Health Committee on Feb. 7th, 2023

[The Chair, Liberal, Sean Casey]

I call this meeting to order.

Welcome to meeting number 52 of the House of Commons Standing Committee on Health. Today we meet for two hours with witnesses on our study of children's health.

Today's meeting is taking place in a hybrid format, pursuant to the House order of June 23, 2022.

I have a few comments for the benefit of witnesses. Interpretation is available for those on Zoom. You have the choice, at the bottom of your screen, of either floor, English or French audio.

Taking screenshots or taking of photos of your screen is not permitted. The proceedings will be made available via the House of Commons website.

In accordance with our routine motion, I'm informing the committee that all witnesses have completed the required connection tests in advance of the meeting.

Just before introducing our witnesses today.... Colleagues, you will have had circulated to you—just today, I believe—a pretty extensive interim summary of evidence for this children's health study, as was requested at an earlier meeting. It's outstanding and timely work done by our analysts that I'm sure you're going to find quite helpful.

With that, I now welcome the witnesses who are with us this afternoon.

We have Catherine Haeck, a professor in the economics department at the Université du Québec à Montréal, who is appearing by videoconference.

We also have Dr. Bukola Salami, professor in the faculty of nursing at the University of Alberta; Ms. Leila Sarangi, national director, Campaign 2000, who is joining us by video conference; and Susan Bisaillon, chief executive officer, Safehaven Project for Community Living.

Thank you for taking the time to be with us today. Each of our witnesses has up to five minutes for an opening statement.

We will start with you, Ms. Haeck.

The floor is yours.

[Catherine Haeck, Full Professor, Department of Economics, Université du Québec à Montréal, As an Individual]

Good morning.

I am a full professor in the department of economics at the Université du Québec à Montréal. I specialize in the economics of education and work.

I am happy to be with you today.

My research over the last 15 years has focused exclusively on children and families and on inequality and how it is transmitted from generation to generation. In all my studies, I pay particular attention to large-scale programs and interventions that have an influence on the development of children and families. To do this, I use high quality microdata and causal inference techniques to establish a causal connection between those interventions and children's development or families' welfare.

I have done several studies on numerous subjects, including Quebec's prenatal nutrition program and reduced-contribution childcare programs. I have also looked at the federal reform of parental leave, class size, and the effect of repeating a school year on children's development and academic success. Many subjects have therefore been studied, and when the pandemic happened, I was contacted to do studies that dealt more with children's development in the context of the pandemic.

At the beginning of the pandemic, I set about reading everything that was written about the repercussions of school closings on children and youth. In this regard, I observed that we had a huge amount of information about what was going to happen. We were not working in a total void. There had been events in the past from which lessons could be learned. We had seen that when schools were closed, learning disparities grew. In general, those for whom it is easy will continue to find it easy and get good results, and those for whom it is harder will fall behind; the longer the schools are closed, the farther behind they will be.

We had estimated that the gap between the strongest and weakest would grow by 30% as a result of the closings that took place in the spring of 2020, at the start of the pandemic. That article was published in the summer of 2020, during the pandemic, in “Canadian Public Policy/Analyse de politiques”, which is a serious journal in Canada. Studies then multiplied all over, and confirmed that performance gaps were growing.

In the middle of it all, I became the co‑director of the Observatoire pour l'éducation et la santé des enfants, which is based at the Hôpital Sainte-Justine here in Montreal. That observatory was created to monitor children's development during the pandemic and to evaluate various strategies or interventions that could be used to mitigate the effects of the pandemic, and especially of lockdowns, on children.

One of the studies we conducted was done in collaboration with Quebec's ministère de l'Éducation. We had 10,000 Quebec children take a standardized test to learn their level of knowledge of French, and specifically in reading. The test we used in June 2021 was exactly the same as the one that had been used by the Government of Quebec in June 2019. We were therefore able to do a real apples to apples comparison. Approximately 10,000 children took the test in June 2021, and we observed that the strongest 20%, the ones for whom things were very easy, were still just as successful on the test, while the weakest children had fallen well behind. Those results were confirmed by the recent results we have seen in Quebec, in the departmental examinations that took place in June 2022. So that is no surprise. We were expecting it. I did a number of media appearances in April 2020 to try to alert people to the importance of thinking carefully about closing schools and making sure it was a good practice.

