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September 24, 1998
Standing Committees
Community Services
Meeting topics: 
Community Services -- Thur., Sept. 24, 1998

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GUYSBOROUGH, THURSDAY, SEPTEMBER 24, 1998

STANDING COMMITTEE ON COMMUNITY SERVICES

7:00 P.M.

CHAIR

Ms. Maureen MacDonald

MADAM CHAIR: We will call this meeting to order. My name is Maureen MacDonald, I am the Chairperson of this committee, and I am the MLA for Halifax Needham. It is a pleasure to be here in your beautiful town, the Town of Guysborough, tonight. It is especially a pleasure for me because I spent a lot of time here as a child. My dad is from Erinville, Salmon River, just outside of town here. I haven't been here for a while, so it is really nice to come back.

As we start, I think the first thing that we will do, which we do in each venue that we go to is have the members of the committee introduce themselves, and following that, we have an order for the persons who have indicated a wish to appear here tonight, and talk to us. We will call people in the order that we have them. If there are people who haven't put their names on the list, and you would like to speak to the committee, then that is still possible. You can indicate this with Mrs. Darlene Henry, the Clerk of the Committee, over here, and she will add you on to the list.

As we call you, you can come and present from this table here. The microphones that we have in front of each of us are connected to the recordings. All of the proceedings are recorded for Hansard, just as if we were in the Legislature. So all of the proceedings are public and are recorded. People can feel free to read from a written presentation, if that is what you have, and that is what you feel comfortable doing. Or if you feel more comfortable just hitting the highlights of anything you have prepared and speaking to them, then that is fine as well. Or if you haven't prepared a written brief, you can still feel absolutely free to come and just talk freely to us.

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At the end of presentations, we will go around with each member of the committee making comments or asking you questions, perhaps to elaborate further or for your views, recommendations or opinions on various things you may have referred to in your presentation. Essentially, that is the process. We like to keep this as relaxed and informal as we possibly can in this kind of way. We will start now and we will have introductions from other members of the committee.

[The committee members introduced themselves.]

MR. RAYMOND WHITE: Good evening, Madam Chair. First of all I want to welcome the committee members to Guysborough-Port Hawkesbury. My name is Ray White and I am the member representing this area.

MADAM CHAIR: Thank you. We may in fact be joined by one or two other members of the committee as well. I understand there are some members en route. Our first presenter is Isabel den Heyer. Isabel.

MS. ISABEL DEN HEYER: Thank you. Good evening honourable members of the Legislature and fellow participants. I would like to thank you as a standing committee for the opportunity to make this presentation. The effort that you are making to hear the views of people in Nova Scotia affected by Community Services' policies is greatly appreciated.

I am making this presentation as a private citizen. In the past, I was involved with early childhood intervention as a founding member of the Antigonish Early Intervention Program, and as a teacher and administrator in the Strait area. I have recently retired from the teaching profession. My interest in services for children with special needs was influenced by my experiences growing up with a younger sister with many challenging needs. My family, and families like ours, faced enormous difficulties trying to acquire services in rural Nova Scotia.

During the past 20 years, medical, educational and social services for persons with special needs have improved greatly in this province, however, families of pre-school children with special needs in many areas still face enormous obstacles when it comes to acquiring the appropriate services for their children; this is particularly true in rural areas. The way to help overcome many of these obstacles is through the establishment of a universal early childhood intervention program for pre-school children with special needs. This program would be fully funded by the provincial government, free of cost to families, follow established standards, and be available and accessible to all families who need the services regardless of where they live in Nova Scotia.

I would like to continue this presentation with a brief history of early childhood intervention programs in Nova Scotia. The first programs in Nova Scotia began in the late 1970's. These early programs were organized by parents and community-based professionals

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who were influenced by developments in programs elsewhere. These programs survived with temporary funding and volunteer help, and hope too. The developments of these early programs corresponded to a time when services for people with special needs were moving from an institutional response to a community-based response. In 1989, the Department of Community Services established a funding base for early childhood intervention programs, and began to develop procedures and guidelines.

According to a draft document, circulated by the Department of Community Services, entitled Early Intervention Programs in Nova Scotia, Standards & Guidelines Manual, 1998 edition: "Nova Scotia's system of supporting and enhancing environments for infants and toddlers with special needs has been influenced by research originating in the United States, shaped by the social and health care resources in Canada, and adjusted in response to the needs of individual families in the context of their communities.".

This same document provides the following definitions of early intervention, early intervention workers, and the rationale for programs:

"Early Intervention is . . . The provision of specialized services to families with children between birth and five years of age who are at risk for or have a diagnosis of development delay. Services emphasize the continued development of functional skills through the planned interactions to minimize the effects of the child's condition. Consultation, information, support and services designed to meet the individual needs of each child and family are delivered in the child's home and may be extended to community-based programs.

An Early Interventionist is . . . A professional, trained to work with children in partnership with their parents and with a variety of community based professionals. Under this partnership, an early interventionist prepares a developmental assessment and helps to design and implement a program to address the child's individual developmental needs. The early interventionist is knowledgable in typical/early childhood development, the importance of play, family systems theory and community resources.".

The rationale for these programs are as follows:

"The early years (birth to 6 years) offer a unique opportunity for all children to build a strong foundation and prevent poor developmental outcomes in later life. An early intervention program will assist infants with developmental delay - or risk of delay - to achieve their full potential.

Opportunities presented in these early years include: accelerated rates of child development along the continuum; a parental interest in education supporting the integrity of their family; and, the minimization of further developmental problems for children at risk. Our increased understanding of an infant's capacity to adapt and learn, given a supportive

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environment, provides the framework that requires us to view child development systematically with the family at heart.".

Early childhood intervention programs in this province are formed at the grass-roots level, and are usually begun by parents with the support of professionals involved with the families. The group establishes a volunteer community board and registers as a non-profit organization. In order to receive government funding, the board must follow established procedures and submit its budget to the Department of Community Services for approval.

From the early 1980's until 1997, the Department of Community Services funded 75 per cent of the cost of five items involved in running an early childhood intervention program. These approved designated items were: salaries, benefits, travel, training and secretarial services. Local boards were required to raise funds for the remaining 25 per cent of the designated items and cover 100 per cent of the cost of facilities, office supplies, phones and resources for children.

In 1998, the method of funding early intervention programs was changed slightly. Programs were given a small increase and a structure for block funding was introduced. The estimated amount a community board in a rural county must raise to support an early childhood intervention program is in a range between $15,000 and $20,000 annually.

I would be remiss to speak of the need for an early intervention program in Nova Scotia without acknowledging other programs and services that exist in varying degrees of intensity for pre-school children with special needs; for example, the Department of Health provides a range of services through hospitals and clinics.

The Department of Education, through the Atlantic Provinces Special Education Authority, better known as APSEA, provides services to children and adolescents from birth to 21 who have visual and/or hearing impairments.

The Department of Community Services supports a variety of programs for which pre-school children with special needs can qualify, such as subsidized day care, in-home support and early childhood intervention programs.

In recent years, in the specific area of early childhood intervention, positive steps have been taken to improve the service. A provincial coordinator was hired, a networking organization called Early Intervention Nova Scotia was established, more programs were started and, as mentioned, the method of funding was revised and the amount of government funding slightly increased. In addition to government services, parent groups and various non-profit organizations help a number of causes associated with supporting pre-school children with special needs.

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These efforts by government agencies and private groups have been very successful in helping a large number of pre-school children with special needs in this province. However, there are gaping holes in the patchwork of programs and services through which many preschool children with special needs fall. The largest proportion of which are in the rural areas of Nova Scotia.

The following counties do not have the benefits of an early childhood intervention program: Inverness, Victoria, Richmond, Guysborough, Digby, Annapolis and large parts of Hants County. It should come as no surprise to people familiar with the geography, demographics and economics of Nova Scotia that these counties face harsh economic conditions and have small declining populations spread over large geographic areas. These factors make it extremely difficult for people in these counties to establish an early intervention program under the parameters laid out by the Department of Community Services. In addition, these same factors make it difficult for families to acquire other often necessary services such as physiotherapy, occupational therapy and speech language therapy.

In the Strait area, Antigonish has had an active program since the early 1980's, and is presently working with the Department of Community Services to extend services to Guysborough County. As mentioned, Inverness and Richmond do not have programs. Most early childhood intervention programs in the province are struggling to raise the necessary funds to keep their programs operational as a result of partial government funding. The enormous burden of fund-raising sustained by all boards places a strain on limited human resources.

I believe that under the current funding arrangement, four main factors inhibit the effective development of early childhood intervention programs in this province and contribute to maintaining the current inconsistent system.

1. Families of children with special needs often require all of the physical, emotional and financial resources that they have, and in some cases more than they have to care for their children and to maintain a balanced family life. If these families live in rural areas, the time and the added cost of travelling long hours to receive frequent medical care for their children adds to the demands on family resources. This often leaves little time for members of a family to drive a distance to meet with others to organize an early intervention program, and fund-raise $15,000 to $20,000 a year. Many wisely figure that by the time they get a program up and running, their children will be in school and the services will be too late to help their families.

2. As mentioned, the rural nature of some areas of our province with small declining populations makes it difficult for families to get together. Often professionals who work with children with special needs in rural areas are in larger centres outside of the area or county and cannot lend the organizational support that they do in larger centres. In other words, families are on their own, and this is a very important point in rural areas.

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3. Partly due to economic conditions, there is a great competition for money to fund numerous deserving causes. To raise the necessary funds to keep programs operational, people involved with early intervention programs often must spend a disproportionate amount of time fund-raising. This takes energy away from the main purpose of the organization and creates additional responsibilities for people already stretched to the limit.

4. The need to raise such large amounts of money sometimes discourages volunteers with an interest in creating new initiatives in early intervention from joining or forming an early childhood intervention organization.

I ask this standing committee to please recommend the establishment of a universal early intervention program in Nova Scotia. This program would be fully funded by the provincial government, free of cost to families, follow established standards, and be available and accessible to all families who need the service, regardless of where they live in Nova Scotia. This would put us in the company of the Yukon Territory, British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick and Newfoundland, who all, through various funding arrangements have early childhood intervention programs committed to serving all children under their jurisdictions. Prince Edward Island has just recently made an effort to extend coverage to all parts of the island through a unique funding arrangement.

I can assure you that the relatively small amount of money spent on such a universal program would be money well spent and could be viewed as "seed money" invested in human potential. There is a good chance that a fair number of pre-school children with special needs will require intensive support from the Department of Community Services after they turn 21 years of age. Every degree of competency a child develops before the age of six is magnified in later years; every degree of competency a person with special needs develops reduces the need for support from families and government throughout their lifetime and vastly enriches the quality of the person's life.

I have had the privilege to work with people with special needs of all ages in the context of their families, schools and communities, and have seen first-hand the value of early childhood intervention. I urge you to ensure that all pre-school children with special needs, and their families, in Nova Scotia have the benefit of universal early childhood intervention so that the children will have the best possible chance of reaching their full potential. I thank you for your time and attention.

MADAM CHAIR: Thank you very much. We'll start now with some questions and some comments, and I will start first with you, Mr. Muir.

MR. JAMES MUIR: Are you working at this now, Isabel?

MS. DEN HEYER: No.

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MR. MUIR: No. I didn't realize that you had stepped down.

MS. DEN HEYER: Yes. This is a volunteer effort. I was involved in early intervention early on.

MR. MUIR: I realize that. Isabel, in the province, what percentage of pre-schoolers would fall into that? Has there been any research done, like 1 per cent or . . .

MS. DEN HEYER: It is usually estimated - and this is a hard one because it depends on what part of the province you live in - about 10 per cent of the population are at some degree of risk, or have identified problems. In Antigonish, I hesitate to give the numbers because I am not representing the group, but the Department of Community Services has all those figures and would give you the accurate one.

We know that in the communities not covered there are a number of children who do not receive service. When I was Coordinator of Student Services with the Strait Regional School Board, there was quite a difference in the services that the children had at pre-school. For example, children who lived in Inverness had to go to the Strait Richmond Hospital outside of Port Hawkesbury to get speech language services, so they virtually had no pre-school services.

MR. MUIR: I think we actually had a student teacher in that intervention program in Antigonish, if I remember correctly.

