SCYR Committee Meeting

SUB-COMMITTEE ON CHILDREN AND YOUTH AT RISK OF THE STANDING COMMITTEE ON HUMAN RESOURCES DEVELOPMENT AND THE STATUS OF PERSONS WITH DISABILITIES

SOUS-COMITÉ DES ENFANTS ET JEUNES À RISQUE DU COMITÉ PERMANENT DU DÉVELOPPEMENT DES RESSOURCES HUMAINES ET DE LA CONDITION DES PERSONNES HANDICAPÉES

EVIDENCE

[Recorded by Electronic Apparatus]

Wednesday, November 28, 2001

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[English]

The Chair (Mr. John Godfrey (Don Valley West, Lib.)): Ladies and gentlemen, welcome. We have the requisite number of members, and in the right configuration, to begin our discussion this afternoon.

We have had a request from the Aboriginal Peoples Television Network to follow our proceedings. I've asked individual members whether they have difficulty with that, and they don't. I've warned the witnesses. So that's fine, providing that the appropriate discretion is observed.

First of all, let me invite our guests from Health Canada to the table. We have Ian Potter and Richard Budgell. Before I ask them to make opening remarks, let me summarize what we're doing here. What the Subcommittee on Children and Youth at Risk is doing is focusing this fall on aboriginal children. We're defining that as being from prenatal in effect to the age of twelve, with a certain emphasis on the zero-to-six population. We are focusing more on on-reserve issues this fall, but not exclusively—where it makes sense to understand off-reserve services or services for non-status Indians or Métis, for example.

Although we are inviting individual departments to tell us about their programs in a silo fashion, if I may put it that way, the work of this committee has always been to be horizontal—that is, to try to figure out how all of these programs, whatever the source, hang together, both at the top here in Ottawa and on the ground in the communities where children and their parents live. So although we disaggregate it for reasons of convenience, we are hoping to be in the aggregation business, ultimately, so that we can make a collective recommendation to government about how to be more effective in delivering the right kinds of programs to these children and their families.

With that framing introduction, if you will allow me, let me introduce an old friend, Ian Potter, from Health Canada, who is an assistant deputy minister. He's in the First Nations and Inuit Health Branch.

You've moved around a bit, haven't you?

Mr. Ian Potter (Assistant Deputy Minister, First Nations and Inuit Branch, Health Canada): Yes, I have.

The Chair: With him is Richard Budgell, who's the manager for aboriginal childhood and youth in the Population and Public Health Branch.

We don't need a whole organization chart here, but you might just tell us in your presentation a little bit about how you divvy up the duties. Maybe we will actually have all of that.

Mr. Potter, would you like to begin? And welcome.

Mr. Ian Potter: Thank you very much.

[Translation]

Thank you, Mr. Chairman, for giving us the opportunity to speak to you today.

[English]

I am joined today, as you mentioned, by Richard Budgell, but also by officials from the Population and Public Health Branch. The Population and Public Health Branch deals with children's issues in general and manages programs for aboriginal children that are off-reserve, non-reserve-based programs. Nicole Lafrenière-Davis is here with me, as well as Richard.

From the First Nations and Inuit Health Branch, which is the organization in Health Canada responsible for health services on reserve and also manages children's programs such as the Aboriginal Head Start program on the reserve, I'm joined by Keith Conn and Debra Gillis.

The Chair: Welcome all.

Mr. Ian Potter: If I could, Mr. Chairman, I had a prepared statement that I could go through if you wish.

As you recall, Health Canada, Human Resources Development, and Indian Affairs made a presentation last May on the Government of Canada's early childhood development programs. Today I would like to provide details on Health Canada's programs and services for aboriginal children and youth, talk about the program impacts, our involvement in evaluation and coordination of our programs with other departments and jurisdictions, and touch on current research and knowledge initiatives that support ongoing program policy development.

