Category Archives: ATI_Story

BC’s naloxone funding is a “good start” says Vancouver Police but the opioid crisis needs ongoing strategy.

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Photo courtesy of College of Pharmacists of British Columbia

By Maureen McEwan

The topic: British Columbia continues to face an opioid crisis. The province declared a public health emergency last April in response to an increase in drug overdoses and deaths.

In September, Premier Christy Clark announced 10 million dollars to go towards combatting overdoses and drug-related deaths. The BC Ministry of Health is providing 1.1 million dollars to provincial police forces for response training and supplies to better prepare the forces. The department’s documented goal is to ‘improve immediate responses from police to an overdose’ by training municipal and RCMP forces in naloxone administration.

(Please click the link below to view the Ministry of Health’s document)

Naloxone is a medication which ‘reverses the effects of an overdose from opioids e.g. heroin, methadone, fentanyl, morphine.’ It has been used effectively by first responders – paramedics, firefighters, etc. – in emergency situations and has saved lives from fatal overdose.

What’s new: Until December, officers in BC could be investigated by the Independent Investigations Office (IIO) during ‘officer-related incidents of death or serious harm.’ The IIO’s mandate was widely considered as a barrier to officers responding in critical opioid incidents. But the watchdog announced it will no longer investigate when an officer uses Naloxone or CPR in order to save a life. This may allow officers to use their new naloxone training in a crisis more readily.

Why it’s important: The Ministry of Health reports there were over 900 drug overdose fatalities in BC last year- the highest number in decades and the highest in Canada.

Municipal and RCMP forces are gradually being trained Canada-wide but the provincial strategies vary. Several cities, such as Calgary and Toronto, have begun training their municipal forces in naloxone administration. The RCMP has trained many members in different regions. But there are large urban areas without any Naloxone officer training in place.

If the training of BC’s forces improves overdose responses, other provinces may follow. With faster response times, lives could be saved across the country.

What the government says: Sarah Newton works for the B.C Ministry of Health’s Government Communication and Public Engagement Department. She provided a statement on behalf of the Ministry in response to interview requests.

“In B.C., we are doing everything we can to keep people safe, including expanding access to life-saving naloxone.”

The statement confirms that the province provided 1.1 million to fund intranasal naloxone costs and administration training for municipal police and RCMP. The verified funding amount currently stands at 700,000 dollars less than the initial 1.8 million proposed by the provincial government.

What others say: Jason Doucette is a Media Relations Officer at the Vancouver Police Department (VPD). In an email interview, he says the VPD was the first department in Canada to train sworn and civilian members to administer nasal naloxone. The issue and training began in September.

“The supply of naloxone we purchased is good for 18 months. The cost of replacement will be an on-going expense for the VPD every 18 -24 months. The 1.8 million dollars is a good start,” he says, referring to the Ministry’s initiatives.

(Please click below to view the Ministry’s open data file in full).

Doucette adds that the VPD has shared all of its Naloxone training materials with different police agencies across the country.

The RCMP and Toward the Heart did not respond to questions before the article was published. Vancouver Coastal Health – Insite declined to interview.

What’s next: The mayors of the largest cities and several federal cabinet ministers met on Feb. 24 to discuss escalating drug-usage and deaths. They are pledging to work together in response to the country’s overdose crises, with BC leading the task force.

The western province serves as the provincial model in opioid crisis-response. The widespread training of police and RCMP forces in naloxone administration may improve immediate responses in ‘high risk areas,’ as the VPD suggests. As a result, BC could see a decrease in overdose deaths in future.

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For instructor reference:

What is the information?
The information was a request released on January 27th, 2017 to a political party for a financial breakdown from the Ministry of Health. It requested a specific breakdown of the 10 million announced by the Premier to combat overdose deaths in September at the UBCM and the precise initiatives that the funding was allocated to in that proposal.

From which department did these pages come?
The BC Ministry of Health – Open Data Website retrieval.

Why was this information helpful?
The information was helpful because training for naloxone is seemingly sporadic nation-wide. BC has put forth funding and policy in order to facilitate mass training for its municipal and RCMP officers. As legislation around naloxone has loosened in the past year, more and more its use is being seen in major Canadian cities.
There was a discrepancy in the BC funding total which was significant but that could be attributed to a number of factors. It was confirmed through communication with the Ministry as 1.1 million.
The information was also very intriguing in relation to the IIO’s mandate and December announcement. Officers in BC may start to engage more as first responders in incidents of opioid overdose moving forward.

Reducing Red Tape Creating More Red Tape?

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Understaffing and underfunding may be causing the projects at the British Columbia Ministry of Small Business and Red Tape Reduction to ironically be caught up in red tape.