MS. DEN HEYER: Yes.

MR. MUIR: Another question, the coordinator - there is a provincial coordinator - what does that person do?

MS. DEN HEYER: Nancy Taylor is the provincial coordinator. She has been very active and, in fact, she was the person in charge of developing the new guidelines that are out - I have a copy of them here - she has had the responsibility, I don't know her full job description, but I know that she has been trying to get some standards and procedures across the province, and this is a very excellent document that describes all the parameters for early intervention programs. It lists the duties of volunteer boards and the funding arrangements; it sets the standards; and it has a family service plan. It is a very interesting document that would be valuable to have.

MR. MUIR: That is brand new, too, and I didn't realize there had been a new one. The other question before I pass it on. At one time the communities had to pick up 25 per cent, and you say this is better now and the number is $15,000 to $20,000. I am thinking of the early intervention program that is associated with the Institute for Early Childhood Education in Truro and I didn't think we were raising that much money.

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MS. DEN HEYER: Maybe you got a better grant. I am sorry, I shouldn't have made that comment.

MR. MUIR: You never can tell.

MS. DEN HEYER: It was 75 per cent of those five items and that's the amount that we had fund-raised in Antigonish for a number of years.

MR. MUIR: Yes, that's a lot of money.

MS. DEN HEYER: It is a lot of money and most boards have established things such as the Antigonish board did. They had their annual ham and bean supper that Hyland attends all the time. They also collected money individually, but it is very difficult because it distracts from the business of working with the children.

MR. MUIR: In rural Nova Scotia, that would be in the smaller, it would just be . . .

MS. DEN HEYER: Yes, it is really difficult. I think the funding arrangement, if I could, when I was involved in this in the early 1980's we really thought when we had three programs up and running, that these were the pilots for the universal program, and we thought that as soon as they would see how it was working and the benefits, that one would come, but, instead, the old funding arrangement continued and the need has outstripped the funding arrangement.

MADAM CHAIR: Thank you.

Mr. Epstein.

MR. HOWARD EPSTEIN: Thank you. What you're telling us is that the funding arrangements that exist in Nova Scotia are out of line with those that prevail in every other province in the country? That's basically the message, is that right?

MS. DEN HEYER: Yes. They've got different methods. I have been away from this for a number of years and I just started this week, when I heard you were coming, to do this. So I haven't had much time to do all the research, every province is organized differently. I know in Ontario the regional boards have responsibility for this and Quebec has another way of doing it, but the thing is that they all have a mandate for universal coverage.

MR. EPSTEIN: Universal meaning 100 per cent funding?

MS. DEN HEYER: Of the children who need it, should get the service.

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MR. EPSTEIN: Is what you're saying, that in Nova Scotia, not all of the children are getting the service, or that this three-quarter funding is universally available, or are you saying it is not?

MS. DEN HEYER: No.

MR. EPSTEIN: It is not?

MS. DEN HEYER: Okay. In the Counties of Inverness, Victoria, Richmond, Guysborough, Annapolis, Digby, and parts of Hants, these are our rural areas and for people to get together and organize a program and raise this amount of money, it is impossible.

MR. EPSTEIN: No, sorry, I didn't mean to be obtuse. You're saying the program is offered there if people could organize themselves to . . .

MS. DEN HEYER: Yes, yes.

MR. EPSTEIN: Just because of the reasons you outlined they're not likely to be able to do that?

MS. DEN HEYER: No, no. This partial funding, this amount, when I put $15,000 to $20,000, that's a rural place like Antigonish. I am sure in Halifax they have proportionately more and would need more, but that's an enormous amount to raise in a small place.

MR. EPSTEIN: Yes. What I wondered really was whether there was any indication from the department as to why it is they're out of line with the funding arrangements that exist in other provinces, and I also wondered if there was ever any intimation from the department as to whether they hoped to move toward 100 per cent funding?

MS. DEN HEYER: I wouldn't have that information because I am just volunteering at the grass-roots level. As I said, I don't know the job descriptions of everyone and the guidelines that the province sets down in the department for funding and things.

MR. EPSTEIN: Okay. Thanks.

MADAM CHAIR: Mr. Pye.

MR. JERRY PYE: Thank you, Madam Chair. I just want to thank you. I think it is a very striking recommendation. It is a singular recommendation that, in fact, simply spells out what the Nova Scotia Government should do and, in fact, recognizes that it should be fully funded. Primarily I do believe, simply because of the economics in the outlying regions, it would not allow those kind of dollars to be generated for families with children with special needs.

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There is another great advantage to this and I know, Isabel, that you probably already thought of it, because when children from birth to six, in fact, are able to get this special needs program, by the time they enter school they had the opportunity to know those very special needs which the child will need for their education and there on. I think that's very striking and very important because many educational district school boards, or regional school boards, have difficulty allocating funding for teaching assistants which, in fact, because they don't fully understand the special need of the student that comes to the school, so I really think that's an excellent move.

Madam Chair, I just simply would like to know if, in fact - and I guess Jamie has made comment to that - is there any cost analysis done with respect to offering a full program throughout the Province of Nova Scotia?

MS. DEN HEYER: I wouldn't have that information.

MR. PYE: I am wondering if, in fact, that would not fall under the Minister of Community Services, initiation of an early program that she had brought forward in the spring called Too Good to Lose, I am wondering if, in fact, was that not a program that was brought forward that, in fact, was going to put money into those children who really needed the funding?

MS. DEN HEYER: I am familiar with that document, slightly familiar with it, and it wasn't specifically in there as such. It was services, but not specifically.

MR. PYE: Yes, and it did relate to the service section of that and providing services to children, and children in need in particular, and I thought that maybe that might cover some of that but you're not certain that that covers that at all? Okay, thank you kindly.

[7:30 p.m.]

MS. DEN HEYER: I would like to make a comment if I could, Madam Chair. You mentioned the benefit that this is to district school boards. I was Coordinator of Student Services in this board until last July. It was interesting this year, all the children that had special needs that were entering the Strait Regional School Board. We had the meetings, the pre-school meetings with the families before May 1st, and I met with the parents of the children that belonged to the Antigonish Early Intervention Program in early April. We went over all the things for school. They asked me all the questions. The early intervention worker organized the speech language pathologist, the physiotherapist, the parents, the teacher we had known who was going to be in Primary and we knew all this at the end of April and this made it very easy to get student program assistance in the budget.

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Now, grant you, the budget was late this year, but in other times it would have been really good to have that information. It will be really good in April. This is what is really important; it cannot be underestimated what this means to have children coming into the school system where the needs are diagnosed, the parents have already worked with the family service plan for the children, and that just transfers right into Primary.

MR. PYE: I just want to make one comment with respect to urban versus rural. Simply because children with special needs live in an urban area, it does not necessarily mean that all those children are able to access the kind of dollars that, in fact, they should be accessing. As a matter of fact, I just recently attended a Halifax Regional District School Board where they had to hire an additional 25.79 teaching assistants simply because they did not anticipate the number of children coming through the educational system with special needs.

MADAM CHAIR: I wonder what a .79 teaching assistant looks like.

MR. PYE: I should clarify that, Madam Chair, it is a position.

MADAM CHAIR: Sorry, I couldn't resist.

Mr. [Charles] MacDonald.

MR. CHARLES MACDONALD: No, I will pass. I am coming in on the last of this, so I will just listen for now.

MADAM CHAIR: Mr. White.

MR. WHITE: Isabel, the association between the Strait area and the work that the department is doing in Guysborough County, can you expand on that a little bit?

MS. DEN HEYER: Not much, because I am not involved. I am not in the organization, but I know that the people involved in community service in Guysborough County and some parents - and Donna Sheppard will address this later - people have worked very hard to try and get a program here. It could not be extended. There were some services extended for a short time from Antigonish, but it can't cross the county line because the fund-raising, this huge amount, is done in Antigonish. If we go back to our community, we can't fund-raise for Guysborough, so it is just these boundaries that we have to respect.

MR. WHITE: So Antigonish at this time is providing some background . . .

MS. DEN HEYER: Leadership, and Nancy Taylor from the department is working very hard to try and make this happen, with the support of Antigonish, but not the financial support.

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MADAM CHAIR: Mr. Balser.

MR. GORDON BALSER: Thank you. Are the programs that are available in various areas fairly standard in terms of structure and supports that are offered?

MS. DEN HEYER: Yes, actually it is very good. The Department of Community Services has done a really good job. Even back in the early 1980's when we were starting, there were efforts made to help us and this is an excellent document. It replaces one that was thicker, but this one has actually more information in it and it is very clear and nicely done. So the effort has been made to standardize the programs but, bearing in mind that all the programs are in the context of the community, the program in rural Antigonish may be quite different than in Halifax because they may have more access to speech language or occupational therapy or programs like that.

MR. BALSER: You've indicated that a number of provinces have a commitment to this type of program. Is there a model of best practice? If the Province of Nova Scotia was going to adopt this, is there a provincial model currently in place somewhere else in Canada that would serve as an example, or the best example of how we should implement a program?

MS. DEN HEYER: Yes. I would have to say that, what is in this document, is collected information from all the other provinces, and there is an advantage to being on the tail-end of developing programs and that's that you can learn from all the others. If there is an advantage, that's it. So the Department of Community Services, through that program, they have definitely taken good things from all departments.

MR. BALSER: What are some of the things that you see we should have learned?

MS. DEN HEYER: What we've learned is the importance of the family being the centre of the program; this is one thing that was learned over the years. At one time people thought the children would come to a centre and receive services, but over the years people learned that the best thing was for the worker to go into the home and work with the family in developing a plan.

The other thing that has been done in rural Nova Scotia is we've recognized that it is really important for that early interventionist to go to speech language therapy, to go to occupational therapy with the family member and the child, and then work to bring that program together, because we can't ask speech language therapists to go from St. Martha's to do therapy in Canso. It is really too far, but there is a way to bridge that gap in doing efficient services and the early intervention worker is the one who coordinates all this and puts a viable program together for the child. I don't know if that's . . .

MR. BALSER: It certainly helps . . .

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MS. DEN HEYER: There are lots of things that have been learned and this is really a big academic topic that I haven't looked at from an academic sense.

MR. BALSER: Being the member for Digby-Annapolis and the fact that we do not have this in place, you touched on why it has failed but, if you were to send a message or I were to convey a message to the people in my area, what were some of the stumbling blocks that kept it from moving forward and how would you overcome them?

MS. DEN HEYER: I couldn't say specifically because I can't speak specifically to your area, but looking at the map I would say the large geographic area with your sparse population would make it extremely difficult. I know that on Digby Neck - is it? - there's a fair number of children with difficulties. I think that's the area and, when you look at where they have to go for services, that makes it very difficult on those families.

MR. BALSER: Is geography a contributing factor in the other areas as well?

MS. DEN HEYER: I would say geography and sparse populations. It is not for lack of will of the people, it is these other physical circumstances that are against them.

MR. BALSER: Would the lack of political will be part of the stumbling block?

MS. DEN HEYER: I don't really think so. This is not a political issue because children with special needs are still few in our population. When I give you that number, 10 per cent, that's the number at risk. We're really talking 1 per cent or 2 per cent with severe needs, that need an early intervention program. It is not something that people do for a political reason because they're not going to make great political hay out of this but it is the right and the just thing to do for children. I think that people just don't really know about it. Unless you've had a child with special needs, you're not really sensitive to all the programs and things that children with special needs actually require.

MR. BALSER: Thank you.

MADAM CHAIR: Mr. Fraser.

MR. HYLAND FRASER: Thank you, Madam Chair, and Isabel, thank you for coming forward. I remember back in the 1980's, the early 1980's I guess, when a group of parents got together to start trying to do something for their handicapped children, and it has grown through the years to where it is today. I know when you're fund-raising, the time comes to do a little bit - I've had a daughter who took the early childhood development course in Truro the past two years and, when she would be home on the weekends, we would talk about the changes I guess, or some of the things that she was learning that I never learned, or forgot if I did learn it, and she has gone off to Mount St. Vincent this year to take

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her child care degree - but I think the involvement of the parents is what has carried it through.