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When we talk about aboriginal populations, we're referring to first nations, Inuit, and other aboriginal people, Métis and non-status Indians, living in urban and northern communities across Canada. According to Department of Indian Affairs and Northern Development figures for March 2001, there were approximately 337,859 aboriginal children aged zero to fourteen both on and off reserve, of which 40% reside on reserve and 60% reside off reserve. Children aged zero to fourteen make up 34% of the on-reserve population, compared to 21% of the Canadian population. So the on-reserve population is quite young.

Over the next two decades the aboriginal population is expected to grow 1.7 times faster than the overall Canadian population. The first nations birth rate is 27 births per thousand persons, which is twice the Canadian average.

Earlier this month you heard from Doug Norris of Statistics Canada, who provided you with data on health and economic indicators for aboriginal children and families. We know from sources such as Statistics Canada and Health Canada's first nations and Inuit regional health survey that the general health and socio-economic status of first nation, Inuit, and Métis children in Canada is well below the national average. These children and youth face compelling challenges to their health and well-being, such as higher infant mortality rates, higher injury rates, higher suicide rates, and many families headed by single parents that are living in poverty, among other factors.

[Translation]

Health Canada has a direct role in the delivery of health care and community-based programming for First Nations people on-reserve and Inuit children. The federal government supports programs on reserves for First Nations children that are comparable to those available more broadly for Canadian children and that promote the development of First Nations communities, people and economies. Health Canada also delivers innovative community programming for children and families at risk, including Aboriginal children off-reserve.

Other federal departments have the responsibility for the delivery of social programs, such as child protection and child care services, to First Nations children and families on-reserve. Provincial and territorial governments are responsible for the direct delivery of health care and social services to Aboriginal children and families living off-reserve.

[English]

On reserve, Health Canada delivers a range of services and programs. These include public health services—a cornerstone of our services for children and families—direct treatment, and community-based programs. Public heath services include well-baby clinics provided by community health nurses that offer immunization, child development assessment, health education, and counselling for caregivers; prevention and health promotion programs such as alcohol, tobacco, and other substance abuse programs, diabetes prevention, nutrition advice, etc.; public education and awareness campaigns such as the recent Health Canada campaign on sudden infant death syndrome. We also provide monitoring of environmental health conditions such as water and indoor air quality, and programs with an explicit focus on aboriginal youth via new programs such as the tobacco control strategy and aboriginal diabetes initiative.

Direct treatment services provided on reserve, in addition to nursing and physician care, include a youth solvent abuse program that includes nine treatment centres across Canada offering addiction in-patient treatment to over 200 children each year. This program can expand in times of crisis, as was the case last year when the department provided treatment to an additional 35 Innu children.

Recognizing the importance of the early years of life, Health Canada focuses a large part of its effort on community-based programs for young children and families at risk, both on and off reserve. Key children's programs include the Aboriginal Head Start, an early intervention program for pre-school children and their families. Now entering its third year of implementation, at $25 million a year, the Aboriginal Head Start program on reserve serves approximately 7,700 children in 305 sites. The Aboriginal Head Start urban and northern program, initiated in 1995, serves approximately 3,200 children over 114 sites, with funding of $22 million a year. Richard Budgell, the manager of the Aboriginal Head Start urban and northern program, will provide some more details on those programs.

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In addition, we have the Community Action Program for Children, often called CAPC, which funds community groups to deliver services that address the developmental needs of children from birth to six years of age living off reserve in conditions of risk. Over a six-month period, CAPC projects served approximately 36,000 children and 34,000 parents and caregivers. The total budget of CAPC is $59.5 million per year. CAPC is not an aboriginal-specific program, but approximately 23% of the children are aboriginal.

Health Canada also provides the prenatal nutrition program, which is a comprehensive program that focuses on the needs of pregnant women who are most at risk for having unhealthy babies. There are currently 277 Canada prenatal nutrition program projects operating in more than 680 communities across Canada and serving approximately 26,000 women. The funding for the on-reserve and Inuit component is $14.2 million a year.

The fetal alcohol syndrome and fetal alcohol effect initiative has a sustained focus on the prevention of FAS/FAE and on the improvement of the health of pregnant women at risk and their babies. Health Canada is investing $11 million over a three-year period on FAS/FAE activities. Of this amount, $3.8 million is targeted to first nations and Inuit communities.