The transition binder prepared for Minister Coralee Oakes when she took the file in August of 2015, suggests that two pilot projects aimed at reducing burdensome forms were set aside due to “lack of staff resources,” according to one of the documents in the binder.

The binder was released through a freedom of information request. The document in question is a PowerPoint slide. The content of the slide has been redacted, but a note clearly suggests that the projects did not go forward.

The fact that the Ministry was able to put time into a project in the first place came as a surprise to NDP critic for Small Business, Jane Shin. “The ministry got the promotion to full ministry status, when in fact it has the operating budget” of a small ministry.

The note under the slide also indicates that the projects produced a best practices guide for forms, but that the guide “remains a tool” rather than a mandated requirement. In response to an email regarding the document, the ministry indicated that the guide was not mandated because forms vary across departments, and having a single format for forms would not make sense.

While the lack of resources is often the reasoning given for sidelining projects, University of British Columbia professor and expert in bureaucracy and red tape, Martin Schulz argues that it is about resource allocation. In an email he said the limited resource reasoning is “often a convenient excuse for the lack of interest or attention.”

Schulz speculates that there might be resistance to altering forms because even a slight change could cause unforeseen consequences, such as abuse. “Small changes of rules can cause dramatic changes to the system,” he wrote in his email.

However Shin still thinks the ministry’s lack of resources had a hand in the projects being benched. She says that the understaffing and underfunding is largely due to the uniqueness of the ministry itself. “In other jurisdictions small business is not really a ministry of its own,” she says “it’s usually part of a bigger file.”

Despite its small size, the BC government pushes Small Business and Red Tape Reduction as one of its prime ministries. The government host several events highlighting the work of the ministry, including Red Tape Reduction Day, which was first observed March 2 of this year.

Furthermore the documents in the binder indicate that introducing more straightforward forms was part of the Reducing Red Tape for Real People Initiative, launched by the BC government in the February 2015 throne speech. Such an emphasis on forms as part of this initiative suggests that there is interest in the project, despite Shulz suggestions.

While it may appear that the form project, aimed at reducing red tape was caught up in red tape itself, the initiative is not set to be complete until June of this year. According to the documents the ministry will report to cabinet on this summer, still leaving time for the projects to be brought full swing.

Documents

Requests

City of Ottawa request
City of Ottawa request
Canadian Revenue Agency request
Canadian Revenue Agency request
Canadian Revenue Agency response
Canadian Revenue Agency response
DFAITD request for pre-released documents
DFAITD request for pre-released documents
British Columbia Ministry of Small Business and Red Tape Reduction request
British Columbia Ministry of Small Business and Red Tape Reduction request

Upstream Battle: Lobby group proposes Act to “modernize” Aquaculture in Canada

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Efforts to overhaul the Fisheries Act have “stalled” according to Ruth Salmon, executive director of the aquaculture lobby group, the Canadian Aquaculture Industry Alliance.

The group has been pressuring the federal government to “modernize” fishing legislature to redefine fish farming as an extension of the federal Ministry of Agriculture. This proposal was brought to the British Columbia Ministry of Agriculture – which appears to be on board, according to documents obtained under the B.C. freedom-of-information law.

The Ministry recognizes the Fisheries Act as expired legislature, a “poor fit” that “lacks the capacity” to allow proper development of the aquaculture industry.

(*) What is the information? 

Briefing notes for Norm Letnick, the B.C. Minster of Agriculture. The document suggests provincial recognition that the Fisheries Act is a “poor fit” and the regulatory framework doesn’t allow growth of the aquaculture industry.

(*) From which department did these pages come?

British Columbia Ministry of Agriculture

(*) Why was this information helpful?

The document helped to provide a focus for the story and directed the questioning for Salmon and the Ministry.

Though the Ministry appears favourable towards Salmon’s CAIA proposal, and they slighted a question regarding their support for Salmon’s proposal, the government remains reluctant to be vocal in their support of rehauling federal regulations.

In an email response the Ministry said they’re aware of the CAIA’s proposal, though there are drafts being drawn up by the Strategic Management Committee – a group of provincial and federal officials from across the country –  to bring the aged legislation up to meet the with modern aquaculture industry.

Salmon argues the Fisheries Act was brought into existence “before aquaculture was even a concept” and that it shouldn’t surprise that aquaculture not a good fit for a dated Act.

There is “a lot of overlap,” Salmon says, and that they comply with 74 current pieces of legislation that are “conflicting” and “confusing” when considering aquaculture as a farming industry rather than a fishery.

According to Salmon, Canada has been “stalled for 13 years” while other nations benefit from federal policy on aquaculture that is cultivating a growing global industry that Salmon estimates is growing at a rate of “79 per cent per year.”

(*) What is the information? 