I talk to some of those parents today whose youngsters - whether they have Down's syndrome or some other, attention deficit, or whatever it is - are now 10 and 12 and they have fitted into the school system. They've become so different than what we used to imagine someone with those handicaps would be 30 or 40 years ago, and I think the program in Antigonish and the people who were involved in starting it and those who keep it going are to be commended.

I only wish that other places in the province could benefit from something of the same but it was parent driven and that's why it is still around today. Even though the government only partially funded it, it was something that the parents wanted for their children and that's why it stayed strong. I just commend you for coming and bringing that forward to this committee. I think it is important that the committee from around the province know what has been done in Antigonish. It has been done very well.

MS. DEN HEYER: Thank you. And if I could refer to, Madam Chair, as you were speaking there, what Mr. Balser, the comment that he made about his area, one of the things, the parents' support was crucial in Antigonish to have a successful program. The other thing that was really crucial there was there was a large number of professionals that lived in the town that could support the parents and kept it going year after year. I think that was the second crucial element that got that program going and kept it going. When I look at counties like Guysborough, Inverness and Richmond, they don't have that concentration of professional people that have the time and the money to put into such a service.

MR. MUIR: I was trying to figure out the university or higher education, community college influence. For example, up in Cumberland County they have child care in the community college up there and I was trying to figure out that base, if there were something common as well.

MADAM CHAIR: I have one last question for you before you leave and thank you for a very excellent presentation. Throughout your presentation I think there is an assumption that we understand that there are costs associated with not providing this program to children and their families that need it. I am wondering if you would comment and make explicit what you think the costs are of not providing services to children, their families, and these communities?

MS. DEN HEYER: The human cost is high. Only families that have had children with special needs can appreciate the difficulties that are involved. It is not just the cost to the child in lack of human potential. It is the lack of hope that exists with some parents for their children. I look back when my sister was born and there weren't services. It wasn't so difficult for my family because nobody had them but I would feel dreadful today knowing what I know

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if I were in an area of this province and had a child with special needs and could not get services for them. That would be a very heart breaking thing.

To put it in, as Mr. Pye was saying, the benefits to the school system, it is so wonderful to see the children coming in. All of the tough questions are usually answered by the time the children come into school and sometimes they compare the stages of recognizing, for a family recognizing they have a child with special needs. They go through denial when they first find out they have a child with special needs. Then they seek the experts. Then they look for help and then they finally come to terms with the parameters surrounding the condition the child has. Well, if the early intervention workers can get in there and help those children and reach that degree of acceptance in working with the children before school age, then it benefits everyone all the way through.

MADAM CHAIR: Thank you very much. Our next presenter is Donna Sheppard.

MS. DONNA SHEPPARD: Good evening, honourable members of the Legislature. My name is Donna Sheppard and I would like to thank you for this opportunity to speak to you. I am here to talk about being a parent of a child with special needs. I have lived in Guysborough County most of my life. My husband has a steady full-time job. My oldest son is attending school and our extended families also live within the communities. For these reasons I have chosen to remain here even after my son, Nicholas, was diagnosed but due to the lack of services within the county I fear that some day I might have to leave.

My son, Nicholas, is very demanding and requires a lot of extra attention. He is incapable of completing any task for himself. He is physically, mentally and visually impaired. We have to do everything for him and there was even a time we even had to breathe for him. Try to imagine for the past four and one-half years tending to a child, or any other family member, night and day. On our free times we try to initiate a play time or physio or interaction with other children. We either receive no response or a slap or a bite or the pulling of the hair or very loud screams. Excuse me, I am kind of nervous. Your life becomes very frustrating, stressful and your patience just flies right out the window. Every day of that child's life is based upon what you can or cannot do for him or for her.

The limitations imposed on your life and that child's life are tremendous. Most parents of healthy children have had to turn somewhere for help but where do the parents in Guysborough County have to turn. We have nowhere to go. Because I live four miles away from the county line of Antigonish, I could no longer take part in the Antigonish program. That was in April 1996. At this point I took it upon myself, also with the help of a worker that the Antigonish program had hired, her name was Carol Day, she was hired for four months, her and I worked together. We visited several town councils within the county. We developed a proposal. We formed together a steering committee and began a letter writing campaign for support for the program and also for donations for the fund-raising part of it. At this time my son became very ill and I could not finish but efforts were still being mailed but to no avail.

[Page 16]

Our day starts and ends like every other day. The only time there is a change is when your child is hospitalized. Sometimes at night when your children are in bed, you begin to think, why do I do this? Then you remember that you love this child. I don't want to give him away. I just want to know how to take care of him. I want to learn how to teach him. What I am trying to say is that due to the lack of services, whether it be a day care, a respite home, or early intervention, you're putting a lot of unnecessary pressure and stress on these families, of the parents who we all know - get passed down throughout the whole family resulting in an environment in which the children are unable to reach their full potential.

If a parent could be relieved of some of these pressures of raising special needs children, it would make for a happier environment in which the children are given a chance to develop and thus a parent in return would not be under so much stress. In order for anything to come to this county we would need full financial aid. As you may or may not know, Guysborough County does not have the capability to commit to such a program. My appeal to you tonight is to consider initiating a support system for these parents. We have waited a long time to receive any financial support from the province for our children and every day we wait is a day that our children lose.

MADAM CHAIR: Thank you, Donna. Could I start and ask you how old is your son?

MS. SHEPPARD: He is four and a half.

MADAM CHAIR: Do you have any other children?

MS. SHEPPARD: Yes, I have an eight year old too.

MADAM CHAIR: Maybe I will start this time with Mr. Fraser.

MR. FRASER: I guess this mother made her point. She did it very well. I guess, unfortunately, she doesn't have the support services that are in Antigonish. I really don't have any questions of you, Donna, I just appreciate you coming to the committee to express your frustrations and whatever but, you know, for four and a half years you've obviously coped very well with looking after your child. I thank you for coming.

MS. SHEPPARD: Nicholas was a year old before we received any help at all and that was through in-home support which some of you may be familiar with.

MR. FRASER: Yes.

MADAM CHAIR: Mr. Balser.

[Page 17]

MR. BALSER: What question could you ask after such a heartfelt and impassioned presentation but you have us here, what are some suggestions of ways that we can help the situation? You had mentioned one which is respite care, that kind of things. What other things can you see that would assist parents in a similar situation, support mechanisms to help them?

MS. SHEPPARD: Within Guysborough County?

MR. BALSER: Well, yes and then to extend it beyond. Certainly what you know of Guysborough would be an example for other areas.

MS. SHEPPARD: The early intervention is about the best program that you could offer throughout the whole province because it has a wide range of services you can receive. They have drop-in times where you can take your kids in there. They have parent support group meetings and they also help you, like Isabel did tonight, she was the one that got me here, she helped me to advocate for my child's rights. They have a toy lending library and they also have books that you can borrow to read up on. Isabel explained about setting up their meetings for the children entering the school system and other things. If you were to ask them I am sure they would help you with just about anything, to be honest.

For a year we did take part in the Antigonish program and that was one of my better years, I might say. Due to the increased caseload in Antigonish County and the extra fund-raising costs that they had to take on, they had several children from Antigonish County on a waiting list while serving Guysborough County. They can no longer afford it so they dropped the children in Guysborough County and took on the children within Antigonish County and that was only four miles off from the borderline and that is why Nicholas was dropped from the program.

MR. BALSER: Do you have a parental support group? It seems as though you are very much fighting this battle by yourself.

MS. SHEPPARD: Yes I am, my husband and I.

MR. BALSER: Thank you.

MADAM CHAIR: Mr. White.

MR. WHITE: Donna I am sure Nicholas and everyone else would be very proud of the presentation you made. How long has it been since you had any support at all?

MS. SHEPPARD: You mean from the community?

MR. WHITE: Yes.

[Page 18]

MS. SHEPPARD: To be honest with you I have not received any support from the community, except for when we did form the steering committee. I have called the Community Services Department in Guysborough in the last year at least three times and I was turned down every time. I have called looking for qualified people for babysitters or respite care. I have called looking to place Nicholas in a home for a weekend respite and they could not give me a foster home or something, people that were qualified, and they could not give me a family.

Another time I had called to ask them to help me pay for in-home physio because Nicholas does not like going into the hospital, it is very traumatic on him. It was only $40 a month and they would pay it.

MR. WHITE: What reason do they give you for not giving you, for example, in-home physio?

MS. SHEPPARD: They never really gave me a reason. They just more or less said no, that they would not do it. My husband does have a good job and I do not know if they took his income into consideration.

MR. WHITE: That is what I was wondering, if they did an assessment because you have income to say we will or will not offer that service?

MS. SHEPPARD: Yes I know that but when you are living off one income it is hard to do, especially raising two children.

MR. WHITE: I am just trying myself, and I think the rest of the committee is trying to understand the rationale of why you were not provided with assistance. If we can understand that it would probably make it easier for us to make some recommendations later. That is why I am asking these questions.

MS. SHEPPARD: I must say though I was given a family care worker who wanted to teach me how to cook but I already know how to cook. So at that time that was not really one of my necessities at that point but that is what they did offer me.

MR. WHITE: Thank you.

MADAM CHAIR: Mr. Charles MacDonald.

MR. CHARLES MACDONALD: Donna, in rural Nova Scotia we do have that problem of trying to find structure to take care of some of the areas we lack in. I should have asked this previously but do you see any possibility with the school system? I know they are not mandated to become involved in the early intervention program or pre-school children but in looking for structure, the children will be going through that process when they do get to

[Page 19]

five or six years old. It would seem that we should have some structure within the school system that would lend itself to helping in rural Nova Scotia, or providing some of that basic support in rural Nova Scotia. It is hard to do it through the hospitals, the hospitals were broken up in the rural boards. I guess really, the school is the only one that designates this, and this one being the Strait Regional School Board. Do you see any possibility there, or do you think that may be something that could be followed?

MS. SHEPPARD: Once he has entered the school system, I can imagine there will be changes. The school board has to meet his needs when he goes into the school.

MR. CHARLES MACDONALD: But I am talking about pre-school, at the present time, if they could be part of the process now. We bring our speech pathologists into the school areas at the present time. We bring some of the rest of the support system in. Surely, we should be able to find some way of helping out in the pre-school-aged children that are in those areas when we do come in. That is what I am referring to on that side.

MS. SHEPPARD: We spent a good six months just meeting with different individuals at that time to try to initiate - when we first wrote up our proposal, we wrote it up based on other intervention programs that were up and running. They were full-time programs. We tried to cut it down into a part-time program, maybe where there would be one visit a month, just to check on or leave a phone number where a parent could call and ask for a particular service or whatever. But the dead end that we met at that particular time was the funding.

MR. CHARLES MACDONALD: The funding wasn't there. One other question, and then I will pass on. Under respite service, and I guess it is something I never thought about, I have worked with some of the community service groups in different areas, but I never got into the pre-school children and respite care, I have never looked at it before. Will government help in the funding of respite centres for pre-school children? Do you know of any?

MS. SHEPPARD: No. I can't answer that one. I am not familiar with respite centres.

MR. CHARLES MACDONALD: Thank you.

MADAM CHAIR: Mr. Pye.

MR. PYE: I guess, Donna, you are here backing Isabel's recommendation 100 per cent.

MS. SHEPPARD: Yes.

[Page 20]

MR. PYE: I see that you have a child who has some very special needs, simply because of the nature of the disabilities which you in fact reflected to us. You are very fortunate to be in front of, I believe, your MLA this evening, Mr. White as well, and very fortunate that he is here to hear your particular concerns. I believe that you probably have tapped every resource that has possibly been available to you or could or should be available to you. Is this the Eastern Region which in fact has community services? I am wondering if you made a special case for emergency funding to your Eastern Region? Particularly because you have a child, in fact you have two children, one which disallows you to have the kind of attention that you should be providing to the other child as well, simply because you don't receive the funding for respite care. Respite care is very important if you are going to have any family life at all.

My question is, Madam Chair, through you to Donna, have you made application for emergency funding based on the stress that it may cause you and your family?

MS. SHEPPARD: No, because of the part that we play with in-home support, we have been turned down, because I was told that we can only receive one service from Community Service branch. I chose the in-home support.

MR. PYE: Can I ask for clarity as to what the Community Services Department actually provides you with now?

MS. SHEPPARD: Here in Guysborough County?