A description of the Government of Canada's activities and expenditures on early childhood development has recently been published. This report is pursuant to the early childhood development agreement committed to by first ministers in September 2000. I believe the members of the committee have received a copy of that report.

All Health Canada's programs are evaluated to identify their reach, their client group, their activities, and their impact. Both the CAPC and CPNP projects are required to allocate up to 10% of their budgets to local evaluation. Let me touch on some activities.

Evaluation of the Aboriginal Head Start program captures changes in children, parents, and communities as an outcome of their participation in the program. In addition to evaluation measures applicable to all children, tools to better address and measure changes in aboriginal communities, such as the aboriginal picture identification inventory, which will assess a child's level of understanding with respect to aboriginal languages and culture, are being developed and pilot-tested.

A full impact evaluation survey will be launched in 2002. A report on 2000 data from the urban and northern Aboriginal Head Start program called “Program and Participants 2000”, as well as the 1999-2000 Aboriginal Head Start on-reserve national annual report, are available to the committee.

The Canadian prenatal nutrition program for off-reserve gathers information on risk factors, utilization of services, and birth outcomes on each CPNP client from entry to exit. A baseline study is underway so information on prenatal risk factors and pregnancy outcomes of participants can be compared to those of non-participants. From the data we've learned, for example, that 78% of aboriginal women from the off-reserve component in these programs breast-feed their new babies, which compares quite favourably to the rate in the general population.

The evaluation process for all the community-based programs will allow us to identify emerging issues, monitor trends over time, and adjust our programming.

[Translation]

Let me know address how Health Canada programs for Aboriginal children are working to better coordinate our services and programs with programs and services of other departments and other governments. On reserve, where the federal government has a larger role, we try to integrate Health Canada programming as much as possible with that of other federal departments. Off-reserve, the focus is on collaboration with provincial and territorial programs. For example, a number of Quebec Aboriginal Head Start sites receive funding from the provincial child care program to operate both an intensive early childhood development program and full-day child care.

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[English]

The translation of research and information into policy and practices is essential to maintain effective and strengthened programming for aboriginal children and their families. Health Canada is engaged in a number of related activities, including a contract with the Canadian Pediatric Society to provide some information on diagnostic criteria for FAS/FAE with a focus on newborns and on adaptation for use with aboriginal infants.

Another activity is a survey of 2,000 health professionals, such as physicians and midwives, on their attitude, knowledge, and behaviour regarding FAS/FAE and alcohol use during pregnancy. Then the centres of excellence for early childhood development and for children and adolescents with special needs are working to provide appropriate caregiver information and to investigate models of prevention for special needs children who live in rural and remote communities. Both have an aboriginal focus.

Through improved health information and research and innovative approaches to service delivery, Health Canada in partnership with aboriginal people, other departments, the provinces, and the territories will be better positioned to predict and respond to the unique needs of aboriginal children and their families.

Collaboration, partnerships, and comprehensive approaches have been important mechanisms in a strategy for systemic change at the community level. There is a realization that complex problems and the needs of families, workers, and communities will best be met with well-developed, evidence-based programs that work together to focus on the specific needs of the individual and the community. This is particularly important given the small size and remoteness of many aboriginal communities.

If I could, Mr. Chairman, I'll ask Richard Budgell to make a few remarks with respect to some of the results we have achieved with Aboriginal Head Start.

The Chair: Mr. Budgell.

Mr. Richard Budgell (Manager, Aboriginal Childhood and Youth, Population and Public Health Branch, Health Canada): I'm going to build on what Ian has told you and focus in much more specifically on the particular program I work with, which is Aboriginal Head Start in urban and northern communities.

I've been the manager of that program since 1994, when we started the initial consultations on the design of the program, which was then announced in 1995. So my experience is with that urban and northern or off-reserve section of the program. However, within the department we work very closely with our colleagues responsible for on-reserve programming, so I work very closely with people in Ian's branch, the First Nations and Inuit Health Branch.