Other studies have been done by people at the Observatoire that relate more to mental health, but we have really observed repercussions on mental health everywhere in the world. The hospital data we have here, from Sainte-Justine and elsewhere in Quebec, indicates a rise in visits associated with suicide attempts or suicidal ideation. In fact, that data was updated yesterday in Quebec, and we see that this trend is continuing. We therefore see a deterioration in our young people's mental health. We also see a decline in physical activity and a rise in time spent in front of screens and eating junk food.

I think my five minutes' speaking time is up, but I could continue talking about this subject for a long time. Overall, the effects on children of the pandemic and the measures that we chose to implement in Canada are not negligible.

[The Chair, Liberal, Sean Casey]

Thank you.

Next we're going to hear from Dr. Salami, a professor in the faculty of nursing at the University of Alberta. Welcome to the committee, Dr. Salami. You have the floor for the next five minutes.

[Dr. Bukola Salami, Professor, Faculty of Nursing, University of Alberta, As an Individual]

Thank you so much, Mr. Chair, for the opportunity to speak to you today on children's health and the COVID-19 recovery.

Just as a reminder, we are situated on the unceded territory of the Anishinabe Algonquin nation. I pay respect to the first nation, Inuit and Métis peoples of Canada, whose presence continues to enrich our vibrant community.

I am a professor at the faculty of nursing, University of Alberta. I'm also the director of the intersections of gender signature area, which is one of five main signature areas of research excellence at the University of Alberta in the vice-president's research office.

My area of research is on racialized Black people and immigrant health in Canada. I've been involved in around 8,500 research studies on this topic.

According to the UNICEF report on child health globally—and it's been discussed in previous sessions—we know Canada has poorer health outcomes for children than other high-income countries, ranking 30th out of 38 countries in 2021.

Canada has one of the highest rates of adolescent suicide due to health inequities. I know Mr. Don Davies and some others have asked why we rank so poorly.

If we want to make a significant cut to that, it will be for us to consider the inequities that indigenous children face in Canada. For instance, Inuit people have a 6.5% higher suicide rate than non-indigenous people in Canada. If you could half that, you'd be able to make tangible and sustainable gains. Addressing health disparities faced by indigenous populations will yield many gains in improved child health outcomes in Canada.

We have seen the consequences of these inequities in the case of the COVID-19 pandemic. Prior to the pandemic, authors widely said that income was the strongest social determinant of health, while COVID-19 told us that it may not be the most accurate.

COVID-19 indicated that racism can reproduce as well as intersect with income to contribute to poor population health outcomes. Data from Montreal, Toronto, Ottawa and other cities indicate that neighbourhoods with the highest numbers of Black people have a higher rate of COVID-19 than neighbourhoods with lower concentrations of them. In 2020, being Black was associated with increased risk of death from COVID-19.

The influence of the concentration of Black people in the neighbourhood was much stronger than the influence of income inequality in the neighbourhood. The central reason for these disparities is not biological or genetic. Rather, it's because of systemic and structural racism and the inequities that this racism reproduces, including income inequalities and spatial inequalities.

Over the last year we have interviewed Black youth in Canada. We've also surveyed, or are in the process of surveying, around 2,000 Black youth in Canada to shed light on the impact of the COVID-19 pandemic on their mental health.

What we know from the interviews is that from 2020 to now, Black youth have been dealing with two pandemics: the COVID-19 pandemic and the pandemic of the Black Lives Matter movement. Black youth have experienced both oversurveillance and retraumatization from constantly watching news about the Black Lives Matter movement.

For many Black youth, also, sport is their outlet to de-stress and to overcome many societal inequities. The closure of recreational facilities and lack of access to sports had an impact on the mental health of Black youth.

Financial and food insecurity was a challenge for youth. Youth, especially those with disabilities, informed us of their experience of begging for food and going to churches just for the purpose of finding food available.

Some youth experienced separation from their families and challenges reuniting with them due to border closure and immigration restrictions.

Youth also experienced barriers in accessing mental health services. While virtual delivery of mental health services provided some solutions, it also caused some challenges. Youth indicated that the virtual delivery of services contributed to a lack of empathy from service providers, and that it was often a challenge to maintain confidentiality. Sometimes a service provider would call them and their parents would be right there—they wouldn't really want to verbalize.

