Mr. Chairperson (Marcel Laurendeau): We will now move on to the Youth Secretariat.

Does the honourable minister have an opening statement?

Hon. Bonnie Mitchelson (Minister of Family Services): No.

Mr. Chairperson: Does the critic of the official opposition party have an opening statement?

Ms. Marianne Cerilli (Radisson): It is interesting when I look at the news release for the secretariat and notice that it was put out the same date as the report released on the Health of Manitoba's Children. That report is very comprehensive and very extensive, and I am hoping that we will see more from this secretariat in addressing the issues raised and the recommendations raised in that report. I also want to acknowledge the work of the critic for Health for the NDP in this area. The MLA for Kildonan (Mr. Chomiak) has spent quite some time asking questions with respect to these matters in the departmental Estimates for Health.

When I was preparing for this, I had the opportunity to read the health report. It has really caused me to give some serious attention to the need for integrated services and the approach that this secretariat is taking. It really is, I think, a systemic, systematic, multidisciplinary preventative approach contrary to the somewhat punitive approach that this government often takes to dealing with children. That punitive rather than preventative approach can be seen in their approach to a number of things that they have dealt with in Justice that have not looked at preventative matters as much as punitive matters, the way that they have approached changes in education with the attitude of expulsion as a solution, again rather than prevention, when they have at the same time increased class size and demand on teachers and withdrawn support on teachers, when they have reduced the budget in Education by 2 percent a couple of years ago, and we have seen 400 teachers lost in the province under this government. A number of the other personnel that are in schools have been lost under this government that provide the kind of supports that this secretariat is addressing so that young people with special needs can have their needs met.

Then there are some other things that this government has almost done and has done with respect to preventative measures for children, things like looking at eliminating physical education for children which they reversed at the urging of the community and the members on this side of the House, as well as the thing that they look like they are going ahead with, which is eliminating health education. They were even looking at eliminating recess.

All of those are things, I think, are not with the best interests of children in mind and are very much not in keeping with the preventative approach to child welfare, health and status issues.

Similarly, in their approach to young people with eliminating the Student Social Allowances Program, the New Careers program, the BUNTEP and Access programs, all of these, I think, are not a very preventative approach to providing for the needs of young people in the community, and similarly, in reducing the subsidies and subsidized spaces for child care and not addressing the funding needs of parent-child centres which were providing such wonderful examples of preventative care in the community.

I think we are seeing a shift in attitude to dealing with children and the needs of children, and I think this follows on the shift and attitude we have seen as a result of much work. In the women's community we know the status of children is often dependent on the quality of health, education and status for women in the community. As we have seen the protection for women in domestic situations improve in our society, I think now we are also seeing similar changes in attitudes with respect to children.

With that I will close my opening remarks and look forward just to asking some specific questions with respect to the activities of this secretariat.

Mr. Chairperson: I thank the honourable member for those opening statements.

At this time, we would invite the minister's staff to enter the Chamber. Would the minister introduce the staff present?

Mrs. Mitchelson: I would just like to introduce Mr. Reg Toews, who is the assistant deputy minister in charge of the Children and Youth Secretariat.

Ms. Cerilli: Mr. Chairperson, I just want to begin then with asking the minister to clarify, I understand there are four staff in the secretariat, if the minister could tell us the functions of those four staff.

Mr. Chairperson: Before the minister answers that, we are on Resolution 34.1 (1) Children and Youth Secretariat (a) Salaries and Employee Benefits $378,800.

Mrs. Mitchelson: Mr. Chairperson, Reg Toews, as I indicated earlier, is the assistant deputy minister in charge of the Children and Youth Secretariat. There is one secretarial staff for support and other than that there are four staff positions that have been seconded: one from the Department of Justice, one from the Department of Education and Training, one from the Department of Health. There are two people who are seconded into one position, half-time, from the Department of Family Services.

Just recently we have decided to add someone from Culture, Heritage and Citizenship from the Recreation branch to the secretariat, because I think a lot of the issues dealing with children have the need of understanding some of the recreational opportunities and activities that should be looked at in a co-ordinated fashion. There will be someone from Culture, Heritage and Citizenship shortly appointed to work with the secretariat.

I want to indicate these are all seconded positions. There are no additional staff costs and any of the activities that are undertaken by the secretariat are activities that would look at redirection of resources within departments or transferring resources from one department to another to deal with the issues around serving children and their special needs.

Ms. Cerilli: Just to clarify then, these are all seconded staff and the budget for this line, which is $144,000, that is all money that has been transferred from these five other departments. It is not any new money.