This document is from the same briefing note. It highlights the discussion of what a Aquaculture Act may provide.

(*) From which department did these pages come?

British Columbia Ministry of Agriculture

(*) Why was this information helpful?

The document helped to understand the depth of the issue and allow experts and Ministry to refer to what has been said about a proposed Aquaculture Act.

Most of Canada’s top competitors – the United States, Chile, Norway, Scotland, Ireland, New Zealand and Australia – have already enacted aquaculture legislation and Salmon believes it’s time Canada modernizes their fishing industry to change policy regarding aquaculture and increase provincial and federal oversight to encourage growth.

Easier said than done.

The complexity surrounding aquaculture policy and the Fishing Act isn’t new; many experts wouldn’t comment (better to say they couldn’t comment) because they are still grappling with the unclarity surrounding an industry in a grey area.

It’s an industry caught between two Ministries; existing as a fishery under the Department of Fisheries and Oceans, but persisting as farming.

Peter Tyedmers, professor of environmental science at Dalhousie, says a federal act will in no way “disentangle” the web of complexity involving the constitution.

He says the division of power and responsibility between federal and provincial governments add to the complex framework. Current government oversight under the Fisheries Act, he says, is a “crazy patchwork quilt” of competing jurisdictions. And that is the leading cause for confusion.

As an example, Tyedmers says provinces like P.E.I. have the authority to provide licenses and decide the size of the farm – a degree of governance with some sovereignty. Though, a federal Aquaculture Act would allow for further federal oversight and mingling into provincial jurisdictions.

“The people drafting this have enough sense to know that they cannot change the constitutional powers of the government with one act,” Tyedmers said. He defines the proposed Act as a “constitutional interpretation challenge,” one that higher courts may strike down based on the federal-provincial conflict.

What remains consistent throughout expert opinion, lobbyists and government officials is the unclear, confusing mess of legislation that overlaps the aquaculture industry and fisheries.

“The complexity as a failure of government,” Tyedmers said.

____________________

Federal: Department of Fisheries and Oceans

**Received a call March 24 to add some to the request. She only added the word ‘proposed’ before ‘federal Aquaculture Act’ so that it may generate more hits, or be less specific as to get a better response.


**Received another call asking if I wanted private emails, because there may not be a lot of records and the emails will add much more.

Provincial: B.C. Ministry of Agriculture

**Acknowledged my request.

Municipal: City of Vancouver

**Acknowledged my request.

Liquified Natural Gas Shows Concern Between B.C. Government and Treaty 8 First Nations

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The B.C. Ministry of Aboriginal Relations and Reconciliation has expressed concern about how to approach Liquefied Natural Gas Development on Treaty 8 First Nations Land.

“Resource use with Treaty 8 and the provincial government has been, let’s call it strained,” says Scott Fraser, who is the MLA for Alberni-Pacific Rim and Aboriginal Relations and Reconciliation spokesperson for the B.C. NDP Caucus Team.

Documents obtained through B.C.’s Freedom of Information Law reveal a Human Health Risk Assessment was completed in November 2014 that covered six Treaty 8 First Nations communities: Blueberry River, Doig River, Halfway River, McLeod Lake, Saulteau, and West Moberly First Nations.

The assessment provides two similar options suggested by the Ministry of Health about how to present the finding s to the Treaty 8 communities. The first suggestion involves the Ministry of Health hiring a consultant to hold community meetings explaining the results and fielding questions. While the second approach involves a cross-ministry approach, lead by the Ministry of Health or another Ministry where consultants would be hired to lead a public information campaign to provide information on the assessment’s findings.



(*) What is the Documentation? – The information is the two options proposed by the B.C. Ministry of Health about how to present the findings of the Human Health Risk Assessment.
(*) From which department did these pages come? – These pages came from the B.C. Ministry of Aboriginal Relations and Reconciliation
(*) Why was this information helpful? The information was helpful because it shows the concern the B.C. Ministry of Aboriginal Relations and Reconciliation and the B.C. Ministry of Health have when it comes to presenting information to the Treaty 8 First Nations.

“We just want to be at the table at the beginning, not towards the end,” explains Rodney Nelson, a lecturer at Carleton University and CEO of Global Governance Group, a consulting firm that specializes in working with Indigenous governments. “If you’re thinking about any problems just bring them on board,” explains Nelson because “some of the First Nations out there are very interested in projects like this” and being able to be partners with the government and various companies.

The assessment concluded that the risks of chemicals of potential concern (COPC) “were not predicted to result in adverse health effects in people living or visiting the study area.”
The assessment also determined that even though some areas exceeded exposure limits for certain COPC’s, it is not expected to create adverse health effects due to the rarity of it happening combined with the safety measures put into the assessment.



