family benefits and income assistance, so I am trying to understand exactly what this recommendation means. What is it you are saying here? You don't want people with disabilities to be labelled as unemployable. So you don't want a program set up for people who are not going to be in the workforce and treat it that way. Can you help me understand what that means?
MR. FYLES: There are two elements to that, one of the main ones being that the person is going to be on long-term assistance. So let me first say that the level of income assistance is too low whether you have a disability or do not have a disability. If you are going to be on short-term assistance, I think that it is reasonable that your income might be slightly less than if you are going to be on a longer term. If it is a short-term thing that you are on, in between jobs, I think you could put up with a certain amount of hardship. I am not saying that the level of hardship we are talking about right now is reasonable in any case. But if a person is going to be on income assistance for their whole life, there should be a slightly different level of comfort built into that system, not that it is going to be anything fantastic.
MADAM CHAIR: I understand now. I understand what you are driving at with this recommendation. The last thing is a comment not a question. It is with respect to an ongoing consultation process. It is just to advise you and other members who are here tonight that the Standing Committee on Community Services is a Standing Committee of the House of Assembly. We have just recently recommended that our mandate be amended so that, in fact, Community Services comes under the standing committee on a regular basis. It is one of the things that the committee will have in its mandate which we didn't have when we started this process. We just behaved as if we did, just so people know that.
MR. FYLES: I would like to make just one more comment and then I will go. Just to do with our connection with the Community Services. We have had, over the years, an excellent connection with the Department of Community Services. We have had a high level of communication and a very good sense of trust between our services and the Department of Community Services. So I don't know what has happened since then, whether it has to do with the fact that they are underfunded, understaffed, or a big change happened when Price Waterhouse, whoever it was, did the audit of the department and changed things over to a regional thing. I don't know whether that is ever going to be successful. I don't know if anybody has the nerve to admit that it is a flop. It doesn't seem to be working very well and it may be a combination of that or just understaffed and underfunding, or whatever. Anyway, whatever we had before, it doesn't seem to be there any more.
MADAM CHAIR: Thank you very much. We have an additional presenter, Roy Muise. Yes, are you ready to present now? Excellent, thank you. Come on down. Hi, good evening.
MR. ROY MUISE: Please forgive me if I am a little nervous. When I arrived here this evening, I wasn't really planning on presenting but I am glad, actually, that I do have the opportunity to speak to the committee. I was at the presentations that were made a week ago and I expect that I will probably be at the other ones that are being made here in Halifax.
My name is Roy Muise. I am a mental health consumer and I am currently on social assistance. I have a couple of points that I would like to bring up. They are quite wide apart so I am trying to tie them in together as I am thinking here but I guess where I want to start
is just to give you a little bit of background on myself. I have been a "productive" member of society for 30 years. I have worked hard. I have paid taxes. I have also done a lot of volunteer work. For reasons that I had absolutely no control of, a little over a year ago I became very ill. It was not the first time that I had had a mental illness but it was probably the worst episode that I have had. In the past, I might have had to take a bit of time off work during my recovery period but it was never long; I used to force myself to go back to work maybe even sooner than what I should have, only because I didn't want to be taking what I saw as money from somebody else who needed it more than I did.
Unfortunately, as I said, a little over a year ago I became very ill. As a consequence I was forced to give up my job. I went on unemployment insurance. That ran out and this year I ended up being hospitalized again. I spent 10 weeks in the hospital. They tell me that it cost somewhere between $600 and $750 a day for me to be there. Before I got out of the hospital, I knew that I was going to have to go on social assistance for awhile. I have been out of hospital now for 2.5 months but I am still treating my illness on a day-to-day basis partially through a day program at the hospital. There are other things that are going to be done so that I can eventually go back to work.
I am trying to live right now on $351 a month. I don't get the $369 yet because you have to wait four months to get that other $18. I am living in a boarding house or a rooming house. Knowing some of the rooming houses, having seen pictures, having been in some of the rooming houses in this city, where I am living is actually a palace compared to a lot. I am allowed $225 a month to live there. It is costing me $236 a month and change. So the balance has to come from my living allowance. For medication, I am very thankful that we do have a Pharmacare Program whereby I only have to pay a $3.00 co-pay and $3.00 does not sound like very much money. I have to get four prescriptions a month. So that makes it $12, so that has to come off my living allowance. Right now I have $102 a month for all other expenses. That includes food, things for personal hygiene, getting my laundry done and everything. I would really like to invite the committee to come with me while I try to make that $102 last. I don't live extravagantly, I don't have to. I am basically a meat and potatoes type of guy and everything else like that, so I am not looking for expensive meals or everything else, but I am trying to look for nutritious meals because I know that part of my recovery will depend on me eating properly.
As I said, the place I am living, I am in a very small furnished room but I am lucky; the roof doesn't leak, it is heated, it is relatively quiet. I am also fortunate, too, that I am one of these people who likes to get up early in the morning and, since there is only one shower and 11 of us who have to use it, I usually get a chance to use it fairly early.
It is hard enough right now, with that $102, trying to survive. It is going to get even worse for me next month because right now I am participating in a program which is working towards my recovery, at the Abbie Lane Hospital and, as part of that program, I get a meal provided each day. I am there four days a week, so that gives me four meals. That is where
my meat for the week, my protein comes from because I can make that part of that meal because I can't afford to, otherwise.
As I said, there are two points that I want to make; number one is the fact that when I left hospital, everything was supposedly in place for me to go on social assistance. As a social worker at the hospital said, Roy, we have jumped through all the hoops, we have done everything they wanted, there will not be a problem.
There was a problem. I got out of hospital. When the time came that I thought I had a cheque coming, there was no cheque. I called, I tried on my own to get it looked after. I called Community Services. First of all, I think