Mr. Chairman, the issue with respect to the barriers between programs is discussed in paragraphs 4.38 to 4.41 on pages 16 and 17 in our report. There we note the coordination between departments is poor, and we particularly highlight the relationship between Health Canada and Indian Affairs with respect to, in this case, the availability of non-insured health benefits to children who are brought into care.
We note that there is a fundamental difference of point of view between Health Canada and Indian Affairs with respect to who is responsible for the provision of health services once a child is brought into care. Health Canada's point of view is that once a child is brought into care, it should be treated like any other child who is brought into care, and the cost of non-insured health benefits should not be covered by Health Canada. Indian Affairs' point of view is that the status of the child does not change, and the ability to access non-insured health benefits should not change just because a child is brought into care. So what happens is that Indian Affairs has temporary authority to cover off health care costs, non-insured costs, when Health Canada will not pay for those costs, but it can only do so once Health Canada has said to the agency or to the foster parent, “No, we will not cover that cost,” and that foster parent or that agency has gone through the appeal process. This can result, as we note in the audit, in delays with respect to children accessing services.
The problem in this case is the terms and conditions of the programs. In order for Jordan's Principle, for example, to be able to work effectively, changes in the terms and conditions of the programs are going to have to occur so that the department that comes into contact with the child in the first instance will actually be able to cover all the cost and then go to the other departments, or perhaps even the provincial government, for reimbursement.
In large measure, it's a structural issue related to the way the programs are set up and the stovepiping that has occurred in the way the programs are established.