The data I'm going to show you is from the urban and northern program, but we believe that it will be replicated and will be very comparable to data produced in the on-reserve program once the on-reserve program is at a stage where we're able to do that.

One of the differences, of course, is that the urban and northern program, the off-reserve program, has been in existence since 1995. The on-reserve program was only initiated in 1998, so it's a much newer program, and therefore the data is not yet as comprehensive.

The first chart, the chart that's in red and yellow, shows you the number of children participating during the last school year in Aboriginal Head Start according to their ages. Off-reserve the program is typically quite tightly focused on three- to five-year-old children. In 2000 we served just under 3,500 children in total.

As you can see from the profiling in the chart, the largest group of children participating in the program are four-year-olds, 1,400 of them four-year-olds last year. Because the program has a focus on school readiness, one of the things this shows us is that in terms of the targeting we are in fact hitting the age range of children we're most aiming for at this point in time.

I should add that many of the programs serve both three-year-olds and four-year-olds, so our programs are typically two years' worth of programming. Three-year-olds come into the program, stay for a second year, the year during which they're four, and then go on into the school system.

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The second chart, the one entitled “Special Needs Children in Aboriginal Head Start”, is, again, just for the urban and northern program. What we have found through our evaluation information is that this is a really challenging area for us to investigate, because there are a lot of issues in relation to special needs children, such as the fear of stigmatization and a lack of availability of diagnosis of special needs. It shows that over the three years for which we have evaluation data—1999, 2000, and 2001—the numbers have been roughly consistent, ranging from 16% to 19% of all participating children.

We think that this is in fact an under-representation of the number of special needs children in the program. We have site-level information that tells us that for some sites as many as 22 of the children out of a median enrolment of 36 are identified as being special needs children. That's extremely high.

Part of the reason we believe that there is some under-representation is that we know that there are barriers to the diagnosis of special needs children participating in the program. We've asked the sites, what are the barriers you can identify? Fifty-two percent of the sites have reported that parental resistance to diagnosis, that is, parents denying that there is any problem with their child, has been a barrier.

That's not surprising, because I think many people don't want their child to be stigmatized and particularly identified, especially if there is then no guarantee that there are in fact going to be special services for that child.

Along those lines, we have found that 40% of the sites have reported to us that their physical distance, geographical distance, from a specialist is too great to obtain proper diagnosis of special needs children. Twenty-seven per cent of sites have said to us that long waiting lists for specialist diagnosis have also been a problem.

There are some systemic things here we're aware of too. For instance, when it comes to learning delays, quite often those services are not available until a child joins the school system, that is, they're not available when a child has not yet joined the school system. The educational system doesn't provide those kinds of services to children younger than five, typically.

On the positive side in relation to this special needs issue is something we have found very challenging. We know from this year's data that 8% of our sites now have special needs workers, as compared with none in previous years. Thirty-nine percent of our sites now have policies and procedures, that is, a protocol in place to deal with special needs children. At least that is a first step, where the site is saying that when we get a special needs child, here is our protocol for dealing with that child, whether it is a matter of referring them to outside services or of particular ways of interacting with that child in the classroom. At least there are in fact procedures in place in 39% our sites.

Twenty-five projects have told us that they have some outside funding to assist in serving children with special needs. We know that's the case in Alberta, where the Alberta provincial government provides a special worker. Where there is a special needs child who has been diagnosed, the Alberta provincial government provides a special needs worker at the Head Start site, a teacher's aide to work specifically with that child.

We know that the program is struggling to do a good job for children with special needs. One of our conclusions within the program has been that we need to put more emphasis on training for Head Start workers at the sites to work with special needs children. This is an example for us of how the data we collect every year in the evaluation can be used towards making program improvements. Then we can identify areas that are particularly challenging and redirect ourselves somewhat to be able to say, let's make this kind of change; let's make this kind of improvement.

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The last chart I'm going to show you talks about the frequency of parental involvement in various activities. This is from the year 2000 data.

Aboriginal Head Start is of course a child-focused program, but we've known from the beginning of the program that if we had been working with children in isolation it would not have been an effective way of doing the programming. So we work very intensively with parents as well.