(*) What is the information? – The information is the findings from the Human Health Assessment. The HHRA claims that the potential for adverse human health effects is low due to potential exposure from Chemicals of Potential Concern (COPC)
(*) From which department did these pages come? – These pages came from the B.C. Ministry of Aboriginal Relations and Reconciliation
(*) Why was this information helpful? – This information is helpful because it provides the information that the B.C. government is using as they pursue Liquefied Natural Gas developments on Treaty 8 First Nations Land.



(*) What is the information? – The information is the findings from the Human Health Assessment. The HHRA claims that Chemicals of Potential Concern risks in the air were determined to not result in adverse health effects for people on Treaty 8 First Nations Land
(*) From which department did these pages come? – These pages came from the B.C. Ministry of Aboriginal Relations and Reconciliation
(*) Why was this information helpful? – This information is helpful because it provides the information that the B.C. government is using as they pursue Liquefied Natural Gas developments on Treaty 8 First Nations Land.

In recent years Liquefied Natural Gas development has been promoted by Premier Christy Clark as a new way to create billions of dollars in economic development within the province. The process involves fracking, where drilling takes place into the ground and a mixture of water, sand, and chemicals is injected in order to crack the rocks and allow the natural gas to flow to the surface.

Despite the assessment’s findings regarding human health, there are still questions for some that are left unanswered. One of the main concerns about liquefied natural gas is the potential environmental effect on the Treaty 8 First Nations land. Scott Fraser remembers vividly the last time he visited the Treaty 8 First Nations, flying late one night where “there’s flaring all over the place. The landscape is being changed in huge ways. Including the wildlife corridors, potential destruction of water supplies. It potentially impacts the way of life that has existed for Treaty 8 people for millennia.”

Rodney Nelson believes the process that the B.C. government is using plays a big role in how they view the environment. The process they’re using was developed in Europe, and in Europe it’s not a concern anymore. They don’t have vast amounts of wilderness to worry about. Here we do,” he explains, “a lot of people are still living off the land or supplementing off it.

In response to reports and assessments made by the provincial government, Treaty 8 First Nations have been conducting there own research about liquefied and its effects. The Treaty 8 Tribal Association among other First Nations groups have hired Dr. Gilles Wendling, a hydrogeologist who is doing work on the potential risk of aquifers and water supplies because of these practices.

“The Treaty 8 First Nations have a treaty,” says Scott Fraser, “this is a treaty nation. The government is pursuing this as though they don’t have a treaty and as though they don’t exist.”

FOI BC

FOI Request CSC-2016-61376

Canadian Heritage ATIP

Access to Information Request – Heritage Canada

PANKE – City of Toronto ATIP

Panke - completed ATI request

Plan to continue selling off BC Rail property on the right track

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BC Rail is selling off industrial parks and prime real estate and making millions.

Once the biggest rail company in British Columbia, BC Rail is now run by the Ministry of Transportation and Infrastructure. It sold off its trains 10 years ago and leases its track to CN. Its mandate is to sell off any property not related to its ports and rail operations, according to information from records released through the B.C. freedom-of-information law. Disposing of surplus property is part of the province’s asset disposal policy.

Between 2005 and 2015 the company sold more than 400 properties. BC Rail gained $144 million from the sales and they’re predicting they’ll sell more surplus land in the next two years, according to information that came from records released through the B.C. freedom-of-information law. In last year’s budget, they estimated they’ll have yearly proceeds of $2.5 million with gains of $1 million between 2015 and 2018.

BCR Properties, the subsidiary of BC Rail that sells its surplus property, sold 11 properties in the past year. Properties in Squamish, Pemberton, Prince George, Mackenzie and Fort St. John have generated proceeds of $4.6 million and gains of $1.9 million, according to an email received from the Ministry of Transportation and Infrastructure.

Before any land can be put on the market, the province has to do any necessary environmental clean-up. For example, a former BC Rail North Yard site took more than six years to complete environmental clean up. BC Rail has worked with Lorax Environmental and Envirogreen Technologies to clean the land to make it safe to sell to the public. BC Rail’s current surplus properties don’t require cleanup.

Larger properties are also sometimes broken up into smaller parcels of land for easier sale. Right now BCR Properties has three properties publicly available for sale through the Cushman and Wakefield real estate company: industrial land in Dawson Creek; an industrial park in Prince George; and retail and office-zoned land in Squamish.

The asking price for the Dawson Creek land is nearly $400,000, while the Squamish and Prince George prices aren’t listed.

(*) What is the information? This is information about what BC Rail is and its strategic goals for the future.
(*) From which department did these pages come? These pages come from the BC Ministry of Transportation and Infrastructure.
(*) Why was this information helpful? This information was helpful because it laid out why BC Rail is selling off surplus properties.

