Cutting social services won't pay benefits

Slashing government programs will push up health-care costs

By Jennifer Charlesworth, Special to Times Colonist

February 17, 2010

An economist with one of Canada's big banks commented to media last month that health-care spending is the budgetary equivalent of Pac-Man, "eating everything else in people's budgets."

In B.C., health-care spending has risen almost 50 per cent in the last eight years and accounts for more than 40 per cent of all provincial expenditures. In Canada, the $128 billion a year spent on health care consumes 12 per cent of the national GDP.

Is that simply the price we have to pay for good health?

In a word, no. For many years, researchers have studied the factors in a person's life that determine good health. They concluded long ago that a good health-care system is by no means the only requirement -- in fact, it's just a quarter of the story. Read more

Despite promises to protect the budgets for special needs, senior Ministry staff have confirmed that unfunded new costs and rising demands will further strain existing services. On top of this, the Ministry is in the midst of another major restructuring, which includes integrating special needs services with other children's services in a new regional management framework.

MOMS was invited to a meeting on February 15 for an update on Ministry plans and challenges. Our unofficial report on the discussion can be found here.  We will continue to share any further information or updates as they reach us and welcome first-hand reports from families about how the restructuring and budget challenges may be affecting them personally.

The "North Region STOB 80 Reduction Planning Process and Principals" (sic) document refers to a process for "cost recovery" for the current year and outlines planning, roles, principles and provincial direction guiding a second process that is also now underway to determine further reductions for 2010-11 in order to meet Ministry budget targets.

While the document specifically refers to the process underway in BC North Region, Children's Minister Mary Polak has confirmed that this is a Ministry-wide initiative that affects all regions.

The leaked document refers to management teams being informed of budget targets at the outset of this process but does not stipulate what the funding reduction targets are for 2009-10 and for 2010-11. Minister Polak told Public Eye Online today that there were no targets and that this was just a discussion document, which is not consistent with what the Ministry document itself states (the Minister has also repeatedly claimed that there are no cuts, which is not consistent with any grasp of reality)

This process appears to be the same one cited in an earlier memo leaked via Public Eye in August, which cited a provincial budget reduction target of $3.6 million for 2009-10 for the contracted agencies under one provincial grouping.  

The STOB 80 Reduction document states that contract funding reduction plans for 2010-11 must be submitted by December 15 and approved by December 18, so that the Ministry can give notice to impacted contractors by January 31, 2010.

The document also outlines the provincial direction guiding the funding reduction planning process now underway:

• These reductions are consistent with the $32 million in cuts or "streamlining" being implemented internally by the Ministry.
• Consultation and collaboration with partners such as the Federation of Community Social Services of BC (Federation) and the BC Association of Child Development and Intervention (BCACDI) in exchange for the Ministry agreeing not to meet its reduction targets via across-the-board funding cuts.
• Non-discretionary services that already face significant cost pressures to be exempted: Children in Care (permanency planning), Delegated Aboriginal services, Child Care, Autism, Medical Benefits and Nursing Support
• Budget cuts will primarily affect community-based intervention and early intervention services and non-residential services, whether the contracts are managed by the MCFD Regions, provincially or under CLBC
• Cuts "required for 10/11 fiscal year may involve some service reductions after all other opportunities for savings have been exhausted."

RECOMMENDATIONS FOR REDUCTIONS

1. Funding services outside the Ministry Mandate (NOTE: MCFD's legislated mandate cover a very narrow range of child protection services, so this is a very broad range)
2. Uncommitted Funding Review
3. Discretionary funding
4. Contracts  that have Repetitive  Surpluses
5. Resolve any commitments that are greater than allocated budget
6. Reorganising contracts to provide efficiencies
7. Programs not Providing any Direct service

 GUIDANCE

1. A communities vulnerability must be considered when planning reductions
2. Non Aboriginal Agencies First
3. Reductions to Agencies must not affect their financial Viability
4. Large contractors have the potential to manage some reductions through efficiencies

Moms shared this information earlier today with community groups, agencies, Ministry staff, media and the Opposition critic, calling for a transparent public process to review where BC is going with regard to services for vulnerable children in this province.  Other concerns raised:

• That Minister Polak and her senior staff have consistently and repeatedly denied to family stakeholders, the public, the Legislature and the media that budget cuts are in store or occurring within our sector, while discussing budget cuts for the current year and further cuts in the year ahead with staff and contracted agencies. 
• The extent to which some or all contracted community agencies have helped government to keep families and the public in the dark about budget cuts expected to negatively impact vital early intervention services for thousands of at-risk children in this province.

This Friday, we mark the 20th anniversary of the UN Convention on the Rights of the Child, which committed us all to putting the interests of children first.

MOMS calls on all those who still believe in that commitment to join us in making it clear that budget cuts to ANY services, programs or sectors that serve vulnerable children in BC are not acceptable - NOT when existing budgets already deny vital services and supports to so many children with special needs and children at risk in our province and NOT when this province can simultaneously afford to spend BILLIONS on other "priorities".

"M. Karagianis: When we look at things like the EIBI program…. Let's talk about that very specifically — the financial implications, which the minister has said is really the sole issue here around why this program was cut. Why did the government not make an attempt to sit down with program providers and families and try and find a way to provide what is very admittedly an exceptional program with exceptional outcomes to more families, rather than saying, "Because we can only reach 70 families at a time, we're cutting the whole program," and rather than actually finding a way to make that very effective program available to, perhaps, more people?

I've talked to program providers, and at no time did the government sit down with any of the program providers and say that "$70,000 per child" — if that is, in fact, the real number — "is not acceptable, and can we find a way to provide this program more cost-effectively?" No program provider was ever approached.

In fact, the government, by their own documentation, has said that because only 70 families at a time were able to take advantage of that program, we're doing away with it completely. The substitute for that, for all families now, is perhaps another hour a week in the kinds of therapies that $20,000 and $22,000 will buy. I'm sure that the minister and the government generally are getting the kind of enormous pressure from families that is very evident to members of the opposition.

I have attended numerous rallies. I have got truckloads of e-mail, as I'm sure has the minister. I have been cc'd on all of the correspondence that has gone to the government on this.

In the case where the outcome for children is so markedly improved and the support systems going forward for children into the future are so much more cost-effective by providing this kind of early and intensive behavioural intervention, why has the government not chosen a path of trying to reach the best possible outcomes, best practice — if we can use those terms?

I know the ministry talks about best practice in everything they do. Yet when I look at this, and many other cuts, it would seem to me that we've gone from best practice to lowest common denominator. Perhaps the minister could just say whether, in the business sense of taking the outcome for these children forward for the rest of their lives where they're not dependent on government funding or support or teaching assistance or anything else as an outcome of this….

It would seem to me that the savings are millions of dollars in the lifetime of a child versus a fairly modest investment at the front end. Why has that not been the criteria? Or would the government consider making that the next step — to try and find a way to work with families and service providers to take advantage of what is a very effective program? To see this thing disappear altogether — except for the wealthy, who might be able to afford it — seems a tragic decision to make and certainly not a good business decision for the ministry to make.

Hon. M. Polak: In fact, that is exactly what we are doing. It is incorrect to say that we are eliminating the EIBI program. We are eliminating the $70,000-per-child support..."

View the rest of the debate here and here and here.