Open Letter to Minister Dean | Post-Meeting

Please feel free to use these questions in your calls and letters to your own MLAs and remember to cc [email protected]. Use this site to find the MLA for your Constituency: https://www.leg.bc.ca/learn-about-us/members

Disclaimer: Some of the data used in this letter is non-comprehensive and used for illustrative purposes only.

Update—Dec 9, 2021: 

Response from the Honourable Mitzi Dean, Minister of Children and Family Development

Friday, November 19, 2021

To: Honourable Mitzi Dean, Minister of Children and Family Development, Victoria, BC
[email protected] & [email protected]

Subject: Follow-up from Nov. 17^th Meeting at the Legislature in Victoria

Dear Honorable Mitzi Dean, Minister of Children and Family Development,

Thank you for taking the time to meet with AutismBC on Wednesday, November 17. We appreciate your verbal commitment to continuing the conversation with us on our concerns regarding your sweeping changes to the Children and Youth with Support Needs (CYSN) Framework and ending Individualized Funding. As you could not address any of our questions during our 30-minute meeting, I am following up to request a written response to the questions I provided.

As stated in our meeting, these questions were raised on Monday, November 15, with a growing collaborative of organizations representing and serving children and youth across the disability sector. These are not only AutismBC’s questions, but they are also the questions and concerns of 24 organizations, and we would appreciate evidence-based and fact-based answers to our questions.

Insufficiency of service providers

Service provider modelling for speech-language pathologists (SLP) demonstrates that there are only enough SLPs in BC in public health to serve 30% of the preschoolers forecasted to need these services[i]. This results in significant wait times, with some kids not currently accessing SLP services until kindergarten.

1. How will you ensure that a needs-based model meets the needs of children and youth when we don’t have enough service providers, such as but not limited to SLPs?
2. What service provider modelling has MCFD used to ensure BC has adequate service providers to support a needs-based model?
3. Will you be undertaking training programs and incentives to build capacity in various service sectors, particularly in underserved communities in the north and remote areas?
4. What will you do to incentivize service providers to stay in BC and work under hubs?
5. How do you plan to involve Indigenous service providers?

Minimizing the role of diagnosis

A recent article by Dr. Roshan Danesh, Q.C., outlines Darwyn’s heart-wrenching discrimination throughout his life, particularly in the last stages. In his article, he poignantly expresses that, “At the heart of the problem that the proposed changes seek to address are the unacceptable delays in diagnosing the challenges children face. But how can any reasonable solution be to minimize the role of diagnosis itself? Diagnosis has a scientific and medical purpose – to understand the specific conditions and symptoms that a person has, and design an approach to address it?”

1. Why is the Minister supporting a system that circumvents the importance of diagnosis and professionals with specialized training in diagnostics?
2. Investment in greater diagnostic capacity would support a more successful needs-based system. Why won’t the Ministry invest in adequate diagnostics to reduce wait times to a maximum of 3 months?
3. Do you understand that children and youth can be traumatized by services that aren’t adequately informed on their unique needs, even when well-intended?

Inadequate needs-based assessment tools and administrators

The instruments you are proposing for needs assessments, the Vineland-3 and the PEDI-CAT, were not designed to determine service needs. Several research studies^{[ii], [iii]} have found a wide range of concerns about using these two instruments, either alone or in combination, when used to identify the service needs and service amounts for children who have developmental disabilities or who are neurodivergent.

1. Given these concerns identified by local experts, how can you assure parents that their children and youth’s needs will be adequately identified using these tools?
2. The manuals of these instruments identify that a social worker can not administer them. They need to be administered by a graduate-level clinician, such as an SLP, Occupational Therapist (OT) or Physical Therapist (PT), or by professional judgment of clinicians or educators who are familiar with the child.
   1. Do you intend to have these tools administered by CYSN workers who lack these qualifications?
   2. Do you believe it is problematic to remove SLPs, OTs and PTs from the understaffed pool of service providers to be administering these tools?

Hub-based model vulnerable to increase in waitlists and additional costs to province and families

Ontario has recently transitioned from Individualized Funding to a Hub-based model, as you announced for BC. Ontario currently has 50,000 kids on waitlists for services. Additionally, funding modelling from across Canada indicates that Individualized Funding programs for children and youth with support needs are the cheapest way to provide services for children and youth, with Alberta’s system quoting approx. $57,000 per child.

1. What funding modelling has MCFD used to ensure this model has a budget that will meet the diverse needs of all BC’s children and youth with support needs?
2. What will you do to ensure tens of thousands of children and youth don’t end up on waitlists like in Ontario?
3. Why are you choosing a model that is more costly to the BC government and families?

We look forward to your detailed responses to these questions, as do parents, families, and service providers. If you are genuinely committed to a process of meaningful consultation, you will support us with the information we need to provide you with informed feedback on your proposed changes. Thank you for your response within seven business days.

Sincerely,

Julia Boyle

Cc: Hon. John Horgan, Premier and President of the Executive Council, and MLA for Juan de Fuca: [email protected] & [email protected]

Ms. Allison Bond, Deputy Minister, MCFD: [email protected]

Ms. Shirley Bond, MLA for Prince George-Valemount, BC Liberal Party Interim Leader and Official Opposition critic for Seniors Services and Long-Term Care, and Health: [email protected]

Ms. Karin Kirkpatrick, MLA for West Vancouver-Capilano and Official Opposition critic for Children, Family Development, and Childcare: [email protected]  

Mr. Trevor Halford, MLA for Surrey-White Rock and Official Opposition critic for Mental Health and Additions: [email protected]

Ms. Sonia Furstenau, MLA for Cowichan Valley, Leader of the BC Green Party and House Leader: [email protected]

Ms. Stephanie Cadieux, MLA for Surrey South and Official Opposition critic for Gender, Equity, Accessibility, and Inclusion: [email protected]

Ms. Jackie Tegart, MLA Fraser-Nicola Opposition critic for Education: [email protected]

Mr. Dan Davies, MLA Peace River North and critic for Social Development & Poverty Reduction: [email protected]

Ms. Teresa Wat, MLA for Richmond Centre and a former member of the Select Standing Committee on Children and Youth: [email protected]

[i] BC’s Paediatric Therapists (2008) “Promoting Manageable Workloads Project; Phase 2  – Preferred Practice Guidelines for BC Paediatric Therapists”

[ii] Cordeiro L, Villagomez A, Swain D, Deklotz S & Tartaglia N (2020) “Adaptive Skills in FXS: A Review of the Literatureand Evaluation of the PEDI-Computer Adaptive Test(PEDI-CAT) to Measure Adaptive Skills” Brain Sci.2020,10, 351; DOI:10.3390/brainsci10060351

[iii] Milne S, Campbell L, Cottier C (2019) “Accurate assessment of functional abilities in pre‐schoolers for diagnostic and funding purposes: A comparison of the Vineland‐3 and the PEDI‐CAT” Aust Occup Ther J. 2020; 67:31–38; DOI: 10.1111/1440-1630.12619   

Download the PDF version here.