(*) What is the information? This is information about BC Rail’s surplus property sales in the past and their plan for the future.
(*) From which department did these pages come? These pages from from the BC Ministry of Transportation and Infrastructure.
(*) Why was this information helpful? This information was helpful because it provided specific numbers and dollar amounts relating to both what BC Rail has already sold and want it estimates it will sell in the future.

Fate of former illegal drug lab site unclear

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The fate of a former Langley, B.C. illegal drug lab is unclear as provincial government officials will not confirm whether or not the contaminated property has been cleaned up.

In April 2014 Langley RCMP raided a property at 20668 72nd avenue that was alleged to have contained an illegal drug manufacturing operation.  A 36-year-old Surrey B.C. resident was arrested in the process and his case is before the courts, says Cpl. Scotty Schumann of the RCMP.

The B.C. Ministry of the Environment did not answer requests for comment on this story. But according to ministry documents obtained through the province’s freedom of information laws, an investigation determined in July 2014 that the site posed a “high risk [of] contamination at both the source and neighbouring parcels due to solvent concentrations (toluene and dichloromethane) in soil and groundwater.”


Both toluene and dichloromethane are chemicals used to manufacture illegal drugs like methamphetamine, according to the U.S. Environmental Protection Agency.

The documents go on to say the province sent letters to the site’s registered owners demanding the property be cleaned up.  The owners did not respond and that “the lack of response to the Ministry’s letter of March 5, 2015 can be interpreted that the parties are unwilling or unable to carry out remediation or to comply with the requirements to remediate the site.”


This leaves it up to the provincial government to clean up the site and recover the costs associated with the remediation from the site’s owners, the documents state.


The province did issue a press release on May 5, 2015 saying the ministry had ordered the site be cleaned up as soon as possible.  The press release also states that the province would be seeking a contractor to clean up the site—however ministry officials have yet to confirm that the work was actually carried out.


Cleaning up a former drug lab – called site remediation – can be a costly and sometimes difficult process, says Kristen Hoedlmoser, a chemical and environmental engineer with the consulting firm Giffin Koerth, Inc.

“You can have these nasty chemicals that are harmful and addictive that are on surfaces throughout the structure and can be in the air,” she says.

That’s why a thorough evaluation of the structures and land must be completed before the remediation crews can begin the clean up, she says.

“You can get a whole host of things that would be bi-products of the [methamphetamine] cooking process,” she says.

Remediation firms can use a variety of methods to clean a contaminated structure, she says. This can include scrubbing the walls with special chemicals, cleaning porous surfaces like carpets to removing finishes like baseboards and panels.

“It depends on how responsive the building materials are to the cleaning activities,” she says. “Sometimes it can take a couple of rounds of cleaning and possibly adjusting the cleaning protocol as required to get the surfaces and the air quality to a level that is acceptable.”

The goal is to make the property habitable again, though sometimes it may be necessary to demolish a structure, she says.

“Anything can be remediated but it becomes a cost issue,” she says. “It often comes down to a dollar and sense conversation.”

 

 

 

What is the information?

The information contained in these ministry documents are about an “orphaned” site that was once a clandestine drug lab.

From which department did these pages come?

B.C. Ministry of the Environment

Why was this information helpful?

It contained information about a hazardous plot of land in Langley, B.C. and the government’s efforts to clean it up.

ATIP Requests below

Federal ATIP request for expenses filed by the chief executive officer of Defence Construction Canada. The is an email stating they have sent the request to the appropriate department.

Municipal ATIP request for the City of Ottawa regarding Ottawa Fire Service records:

Provincial ATIP request regarding expenses filed by the director of the Ontario Film Authority:

Page 1:

Page 2:

Completed ATIP request from the federal department of Canadian Heritage – ministerial briefing book.

Pain BC serves a chronic pain relieving function in British Columbia

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The British Columbia Ministry of Health relies on an outside agency to deal with the most common reason for seeking health care in the province.

A briefing note prepared for the Minister of Health, which was released under the B.C. freedom-of-information law, identified Pain BC as “an integral part to providing British Columbians with effective and appropriate care.”

Pain BC is a coalition of healthcare providers, researchers, decision makers working in healthcare and patients, who work together to provide solutions to chronic pain in the province.

“It’s a very misunderstood condition,” said Maria Hudspith, the executive director of Pain BC.

Patients of chronic pain are frequent users of the healthcare system. Their consistent reliance on medication and health care services makes the disease expensive to treat, Hudspith added.

(Click on annotation to read the full document)


The B.C. Ministry of Health said in an email statement that physicians and patients in the province have been seeking “additional tools, resources and effective treatments” to manage chronic pain conditions and increase quality of life.

To achieve that objective, the province has awarded Pain BC about $2.8 million for its Chronic Pain Management program since 2014.

