Human Resources Committee on May 11th, 2009

[The Chair, Conservative, Dean Allison]

Pursuant to Standing Order 108(2), we are continuing our study of the federal contribution to reducing poverty in Canada. We are now starting meeting 22, our third meeting of the day here in Halifax, to discuss some of the issues of poverty.

I want to extend warm greetings to all our witnesses and to thank each and every one of you for taking time out of your busy schedules to be here to talk to us about this issue.

I know that my colleague Mr. Savage will probably echo these comments, but as a little bit of background for you, this is our first run at this study on the road. We've been studying this issue in Ottawa, so we do thank everyone for taking the time to be here.

Mr. Crooks, I want to welcome you here, sir. I understand you're here with the Phoenix Youth Programs. Maybe you could talk a little about what the programs do or what you guys do, before you get into your opening remarks.

I understand that each of you has about five minutes, and we're going to be flexible on that, but we'd love to hear what your organizations do as well, for those of us who are not from the area.

Mr. Crooks, the floor is yours, sir.

[Timothy Crooks, Executive Director, Phoenix Youth Programs]

Great.

First of all, thanks for having us. This is a great opportunity and an important opportunity. If ever you want to tease folks from the community, ask them to concisely describe what they do in five minutes. So we'll do our best to rise to that challenge, and again, thanks for the opportunity.

Here is a little bit about Phoenix. Phoenix is a community-based organization that's been in existence for just over 20 years. Perhaps one of the features for which we are best known—and I'm going to speak to this just very quickly this afternoon—is our continuum of supports and services that we offer, which covers a very broad range. It covers a range from a prevention program, which is largely school-based, to a drop-in centre, to residential programs, to a learning and employment centre that focuses on life skill and pre-employment development as well as job placement, through to a follow-up or after-care service. Across all those programs we offer health care, which is an essential component of what we do. We primarily work with youth between the ages of 12 and 24, so it's very key to understand the age range.

We also offer parenting support and a program we call special initiatives, which works with our youth to find their voice and to find their skills and to be involved in arts and culture and therapeutic recreation as well.

So that's a little bit about our organization.

Now, I know part of the challenge you have before you is to understand our efforts in the ongoing debate on best measurements of poverty. So whether we're talking about low-income cut-off as a measurement or low-income measurement or market basket measure, the thing I would encourage the committee to understand—and I hope it's reflected in your work going forward—is the importance of being completely as inclusive as possible in the way in which we look at those measures. So it's to understand the issue of poverty not just around an issue of finances but to understand it as we see it lived out daily as the poverty of lack of opportunity. It is poverty meaning no chance to engage and no chance to have the opportunities many of us take for granted.

Our work at Phoenix is work of a restorative nature, so the question is how you facilitate the process by which kids and their families move from the margins and become fully involved in the world around them. In essence, it's an examination of the difference between ability to contribute to culture and being only in a position of consuming it.

Through that lens and with that understanding, I want to just highlight really quickly the work we're most hopeful about at Phoenix. If we think about our opportunities—government or a set of community-based organizations or just simply the individuals in our communities around us—and our responsibility to do what we can to make sure people have their inherent right to have their basic needs met and to feel the opportunity to thrive and to succeed in their lives, then we can think about it potentially in three stages. I'll just go through them very quickly.

Stage one is early intervention and prevention. Stage two is crisis management: crisis is already happening, so as a government through services or as a community, we're scrambling to provide some assistance around the management of that crisis. And then stage three is the opportunity for someone to thrive and make use of community-based support.

It's a very linear way of thinking about it, I realize, but it gives us the sense of that continuum from early on to crisis itself and the way in which we manage it regardless of which social issues we're talking about, and then the opportunity in the end to provide meaningful support so people don't go back into that place of need.

Something that has been successful for Phoenix is that we offer a continuum of support, as I've mentioned. This allows us to deal with the whole person. This allows us to understand their lives in a context and it allows us to leverage and to build and to make good use of a relationship that's sound and of substance and is informed of the understanding of how we can best be relevant to the people we have the privilege of knowing through our work. That continuum is essential.