The lack of representation of Black people in the provision of health services is a barrier to accessing mental health services. Despite this, Black kids were resilient. Youth also drew on their inner strengths, community and spirituality to improve their mental health.

Based on the findings we have conducted so far we have some recommendations.

Reinvest in sports participation for youth.

Invest in targeted interventions for high-risk, racialized populations, especially indigenous and Black youth in Canada.

Invest in programs that strengthen community belonging and positive identity, such as parenting programs and mentorship programs.

Address racism experienced in the school system.

Diversify the health workforce, improving access to the profession for internationally educated professionals and implementing measures to ensure the upward mobility of indigenous, Black and racialized professionals and mentorship of Black, racialized and indigenous youth.

Include accountability in anti-racism initiatives, including having anti-racism as an evaluation criteria and as a standard of practice for all health care professionals.

Build and capitalize on the resilience of indigenous, Black and racialized youth, and amplify public information about the contributions of Black and indigenous people to Canada.

Build the capacity of informal support networks such as churches and community leaders, while offering the first point of contact in cases of mental health challenges.

I believe these strategies will contribute to positive health outcomes among Black, racialized and indigenous populations in Canada.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you very much, Dr. Salami.

Next we have Leila Sarangi, national director, Campaign 2000.

Welcome to the committee. You have the floor.

[Leila Sarangi, National Director, Campaign 2000]

Hello. Thank you, Chair and members of the health committee, for the opportunity to speak today.

Campaign 2000 is a non-partisan, pan-Canadian coalition of over 120 organizations working to end child and family poverty.

We submitted a brief to you that we co-authored with colleagues at PROOF, a research program based out of the University of Toronto that focuses on policy interventions to address food insecurity. We are recommending several changes to the Canada child benefit as a key tool enabling the federal government to improve children's health. These recommendations would enable the CCB to have a bigger and broader impact on reducing poverty and food insecurity in Canada.

Our recommendations are these.

First, increase the CCB amounts for the lowest-income households so that there is a targeted focus on families living in deep poverty, by creating an “end child poverty” supplement for families living with incomes below the low income measure, as modelled in the 2023 alternative federal budget.

Second, create an additional supplement to provide more money to low-income families in remote and northern communities.

Third, enable families with precarious immigration status to access the CCB. Many are considered residents under the Income Tax Act, but eligibility for the CCB is arbitrarily tied to immigration status. This means that even though these families work and file taxes and may have Canadian-born children, they are ineligible for the benefit.

Fourth, end the ongoing clawbacks of the CCB for moderate-income families who received emergency pandemic benefits.

There is an inextricable link between poverty and ill health. Research shows that poverty is causally related to children's developmental outcomes. Poverty is one of the strongest and best-established predictors of poor health and child development.

In 2019, more than 1.3 million children—nearly one in five children—lived in families with low incomes in Canada. Their average income was 37% below the low income measure. This is a matter of health equity, as we just heard, since child poverty rates are significantly higher for groups facing colonization, systemic racism and marginalization.

In 2020, despite a global pandemic, we saw rates of child poverty being reduced significantly because of large investments in income transfers to families. These benefits have all expired, and Statistics Canada is predicting that poverty will return to prepandemic levels.

Household food insecurity is the inadequate or insecure access to food due to financial constraints. It is a potent social determinant of health, with associated health disadvantages being similar to those of low income. Living in a household struggling to afford food is toxic to children's health and well-being in ways that are not limited to poor nutrition. These children are at greater risk of mental health problems like anxiety, depression and suicidal ideation.

Food insecurity is not just about food, but rather about the household's financial well-being. It is a marker of pervasive material deprivation, and at its core is a problem of income inadequacy.

The persistently high proportion of children living in poverty and in food-insecure households demonstrates that the CCB has not provided enough money to enable families to be secure. In 2021, 1.4 million children lived in households affected by food insecurity across the provinces. In Canada, the mere presence of children in a household increases the probability of food insecurity. The situation is especially dire in Nunavut, where almost 80% of children live in food-insecure households.

As the primary federal policy supporting low-income families with children, the CCB has the potential to have a much larger impact. It is currently failing to live up to this potential, because it is not providing enough money to lift families out of poverty, and there are barriers to accessing it for families from systemically marginalized communities. The exceedingly high proportion of children affected in Nunavut also demands special attention in the form of an additional supplement for northern families that addresses the high costs of living.