Mrs. Mitchelson: The $144,000 in this line is not staff salaries. It is operating costs. That is for space and telephones and all of the other things that are necessary to operate an office, and that is money that is recovered from within the departments that are participating in the secretariat, so it is not new money.

The staff salaries are still in each department. There are staff here who remain in the department but they are seconded over to the secretariat for support.

Ms. Cerilli: That is what I understood. The question was, then there is no new operating money for any services they may wish to provide that is also going to simply be the reallocation and reco-ordination, if you would, of money and services from those departments that are represented in the staff.

Mrs. Mitchelson: Yes, that is correct. The secretariat itself will not be undertaking new initiatives or new programming. What it will be doing is co-ordinating and looking within departments where the overlap and duplication might be, and where it might make better sense to deliver the programming. That advice will be given and monies will be reallocated from department to department as need be in order to try to address those issues.

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Ms. Cerilli: Assuming then as well, the staff who are listed, perhaps other than the two sharing the position from Family Services, are working on this function full time and that function would be to, as the minister has said, analyze how services could be co-ordinated better, specifically, I understand, just for children with severe medical conditions or lifelong disability. I am wondering how those staff are undertaking that analysis of the co-ordination.

Mrs. Mitchelson: That issue was an issue that has been partially addressed already by the secretariat, and I think there was an announcement made whereby we were looking at medically fragile children and how we could best try to address their needs.

One of the concerns, one of the issues that I have heard many times from parents out in the community with medically fragile children is that they have gotten, can I say, the bureaucratic runaround where there are several different intake processes, and it depends on whether you are in the health system or the education system. Maybe it might just be in child care. You need child care services, and there are several different intake processes, and there was no co-ordinated effort to try to address the issues. It was a health problem, and yet the Department of Education was being asked to fund some of the support services.

Also, the Department of Family Services was involved through Children's Special Services, and there was no co-ordinated approach, and what we have been able to do by working through the secretariat and working within all departments is take $650,000 from the Department of Health, move $450,000 to the Department of Education to deal with the needs of the medically fragile children in the school system and take the other $200,000 and redirect that to Children's Special Services and Family Services, so there will be one intake and referral process, and we should be looking at from birth right through to 18 for all children. There will be one central intake process, and the referral will be made through Children's Special Services.

So the dollars have been reallocated in order to streamline the system, make it cost-effective and manageable. The Department of Education now has the funding from Health to deliver the service, and Children's Special Services and Family Services has the ability to co-ordinate and do some of the staff orientation in our school system or in our child care system, wherever it might be appropriate.

Ms. Cerilli: I thank the minister for that answer. I am wondering how many young people this is anticipated in assisting. Bear with me for a moment.

I see from the child's health report that there are approximately 850 severely disabled children in Manitoba, 2,723 with moderate disabilities and 14,814 with mild disabilities, and from that, how many children does this new approach expect to service?

Mrs. Mitchelson: I do not have those statistics. I might just ask my honourable friend if she might provide for me a copy; in the Postl report, okay. Mr. Chairperson, could I ask what page in the report that is on?

Ms. Cerilli: It is interesting if the minister is saying that she does not know how many children are going to be serviced, but she has already decided the amount of money to be allocated to the different departments.

I am reading page 105 of the children's health report.

Mrs. Mitchelson: I guess the figures that are on page 105 in the Postl report and the numbers that we have are compiled in a different way, so when my honourable friend gave me some numbers--I guess what I should be explaining is if you look on page 105, the 21 technologically dependent children are the very high-needs category.

In the instances where we are providing support for medically fragile, it is in the way of providing nursing services within the school system so teachers do not have to provide medical treatment or nursing services. The $450,000 that has come from the Department of Health into the Department of Education will go to fund the nursing services that need to be provided for the technologically dependent. That 21 in that category and those in the next level, we had indicated would have been in the 300-plus number that needed some type of support and service from trained personnel.

Some of those could be paraprofessionals that are working in the school system, but what we wanted to do was provide the ability to train those paraprofessionals or professionals in the school system to do the tasks that were non-nursing tasks but were needed in order to maintain these children in our school system. Those were the areas that we concentrated on.

The other 3,000-plus or 6,000, I guess, that are indicated in the book in these numbers are being looked after through different levels of funding in the Department of Education presently, and there was not a pressing need to address that issue with reallocation of resources.

The money that came from Health was money that would allow nurses to provide the nursing services that are required and free teachers up in the system to do what they do best and that is teach our children.

Ms. Cerilli: I thank the minister for that answer.