Hudspith defines chronic pain as pain which persists for more than three months. Pain BC estimates that one million British Columbians endure this condition. In 2030, the number of chronic pain patients is expected to increase by roughly 25 percent, with the highest number of those affected being seniors.

(Click on the annotation to read the full document)


The searing effects of this condition do not end with the healthcare system. Hudspith said they creep into a person’s ability to execute everyday activities. They can also affect one’s mental health and cause addiction.

“It’s (chronic pain) something that government on its own may not really have tackled and it is really necessary for an outside agency to be driving government to pay attention and to act on this issue,” said Hudspith.

Pain BC is the only organization in Canada working with patients and health care providers to address chronic pain management, the B.C. Ministry of Health wrote in an email statement.

The not-for-profit organization has created online patient education sessions to teach patients how to manage their pain, started peer support groups that now have more than 4,000 members and has trained doctors, pharmacists and other health care providers to assess and treat chronic pain. More than 500 physicians in B.C implement these in their practice.

Pain BC is also working with hospitals to change their policies and procedures to better serve patients of chronic pain.

“The healthcare system is very complex and there are many different agendas driving change in the system,” Hudspith said. “We are one of many voices trying to get our issue on the agenda for decision makers.”

“We have all of the thought leaders in the room. It’s been a very important part of our success to have such a broad coalition in terms of building credibility to government and other sectors.”

(Click on the annotation to read the full document)


According to a briefing note obtained under the B.C. freedom of information law, the British Columbia Ministry of Health does not have a registry for measuring the incidence, prevalence and cost of chronic pain in the province.

The B.C. Ministry of Health said Pain BC’s work will contribute to its service plan objective of “improved patient health outcomes and reduced hospitalizations for seniors through effective community services.”

“Our early assessment of Pain BC is that they are doing good work,” the Ministry added.

______________

What is the information?

The files are briefing notes prepared for the B.C. Minister of Health for a meeting with Pain BC. The details in the note highlight the history of Pain BC and make reference to the significance of the non-profit organization to the province’s health agenda

From which department did these pages come?

The B.C. Ministry of Health

Why was this information helpful?

The details in the note emphasized the significance of Pain BC’s work to the Ministry of Health. As a result, it inspired the approach I took to write the story and the questions I asked. It also provided some helpful statistics about the extent of chronic pain in British Columbia as well as the cost of treating it.

Relevant Documents for ATIP Pain BC

Federal Access to Information and Privacy (ATIP) Online Request

Federal ATI Request

Provincial ATI Request

Municipal ATI Request

Just below is an email confirming that I applied to receive files that had already been requested under the freedom of information law.

Completed ATI request

B.C. government looks to save millions in prescription drug costs

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COSSETTE-Etanercept_Enbrel
A patient holds an Enbrel auto-injector syringe. Enbrel (Etanercept) is one of several biologic drugs used to treat rheumatoid arthritis. (Creative Commons licence provided courtesy of Flickr user mnicolem)

Faced with soaring prescription costs, the B.C. government is looking for alternatives to expensive biologic drugs, not long ago hailed as revolutionary.

Used to treat debilitating joint disorders like rheumatoid arthritis, biologics were “game-changers” when they were first invented 15 to 20 years ago, said Dr. Jason Kur, president of the B.C. Society of Rheumatologists.

Biologics are genetically-engineered proteins, developed using living cells. As such, they are far more complex — and costly — than drugs manufactured through a conventional chemical process.

According to documents obtained through an access to information request, B.C. PharmaCare spent a record $82.5 million in 2014 to treat the three most common forms of inflammatory arthritis using biologics. That’s more than 12 times the amount the province spent on these medications when they were first introduced in 2002.

Excerpt from an information note provided to B.C. Health Minister Terry Lake
Click annotation to see full document



With an annual cost of around $20,000 per patient, one drug alone — Infliximab — accounted for $51 million in spending in 2012-13: PharmaCare’s single largest drug expenditure that fiscal year.

Documents also show the number of patients receiving PharmaCare coverage for a biologic to treat one of the three most common forms of inflammatory arthritis grew more than tenfold, from 547 patients in 2002 to over 6,400 patients in 2014.

Cheryl Koehn understands the importance of biologics first-hand.

A former Olympic-calibre volleyball player, she was just 27 when she developed rheumatoid arthritis 27 years ago.

“Before these drugs, we basically were left at home to become disabled and die,” said Koehn, who now works as founding president of Arthritis Consumer Experts, a national organization offering science-based information to Canadians living with arthritis.

But PharmaCare administrators hope subsequent entry biologics (SEBs) will offer not only comparable patient results, but also huge savings to the province.