Policies that have increased the financial resources for low-income families have repeatedly shown that they lower food insecurity among families. Considering the strong relationship between food insecurity, poverty and health, the Canada child benefit is very much a health policy. CCB enhancements and reform stand to protect children and their families from circumstances that are very toxic to their health.

Thank you for your time today. I look forward to answering any questions.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Sarangi.

Finally, we have Susan Bisaillon, chief executive officer of the Safehaven Project for Community Living.

Welcome. You have the floor.

[Susan Bisaillon, Chief Executive Officer, Safehaven Project for Community Living]

Thank you for inviting me here today.

Safehaven is an organization that provides community-based care—respite and residential—to children, youth and adults who live with complex medical needs and disability. We've been around for over 35 years. We have six locations in the greater Toronto area.

We believe our clients have the right to belong in all aspects of society. We're continually striving to advance our work towards inclusiveness with our #WeBelong movement.

Today I would like to highlight how investments into community-based care models for children with disabilities can liberate capacity in our struggling hospitals, provide choice and enhance the system of care. As well, I would like to identify the need for providing enhanced funding to support individuals directly, along with the need for creative housing solutions to ensure that individuals with disability are able to transition into adulthood with dignity and respect when they turn 18.

While our organization operates in Ontario, I know I speak for my colleagues across the country, as our funding and systems of support for vulnerable individuals in Canada aren't adequate.

Safehaven is a unique provider in the province and across the country. We care for children with incredibly complex needs and rare conditions. We are a critical part of the care continuum with our children's hospitals, which are continually under siege with capacity limitations and challenges with health human resources. Many of our clients come from SickKids and Holland Bloorview after very lengthy hospital stays.

Our current system is failing our kids, but we have the opportunity to make it right. Safehaven cares for the most vulnerable children, the ones who were never expected to make it. However, thanks to medical advancements, innovations in care and some of the best pediatric hospitals in the world, these children's lives are being saved, and many are now living into adulthood.

The physical, emotional and financial burden on families who care for a child with complex special needs is enormous. If they are able to care for their child at home, almost always one of the parents is required to quit their job and stay at home as a full-time care provider. Some families cannot cope and resort to giving their children over to government care. It's an act of desperation, but they have no other option to access help, support and services because of the long wait-lists. I'm sure many of you here today are parents and see this as being unconscionable, yet this is happening in our country.

Ontario's Financial Accountability Office detailed that the wait-lists for children's services grew from 1,600 in 2012 to 27,600 in 2020.

Safehaven regularly hears first-hand from families in need of services for their children with developmental disabilities. We are met with requests weekly from families across the province for respite care. We were able to accommodate only half of the families who requested care, due to capacity and eligibility restrictions.

There's a particular challenge with transitioning from children's services to adult services, because these children were never supposed to make it to age 18. An integrated system of care was never developed for the duration of their lives. Parents describe going from childhood into adulthood as being like falling off a cliff. Instead of celebrating their 18th birthday, this is a dreaded milestone. As well, individual funding supports are extremely low for these children who age into young adulthood, if they survive, and this forces them to live below the poverty limits.

As Bill C-22, the Canada disability benefit act, progresses towards the Senate, I want to emphasize the importance of supporting programs like Safehaven, which promote inclusionary care for the most vulnerable. Specifically, children and those who transition into adulthood need a stable income and affordable housing.

These individuals deserve a right to life as much as anybody else or any other healthy child. A young adult should not be sent or even considered for long-term care.

Our proposed solutions focus on investments that need to be made now to make available spaces and programs for children, youth and adults and address gaps in our current system, enhance support for families who want to keep their children at home, and provide good respite programs and residential programs for parents as they age and can no longer care for their children.

Also, medically complex individuals need financial support to ensure that they escape poverty. The very complex children I'm speaking about today need a lifetime of care, from infancy to adulthood.

These are considered medical miracles. We need to ensure they are living longer and we have a system in place that can care for them.

They will never outgrow their disease. They will never recover or get better. They have the right to a safe and secure home and a system of care while they are alive. If we do not address the needs, the gap will only continue to get wider. These vulnerable children and their families deserve better.

The mantras of Safehaven and #WeBelong align with the four pillars of Bill C-22, the new legislation being proposed, with financial security, employment, accessibility, inclusive communities and a modern approach to disability.