The second thing I want to talk about is our prevention program. We work from a perspective simply known as narrative, and Michael White has been key in the creation of a narrative approach. Simply said, it helps us understand how the story of someone's life has been written and it helps us understand our opportunities for the writing of a new story authored by the individuals themselves but supported by us, as people who are caring and providing support around them.

Since our prevention program is community-based, we have limited wait times, so that allows us to work really effectively with kids and their families. We're seeing individuals and families with more and more need, so our ability to respond quickly within an informed context is essential.

The last one is special initiatives. It is a program that allows our youth, through partnerships we form as an agency, to become engaged in the world around them. We have a partnership, for instance, with the Art Gallery of Nova Scotia, where our kids not only learn how to paint and how to express themselves, but learn how to curate a show and eventually launch it at the art gallery. It's a transformative thing on the night of a launch to have Monet hanging in one corner and your work hanging in another.

We start to understand the importance of having those opportunities for success by developing connections through the community, a sense of collective identity, and eventually coming into our own sense of entitlement and the ability to influence the world around us. It's that sense of entitlement that allows people to understand what they're called to do with their lives, to be excited about it, and to feel like they have a right to find their talents and really thrive. That's key.

It comes back to the notion of how we contribute to the culture or the world around us. We know that hopeful youth are most likely to lend themselves to being part of healthy neighbourhoods, which leads to healthy commerce, and healthy communities that are most likely to generate healthy individuals. So hope is at the centre of that, and we need to understand that in the context of our work and our policies as a government. We need to understand that inclusion and the finances of a family are key considerations when we turn our attention to the work at hand.

I'll leave it at that and hope that questions will allow us to get to other discussions.

[The Chair, Conservative, Dean Allison]

Thank you, Timothy. I appreciate that.

We'll now move to Louise Smith MacDonald, who is the coordinator of the Women's Centres Connect.

Welcome. We appreciate you being here. You can tell us a bit about your organization.

[Louise Smith MacDonald, Coordinator, Women's Centres Connect]

Thank you very much.

Those who know me well say I would never be able to speak in five minutes, but I've practised, so I'm certainly going to try my best.

I am here representing Women's Centres Connect. There are eight women's centres in Nova Scotia, spread across the province. Most of them are in rural areas. I speak on their behalf, and on behalf of the many thousands of women and adolescent girls we work with on a yearly basis. I thank you for the opportunity to make this presentation today.

We have served tens of thousands of women in our community, mainly around issues of poverty, violence against women, and women's health. We are concerned about women's education and employment, and we foster women's leadership by supporting women's participation in civic organizations and in government functions.

We, as Women's Centres Connect, have a rural perspective on women in Nova Scotia. Our women's centres are mostly located in small communities, in Antigonish, New Glasgow, Truro, Sheet Harbour, Cornwallis, Yarmouth, and Lunenburg. I represent the only women's centre that would be considered to be in an urban area, which is Sydney. I'm afraid anything outside of Halifax is considered to be rural, so I also consider that we're in a rural area.

On a daily basis, the staff and volunteers in our women's centres provide direct service and programs to women who are living in poverty. We see the impact that poverty has on women's lives. We provide education and life-skill supports, and we support individual women in their struggles and through life transitions. We advocate for women when they run out of food, when they've had their electricity disconnected, when they're trying to support transportation, education, and trying to seek employment.

We view the development and implementation of a national poverty reduction strategy as an essential step towards eliminating poverty in Canada. We implore you to ensure that awareness of the specific needs of rural women is fully integrated into any such strategy.

Our vision of a healthier and more equitable Canada involves two major areas of concern, which should be addressed through government action. The first is adequately meeting people's basic needs and supporting people's efforts to develop their skills and capacities so that they are able to fully participate in community life.

As out-migration erodes community vitality, and the number of seniors and single-parent families increases, women confront tremendous demands to provide care for their children, elders, and family members with serious health problems. They must do this as they deal with inadequate housing, low income, lack of child care services, and no public transportation. Many women who become unemployed do not qualify for employment insurance benefits, and for many the overall situation is extremely difficult and fraught with well-founded anxiety.