The second initiative that was to be completed by the secretariat is an interdepartmental protocol for children and adolescents with severe to profound emotional behavioural disorders. I also would recognize that this is another report, or I should say another recommendation, that stems from the children's health report that talks about the Level 5 children having a joint responsibility through Health and Family Services.

So I am wondering if that is what this is to be addressing. Can the minister tell us how far along we are in developing this protocol?

Mrs. Mitchelson: Mr. Chairperson, the protocol was signed by all four departments back in March. There was a paper at that time that was released, and I will share a copy with my honourable friend, that talks about the protocol. All of the interested partners have received a copy of the protocol agreement and it will be implemented coming this school year in September, and how the protocol will work will be circulated to all of the interested partners over the summer.

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Ms. Cerilli: Thank you, I appreciate receiving that.

It appears then that the initial two goals set out for the secretariat have been met. I am wondering if other than evaluating these two activities, what the future goals and objectives of the secretariat are?

Mrs. Mitchelson: There are several different initiatives that the secretariat is working on. Can I indicate that the responsibilities of the secretariat is to work under the direction of the Human Services Committee of Cabinet to co-ordinate many intersectoral activities and projects across departmental lines and to resolve some specific impasses between departments that presently exist.

There are two initiatives that have been completed or are still underway, and that is the interdepartmental protocol and the dealing with the medically fragile children in our school system. Those two are well on their way to being implemented and resolved.

There was an initiative within government that had been in the works for several years which was the Red River Community College child and youth care worker program. It involves a commitment from the Department of Education and Training, the Departments of Family Services, Justice and Health. I think we are at a point where we finally have all departments working together and contributing so that the program can be up and operational by January of 1996.

What the secretariat has also been doing is trying to compile from all four departments the number of dollars being spent on serving children and children's needs. We will be looking at a budgetary process, possibly into the future, that will try new ways of delivering certain portions of the budgets in each of those departments in a more co-ordinated fashion to serve children. So we will be testing new ways of delivering, attempting to see whether departments are doing things that are very similar to each other and would it be more appropriate for one department to take the lead on that programming and have dollars transferred internally to see a more efficient program.

So they are working on that and that includes, of course, as I said earlier, reviewing programming that is ongoing within departments, seeing if there is an overlap or duplication of similar programs that are trying to serve the needs of the same children and co-ordinating that, getting one department to take the lead in every instance.

Other work that is in process, of course, is dealing with the Postl report and the recommendations that have come from that report, looking at what recommendations are feasible to input in the immediate future and which ones may take a little longer to implement, but that will be a major part of their work over the next period of time.

There have been some issues around Seven Oaks Centre, and we are trying to get a co-ordinated approach interdepartmentally to resolve some of the issues there, and the secretariat is taking the lead on that.

As individual issues come to the attention of government, the secretariat has been asked to co-ordinate, do some information gathering and see if we can find new solutions. In the instance of rural foster home placements, a number of the school divisions that are surrounding Winnipeg have expressed concern about the large number of foster home placements that are occurring, and the family services agencies have expressed concerns about the refusal of school divisions to meet the needs of these placements. So the secretariat is reviewing the situation trying to gather as much information as they can to get a sense of how that issue may be addressed.

They are pulling together profiles of high needs children throughout the system that receives services from all four departments or any two of the four departments. So they are developing those profiles and gathering information to see whether there are more effective ways of providing intervention and support for those children.

One of the issues, of course, that is always raised is the privacy and the confidentiality issues between agencies and departments, and I think we want to try to address that issue. One of the issues that has come to my attention in the past is from agencies dealing with children. It might be a daycare or child care facility, for instance, that has a child in their care and there are family problems or issues and there might be another child from that same family in the school system. Child cares and schools cannot share information with each other that might actually help to identify family problems, and there might also be a better way of trying to work with those families to address the issues. So we are looking at all of that to see whether there is not a better way of trying to co-ordinate the services for families.

Those are big issues, and I am not sure there is an easy answer to that because there is a lot of privacy, confidentiality and information sharing that cannot happen presently, and unless we can try to work together more co-operatively, we are not going to see the improvements in the family circumstances that we might be able to see if we could all work together around the issues.

One of the issues for me, if I might just mention, is the issue of adolescent parents, adolescent teen pregnancy, and I have had many discussions throughout the community around how we try to deal in a more proactive way with early intervention.

We all know the issues around pregnant moms not looking after themselves and having children with low birth weights, fetal alcohol syndrome and all of those things that contribute to problems and need for special intervention as a result. Sometimes it is the Child and Family Services agency that has the lead, sometimes the school division, if there is an early identification, it might be the obstetrician who is the first person to see that young woman, could be the public health nurse, although they do not seem to be as involved in the early intervention side of things as they maybe were in the past.