The chart shows you a range of participation in different activities. We know from our evaluation data that in 84% of our sites now parents are participating on parental councils that advise on the programming in their sites. So that shows up in the second set of columns there under “Management Decisions”.

In 2000, the year from which this data is drawn, 49% of sites told us that there was an increase in the overall level of parental involvement, which is positive. However, 88% of sites also report to us that parental involvement is a particular challenge for them.

We find that not surprising, given that we know that many of our parents are living in difficult circumstances and high vulnerability, but we believe that parental involvement could be improved in the program through more intensive home visiting—in other words, having workers from the head start sites going out into the homes of the families, doing home visiting in a systematic kind of way. That also allows you to work one on one with parents involved in the program. So you have the program go to them, instead of waiting for the parents to come to you in the site.

These three charts are a very small glimpse of the kinds of things we're learning from evaluation data and conclusions we're making about them. You are having made available to you a range of publications. I'll show you a couple of them.

One publication is “Program and Participants 2000”, a small booklet from which some of this data is drawn that reports on year 2000 data from our evaluation.

Another booklet publication you will get that I wanted to draw your attention to is this one, Johnny National Super Hero. It's a story that we commissioned from the aboriginal writer, Thomson Highway, who looked at evaluation data and local evaluations that we had. His goal through this publication was to come up with a human story and put a human face on the kinds of experiences that families and children are having in the program. We just released this about a month ago. The Secretary of State for Children and Youth, Ethel Blondin-Andrew, launched the publication for us at a national training workshop. We think that this story will help tell a story in addition to having data on the program.

There are a range of other publications that are being made available to you: the national annual report from the on-reserve program, maps showing the location of sites in both the on-reserve and off-reserve programs. So you'll have lots of reading to do when we're done with you. I'll leave it there for the moment.

The Chair: Thank you very much.

Colleagues, we are all going to be treated, if that's the word, with the maps, with “Johnny National”.

[Translation]

Take note: it is not “Johnny Federal”.

[English]

I think we're going to be giving this out to you all so that you can stagger back to your offices with your own wheelbarrows.

We want to thank you very much for those remarks. I think it really helps when you drill down into a program to start getting a bit of the flavour of the parental involvement. It's also great to have with us somebody who has been sticking with the program so there's a kind of institutional knowledge there. I think you're to be congratulated for these programs.

Why don't we move along to our members. I might start on this side. Carol Skelton.

Ms. Carol Skelton (Saskatoon—Rosetown—Biggar, Canadian Alliance): Thank you very much for coming before us today. I have a couple of questions I would like to start with.

In the 2001-2002 main estimates, one of the planned activities for the First Nations and Inuit Branch is to explore opportunities to address program gaps in Aboriginal Head Start, CPNP, and other early childhood development initiatives. What exactly are the gaps in the ECD programs that this statement refers to? Can you tell me, gentlemen? And what measures is Health Canada going to take to correct it?

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Mr. Ian Potter: I could begin, Madam Deputy, and maybe I would ask Debra Gillis, who is the program manager, to join me, with your permission, and she could give you some more of the detail.

Ms. Carol Skelton: That would be great, thank you. I'd really like to know about that if you could tell me.

Mr. Ian Potter: The issues around program gaps relate in a variety of different areas. One is the breadth of coverage of the program in terms of the number of children we can provide service to. Right now the on-reserve program is providing services to about 7,700, and off reserve it's about 3,300, for a total of about 11,000 children.

This is not all of the children who we believe need the service. Therefore we have been very successful in working with other organizations to expand the resources and to integrate services. On the reserve, first nation governments have brought their resources to expand programs, and other departments, such as day care, etc., have pooled their resources to provide service to a larger number of children. That was one area.

The other area has been the extent of the content of our services. And as Richard has pointed out, special needs issues are an important element. The programs on reserve have only been in existence for three years, and some of them have just started. The off-reserve component has been running longer. The development of the capacity of the staff, the training of the people who are working with the children and bringing in the expertise and how to deal with programs in disabilities, fetal alcohol syndrome and fetal alcohol effects, for example, are areas where we need to work and to find ways to work with the groups we fund to encourage their training and their development of their staff.