Our vision for a national poverty reduction strategy would ensure that low-income Canadians have their basic needs fully met through sustaining employment and/or income-support programs. The strategy must be founded on valuing and supporting the caregiving work for which women have been traditionally responsible. Strong national standards for all programs must undergrid the strategy. And an understanding of the specific needs of women and of rural people must be integrated throughout.

We recommend that the Government of Canada implement a poverty reduction strategy that contains the following key elements: a guaranteed liveable income; a national housing strategy; an affordable and accessible public transportation system for rural areas; a national child care program, which will no doubt work differently in rural areas compared to urban areas; a sustainable reform of the EI system that would provide coverage to those working part-time and in precarious employment, including self-employment; a substantial increase in front-end grants for post-secondary students; and debt relief for graduates who are not earning enough to repay large loans and manage family responsibilities.

In order for a poverty reduction strategy to produce results, adequate funding must be provided to all provinces and territories as they are able to implement. However, simply transferring money to provinces without ensuring that the money is going to be spent on what it is designated for.... I think that's a very important component of that.

Without national standards and the funding to support them, our people and communities will continue to suffer, and our rural communities will remain at a significant disadvantage.

I'll stop at that and hope for questions.

Thank you.

[The Chair, Conservative, Dean Allison]

I think you'll get a lot of questions. Thank you very much for working on that.

We'll now move over to Sharon Lawlor and Patti Melanson from the North End Community Health Centre. I want to thank you both for being here. We're looking forward to your comments and also to hearing a bit about your organization.

The floor is yours for five minutes.

[Sharon Lawlor, Health Team Manager, North End Community Health Centre]

I'll introduce Patti in the context of what the organization is.

First of all, thank you for the opportunity to speak today. Before I begin, I want to concur with everything Tim and Louise said. We don't want to repeat that, but we support everything they've already said.

The North End Community Health Centre is a community health centre that follows the full philosophy of community health centres that you see throughout Ontario and Quebec, primarily. We are an independent, non-profit organization that is staffed by an interdisciplinary team that has been operating for just over 37 years in the North End, or the inner part of Halifax. Some of our staff have worked there for upwards of 25 to 30 years. They have made that strong commitment to the needs of citizens living in the North End who have a lot of experience with poverty and with trying to maintain an adequate status of health.

One thing I want to point out, before I hand it over to Patti, is the fact that our staff has worked consistently to try to bridge areas between poverty and health care and to point out to the federal government that the health care system is not sustainable and is not equitable across the board. When you look at Tommy Douglas's reference to the second stage of medicare, we cannot assure that all clients have access to health care. There's no access to pharmacare and no access to dental health. Least of all is access to certain diagnostic treatments that are necessary. That's just some context.

Our staff works diligently to assist in breaking down barriers so as to ensure access to treatment and diagnosis.

I'll let Patti talk a little more about the specifics of one of our programs.

[Patti Melanson, Coordinator, Mobile Outreach Street Health Program, North End Community Health Centre]

Thank you very much for the opportunity to speak today.

I come very humbly, I guess. I became a nurse a number of years ago--maybe twenty. At the time, I learned a lot about nursing and knew nothing about poverty. I started my understanding of that about nine years ago, and since then I have been working with youth and adults who are homeless. It's been quite a powerful journey.

When I started out as a nurse, I was certainly and still am privileged and quite resourced. I had no understanding of how wide the net could be cast in the life of a person who is affected by poverty and the many ways in which he or she could be affected. So when I speak today it'll be from a lot of the personal learning and experiences I've had over those nine years.

People have a right to health care, but we rarely speak of the right to health. Living in poverty and being homeless is a health risk. Forget any family history of heart disease or any other familial risk, being poor and homeless will have you experiencing twice the amount of health concerns to those who are housed and not living in poverty.

So to act on a poverty reduction strategy could be a huge benefit, in many aspects, of the lives of individuals who are affected by poverty.

There has been a newly established program of the North End Community Health Centre and it's called mobile outreach street health, or MOSH for short. I have been hired as the coordinator.

This program demonstrates a willingness and an understanding on the part of the Department of Health and the CDHA, Capital District Health Authority, to connect the dots between poverty and health and the impact poverty has on the health and wellness of an individual.