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I guess we are trying to find a co-ordinated approach, not only with the service providers but with the community at large. How do we all try to come together and resolve the problems around trying to ensure at least that children are born healthy, and once they are born healthy, how do we provide the supports to ensure that they are fed, nurtured, loved and cared for in a manner that they will not need to use our Child and Family Services system or our justice system, and they will not have the emotional behavioural problems that might present themselves in school as a result of lack of parenting skills.

So there are some major issues that need to be addressed, and we are seeking some co-ordination and some proactive thinking from the secretariat around some of these issues and how we might be able to better address the needs of children before we get into the circumstance or situation where they have to be apprehended from their homes or disciplined or expelled from the school system or, you know, God forbid, end up in our justice system.

Ms. Cerilli: Well, that is a very ambitious and somewhat comprehensive set of goals and objectives for these essentially six staff who are working in the secretariat.

I want to pick up on just two things with the limited amount of time that we have here. I am pleased to see that this secretariat is directly then responsible for analysing the recommendation from, as the minister calls it, the Postl report, recognizing Dr. Postl's work there.

One of the other things that the minister mentioned just lastly that I want to connect with are issues around teenage pregnancy and motherhood, and fatherhood, I guess we would also say. That is, one of the recommendations in the Postl report that is repeated over and over again is the recommendation to have health education in Manitoba's curriculum, and that is one of the things that the education blueprint document has been recommending to eliminate. Currently in Manitoba we are in a transition period where it is really questionable about what different school divisions are doing and what different schools are doing.

One of the concerns that I have heard and that I would share is that we are no longer having a requirement for all K-8 students to have health education and that there be a component of comprehensive health education as recommended in this report through high school. What we see right now is no requirement for health education. There is a curriculum change being looked at in the physical education curriculum, and the health education curriculum is going to be halved into parts and integrated into the other courses in the core curriculum. I have heard that presents a number of problems, first, in ensuring that there are qualified health educators or in-service teachers teaching those units, and it is also difficult to ensure that those units are taught if they are simply one part of a science curriculum or English curriculum or what have you.

So I am wondering if the minister shares this concern, and also the concern that in the physical education area, there is another concern that it would mean a loss in activity time. We do not want to have teachers and young people in the position of having to choose what is more important, children getting education on issues like drug and alcohol prevention, human sexuality, personal safety or to have physical activity time. I think they are both important. I am sure the minister would agree, equally important, and I do not want to see schools being put in the position to choose one or the other. We do not want to see a loss of physical education activity time in order to have some health units integrated into the phys ed curriculum.

I am wondering if the minister is advocating then on behalf of children in Manitoba, the interests of children's health in Manitoba, to ensure that there is going to be all those 4,000 teachers that have been in-serviced in the family life curriculum, to make sure that they are going to be teaching those units and that it is going to be required, as well as a comprehensive mandatory health education curriculum.

Mrs. Mitchelson: Mr. Chairperson, I think what we have to be looking for, for all of our children, is the ability for them to have a healthy, quality lifestyle. My sense is that it is not only the school division or the school day. I do not think school and teachers are the only vehicle to help and to facilitate that kind of healthy public policy that we are all looking to see. I mean, we all know if we live quality, healthy lifestyles, and we are loved and cared for and nurtured, that in fact we are going to be better people.

You know, we have not had the opportunity to talk about child poverty and some of the issues surrounding child poverty. I think I had the opportunity in my Estimates on Family Services to discuss the issue of child poverty to some degree, but I have come to believe that when we look at measuring the numbers for child poverty, there are two different types of poverty. There is financial poverty and there is behavioural poverty, different types of poverty based on the kinds of lifestyle options that are presented to young children.

Not necessarily does every young person that lives on a low income live in poverty when we look at the definition of poverty as opportunity. I think that many children that grow up in poor households, and I made the comment that probably if the statistics had been gathered when I was growing up, and they may have been, I probably would have come from a household that lived below the poverty line. I do not ever consider myself a child that lived in poverty because I had a family that cared, I was loved and I was nurtured and I was encouraged to do my best. The quality time that was spent with me as a child was what enabled me to become a professional and feel good about myself and my circumstances, have some degree anyway of self-confidence in the ability to make something of my life.

I think when we are talking about children, and ensuring that they live quality, healthy lifestyles, there is more than a role for just the school division or the individual school or the individual teacher to play in ensuring that our children lead healthy lifestyles.

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So, yes, I believe in physical education and that children should have that opportunity for physical activity, but there is no question in my mind that a lot of the issues around loving and caring and nurturing and providing opportunity for children can be developed and worked into a lot of the curriculum that is taught in our school system, and I think that is the challenge for us as we move ahead into the future.