MR. PYE: Here in Guysborough County.

MS. SHEPPARD: None.

MR. PYE: And that is based on what they believe is the income level of your husband?

MS. SHEPPARD: That is based on the fact that we take in the money for respite care for in-home support, which is also a branch of Community Services.

MR. PYE: I guess you alluded to that anyway, that you had made presentation to the local municipal council?

[8:00 p.m.]

MS. SHEPPARD: We have made presentations to the Mulgrave Town Council and the Guysborough Town Council, and then my child became sick at that time, and I had to drop out, but I do believe, maybe, one may have been made to Canso, but we have not made it to Sherbrooke yet.

[Page 21]

MR. PYE: Sherbrooke, that is quite a distance away.

MS. SHEPPARD: It is quite a distance. It is quite a distance for a parent.

MR. PYE: Because you did say that you only live four kilometres from the Antigonish/Guysborough border, I would assume . . .

MS. SHEPPARD: Yes. I live in Mulgrave, and Aulds Cove is the cut off, and that is only three kilometres from where I live.

MR. PYE: I know we are here asking for recommendations from you and so on, but I think it is also important, Madam Chair, that we recognize if there are any avenues that we can possibly direct individuals who come to us, that we should make suggestions to that. It is unfortunate that I can't make you any suggestions, because I do believe that you have tapped every avenue possible to you.

MS. SHEPPARD: This is why I chose early intervention as my proposal to you tonight, because I have met other families here in Guysborough County with different children with different needs with different disabilities. Each child is unique, even though they are all disabled, they are all unique in their own way. Early intervention is so universal that it can meet the needs of every child, no matter what the disability is or the level of the need is within the family.

MR. PYE: Yes, and I can understand children, particularly with those special needs who would not live in a community like Mulgrave, where in fact there is a reasonably large population, but in communities where in fact the populations are only 50 or 100, and have that particular need, it is extremely difficult. I want to say thank you for supporting Isabel and her recommendations. As I had said earlier, I believe it is a very significant recommendation. Thank you.

MADAM CHAIR: Mr. Epstein.

MR. EPSTEIN: Do you think you are able to quantify for us, at all, the numbers of families that might have similar requirements in Guysborough County?

MS. SHEPPARD: In 1996, when he had completed our proposal, I do believe there were only six families at the time. This is why, like I said, when we had copied a proposal based on the other programs that were up and running, full-fledged programs, and this is why we decided we were going to cut back to a part-time program, because there was only six children.

MR. EPSTEIN: And that would represent the whole of the county?

[Page 22]

MS. SHEPPARD: Yes. But within six months after I had dropped out of the program, the Antigonish Early Intervention Office had received four phone calls within that six months about other children. There have been steady phone calls into that office since. If you actually wanted a real number, you could get in touch with the Antigonish Early Intervention. I am sure there is an increase in the families.

MR. EPSTEIN: Yes. The support group that you mentioned, is that a group of parents who live in Guysborough County?

MS. SHEPPARD: There is no support group in place, but when we were involved in the Antigonish Early Intervention, there were families from Antigonish.

MR. EPSTEIN: I see. Okay. I didn't understand that. I wondered if there was one that you met with now.

MS. SHEPPARD: No. There is no one.

MR. EPSTEIN: If you think about your personal knowledge then, of other families in Guysborough County that are similarly placed, is six about the number of families that you are aware of, or is it larger than that?

MS. SHEPPARD: In 1996 it was, but like Isabel, I have also been out for a while, and this week I have been trying to update, but my husband works a 12-hour day, so it is hard for me to get on the phone and make the necessary phone calls. I don't have that time.

MR. EPSTEIN: Okay. So it is at least six, but you think it is probably more.

MS. SHEPPARD: I dare say, it is more. I am almost positive it is more.

MR. EPSTEIN: Sure. Thank you very much.

MADAM CHAIR: Mr. Muir.

MR. MUIR: Donna, thanks for sharing your story. A couple of questions. You had indicated that Nicholas was visually impaired.

MS. SHEPPARD: Yes. He does attend APSEA.

MR. MUIR: And APSEA is providing some service. What service does APSEA . . .

MS. SHEPPARD: Last year, they provided parent coaching, where I went to the school with him, and went to his classes, and stuff like that just to see what I could do with him. But I have to say, Nicholas' itinerate teacher arranged most of that.

[Page 23]

MR. MUIR: And the other question I had, just for clarification, you had mentioned that you are receiving some in-home support?

MS. SHEPPARD: Yes.

MR. MUIR: But you also, at the same time had indicated that you were not getting any support from Community Services. Who provides the in-home support for you?

MS. SHEPPARD: Cathy Bonner.

MR. MUIR: And who pays for that?

MS. SHEPPARD: The in-home support pays for it, and I don't know where they get their money, but I do know . . .

MR. MUIR: Is that out of Antigonish or out of . . .

MS. SHEPPARD: No. That is out of Halifax.

MR. MUIR: It is out of Halifax, okay. I am not really familiar with that program, and I guess Jerry . . .

MS. SHEPPARD: I didn't know about that program, when Nicholas was first diagnosed, he has a brain disorder, his doctor, the neurological specialist at the IWK did know about the program. He was the first one to initiate the meetings with them.

MR. MUIR: But, you also indicated that because you are receiving, or Nicholas is receiving the in-home support, that Community Services looks at that as being the extent of it?

MS. SHEPPARD: Yes.

MR. MUIR: I would like to say their commitment, or because you can't have two things?

MS. SHEPPARD: Right. That is because of the lack of services in the Guysborough community. Any family is lucky to obtain one service at all. I am lucky I am getting that service, and like I said, that was through Nicholas' specialist at the IWK that I got that. A lot of families in Guysborough County don't receive any services at all.

MR. MUIR: Right.

[Page 24]

MS. SHEPPARD: A lot of the parents don't really know how to advocate for their children either. It is a fairly sparsely populated county.

MR. MUIR: Right.

MR. SHEPPARD: But Mr. MacKay could probably comment more on the community services here within the county. I am not very familiar with them. I was just told on several occasions that if I needed this, I should call, and I did call, and each time I was told no, because I was already involved with in-home support.

MR. MUIR: Thank you.

MADAM CHAIR: Just a final comment. The fight to get services and to get social programs in this country, in this province has been a long one. Quite often, the assumption is that families are the first line of taking responsibility for the needs of family members, and that puts a lot of pressure on families. And that is an assumption that some of us have really fought long and hard to challenge, and to say that there is social responsibility for the provision of services and for making sure that families and family members have what it is that they need to have good and productive lives in their communities.

So the kind of fight that you are engaged in to get services is really important. Although you obviously sometimes probably feel quite a bit of despair around whether or not you are ever going to get people to listen to you, the fact that we have services and there is an ongoing fight for services is really because of the efforts of people like yourself.

MS. SHEPPARD: I would also like to make a comment. I am not only here to fight for the rights of my child, it is for all the children of Guysborough County that are lacking the services that they need. I am sure, if you did a study, you would notice the difference between the children with special needs in this county and any other county that does receive services. All we are asking is for just one little program.

MADAM CHAIR: Yes. Absolutely. Don't let it get you down, keep going, because you will probably get those services as you work with other parents for them. The kind of change you are looking for begins with people like yourself coming out. Thank you for doing that.

MS. SHEPPARD: I would also like to make a comment to Mr. MacKay. Your community services here in Guysborough, there was a lot of people that volunteered out of your community services to serve on the steering committee also, and Harold Roberts did send in a letter of support for the program, and he did send letters out to other individuals that he thought would participate in helping run the program.

MADAM CHAIR: Our next presenter is Anita Foley.

[Page 25]

DR. ANITA FOLEY: My name is Anita Foley. I am a doctor here in Guysborough and I have been here for 22 years. Really I am not even sure if this is the right forum where I should be, but I have come to protest a change in the social services policy that has been going on in the last few months. I want to talk about drug coverage. I am probably one of the biggest pushers in the county, so I know a lot about it.

This is the poorest county in the province. It is probably the poorest county in the country. Although I think Kenora may be more poor. We have a very high unemployment rate, reaching close to 40 per cent. Our people live in scattered areas and they have to drive long distances to come for medical care. It is not the driving that is the problem, it is the paying for the driving that is the problem. They have to pay to get a neighbour, a cousin, or a taxi to take them over here.

Many of these people live at subsistence levels, many of them are disabled. They are disabled because of the type of work they had to do when they were young. They had to do extremely hard, physical work in the woods and in the fishery. They have limited education because they had to quit school to go to work in order to feed themselves and to help their parents feed the rest of the children. Many of these people have major medical problems and need drugs. I know many drugs are expensive but the people here need the same kind of drugs as the people who wear three-piece suits and work in offices in Halifax. They are entitled to these drugs as well.

Many of my patients are on municipal or provincial welfare schemes. Up until a short time ago, if a person who was on municipal or provincial welfare needed to have drugs and they were on one of these schemes, they could get the Department of Community Services to pay for their drugs. For some reason this program was stopped. There is now some kind of limit as to how much money comes into a family, whether or not people are allowed to have any drug coverage. Let us say, for example, if the limit is $500 and a family takes in $501, because they are one dollar above the limit which was set by someone in Halifax, they cannot get any drug coverage. If they bring in $499 then they can get drug coverage. This is extremely difficult for people.

You do not just live by paying your rent, buying oil, electricity and food. You do sometimes want to have new curtains in your house, you do want to change the cracked linoleum. You need extra money whether you live on welfare or PSA or whether you live on a $30 million a year salary. I find that my people sometimes are not allowed to need anything extra. For example, I will tell you about a patient of mine. This lady had bad diabetes and bad hypertension and needs a lot of drugs to control her medical problems. She is poor and her husband is disabled and also poor. He has a lot of medical problems and must take a lot of drugs as well. This was fine up until a few months ago when the provincial Community Services paid for her drugs. If I wrote her a drug she could go down and get it paid for. The interesting thing that happened is the basic income that comes into that family, she is over that, not by much, only by about $10 maybe. But her drugs are about $300 so where is she

[Page 26]

going to get her $300 all of a sudden to pay for her drugs? The interesting thing about this lady is she got metastatic carcinoma, metastatic means it has spread. She has to go to Halifax to the Cancer Treatment Centre. She has to hire someone to take her up there, to look after her in the big city which she is not used to, she has to have someone looking after her when she comes home because she is so sick from her chemotherapy. She still needs all of her regular drugs but she does not have the money for them.

Asthma is one of our major diseases in this county. Many of the families cannot afford to buy the asthma drugs for their families so what happens? I put them in the hospital so we have cut off our nose to spite our face. We are now paying hospital costs which are about $300 to $400 a day when asthma drugs may be $50 for a month, so we have these problems. It is the same thing with high blood pressure drugs. Many people are on high blood pressure drugs, their pressure is stable, they come every now and then for their check-up, I write their prescriptions. Now I am finding that my people are coming in and their blood pressure is not so controlled. When I ask them what they are doing different they say nothing, we could not afford to buy the pills this month, we have to wait until the end of the month when the welfare check comes in so that we can buy our pills. I do not think this is right and that is why I am here.

That is all I am going to say but I respectfully ask you people to please I check the new policy in Community Services that makes it difficult for people who are poor and disabled, of which there are many in my county. I don't think it's fair that they should have them.

Many patients come to me and they say, do you have any samples, doctor? Yes, I have samples. This week they get Brand X because I have Brand X. The next time, a different drug salesman has been around, I've got the same drug but under a different name. So now they are taking a different colour pill, different time schedule. It gets confusing and it's not fair. That's all I have to say.

MADAM CHAIR: Thank you. Who would like to start?

DR. FOLEY: You don't have to ask me any questions. I just came to say this.

MADAM CHAIR: Mr. Pye.

MR. PYE: I don't mind starting, Madam Chair. Dr. Foley, I may as well call you Anita, I've called everyone by their first name this evening. Anita, I must tell you that this is, in fact, a serious problem.

First of all, I'm surprised that the rigidity has set in to the municipal services in Guysborough County with respect to . . .

[Page 27]

DR. FOLEY: Can I interrupt. It is not the municipal services' problem. It is the problem that the word has come from Halifax that this is what those boys in Community Services have to do and there is no way around it.