This new program is the result of community collaboration. It started out as a meeting on the corner of Cornwallis and Gottingen Streets, and now, hopefully, it will be a very well-received service in our community.

This program is housed, administrated, and employed by the North End Community Health Centre. Certainly the health centre has been a strong force in the community, supporting strategic planning that addresses poverty and promotes the poverty reduction approach. This is done through the community action on homelessness program out of the North End Community Health Centre.

The MOSH program will deliver health care to people who are homeless, street-involved, and insecurely housed. We know, from a research perspective, that stable housing links people to primary care and this allows follow-through with medical treatment plans. Stable housing and the security of feeling safe also allows someone to grow from just following treatment plans to a place of wellness and self-care.

I've certainly witnessed the concept of stable, safe, and, when needed, supported housing to be the turning point for a large number of people to care for their health concerns in a way that is not crisis-driven. This is a key point, because when someone feels they are self-managing their lives in a way that feels controlled, then we see a contribution back to society. And this re-engagement to the community is often a measurement we do not take into consideration when looking at achieving targets.

There have been many health consequences to those living on low rates of income assistance. It becomes difficult to pay for prescriptions, eat a balanced diet, and pay a power bill on approximately $200 a month. With this reality, it is important that we offer programming that assists people in the reality they're living in, to buy food that will promote health, and to help them with the special needs they may need in their lives.

Working with only a physical health hat on is not adequate. It is important to understand the income assistance program, the food bank resources, and the housing options, whether that be shelter or otherwise.

Many health care professionals working with people living in poverty have had to break down silos for the good of their clients and through to government for the good of our country. We currently encourage a structure that is siloed. Certainly we've seen recently here in Nova Scotia that the youth strategy is a good example of the bringing together of many departments.

We have an obligation not to accept that people are living in shelters as a permanent housing option because safe, affordable, and, when needed, supported housing options are not open to them. We in the North End Community Health Centre certainly have witnessed the many areas that have become gentrified.

There are many subtle and discreet barriers that people experience to accessing health care that often are not talked about, and that is the feeling people get when they walk into a health care facility and know they're being treated differently because they are homeless or because they are suffering from addiction issues or mental health issues.

It is with that in mind that I talk with you today and stress the importance of what I have learned over my journey of bringing together not only thinking of things from a health perspective, but thinking of them as a whole person and being able to address the many needs that individuals have. That help is not only about the treatment and care that we give, but it's also about how the person lives, whether they're able to afford the prescriptions or able to house the medication that's being given to them to manage the condition they have in their lives.

I thank you very much for this opportunity.

[The Chair, Conservative, Dean Allison]

Thank you, Patti and Sharon, for that presentation.

We'll now start our first round of questions. We have seven minutes for questions and answers for the first round and for the second round it is five minutes.

Mr. Savage, the floor is all yours, sir.

[Michael Savage, Liberal, Dartmouth—Cole Harbour, NS]

Thank you.

Thank you for coming. I appreciate you taking the time to talk about this with us. This is our first travel meeting. We've had a number of meetings in Ottawa. One of those meetings was with Mike Kirby and we talked about mental health.

I'd like to ask some of you.... Incidentally, my sister was proud to work at Phoenix Youth Programs with Tim for a number of years, and it's a wonderful program, the work you do there. I remember stories of my father working in the north end of Halifax, St. Joseph's. Back then they called it day care--and the work that Paul does up at the health centre. And thank you, Louise, for giving us some very specific recommendations. What we're trying to do is figure out what we can do. You've all talked to panels like ours before, and we want to get to the point of actually making a difference, so specific recommendations are very helpful.

I'd like to talk about young people with mental health issues or addiction issues and try to get some recommendations for a federal role, keeping in mind that both the blessing and the burden of Canada is our confederated model. You have to work federally, provincially, municipally, with civil society, with NGOs. Mike Kirby told us housing was an issue. When you talk about young people who have issues with mental health, there are diagnoses, there are drug issues, drug coverage issues, housing, social infrastructure, stigma, income support, all those different things. But what do you think the federal government could do to assist you to deal with young people who have mental health issues?

Maybe I'll start with Tim, and anybody else can slide in.