We should all aspire to achieve a world where our kids belong to and are part of inclusive environments and communities. Thank you.

[The Chair, Liberal, Sean Casey]

Thank you very much, Ms. Bisaillon.

We will now begin rounds of questions, starting with the Conservatives, and Dr. Ellis, for six minutes.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you, Chair, and thank you very much to the witnesses. Certainly, it's interesting at this panel to hear all of your statements from very different perspectives. Hopefully, we'll be able to have a rich discussion.

I'm a former family physician. One of the things that make me most sad is really understanding the plight of children in this country, and how government is failing them in terms of the financial needs they have at the current time. We know that's been declining.

Dr. Salami, I have a question for you. It's specifically related to the pandemic. You talked about particular difficulties that children from racialized communities may have experienced during the pandemic. At some point, I suspect that this committee, or perhaps Parliament as a whole, will need to address the pandemic response.

What I would like to hear from you, if I could, is this. What do you think we should have done differently during the pandemic?

[Dr. Bukola Salami]

It's not as much during the pandemic; it's what we should also have done before the pandemic. One of the things we didn't do so well was addressing issues related to systemic racism, which contributes to child inequities.

One of the big things we didn't do well before the pandemic was race-based data collection. Before the pandemic, we didn't really know about the disparities in health outcomes related to children. I did a review of the literature and found many studies that had been done on immigrant child health, but oftentimes we did not disaggregate that data by race. We lumped everyone together, and then we expected to find a solution. We know that if we had disaggregated the data and looked at Black people separately, we would have been able to have a much more targeted response to this.

The other thing we didn't do too well, which we started doing much better during the pandemic, is capitalizing and mobilizing opportunities related to health care professionals and health service providers, namely Black and racialized health service providers. That's one thing that has changed during the pandemic.

We now have many more Black organizations that have emerged. It's probably also from the influence of the Black Lives Matter movement. We have, for example, Black Physicians of Canada, the Black Physicians' Association of Alberta, and a Black nurses group.

We need to continue to capitalize on some of the strengths of some of those organizations in order to move some of our approaches and interventions along and positively influence the needs of communities.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you for that, Dr. Salami, I appreciate it.

My next question is for Ms. Bisaillon.

You talked a lot about children with rare diseases. Certainly, we see children with disabilities and rare diseases transition into adulthood, and often the transition is from a children's hospital to an adult hospital. We often have that difficulty. I think Canada is the only G7 country without a rare disease strategy.

Do you have any comments on that, on the difficulty it presents for children with rare diseases, and perhaps disabilities in general?

[Susan Bisaillon]

Thank you so much.

You're absolutely right. We do not have a rare disease strategy. For many of these kids who we have, their conditions have been diagnosed. I speak for individuals with medical complexity and rare disease.

Many of these kids were never expected to become adults. That's what I'm grappling with every day. Like I said, these kids were given a home for life in Safehaven when we started, 35 years ago.

You can see medical technology.... We have kids on ventilators. We have kids who are on G-tubes. We're really able to sustain life with a lot of medical technology. These kids are set up to actually live into adulthood.

The issue is that they require a life of care. The transition from childhood to adulthood is incredibly difficult. There is no well-established system. When you talk about rare disease and medical complexity, we need to have a very well-thought-out transition program and a safety net.

That's one thing I'm proud of. We just introduced a new program to enable 14 adults to successfully transition from childhood into adulthood. That was supported, actually, by the Ontario government. I would say it is not very usual across the country.

I think it's really important that we think, when these children are born, that they can potentially go into adulthood. What does that look like? How can we support them? We also need to make sure they have a home. You cannot think of good health in the absence of a home for these children.

I hope I've answered your question. For sure, we definitely need a very comprehensive, well-developed strategy from childhood to adulthood to support children with medical complexity and rare disease. I'd love to be a part of that and see it happen.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much.

I know I have limited time, Mr. Chair.

I'm wondering, Ms. Bisaillon, if you could table with the committee your actual approach to that transition for children from childhood into adulthood. I think it would be interesting for us to see.

[Susan Bisaillon]

Yes.

To give you a sense, I joined Safehaven just over five years ago. I spent most of my career in a large academic health sciences centre. I've certainly been very well exposed to the notion of medical complexity.