Biologics cannot be perfectly replicated, but SEBs — or “biosimilars” — have been shown to offer similar relief of patients’ symptoms. In other words, they are designed to be comparable, but not identical to the original biologic on which they are based. Importantly, they are also developed to be significantly less expensive.

Since Feb. 19, 2016, a biosimilar of Infliximab — Inflectra — has been available through PharmaCare, priced about a third lower than the original Infliximab. Inflectra is also listed in provincial drug coverage plans in Ontario and Quebec, and will be available in Manitoba in April.

Excerpt from B.C. PharmaCare’s February 2016 newsletter
Click annotation to see full document


Kur said he and his colleagues are “cautiously optimistic” about the arrival of biosimilars in B.C.

“We’re all quite aware these are some of the biggest costs driving drug expenditures,” he said, adding there are some lingering concerns.

Many of the original biologics have more than one or two decades’ worth of data to support their safety and efficacy, he said. “That’s not something that should be taken lightly.”

Still, Kur supports the B.C. government’s decision to have Inflectra prescribed to patients who have never before taken Infliximab. Long-term studies conducted in Europe strongly suggest the drug is just as safe and effective as the original biologic.

Koehn, too, agrees that SEBs offer an exciting opportunity, especially if the provincial government re-invests savings to expand coverage to other biologics and SEBs.

She also hopes the government might relax some of the eligibility criteria, which require patients to take less effective medication before being considered for a biologic.

Only biologics and SEBs, said Koehn, can restore up to 50, 70 or even 90 per cent of a patient’s health.

“It’s like saying to a cancer patient, ‘We’ll get rid of 20 per cent of your tumour and tough luck with the rest,’” said Koehn. “You don’t say that to cancer patients, so why should you say that to people with auto-immune arthritis?”

Additional information and ATI requests

B.C. Ministry of Health – Information note and additional information

ATI request – Federal government – Public Safety Canada

ATI request – Provincial government – Ontario Ministry of Community Safety and Correctional Services

ATI request – Municipal government – City of Ottawa

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Determined to fail: BC legal aid society admits self-imposed targets are “quite low”

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In it’s most recent annual report, BC’s Legal Services Society, the body responsible for providing legal aid in the province, set overall targets of pleasing just 62 per cent of lawyers and 66 per cent of clients.

The targets are “quite low,” says Cathryn Spracklin, manager of strategic planning and policy at LSS. “We are trying to be realistic about what we can achieve in terms of improving on that baseline, and set our targets accordingly.”

The report also included targets of just 35 and 52 per cent for lawyer and client satisfaction with respect to the level of support provided by LSS to assist clients in resolving related legal issues.

“People’s legal problems don’t occur in isolation,” says Spracklin. “They’re often co-related to issues with poverty, with mental health, [housing], all sorts of things.”

With current satisfaction rates either slightly below or equal to stated targets, achieving these objectives will produce only modest improvements in overall satisfaction, says Spracklin, noting that while funding of legal aid services in the province has declined substantially over recent decades, the number of low-income persons in need of such services has remained constant.

“You can be very poor and still get no assistance,” says Spracklin. “It’s a struggle to try and decide whether you provide a higher level of service to fewer clients, or greater access to service for a higher number.” 

Screen Shot 2016-03-26 at 8.03.14 AMSource: Legal Services Society BC, Legal Aid by the Numbers, 2013

Increased access to legal aid

Andrew Pilliar, a Vancouver lawyer and advocate for expanding access to legal aid, says surveys such as those conducted by the LSS are often flawed.

“You don’t get an adequate sample,” says Pilliar, “You get the people who are really pissed off or who are really happy.”

Pilliar also questions the wisdom of setting such low targets.

“I’m not convinced we’re being ambitious enough,” says Pilliar, who believes access to justice and legal aid services should be universal, noting that 45 per cent of all adult Canadians, or roughly 12 million people, have experienced some form of legal need in the past three years alone.

“Legal aid has become an afterthought for most people,” says Pilliar. “Something that they don’t think will apply to them because its only for poor people and criminals.”

But, as Pilliar explains, being charged with a crime is just one reason why someone might require a lawyer. Simple contract disputes – like those related to a lease or mortgage agreement – divorce, and child custody battles are amongst the most common reasons why Canadians seek legal advice – the vast majority of which is paid for out of pocket.

Still, Pilliar says less than 10 per cent of Canadians with legal issues seek the advice of a lawyer – opting instead to represent themselves or resolve their legal issues through alternative, and invariably inferior, means.

 

Ontario lawyers confront similar problems

While access quality legal aid services has improved significantly in Ontario during the past two decades, the province’s lawyers and clients still face many of the same challenges as those found in BC.