[Timothy Crooks]

I'll give you a broad answer first, and then I trust that the folks to my right can answer in more specific terms.

The broad answer is that the challenge for those of us who are service providers in the community is, on a daily basis, one of funding. One of my biggest frustrations and biggest points of bewilderment is trying to get the message through about the importance of the federal government to understand its working nature with provincial governments and the desire to strike funding formulas that have a long-term view.

That's the answer I give you as a starting point on this issue. In order to get where we need to be, in general relationships with our youth and specifically with those who have mental health issues, that is often a longer road. In order to travel that road, governments need to be able to partner with NGOs that are secure in their day-to-day operations.

Increasingly, when funding is based on a specific initiative, or the funding is project-based or short term, and then the project may or may not get renewed, it really ties our hands in terms of what we can do, both by way of immediate and day-to-day service delivery and also by way of thinking in very innovative terms about longer-term solutions.

It's a real problem in terms of our ability to establish and maintain the relationships that we need to have with, in our case at Phoenix, the kids whom we're very privileged to get to know.

I hope that we can start the discussion there, then, on the importance of understanding that, in the absence of that kind of security, it could lead to organizations becoming fairly risk-averse around what they are prepared to take on. It's been our experience, and the literature often reflects it, that the most innovative work is the work that involves a certain level of risk and a certain level of mobility--that is exactly why this community is so excited about the piece that the north end clinic is doing through Patti--so that we are able to go out and meet folks where they are and address their needs in the way that they're identifying they need to be addressed.

I'll turn it over to Sharon and to Patti to answer in more specific terms, but I guess what I want to say to you is that the starting point for that really ties into....

The outreach piece that Patti's now doing is a fine example. That was years in the making. While that was developing--much to the credit of all the front line folks who were involved in it--there were folks who were really suffering and really needed support. One of the things that I hope your committee looks at is the funding model around how you bring fortitude to the very partners who are your essential and key partners on the community side working with government going forward. It's a major consideration, and one that we're a long time getting to in Canada.

[Michael Savage, Liberal, Dartmouth—Cole Harbour, NS]

Thank you.

Patti or Sharon, did you want to add something?

[Patti Melanson]

I'll just comment briefly on that.

In regard to mental health and youth, it's very important for us to be looking at quick and immediate intervention to support not just youth but families.

There's been a bit of a shift. A federal study was done on the rates of sexually transmitted infections among street youth over a number of years. This was done by the Public Health Agency of Canada. One of the questions was about education. They were doing this study to find out about rates of sexually transmitted infections.

In that study came this real gold nugget--in Nova Scotia, anyway--that 72%, I think, of youth that we surveyed had only grade nine, had been kicked out because of lots of issues. At home it was really too much for family to handle them, and then they were out of the home and living on the streets, or living in a homeless situation.

I think that says something about the state of what families are needing to deal with and how they're having to manage. We need early intervention, and certainly programs that are directed towards that, not just for youth who have mental health issues but also, I believe, for families. We need to be doing a better job supporting families in their ability to parent, to support their children.

[Michael Savage, Liberal, Dartmouth—Cole Harbour, NS]

Thank you, Chair.

[The Chair, Conservative, Dean Allison]

That's all the time we have; you were right on seven minutes.

We're going to move to Madame Beaudin, for seven minutes, please.

[Josée Beaudin, Bloc, Saint-Lambert, QC]

Thank you very much.

We received a backgrounder that contains a chart that compares the percentage of people under the low-income cutoff in 2001 to the same percentage in 2006. One figure that strikes me in particular is the percentage of women underneath the threshold. The number of women underneath the low-income cutoff has not dropped very much. Women still find themselves in a precarious situation, living in poverty. For women, this percentage fell from 10.8% to 9.4%, whereas the percentages for men and young people dropped much more significantly.

Are there programs intended specifically for women? I know that people who are alone often find themselves in difficulty. Is this percentage particularly attributable to women who live alone? Ms. MacDonald, how would you explain this situation?

[Louise Smith MacDonald]

Yes, I certainly think that when you look at lone-parent families in Nova Scotia, the highest percentage of them are led by females. Females who try to retrain or try to increase their education have such a difficult time finding child care. Women who need to go to work or try to go to work at call centres, for example, which have become one of the staples in our province, may be working from three in the afternoon until three in the morning. So it's extremely difficult to access child care.