We developed a program and we felt it was important that it be seamless. When I first said we were going to create a seamless program from childhood to adulthood, people kind of looked at me and said, “Okay, that's very ambitious.” We just successfully transitioned those 14 individuals on the first of this month. We created spaces. We partnered with an organization so that we could have housing for them. They have secure housing. They have 24-7 care provided. They are now in what's considered an adult location. They have a home. It's really exciting for us. I think we're doing something that was never thought possible.

I think this is a model that can be packaged, scoped and spread across the country. I'm in touch with my colleagues in British Columbia and on the east coast. I know it is possible. It requires a commitment and partnership with governments at all levels to really look at housing, to look at how we actually transition the funding models that go with it. They need to have funding for the housing, and they also need to have funding for the care. It's really looking at that comprehensive approach to a system for housing and care.

Like I said, we just did the first 14. These are very complex kids. These are kids who lived in a hospital for a decade—

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Bisaillon.

We want to try to allocate the time fairly, so that everyone gets a chance.

Next is Dr. Hanley, please, for six minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much to all the witnesses for coming. These are really interesting topics.

If there's one common theme emerging, it's about increasing...what we see in disparity in health outcomes when there's a stressor. Whether that stressor is the pandemic, economic difficulties or racism, the disparities are accentuated.

I want to go first to Madam Haeck.

My question is about whether there are some ways we can help to build resiliency to enable children at higher risk for worse outcomes to do better under stressful circumstances, whether that is the pandemic or the next stressor. How can we do that?

I would ask you to be fairly brief, as well, because I have some other questions.

[Catherine Haeck]

It is my pleasure to answer your question.

Ultimately, we have to take into account all dimensions of children's lives. The biggest ecosystem in most children's lives is the childcare centre when they are very young—in some provinces they are still at home—or the school when they are older. Clearly i, is extremely important to maintain the systems in which they develop in order to facilitate their success and reduce their vulnerability.

In our data, we observed a striking phenomenon. When a school is closed, the most vulnerable children are the most affected, because there is an entire ecosystem built around the school to help them. So we see that we could help these children more within the school structure, among other places. It would be desirable to do that.

It is therefore very important to maintain these systems and ensure that they stay open. We also have to preserve the services. When there are shocks, all of this becomes very important for these families, for all sorts of reasons. I could talk about this at length, because closing a school also has repercussions for parents and, by a ricochet effect, for children. When we are developing programs and policies, we have to make sure that the most vulnerable are protected.

Things always go well for the less vulnerable children. They come through it. They have all sorts of mechanisms around them that mean it will keep going and they will get through it.

However, when there are changes made, the situation can become quite serious for vulnerable children. The school closings, which lasted a very long time, were quite disastrous.

To be honest with you, I will add that it was really not possible to mitigate that. There was no way to replace daily human contact using Zoom, for example, particularly when we are talking about young children. It doesn't work at all. It is completely utopian to have thought we could replace the school.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

I am reluctant to cut you off, but I have other very important questions to ask.

[Catherine Haeck]

No problem.

[Brendan Hanley, Liberal, Yukon, YT]

Thanks again. It is very important that we hear what you have to say.

Ms. Sarangi, I wanted to thank you for highlighting income disparities as a determinant to child health, for highlighting that gap. You talk about additional support for northern families, particularly in Nunavut.

I wanted to just focus on what you suggested about CCB, if we were to look at how we were to improve CCB, especially targeting children more at risk.

Could you elaborate a little on how you would see that working and how you might suggest that be structured?

[Leila Sarangi]

The 2023 alternative federal budget that gets released annually through the Canadian Centre for Policy Alternatives has put forward a model that is income tested. It's a supplement to the Canada child benefit that is income tested using tax-filer data.

The poverty measure that is calculated with tax-filer data is the census family low income measure, which is after tax and adjusted for family size. It's a relative measure of poverty that is based on median income. Anybody who's falling below that 50% median income is considered to be poor, according to that measure.

This supplement would target families below the low income measure. It would give them additional income based on—

[Jean-Denis Garon, Bloc, Mirabel, QC]

I would like to raise a point of order, Mr. Chair.

[The Chair, Liberal, Sean Casey]

Monsieur Garon.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Mr. Chair, there is construction going on near our room. I don't know whether it is a torture chamber or something else. Unfortunately, it is preventing the interpreters from doing their job.