MR. PYE: Well, okay, then, let's say it comes from Halifax. I can tell you that with respect to being over budget by some $10, normally Community Services does another evaluation of the individual's needs. If, in fact, it is only $10 or so, they certainly make adjustments and provide a medical card.

I have to tell you that you do surprise me. I am shocked and did not know that there was, in fact, a limit of $500 . . .

DR. FOLEY: Oh, I don't know if it is $500. That is my example. There is a limit.

MR. PYE: I'm surprised, doctor, that there is a limit at all for families using their Pharmacare card or their drug card for medication.

DR. FOLEY: You can't get a Pharmacare card now anymore. I'm sure of that. All my patients say there are no more Pharmacare cards. I'm just going with what my patients tell me.

MR. PYE: Sure.

DR. FOLEY: This is what they come, day in and day out in the last several months telling me this. I don't think there are Pharmacare cards now. Well, will your Pharmacare pay for this? Well, I didn't get a card this month. I can't get a card this month.

MR. PYE: Some people I do know who, in fact, are on Canada Pension, CPP, do get a drug card and so on.

DR. FOLEY: Oh, that's different.

MR. PYE: People who, in fact, are on IAP, Income Assistance Program, and those who are on family benefits do receive a card. The Income Assistance Program, IAP, is a short-term program. In a short-term program, what they do is they have an account with a drug store in the local vicinity or the local area, the drug store of their choice, and the drugs are usually called in by their caseworker and approved by their caseworker. Then the person who needs the drug goes in and picks it up. I guess, apparently, that doesn't happen here?

DR. FOLEY: It's not happening anymore. It used to happen like that until the last few months.

[Page 28]

MR. PYE: Well, it happened just the other day when I left the city - that's for sure - and that is the reason why I guess it is important to have this Community Services Committee going across the province. Obviously, what you are telling me is that there are discrepancies with respect to the level of services that are provided throughout the province when, in fact, as of April 1, 1998, Community Services took over across the province and made it a provincial jurisdiction that, in fact, they would be responsible.

DR. FOLEY: It's since then we have had the problem.

MR. PYE: In fact, what they had stated was that there would be the same level of service throughout the province to everyone with respect to community services. What you are telling me is that that is simply not the case.

DR. FOLEY: I find it totally different since April 1998.

MR. PYE: Madam Chair, I might come back at another moment.

MADAM CHAIR: Mr. Epstein.

MR. EPSTEIN: No.

MADAM CHAIR: Mr. Muir.

MR. MUIR: Thank you, Madam Chair and Dr. Foley. The question or the problem of drug coverage that you have raised is one which I ran into when I first became an MLA. This limit, whether it is $1.00 or $10 as Mr. Pye said and the couple of cases that I have dealt with, we have been able to come to some resolution. I wonder if there might not be some.

The difference in the parent services - and, again, the short of it, it certainly supports what Isabel and Donna said about rural Nova Scotia. It appears to be a lesser level of service available to the rural residents than in the more urban centres. I know that the role of a family practitioner in rural Nova Scotia is often different than the role of the family practitioner in the urban centres.

I am really delighted that you took the time tonight to come down and meet with us. As you say, the role that the family practitioner, the numbers of community services things that you would be dealing with in, of course, your practices, getting your view on it is very helpful. Thank you.

MADAM CHAIR: Mr. Fraser.

[Page 29]

MR. FRASER: Thank you, Madam Chair. Doctor, I was just wondering, when you were talking about the drugs, my understanding was - and you can correct me because you are the one that has hands on, we are only taking it from people who come to see us - that if there was a shortfall of some amount, let's say if somebody's budget would allow them to buy drugs up to, say, $60, $50 or whatever it is, and their drugs were $250, that the difference was paid for by Community Services. Now, I might be wrong but I . . .

DR. FOLEY: I have no knowledge of that. That may be the case. I am just here telling you what my patients tell me.

MR. FRASER: Thank you. I appreciate that. I'm just wondering . . .

DR. FOLEY: I must say, I did call Community Services about it and they said, yes, if the income was over a certain level they couldn't have their drugs paid for.

MR. FRASER: Well, I thought, if it put them in a deficit position that the difference was picked up but I may be wrong on that. We've been able to, through our offices, get that covered, or at least I think we were. I mean, I was under the understanding that we did.

MR. PYE: Madam Chair, if I could just make a comment to that. I want to say that, in fact, there is an appeal procedure. Normally when, in fact, the individual is confronted with this problem and they go to Community Services to have that addressed - let's use the example of $510 as their allocated monthly budget and it is over by $10 or $100. Community Services then will review their application, take into consideration the number of dollars that it spent on their drugs and then reassess their particular needs. Now, that happens in many circumstances and maybe it's not fully exercised in Guysborough County.

Another thing that I have noticed as well with, in fact, Community Services and their drugs, there may be the need to prescribe a drug that is not covered by Medicare. What happens in this particular case is that if there is a special letter from their doctor then, in fact, even though that is not covered . . .

DR. FOLEY: Oh, yes, I know all that. I'm not talking about those . . .

MR. PYE: . . . they will send that forward. I am absolutely surprised that this, once again, is happening.

MADAM CHAIR: Mr. Balser.

MR. BALSER: Thank you, Madam Chair. Certainly, the issue raised is one that has been expressed by the people in my riding, representing Digby-Annapolis. The Early Childhood Intervention Program doesn't exist and the problem of medical care is ongoing.

[Page 30]

I think part of the problem is that we are witnessing the difference between theory and practice and that is that once the province had moved to single-tier service provision, it removed the opportunity for discretionary judgement on the part of the people who could - as you pointed out - if it is $501 or it is $499, exercise a bit of judgement.

I think that that is the inherent difficulty that I am hearing, is that people who are in a position to make decisions do not have the authority or the comfort level necessary to be able to do that.

DR. FOLEY: I think that's the problem. I'm just here on behalf of my patients.

MADAM CHAIR: Mr. White.

MR. WHITE: Dr. Foley, I want to thank you for the interventions on behalf of your patients. I have intervened in some of the ways that the members have mentioned but, very often, those similar patients, we don't hear it unless we hear from a professional such as yourself. If it means changes have to be made then that is, I think, why the committee is here and that is what we want to hear. Thank you.

MADAM CHAIR: Mr. [Charles] MacDonald.

MR. CHARLES MACDONALD: I don't have any questions for Dr. Foley. I think it is interesting, though, you raised the concern that in rural Nova Scotia it, indeed, costs a lot more even to get to the doctor's office. It costs more to get to the grocery store or wherever. A good part of the budget then gets used up in trying to access or get to your service areas. I thank you for your time.

DR. FOLEY: Thank you.

MADAM CHAIR: Thank you very much.

Our next presenters are Wendy Panagopoulos and Bill Ryan.

MS. WENDY PANAGOPOULOS: Hello. I don't have anything formally prepared and I don't have a lot to say but I do have a couple of things to say as a private citizen and as a person living in Guysborough County, doing some of the work that is community-based work and has a lot to do with social justice kinds of issues and social services, that there is a need for people to have here.

I have been living here about 11 years. I grew up just down the road so I've been living in rural Nova Scotia for a long time. I've been involved in a lot of work at the community-based level doing a lot of volunteer work and in my work in capacity of the different things that I do. I am one of those people doing a lot of things to try to stay alive,

[Page 31]

like a lot of people these days, which is, in itself, an upcoming health issue, the nature of the workplace and what people are having to do to live.

I am an outreach worker with a transition house that serves this area. I have been doing that for a while. I have been involved in issues of family violence and trying to do that work for a long time. I work in Justice doing some preparation with children that are in a court process. I am a nurse by trade and I have worked in addiction for the last 15 years. I have been involved in a lot of volunteer organizations that speak to issues that have to do with people, especially people having difficulty, people in trouble in different areas of their lives. I am involved with a family resource centre here and involved in a lot of committees that have to do with these kinds of things. I have seen a lot of people over the years.

A lot of people in our county - given the nature of where we live and how we live and the kinds of issues that have been part of our lives, especially over the last 10 years, with a lot of the changes that have affected people deeply - are struggling and having a hard time, in my opinion. Some people are doing very well. I see people trying to live on very little sometimes. I know a single woman who has been told, on assistance, she is available to receive $360 a month to live on which is totally unacceptable and not appropriate, in my opinion.

There are a lot of children involved, in all kinds of families, that are living in poverty. This whole issue of child poverty - you know, I start thinking that maybe we should be calling it baby poverty because it is like, somehow children get to be poor on their own and are not part of a family that is struggling with these issues, to survive.

I would like to say that I think all of these things are political issues. I think the level of service that we have here - we have some very basic service - I know we have a large population, it is a very rural population but there are people living here who choose to be here. I am one of them. I would like to have a similar level of service that other people in other parts of the province are able to have.

I listened to the woman speak about early intervention. That is one example. I know people trying to do work in this area that are working the way I am working. We have one community health worker who works in addiction services who is also spread out over other areas of other parts outside of the county. We have one Family Service of Eastern Nova Scotia worker that is a social worker who has a caseload. We lobbied for a long time to have that position refilled as an inter-agency group working on issues of family violence. It took a while to get that refilled and in the time that position was empty there was not anyone here covering that caseload. We have very basic Community Services staff and a very basic program that tries to do outreach to the other areas of the county. We have one position doing 20 hours a week on family violence kinds of issues, so it feels like there is not a lot of support for families who are struggling. We have a lot of people who are working poor that

[Page 32]

are just above whatever the lines are that are drawn in the sand about what the numbers mean, so those people are struggling in different ways as well.

[8:30 p.m.]

I just want to say that I think the political will needs to be found to be able to provide the kinds of services that people need that are customized to a rural area. How we do that, I do not know but I think that is one of the things that this committee needs to struggle to try to create because what is happening is just not good enough for the people of Guysborough County and for any group of people living in a rural area that need services and are not getting them because of the nature of where they are or the numbers. Unfortunately, it feels like numbers are what dictates how a lot of things happen here.

I am involved in a lot of different organizations at different levels. I just came from a community health board meeting today and again, I am trying to have the powers that be understand that we have different needs, we have a different geography. I put 1,100 kilometres a month trying to get to the women and children that I am trying to serve as victims of family violence in this county, as an example. It is a huge area and the same kinds of things do not fit. We need specific kinds of services.

I guess that is basically what I want to say, we need more of the kinds of services that people require here. Thank you.

MR. BILL RYAN: My name is Bill Ryan and I was diagnosed as being a paranoid schizophrenic. Two months ago I suffered a heart attack and spent a couple of weeks in the Antigonish hospital. I am on a lot of medication and I also was operated on both shoulders, I got hurt on the draggers quite a while back, the clavicle bone was separated. I am on social assistance and a little bit of Canada Pension. I get $385 a month from Canada Pension and $101 from social assistance.

I am living in an old shack down there with no running water, no bathroom, I am living by myself and I am going up against a dead wall. I went to all of the people who were in the position to help me out but I guess their hands are tied too because I approached Ray White before and Frank Fraser, who is my worker and Brad Pellerine. I wrote to all of the ministers in Halifax and they just referred me back to Frank Fraser again, right, so I am just going up against a dead wall.

I just do not have enough money to live on, $111 is given to me for food for one month. They give me $20 a month for clothing. The only thing I know that you might be able to buy in clothing for that amount would be shoe laces.

MR. MUIR: How else is that broken down?

[Page 33]

MR. RYAN: I get about $20 for clothing, I get about $22 a month for property tax, I get maybe $100 a month for oil and $50 every two months for electricity, and they tell me I am over budget, that I am getting way too much.

MADAM CHAIR: How old are you?

MR. RYAN: How old am I? I am 52. I was 52 last Sunday. At one time, last year before the new thing came into effect there where the province took over the social services, I used to get special needs. I used to get my oil paid for, which used to help me out quite a little bit, right? And then besides, Blair used to give me, maybe, a clothing allowance so that I could buy a few pieces of clothes. I would get a couple pairs of pants or something like that from him and maybe a pair of shoes. But since the new policy came into effect, I don't get anything anymore. I am just fighting a losing battle, that is what it is.

MR. MUIR: Bill, do you have a drug card? Did you get a drug card?