I do not think that we can just sit and look at what has happened in the past and think that is good enough. The world is changing and if we have the opportunity and the ability to try to deliver healthy positive lifestyles for our children, whether it be through the science curriculum or the phys ed curriculum or the math curriculum, I think that we have to look at those innovative and creative ways.

Heaven knows, there are not enough hours in the school day to provide all of the things that have been provided in the way they have been provided in the past. I think the challenge for all of us into the future is going to be to have to look at new and innovative ways. I think that we have to get beyond the old-think and look at the new direction and skills and the qualities that our children are going to have to have to live in this very competitive, very challenging and very changing world.

Ms. Cerilli: I do not think I could ever be accused of being one going back to old-think. I think that the government though is going back to old-think in eliminating health education as a required course. We had one of the best programs in Manitoba. It was recently evaluated in 1991. I have a report here.

When I asked that specific question, I was hoping that the minister would give me some assurance that the recommendation from the Postl report to keep mandatory health education as a course in the core curriculum would be accepted. This is one opportunity the minister could have of ensuring her concern about teenage pregnancy is addressed, and that is recommended in the report, too, that that is one way--not the only way, there are many other agencies that can do that kind of work as well--but that is one way to ensure that all students in Manitoba are going to receive that kind of preventative health care in an area that is so crucial.

I want to ask the minister another specific question. I think this will be it, because I understand that my Estimates in another department are beginning. Will the secretariat look at an issue such as also related to her concern about health care for adolescent moms and their babies? Will it also look at the policy that this government has implemented to move to a 24-hour release for new moms from the hospital? This has had a huge impact, I understand, on the success rate for breast feeding. It has had an impact then on children's health, a dramatic impact. Given the minister's background, I know she would be aware of those concerns. So will the secretariat be looking at making recommendations for a policy which obviously is aimed at cost saving and freeing up time in the hospital beds but could have serious implications on maternal and child health?

Mrs. Mitchelson: Mr. Chairperson, I want to indicate that the issue that has been raised is an issue that I am not so sure we have moved in the wrong direction with early discharge from hospitals, but I think what we have to do is examine the role of the public health nurse and what role they play in the community.

I am very receptive to trying to understand and get a sense of where we are at and where we need to go. I think that there is a major role for nurses to play in community health and well-being, so I am very interested in trying to find a way of ensuring that the follow-up support in the community is there for women and for children. I am not so sure as we look to all of the co-ordination of services that we will not find that the public health nurse becomes a very important player in the development of Healthy Public Policy.

I am very open and receptive and I am certainly not turf protective of what activities are ongoing within the Department of Family Services. If it makes sense for interventions to take place in a different way, I think we have to be open and receptive to trying to do what is in the best interests of the people of Manitoba and break down the barriers so that we do have the opportunity to utilize the skills and the resources that are there to the best of our ability. So I am very open and very receptive to examining that whole issue and trying to find the right combination of supports.

Ms. Cerilli: Mr. Chairperson, I think the idea that women being released from the hospital, given that they are healthy, into their home environment to initiate breast feeding and care of their new baby could be positive, as well, as long as there is going to be that community and home support. The problem I think is why we are seeing the success rates for breast feeding decrease then is because those supports are not there currently, that the budget cutbacks have also affected public health nurses and resources in the community. What we are seeing is women released with their new babies from the hospital and left on their own and then having to make costly trips, and I would say very stressful trips, back to the doctor in the hospital.

So I think it seems then that the minister is open to that kind of recommendation. I am hoping then the secretariat would also look at those kind of decisions that this government is making that are affecting children and pre- and post-natal health.

Mrs. Mitchelson: Mr. Chairperson, I think that probably all of us could come up with some creative ideas around how we can try to solve the problems that exist. If we had all of the answers or if we were doing everything perfectly, we would not be in a circumstance or situation where we needed the many resources that we put in place today for our health, our education and our social services.

We are always open to suggestion and idea and positive constructive recommendations on how we can do things better and that is what we are trying to accomplish through the Children and Youth Secretariat.

Mr. Chairperson: 1.(a) Salaries and Employee Benefits $378,800--pass; (b) Other Expenditures $144,000--pass; (c) Less: Recoverable from other appropriations ($378,800)--(pass).

Resolution 34.1: RESOLVED that there be granted to Her Majesty a sum not exceeding $144,000 for Children and Youth Secretariat for the fiscal year ending the 31st day of March, 1996.

This concludes the Children and Youth Secretariat. I thank the minister and her staff.