Mark Ertel, a long-time criminal defense lawyer and past president of the Defense Counsel Association of Ottawa, says the costs of running an office, combined with a low hourly rate of pay, make it difficult for lawyers in Ontario to accept legal aid cases.

“We essentially were doing charity work,” says Ertel. “Lawyers were working for $20 an hour, really, and we were getting our cars fixed by guys charging $60 an hour.”

“We’ve done this to these people,” says Ertel, frustrated with the lack of support for legal aid services. “They feel like a welfare case. They’re treated like a welfare case. And so long as they get any kind of representation at all they think it’s great.”

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INFORMATION ON DUCUMENTS

1) What is the information?

A: The documents describe specific performance measures from the most recent Annual Service Plan Report of the Legal Services Society of British Columbia.

2) From which department did these pages come?

A: The pages were prepared by the BC Ministry of Justice for use by the Attorney General in recommending new appointees to the LSS board of directors.

3) Why was this information helpful?

A: I used this information to a) develop a story idea, b) develop specific and targeted questions for interview subjects, and c) to develop a list of possible sources for the production of my story.

LSSBC Performance Measures

Access to Information and Privacy (ATIP) Online Request

Informal Request for ATI Records Previously Released _ Open Government

Access-to-information-request

FOI Request – Billing Records

FOI Request – Office of the Premier

FOI Request – Jim Sutherland’s emails

FOI Request FNR-2016-61351 – brihill9@gmail

FOI Request_ Our File No. 2016-090 – ack – brihill9@gmail

FOI Request OOP-2016-61352

B.C. needs to know where the party’s at

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By Rupert Nuttle

new-classic-stretch-suv
Interior of a party bus. (image: http://newclassiclimo.com/rates.html)

The B.C. government is screening drivers and keeping a close eye on “party buses” amid growing concern over the industry’s handling of public safety and underage drinking.

Companies operating stretch SUVs and limo buses – which are popular among students celebrating graduation, and as a classy way to get from Vancouver to Whistler – were subjected to increased regulation from the Ministry of Transportation last spring. Companies operating under the old regulations were made to re-apply for updated licences.

According to documents obtained under the B.C. freedom-of-information law, the new rules were also accompanied by an emphasis on knowing where the vehicles operate and a renewed scrutiny of the companies themselves.

“The (ministry) has access to information on all vehicles operating limousine style services, and knows exactly where the vehicles are operating,” the documents read. They go on to explain that this information “will assist with auditing and other enforcement measures.”

The party bus industry is regulated by the passenger transportation department of the Ministry of Transportation. Kristin Vanderkuip, the department’s director, says she uses a specific penalty framework to determine what enforcement measures to take when operators break the rules.

If a party bus operator is caught outside their predetermined boundaries, for instance, they’re fined $500. Other infractions include leasing a vehicle’s plates for a fee (a $1,000 fine), and smoking while driving ($100).

According to its website, the department also conducts “random” audits of party bus companies on an annual basis. If an operator isn’t up to snuff, they are given the chance to make the necessary changes.  In more extreme cases, though, the ministry will notify the Passenger Transportation Board, an independent tribunal that also monitors the industry.

Last year, the single-vehicle company called New Classic Limousine & Coach Services was forced out of business when it was discovered that then-president, owner and sole operator, Hardyal Singh Dhanoa, had been convicted of three criminal offences while operating his party bus service. These included dangerous driving, possession of a weapon, and assault with a weapon, according to a document on the Passenger Transportation Board’s website.

Vanderkuip’s department brought this information to the attention of the board last June, and the board found that Dhanoa had failed to acknowledge his criminal record when applying for special licensing under the new regulations. They then issued a directive to cancel the licence, effectively forcing New Classic to shut down. (The company still has a website and an active phone number, but refused to comment.)

Ranji Virk, the manager of Time Limo, a Vancouver company, says that single-vehicle operators like New Classic are among those most affected by the province’s new regulations. Virk’s company has a total fleet of 20 vehicles, including vans, SUVs, stretch limousines and 3 party buses. He says the new rules have had very little impact on his business.

But he also says he’s not sure how effective the changes have actually been, and believes the department isn’t diligent enough. “They’re not really tracking, I can tell you right now,” he says. As for audits from the department, Time Limo hasn’t seen one in “many years.”

The efficacy of the new regulations has come into question lately, after a 23-year-old woman died when she fell out of a moving party bus in downtown Vancouver, just over two months ago.

According to Virk, that incident points to an issue that the department isn’t addressing: where the party buses come from. Many of the vehicles operating in Canada are modified shuttle buses manufactured in the U.S. The vehicles don’t always comply with Canadian safety standards, says Virk, but they manage to get across the border anyways.

“Those vehicles are not allowed in Canada, but those vehicles are in Canada,” he says. “They don’t track that.”

 

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