MR. RYAN: Yes, I have.

MR. MUIR: Okay. And that covers basically all of your drugs, you don't . . .

MR. RYAN: No, not all of them.

MS. PANAGOPOULOS: It is $101.

MR. RYAN: No, it is not. $101, that is what I am getting from social services a month, but they cover my medication.

MR. MUIR: They do, okay.

MR. RYAN: Yes. Only thing, if I have to buy anything over the counter, I have to pay for it myself, right? That is the pharmacy card here. That is the stub from the cheque, I get $101 from social services.

MR. PYE: That is a supplemental. That is an income supplemental . . .

MADAM CHAIR: Mr. [Charles] MacDonald, would you like to start.

MR. CHARLES MACDONALD: Bill, we have many people that I know, I have them in Inverness County, and it is one of the problems, one of the hardest problems I believe, that we are faced with at the present time, it is in the housing issue and how do we provide housing or . . .

MR. RYAN: Yes. I am living in sub-standard housing, that is what I am living in.

[Page 34]

MR. CHARLES MACDONALD: Yes. I know, I would just refer to my own county. I know I have many people in the same position, and it is one of the issues that I am battling with myself, I guess, personally in trying to understand how we may be able to overcome some of that, but it is a tremendous challenge to us at the present time. On that income, it is not possible to maintain any standards in housing and services.

MR. RYAN: Well, you just survive day to day.

MR. CHARLES MACDONALD: That is right.

MR. RYAN: I just like it when Dr. Foley was up there talking, I mean, I didn't know it was her, but what she was presenting, her presentation was kind of nice. It went along with me, because I am living the same kind of style of life.

MR. CHARLES MACDONALD: I don't have anything further.

MADAM CHAIR: Mr. White.

MR. WHITE: Wendy, you mentioned that one of the things you observed was the change in the nature of the workforce. What did you mean by that?

MS. PANAGOPOULOS: I am one of the people who is working four part-time jobs to stay alive. I know there are more and more people are doing that. I think at some point, it is going to get to be a health issue for a lot of people. It is very difficult, there are some neat things about working in a lot of different places, but boy, it is tough. I work sometimes, the regular jobs that I am doing, some of the contract work, and I work casual on the weekends at detox. That is just the way it is. I am not sure it is the way it should be, but it is the way it is.

MR. WHITE: Bill, I think one of the things you are trying to point out is, in the previous arrangement, there were special needs that were dealt with by council, so that if it wasn't normally covered by Community Services prior to the change, you could appeal to the social services committee, and they would consider a special allotment. What you are running up against is, based on your budget, they are saying, for example, you mentioned the $100 each year, you would look forward to for your fuel, right?

MR. RYAN: Yes.

MR. WHITE: Now, what they are saying to Bill is, it is built into your budget, and therefore there should be enough money for you to get it, but you have indicated the reality of trying to live with what you have. Since you brought it up, I can mention it, that is the dilemma we have when we end up with a situation similar to Mr. Ryan's; I think that is what he is trying to point out to us.

[Page 35]

MADAM CHAIR: Mr. Balser.

MR. BALSER: You spoke to the need for more services generally. If you could offer suggestions as to where to start or where to focus, if we were going to take away one initiative, what could we do or what could we recommend that would do the most good, recognizing that money is scarce? Where do you see us focusing energy that would produce the biggest result?

MS. PANAGOPOULOS: Well, I guess, given the nature of the kind of work I am involved in, and the kind of work I have been involved in for a long time, I think we need to rearrange some of the priorities of the way we spend money. For me, there is a whole issue around the appropriate use of technology. I think, instead of trying to wire up half the world, we should be trying to take care of people first. I think some of the social-based services like having more people that deal in those kinds of issues, where there are issues for people, are the kinds of things that we need to focus on. So having more than one community health worker, who is in one area one day of the week, in a county like this, is crazy.

It is interesting, because of the nature of where we come from, I go off work for a week in the summertime, people think my service disappears, because we are so used to either not having it or losing it or where is it, because it is not all in one place. Services, I think that is really the key to a lot of the difficulty. I think if people can get what they need when they need it, for families that are having issues like that, I think we can save an awful lot of money in the long run, by providing the service when it is needed.

MR. BALSER: You spoke to your work with family violence and so on, do you see an increasing demand there as a result of the declining economy? Is there a direct correlation and, if so, have you noticed a marked increase in those demands for services around that kind of issue, like the issues of the working poor and the stress it puts on families?

MS. PANAGOPOULOS: I am not really sure that that translates into an increase in family violence. I think family violence is an issue that is in all of our communities and it is related to a large number of issues. I don't think bad economics causes family violence, but I think the increase of the stressors on families is from many different directions. It is interesting, and I am not sure what is going on, but around issues like this it feels like it is almost locked down and that people are just so busy trying to survive that they are not necessarily in positions where they are even able to make changes or move out of situations that may be abusive.

I think part of that is because of the nature of the income assistance program and that it is just a lot more difficult to get those kinds of services. So women and children are just saying, well, what do we do? Where do we go? We have transition house services and that is wonderful, and they need to be there for women and children who need those, but there are other issues going on in communities as well. It feels like it is very difficult right now.

[Page 36]

MR. RYAN: May I also stress something else. I have to go up to Antigonish now twice next week to see doctors up there. At one time, social services used to pay my way to go up there. They used to give me maybe $20 or $30 to go up there for the day to see the doctor. Now they won't even cover that basic need. I have two appointments, one on October 7th and one on October 8th. Such cutbacks, it is really putting the people in jeopardy.

MADAM CHAIR: We have heard in other locations that people are losing emergency and special needs assistance, very much like this. Mr. Fraser.

MR. FRASER: Maybe you are just walking into what I was going to ask, Wendy. Since you are involved in the community, when the transition took place April 1st, people who were on municipal assistance at that time then went on the provincial program. When the determination is made for special needs, they use the amount of the old provincial, people who were on family benefits, and they show them then to be in a surplus position or not showing a deficit which the municipality or social service department would pay for special needs. I think that is a crack that people are falling through. I think it is just what was referred to here.

I presume the committee has heard it elsewhere. I guess in the transition, I have heard more than anything else, that people who used to qualify for special needs, say of $50 or $100, can't qualify now, because they say that they are in a surplus position, because they use the figures of the old municipal program and the people are getting the family benefit rate. The difference there is, and people say, well, you have a surplus in your budget, and it is just like Mr. Ryan said, I don't have any surplus in my budget, I don't have enough to go around now. But when it is calculated, they are saying it is a surplus. I think that is a problem that needs to be addressed. That is probably the biggest problem that I hear in the transition of April 1st.

MS. PANAGOPOULOS: The other difficulty that I hear from women a lot is the whole clawback with the family allowance issue. For some women, in situations like this, they felt that it was going to take a little bit of the pressure off, and for families that are on family benefits, that gets taken directly out. It is a paper chase, and it really doesn't make any impact on the family that needs it at that moment.

MR. RYAN: The other thing too, if anything goes wrong, like my furnace breaks down, I will just have to lay in the cold, that is all there is to it. At one time social services used to cover maybe getting that fixed, but they won't even do that anymore. Like you said with the paperwork, they say you are overbudget, and you look back on that, well, maybe I already made two trips to Antigonish before that and it took up that money, and maybe I had to buy a pair of shoes or something like that. At one time, special needs would look after it.

MR. FRASER: Thank you, Madam Chair. I just wanted to make that point.

MADAM CHAIR: Bill, is there any subsidized housing in the area that you would qualify for?

[Page 37]

MR. RYAN: Well, there is, but I have to be 58 years old in order to get into the seniors' apartments. They wrote me a letter and told me I had to be 58. My name was in before five people now and they all got in before me. I like living where I am at, if I had enough money; if I was warm, I could manage there.

MADAM CHAIR: Wendy, you said something that has come up in other presentations before. You made the comment that you would like to see similar services here as there are in other areas, and if you are working with the transition house - I presume that is Tearmann - you would probably have some knowledge of some of the things that are available to people in New Glasgow and in the Antigonish area. Could you comment maybe on some of the specific things that you think are required in Guysborough, that would establish a bit of a level playing field with those other communities.

MS. PANAGOPOULOS: Well, I think part of it goes back to the formula and the numbers and how things get decided. I am an outreach advocate worker, I am working both of those positions, but I am working 20 hours a week. I have 10 hours that are considered to be outreach hours, and 10 hours that are considered to be advocacy. It is all the same work, but it is funded by different parts of Justice; it is managed differently, which is fine. But it is still not necessarily enough.

Tearmann did a needs assessment around issues of family violence back in 1992, and one of the biggest concerns in our county was still the lack of information about what the services are and where they are. We can get men on the moon, and maybe it is the nature of the rurality of where we live, but again, I think it is a lot of people just busy trying to survive, and when you are busy trying to survive, it is also the nature of the service. People don't come looking for this until we need it, but when women and children and people need it, it needs to be here.

It gets back to the numbers. In New Glasgow, for example, they have a position that is funded similarly, that is funded for 35 hours. In order to do work like this in this county, it is a constant, because we have to come from a community development kind of place, and people need to be able to identify their issues and to come to that to know where things are. Without being able to do that work, you are always starting, you are always beginning again and again. I have been doing this work for 10 years now and we are starting over all the time. That is the nature of the work, but that is what needs to be done. Those kinds of components, I think, have to be in the services that we deliver.

It is interesting, we have done community-based projects here for a long time through different pieces of work but you know the profile around the issues are out there when we are doing the work. You have a project, you have an office and you have people who are visible. You have to continually keep trying to justify your existence doing proposals. Look at the voluntarism. Most of us are exhausted from trying to do the work. There are issues that are

[Page 38]

connected that have to be dealt with. The numbers are not enough to determine what we need.

MADAM CHAIR: Can you explain to me why Guysborough County gets allocated 20 hours for outreach services?

MS. PANAGOPOULOS: Because we have less numbers.

MADAM CHAIR: So it is all numerically, population based.

MS. PANAGOPOULOS: And I feel it is the same in education, in health and in all of the services. Given that we have to deliver services differently here it creates a real problem for us.

MADAM CHAIR: Thank you. Mr. Muir.

MR. MUIR: Madam Chair, back to Bill just one observation. Have you talked to the Department of Housing and Municipal Affairs?

MR. RYAN: Yes, I have.

MR. MUIR: There is some money available for emergency repairs.

MR. RYAN: Yes, I have gotten some of them. I have gotten one to get a furnace and one to get my roof shingled here last year or the year before.

MR. MUIR: Okay, so you are aware of that.

MR. RYAN: Yes. Another program, I forget now what it was but I got it one time before for $3,000 and they put the gyprock up in the old house for me.

MR. MUIR: That is good.

MR. RYAN: But still they told me it would cost me about $20,000 to get a septic tank put in, well they got the water in over there now but I haven't got it hooked up but to put a septic tank in and to get more things done to the house.

MR. MUIR: The other question is how do you get into Antigonish for your medical appointments?

MR. RYAN: I have got an old car out there that really should not even be on the road.

[Page 39]

MR. MUIR: The reason I ask this is because bus service to the rural areas, which seems to me to be a rather key factor in rural Nova Scotia . . .

MS. PANAGOPOULOS: We have one bus.

MR. MUIR: Does it run down through Guysborough and . . .

MS. PANAGOPOULOS: It is a van.

MR. MUIR: But it is not public transportation, it is . . .

MS. PANAGOPOULOS: From Canso, yes, there is a bus that runs every day except Sunday from Canso.

MR. MUIR: But it is not regulated, for example, under the Utility and Review Board?

MS. PANAGOPOULOS: Yes.

MR. MUIR: Oh, it is.

MR. RYAN: They come up there at 10:00 a.m. and they leave to come back at 1:00 p.m. But if you have an appointment at 2:00 p.m., you are just out of luck.

MR. MUIR: I guess one of the things that I am concerned with as a member of this committee is the access of rural Nova Scotians to services. The transportation system seems to be shrinking, I am getting a little concerned about that.

MS. PANAGOPOULOS: If I could get a microchip in my brain I could probably get funded much better.

MADAM CHAIR: Mr. Epstein.

MR. EPSTEIN: Thank you. You have made the problems very clear. I do not have any questions at this time.