The training programs that are going on right now aren't always ones where you're going to be able to access employment. They get you through a couple of years of training at community college, which is what our community services department here will support, but you're still being streamed into very low-paying jobs.

[Josée Beaudin, Bloc, Saint-Lambert, QC]

Thank you very much.

Mr. Crooks, you spoke about a continuum of services, and I found that very interesting. All of you have suggested many good ideas, but I would like to put a question to all four of you. We are being told that we have to work on all fronts at the same time. We are not yet out of the woods! To break this infamous cycle of poverty, what measures would have the most impact quickly?

[The Chair, Conservative, Dean Allison]

Sharon, do you want to...?

[Sharon Lawlor]

I will try to give my humble opinion.

I think we're too late if we do not intervene early. I think there has to be federal support across Canada for early childhood intervention. There've been different aspects mentioned here, both from a parenting perspective to a mental health perspective.

Parents pre-birth, whether they're single or low income, need that support to develop a healthy child and to go into the delivery of the child, recognizing that they need help in learning how to parent and how to provide the child with a safe, healthy early childhood development stage. We know that if you miss the first three years, you are lost. A lot of our mental health challenges come from things in those early years, whether they are delayed developmental issues.... The child is struggling at school; they've already set that pattern for down the road. Therefore, they are labelled as not fitting the norm; they do not fit into our school system, etc.

There are other offshoots that could also provide support, such as extended parental leave, mother's leave beyond the year. Look at the European programs that deem or give value to mothering and parenting beyond that time. Thank heavens, we have the year now, but a lot of our parents on low income cannot afford to stay off a year; it is not viable for them to stay off a year.

[Josée Beaudin, Bloc, Saint-Lambert, QC]

What do you mean by longer parental leave? What kind of duration do you have in mind?

[Sharon Lawlor]

Similarly, in Europe I believe there are upwards of three to five years in various countries such as the Netherlands that give value to parenting and to motherhood. It's like Louise's experience. The help the Canadian government gives to mothers is not going to help her children currently, but there are many other programs, including Invest in Kids in Ontario and the western provinces, Best Start in Prince Edward Island, and Healthy Beginnings in Nova Scotia, which are aspects of early childhood intervention.

Some of those programs have universal screening and assistance with no measurement needed. The models are following the healthy child program in Hawaii, where parenting supports, peer supports, can come into homes and truly help parents learn to parent without the stress of wondering where they're going to get the next meal for their child.

There's so much more we can do that really centres on early childhood intervention and that will have reams of outcomes down the road, but we cannot measure it immediately. That's the problem. We cannot see the outcomes immediately. It will take a while, but it's been proven, so we just need to adopt it.

[The Chair, Conservative, Dean Allison]

Just a quick response, please. That's all the time we have. Go ahead.

[Louise Smith MacDonald]

I agree with Sharon in terms of early, early, early intervention. What we see now at women's centres is a combination of young people who are victims of their environment in terms of poverty, addictions, and/or violence, which have interfered with their development to the point where they display unusual behaviour. Whether it is mental illness or not is questionable, but they display behaviour that's not acceptable.

In order to overcome that--and we know that children who are victims of seeing violence and what not develop differently and are poorer--I think we really need to get back to mentoring in the home and respite for moms. You can't struggle with poverty, poor housing, raising your children, and no family support and not be able to have two hours for yourself in the run of a week. It's extremely difficult.

[The Chair, Conservative, Dean Allison]

Thank you very much.

We're now going to move to Mr. Martin. You have seven minutes, sir.

[Tony Martin, NDP, Sault Ste. Marie, ON]

Thank you very much.

There's a lot of good information here. I have a couple of questions.

First, Louise, you talked about employment insurance, the regulations, and so many people, particularly women, not qualifying when they lose their work because it's seasonal and part-time work and that kind of thing. One of the questions, I guess, is that once women, particularly single women with children, lose their jobs and don't qualify for EI, where do they go? In Ontario, you have to shed yourself of absolutely every asset before you qualify for welfare, so where do they go?