MADAM CHAIR: Mr. Pye.

MR. PYE: And I guess Jamie was reading my notes across the table because I did want to know if you had made application to the Department of Housing with respect to grants. I guess the one you had for gyprock was an RRAP, a Residential Rehabilitation Assistance grant and it was a forgiveness grant too?

[Page 40]

MR. RYAN: Yes it was, for $2,500.

MR. PYE: I guess the only thing Bill, I guess I am shocked that there are still outhouses in Nova Scotia. I am sure Sherman Hines would not be shocked and he might want a picture of your outhouse as well.

MR. RYAN: My outhouse is in the house.

MR. PYE: Is that right?

MR. RYAN: Yes.

MR. PYE: Okay because you said you have no bathroom and no running water as well.

MR. RYAN: No.

MR. PYE: I am surprised. I thought there was a requirement in Nova Scotia by municipalities that one could not live in homes unless they had, I believe that was three years back that the Department of Municipal Affairs made that change? I am not sure, I am just wondering if there has been a change and if that reflects in all counties or not. It is something worthy of looking at. In fact, I am surprised that the Department of Housing would not have provided you with funding for at least a bathroom.

I guess the other thing is you do not have much money to live on. I know that Jamie did make some calculation but I made a calculation that you are actually spending $192 of that money on essential needs and it does not leave you much for food. Are you on a special diet?

MR. RYAN: I am supposed to be yes, but it is pretty hard to follow a special diet when you do not have the money to buy it. I am supposed to be on a low fat diet.

MR. PYE: And that in turn hampers your health even further and creates a health problem where in the future you might end up in the hospital costing more money.

MR. RYAN: Yes.

MR. PYE: Wendy, I want to talk to you about victims of violence, particularly women in rural areas. They find it far more convenient to continue to live in an abusive relationship simply because they do not have the services available to them but that is not the only reason. There is a stigma attached to them as well for leaving that relationship in the community. Do you encounter that and find that it is the single most important reason why people do leave that kind of a relationship, or is it a monetary factor?

[Page 41]

MS. PANAGOPOULOS: I think there are all kinds of factors. I think instead of focusing on why women do not leave we should be looking at where women get the courage to leave, given everything that they need to deal with. Aside from that, I think there are a lot of things that come into play. It is interesting that when the term and needs assessment was done in 1992, when the research was done there was a community needs assessment done at many levels of the community and I believe there were seven or nine women that were part of that segment of the population in Guysborough County who had left and received services at the house. Now most of those women were on their way out because there was nothing to come back to, there was no service. We lobbied and we had a full-time person here when we started doing the work in 1992 and in 1993 again, given the nature of the numbers, the decrease in funding and the needs of the house and mostly the numbers that dictate where the service ends up, at times over the last few years we have had a person here doing a 10 hour outreach job.

The Framework for Justice provided the advocate piece of this position and I happen to be the only person in the project proposal that we are working on where I am doing both the advocacy and the outreach. I have worked with at least 20 women in the last year, and their families, and some of those women are receiving services in their own community. Women very much say that the house needs to be there for safety and support and there are some women that will always need to access a transition house in terms of safety. But there are lots of women who want services in their own community, they want their community to own this collective issue and it is an issue that belongs to all of us. We are breaking down the community denial and we have done some wonderful work in Guysborough County around that.

MR. PYE: I did not mean by my question to ask you to focus in on why they continue to stay there. The reason I asked you that question is to be able to provide the kinds of services that would prevent them from continuing to stay in abusive relationships.

MS. PANAGOPOULOS: That is right. I think services like this and more of the advocacy and the outreach component are very useful, along with all of the other things like the housing, being able to live on the amount of money you need to when you leave an abusive relationship and all of those things.

MR. PYE: My final question, Madam Chair is, is there a sufficient number of subsidized or affordable housing in Guysborough County to meet the needs?

MS. PANAGOPOULOS: In the group of working with family violence victims there isn't any specific housing that is designated that way. There are units in different places in the county and there are some families accessing those units. We do not have a safe space. We did at one point, as a group, try to make application around some of the housing units that were empty in the county to try to make use of that space to be able to put women and children that were in transition or may have needed - we do not have any second stage

[Page 42]

housing here, or we do not have any specific housing for those issues. Affordable housing in general for women and children in this situation would be helpful; maybe housing that was designated, I am not sure.

MR. PYE: Thank you.

MADAM CHAIR: I would like to thank both of you for coming and first of all to say, to Bill, we have heard from other people who are being hurt by the loss of assistance for emergency and special needs, especially around health care issues, and I am sure that is something that is of a lot of concern to all of us on this committee. When we get around to writing our report, we will be talking about that one I am sure.

[9:00 p.m.]

MR. RYAN: By the way, I used to have two other addictions one time. I had an addiction with alcohol, which I gave up 14 years ago, and I was also addicted to nicotine, which I gave up a year and a half ago to make ends meet and also for my health.

MADAM CHAIR: Well, good for you.

MR. RYAN: Thank you.

MADAM CHAIR: Thank you both. Our next presentation is from Nancy Wright.

MS. NANCY WRIGHT: My name is Nancy Wright and I am a fieldworker with the St. F.X. Extension Department. I work in Guysborough County, primarily in community- based development, in economic development and, as well, in health and social justice issues. I served as a municipal councillor early in the late 1980's and chaired the Municipal Social Assistance Committee, so I am very pleased with any transition that takes us from a situation where elected officials are making decisions about whether or not people are eligible for need. So I am certainly pleased to see the system changing in that direction.

I do want to make a couple of comments. There are a few things that I have been very pleased with in terms of the kinds of support and involvement I have seen from the Department of Community Services in community development. I think there are also some areas where there certainly could be more support.

One of the programs that has been of particular support to us is some of the funds that have been available through family support programs for parenting programs that our local group, through the inter-agency Family Violence Committee that Wendy spoke about, we established parenting programs and a parenting subcommittee. We have been able to get funds to support parenting programs over the last few years. It is not a lot; it doesn't pay for an

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ongoing coordinator, but it is the kind of support that can really help you begin. It is seed money to help start developing programming.

One of the areas that has been an ongoing problem - and I think Wendy mentioned it - is the funding that's available to outreach programs from transition houses. I had the position before Wendy with Tearmann House and one of the things that I think is not very well recognized is that the way the statistics fall out in terms of the numbers of people you see, and that being connected to the funds that you receive, is that you can see eight women in a day in a shelter in an urban centre, and I might be able to see one or two women a day in a rural community. I can travel from here to the other end of the county and spend all day and maybe see one client. So the distance that is travelled, the amount of time that it takes to spend with clients, is certainly not reflected in the numbers and the amount of funding that you need. So if the only thing that really is considered is the number of clients, it certainly does not take into account the nature of the work and the nature of the travel to develop those services.

The other service that we have not been able to obtain here in terms of family violence, prevention and intervention, is services for men. We have a men's treatment subcommittee that has been planning, over the last few years, some programs and some ideas we have for trying to create more family-based interventions and while we have had some services to work with women, we have no services to work with abusive men. We have tried to work with New Leaf, who also have not been able to secure the kind of ongoing funding that would provide an outreach program in Guysborough County. Right now there are no services provided that would match the kinds of services that have been provided for women, so we also see sort of the ongoing program funding for Guysborough County for men's treatment as being important as well.

I would like to make just a couple of comments about economic development. I am working with a number of community economic development organizations and community development committees who are looking at trying to find ways to create employment, to develop strategies around tourism, or small business, and there are a number of barriers that people who are receiving social assistance face. In terms of the kinds of strategies that are being proposed, of course one is Sable gas, and it is an industrial strategy. The people who are on social assistance by and large in this county are not going to have the training or the skills at this point and at this phase I don't believe to be able to really benefit a lot from that endeavour. They may in years to come if there's enough work done to prepare and to provide the training necessary, but in this development I don't see that they're going to be able to participate highly in that and be able to get off the social assistance system.

One of the things that I think is another drawback is that the other major strategy is small business development. Small business development, as you know, requires capital and it requires confidence and it requires skills, and those are things that some of the recipients of social assistance do not have access to. I have heard that there are some programs available for people who want to start cooperatives and certainly, from my point of view at the

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Extension Department, we're more than willing to work with people who want to start cooperatives or work together in community-owned business, but capital is a problem and particularly the kind of capital that's needed to start value-added fisheries, forestry, or tourism businesses. For people on social assistance, I think those are real barriers.

Training is another one. In years gone by, I recall programs like the SARS Program and training programs that put groups of people through fairly specialized training. We have a lot of women now with training in day care workers with level 1 and 2. We put a group of carpenters through the SARS Program. They don't match the employment opportunities, so we're not doing enough, I don't think, to establish employment opportunities that actually match the training needs and capabilities of the people in the county.

I guess my last concern is what kinds of programs may be in place for the families who are now going to be coming off the TAGS Program. I know some people have gone for training and they've been in school three or four years and the employment opportunities may not be there. Is there going to be some program in place to actually take care of the gap in the meantime when families begin to need to go to receive social assistance, because I think that's going to be an increased burden on the Department of Community Services as well. I have a concern that in the meantime, until there is some employment created or some opportunities created, that's also going to be a burden on the system and a real stress for families who have never had to go in that direction. I think it causes a certain amount of stress and hardship to even have to be considering going to receive municipal assistance or provincial assistance at this point in their lives. Certainly it is an issue of not only dignity and pride, but a real feeling of helplessness.

I am working with inshore fishermen and their wives and families and I think they're feeling a certain amount of stress that, you know, even though they want to stay in the fishery, there's not a lot to support their families in the meantime. Thank you.

MADAM CHAIR: Thanks, Nancy.

Mr. White.

MR. WHITE: I certainly can support Nancy's, or anyone's, argument that if you're dealing with any formulas for Guysborough County, distance is a major factor that has to be considered. Nancy, you mentioned the work you're doing with people on social assistance. What type of incentives do you feel should be in place to help them get off social assistance? You mentioned the need for capital, training, is there anything else that . . .

MS. WRIGHT: One of the areas that I find there is a lack of involvement, there are community development organizations that are being started, but families on social assistance can't always participate. Child care is a problem; travel is a problem; feeling confident in skills to be able to organize, to be able to run meetings, to have the sense that you can participate

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equally. When you look at the table of who the volunteers are in the communities and who are the people who are making decisions, how far do we go to try to involve everyone in the community? Do we just involve the people who have already got leadership skills or access to funds, or are there provisions to try to include everyone in the community in the kinds of development that's taking place? So I would say programs that would create incentives for people to become involved in community development, and looking at the ways they might be able to try to develop enterprises or organizations or build business in their areas.

MR. WHITE: Just one final question, Madam Chair. Has one of the problems been that most of the programs that come along are short term, so you just get somebody up and running and then it is dropped?

MS. WRIGHT: Absolutely. As Wendy mentioned, we had a women's organization and the Inter-Agency Committee on Family Violence, we have had Kids First, we've had a number of programs over the 20 years I have been here, and we've probably been in every building in Guysborough. You're up for six months. You're down. You're up, you're down. There has been no consistent and steady source of funding for community and family services that are community based. It hasn't existed.

MR. WHITE: Okay. Thank you.

MADAM CHAIR: Mr. Balser.

MR. BALSER: Thank you, Madam Chair. It is interesting to see you tie the need for community service to integrate with economic development at the community level. There is an overlap and we're hearing that education issues, health issues, spin into one another. Adding to what Mr. White had said, what would be one means to get the most bang for your buck so to speak? It seems to me one of the things I have heard is that there is a growing number of working poor and multiple jobs and so on. It would seem that perhaps adequate subsidized day care facilities for people who are working shifting hours and so on would be one way to really free up time and opportunity for people and may address a number of concerns. Would that be something that would work well?

MS. WRIGHT: You've probably touched a nerve with me. We've been very involved in having day care as one of the services that we tried to provide and family day care. We had a subsidized family day care in Guysborough for 10 years. The day care folded eventually and one of the issues was the lack of understanding in terms of regulations about the kind of care that people in rural communities need. They're not all living in an apartment building in Sackville where the caregiver can go upstairs or downstairs. Caregivers sometimes live quite a distance from families. People here work shift work and sometimes it is better to have a caregiver come to a parent's home.

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Those kinds of situations need to be flexible and the regulations need to be flexible. In the case of Guysborough County and in other rural family day cares, the regulations are not flexible enough to meet the needs of the families who live here. So the choice, I think, at some point becomes, do you break the rules or do you stop trying to participate in that system?

The licensing regulations have not met rural needs and it is understandable. Family day care was developed in urban centres. It was developed in Nova Scotia in Sackville first and in some of the cities and larger centres. We were the first rural family day care in the province and really tried to lead the way in creating some advocacy and some understanding of what it is like to do day care in a rural area. The current models do not work. Centre-based day care does not work here for the same reasons: people live too far away and the number of families are too spread out.

There needs to be more flexible alternatives for families to have child care and that means that for some families, they need to be able to receive subsidized child care in their own homes, to have caregivers come to those homes. To date, to my knowledge, that has not been something that has been certainly accepted or regulated by the province.

MR. BALSER: Thank you.

MADAM CHAIR: Mr. Fraser.

MR. FRASER: Nancy, last week, our caucus had an opportunity to visit Guysborough from one end to the other, well, not even to the other; some of us didn't get as far as Ecum Secum, I think one of the disadvantages that you have among all the optimism there with the Sable gas and other things, is the tremendous distances between centres where you might try to provide service. While there is all kinds of potential, there's always a downside and I presume that if industry does come to that area of Guysborough, where gas is coming onshore and that sort of thing, people on community services, with the fishery and the downturn and that sort of thing, I fear the cost of living is going to go up.

MS. WRIGHT: It has already. The rents have gone up.

MR. FRASER: Yes, I expect it has gone up. So people who are on social assistance who can't get off, they were on TAGS, or whatever, they're going to be worse off because of the sort of developing economy.

MS. WRIGHT: They are in the rental units and the rental unit prices are what has already started to increase.

MR. FRASER: Yes, and we see that in Antigonish where people who are on social services usually don't have any mode of transportation. They would like to live close by where they can walk to where they have to go but rents are so high, for instance, in the Town

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of Antigonish that people live out in the rural areas but then they don't have any way to travel. So that's the same thing that will happen. You will get a place where you would like to have them but there's no housing available that's affordable so they move out into other areas where housing is cheaper but then they're at a disadvantage for some of the things that communities can offer, where because of the economies of scale an entrepreneur can set up a business where people are sort of in an area. But it doesn't help anybody out in the rural areas because that's the only place that they can afford to be. While I think there are lots of opportunities down here, I think there are some downsides that people like yourself are going to have to address.

MS. WRIGHT: Absolutely, there are barriers.

MR. FRASER: Thank you.

MADAM CHAIR: When did the family day care close?

MS. WRIGHT: I think it has been two years but I would need to check that.

MADAM CHAIR: So what do people do?

MS. WRIGHT: They make private care arrangements. There are no subsidized seats in the Municipality of the District of Guysborough. There are some subsidized seats in the Town of Canso, but there are no subsidized seats at all in the municipality.

MADAM CHAIR: Not one subsidized seat in the municipality?

MS. WRIGHT: Not to my knowledge, there isn't, no. Our MLA Raymond White might know, but I don't think there are any. No. There is a group in the Drum Head/Goldboro area of families, that as a result of work in the gas project have started to look at the feasibility of day care, and we have applied to have five seats reserved if that group forms a board and looks at day care, but right now, there are no seats. Part of it is that the situation does not lend itself to meet the criteria that exists for day care. It is not flexible enough to meet rural needs.

MADAM CHAIR: I am speechless. I can't believe that.

MS. WRIGHT: If you are a single mother with two or three children, why would you go to work for $200 a week, to pay that much back in child care? The disadvantage for people who want to work is quite high.

MADAM CHAIR: No kidding. Okay. I am going to pass it over. Mr. Muir.

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MR. MUIR: You have raised a couple of issues that I hadn't thought of, and I wanted to thank you for that. The one that Maureen is still thinking about, and also Hyland Fraser's point there about economic booms driving up rents and it has the reverse effect of that, which most of the time we don't think of. The assumption is, if things are better, it is better for everybody.

MS. WRIGHT: No, and with a ceiling on shelter costs, that is going to be a problem for families.

MR. MUIR: Yes. I think that is something we are probably going to have to take a look at when we are preparing this report. Thank you.

MADAM CHAIR: Mr. Epstein.

MR. EPSTEIN: It has been very striking this evening, that although the focus of the committee hearing has been on social assistance reform and although we have heard some comments that are very directly related to that, such as the requirement for funding for services for special needs children and problems with the coverage for medication, as well as the general low levels of benefits, all of those being directly related to the topic, what we have also heard have been linkages of the general problems of poverty with ill health, and therefore with the need for social services especially in rural areas.

It sounds as if you are very much of that view, that all these things are linked and we have to see them together. It seems quite clear that all of these things do lead to the area that you identified, local economic development, and what relationship it has to the topic we are dealing with, and I have spent a lot of time thinking about these problems.

I think you are right to say to us that it is particularly difficult in Guysborough County, an area that I think is often overlooked when a lot of the planning is being done, and what is generally touted as a big economic infusion for Nova Scotia, the Sable gas project in the local area here, is not necessarily going to be a big or lasting boon. Certainly during the construction phase, there are opportunities, but as we heard on the news today, the benefits in Nova Scotia are only at around the 20 per cent level of the overall construction, and that is a disappointingly low figure. We do know that in terms of the long-term projections for the project that there is only a total of about 280 jobs that are going to be generated each year directly by the whole project, which is not a high level. So this is a real problem.

What I wondered about in particular, arising out of your comments, was the passing one that you made about access to capital. I wondered if you could help me get a better grasp of what you . . .

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MS. WRIGHT: What I am referring to is the ability of people on social assistance to borrow funds to start businesses. Credit ratings are one problem, but being able to actually access the kinds of funds you would need to begin any kind of an enterprise that requires equipment or buildings or purchases of that nature is pretty much impossible.

MR. EPSTEIN: People often mean different things when they talk about problems of access to capital. So the direct part of it that you were talking about was the problem that anyone who is a social assistance recipient . . .

MS. WRIGHT: Or an organization, for example like a co-operative, where the people don't have a lot of money to purchase shares, they don't have enough money to purchase shares at a high rate as well.

MR. EPSTEIN: Yes. Can you tell me the situation in the county with respect to credit unions and local economic development? Are they attempting to make money available in the local communities?

MS. WRIGHT: There is only one credit union in Guysborough County and that is in Mulgrave, and it was just established a few years ago, when I think the Royal Bank was leaving the area. There are banks, but there were credit unions at one time in Drum Head and Larry's River, and over the years, I think, those have closed. There is no credit union involvement here at all now.

MR. EPSTEIN: Are there examples of particular projects that you have seen that people have tried to get going, that have not been able to get going because of problems with access to capital?

MS. WRIGHT: I think one of the areas that I am starting to find that happening, particularly right now, is in the Drum Head/Goldboro area where the Sable project is coming onstream, and what we have been doing there is working with a co-op that is trying to find local employment for people. What we are running into is people who are interested in starting businesses, but they have either been on TAGS or they have been on assistance, or they have had very low seasonal income, that don't have assets built up, and don't see themselves being able to get money from the bank or being able to go and get money from the conventional lenders. That is the kind of concern, or even to start business development; certainly, a fear about the future, making those kinds of investments.

MR. EPSTEIN: Good point. Thank you very much.

MADAM CHAIR: Mr. Pye.

MR. PYE: This is the first time I have nothing to say, Nancy, just thank you very much for the report.

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MADAM CHAIR: Well done. Thank you very much. Oh, I am sorry. Nancy, I forgot Mr. [Charles] MacDonald.

MR. CHARLES MACDONALD: I was going to raise some of the issues with Wendy before. One area, Nancy, and that is the area of control over the programs or administration of the programs. Programs that are Halifax-driven or whatever have their own contacts in Halifax, they don't apply the same way in rural Nova Scotia. So trying to allow that local administration to have some flexibility in how they administer or deliver that program, is that what we need?

MS. WRIGHT: Oh, yes. I think we need rural solutions, particularly in child care services. We need for families to be able to say, the kind of services that the parents and children require, that is in the best interests of the family, given where they live and their income and their situation, and to be able to have some flexibility to make those solutions possible, within a subsidized system.

MR. CHARLES MACDONALD: Within a subsidized system. In day care itself, we almost need a floating subsidized day care . . .

MS. WRIGHT: Absolutely, it needs to go with the families. If there was ever a case for subsidy to travel with the family, it is in rural Nova Scotia.

MR. CHARLES MACDONALD: As opposed to being tied to the centre.

MS. WRIGHT: Yes, that is right.

MR. CHARLES MACDONALD: Okay. That is all I wanted. Thank you.

MS. WRIGHT: Can I make one more comment? I forgot, there was something else that I would like to just mention to the committee, and that is the importance of the ability of rural Nova Scotia to have distribution of natural gas. It is an issue that is very slow to build in rural areas, but in this area, it has been moving quite quickly. One of the things that I think, not only is it supposedly a cheaper source of fuel that would certainly benefit the fuel budgets of families, but it may provide the kinds of development that is not now available, the kinds of small business development around greenhouses or small manufacturing, value-added fisheries manufacturing that families could become involved in owning, and become involved in working in and being employed in; enterprises in their community that could benefit from the cheaper source of fuel.

Again, I wanted to make that plug that there is a connection between social assistance and economic development. We sort of need to be advocating for all of the things that can provide employment opportunities for families.

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MADAM CHAIR: Before I let Howard have his say, I just wanted to say that we do talk and I suspect we have heard already and will hear a lot more, people talking about well, what are the incentives to get off social assistance, as if there is something inherent in the social assistance system that keeps people on welfare. I always try to argue that if the labour market can't provide decent work and wages, that is where the lack of incentive lies, it is a labour market problem, not a welfare problem.

MS. WRIGHT: It is certainly not an attitude problem.

MADAM CHAIR: That is right. We know that the Economic Council of Canada has been doing reports that demonstrate that there are good jobs and bad jobs in our economy and there are way more bad jobs being created than good jobs. That has been the scenario now for probably 12 or 14 years and we really have to get a handle on creating good jobs and making the labour market provide the incentive for people to be able to work and have good wages and livelihoods. You are absolutely right in raising the economic development issues. I think as a piece of what it is that we have to . . .

MS. WRIGHT: Which certainly does not discount the need for income support systems.

MADAM CHAIR: That is right. Mr. Epstein.

MR. EPSTEIN: On this particular point that you mention about rural distribution of natural gas, I couldn't agree with you more that it is very important that rural areas, that all areas of Nova Scotia be able, on an equitable basis, to have access to natural gas. It is our gas and we should be able to do that. What puzzles me about it is that when many of us have thought about this problem we tended to assume that regions that were immediately adjacent to where the main interprovincial international pipeline is located, are likely to be able, without a lot of problem, to have access to that gas. Is there a reason that you mentioned that for this area because this area would be a prime . . .

MS. WRIGHT: I don't think there are any assurances that all of the communities in Guysborough County are going to get gas. We have been told that having a load at the end of the pipe is the most important factor. There is a fish plant at the end of the road to Canso but there certainly isn't a high load in Little Dover, there isn't one is Isaac's Harbour, there probably isn't one here in the Village of Guysborough. If there is no industry in a community to carry the load to make it worth the price of putting in place the pipe and the system, then are there going to be other incentives or supports to make sure that rural Nova Scotia gets gas? If we do not get gas and the other areas of the province do get gas, our depopulation is going to continue, in my opinion, and who is going to want to start a business in an area that does not have a cheaper source of fuel that the community 50 miles away does? So I think it is a real disadvantage to not have the assurance that whoever gets the system puts it everywhere.

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MR. EPSTEIN: Very good point, thank you.

MADAM CHAIR: Thank you very much. Are there any other people who would like to present? I am going to close, but I am going to ask the members of the committee if we can come back in five minutes and discuss one thing. Very briefly, we have so many calls and requests to appear before us in Halifax that there is no possible way that we can handle that and we need to have a brief discussion about scheduling an additional meeting. So if we could come back to make that decision. Thank you.

[The committee adjourned at 9:28 a.m.]