Debra, perhaps you could fill in what I have missed.

Ms. Debra Gillis (Director, Health Programs Support Division, Community Health Programs Directorate, First Nations and Inuit Health Branch, Health Canada): Thank you, Ian. Actually, Mr. Potter provided a really good assessment of some of the needs, and perhaps I could talk to some of the measures we're working on with first nations and Inuit and with our staff across the country.

With respect to where we're going in trying to more clearly identify what some of the measures head start programs would like to be put in place, each region—we have seven regions across the country where headstart programs are located—is working with its first nations partners. There's a regional advisory committee, and they're doing an assessment of what the gaps really are in their region. Those reports should be available by the end of this fiscal year. That will be put together, wrapped up, and be taken to the national advisory committee for this program to start looking at where we need to also put additional time and attention.

The preliminary indication is we really need to address children with special needs, as has been mentioned previously, and the training. The need for standards has also been identified, and we've been working very hard in the development of program standards and program protocols for the on-reserve program.

We hope that over this next period of time we'll have a very good definition and a better, clearer picture of exactly what measures people would like to be put in place and then start putting forward plans to start addressing some of those through the integration of different programs, working with other programs that have identified similar issues.

We're also working very closely with Human Resources Development Canada, who have day care programs, and many of the head start programs are working very closely already on reserve. So we're talking about how can we best work together to address very similar needs, and there's a group of staff from both departments, as well as from the Department of Indian Affairs, who are meeting on a more regular basis than they have previously to start looking at how we can start coordinating our activities much more.

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Ms. Carol Skelton: You say you have seven regions. Would you give me a geographic breakdown of those regions?

Ms. Ian Potter: Essentially, the regions are the Atlantic provinces, Quebec, Ontario, Manitoba-Saskatchewan, Alberta, and British Columbia, and there is a northern secretariat that works with the Northwest Territories, Yukon, and Nunavut to coordinate some services there. By and large, in the territories the services are provided through the territorial governments.

Ms. Carol Skelton: You have 11,000 children in the program, is that correct? Was it 11,000 on and off reserve?

Mr. Ian Potter: Yes, that's right.

Ms. Carol Skelton: Do you know offhand the percentage of those children in the Manitoba-Saskatchewan region?

Mr. Ian Potter: We can find that out for you. We can provide you with those numbers.

Ms. Carol Skelton: Thank you very much. I'd appreciate that.

Another concern I have, because I have a large urban first nations population of youth and children in my riding, is about youth suicide, a big problem. It's quite serious in Canada among youth generally and among aboriginal youth in particular. It's not only a problem of youth, it's about younger and preteen aboriginal children too. What measures are you taking, such as planning, to come to the aid of these children who are having problems? Have you seriously looked at that?

Mr. Ian Potter: Yes, we have. Thank you for the opportunity to talk about the issue, because it is an issue that preoccupies us enormously.

Health Canada offers a variety of services. On reserve we provide mental health services through mental health counsellors. We have special initiatives around suicide. We send groups into a community if there is evidence that there is likely to be if there has just been a suicide, because often there are copycat situations. We do have a fairly well-developed service to deal with that. That's not to say that the needs do not go down with the services.

We also have been working to try to improve some of the basic issues. For example, we provide a program called “Brighter Futures in Building Healthy Communities”, which is a program to fund some of the basic social infrastructure in a community to encourage what you would call mental health promotion activities.

We have been working with the Assembly of First Nations and the Inuit Tapirisat of Canada, an organization representing the Inuit, and we've created with them a partnership called the National Mental Health Working Group. They have been asked to develop plans for us that would be more comprehensive for culturally sensitive mental health services.

In addition to that, to focus more on aboriginal suicide itself, Minister Rock, along with the national chief of the AFN, Matthew Coon Come, appointed an advisory group in September of this year to look at the situation and make both short-term and long-term recommendations. Our expectation is that the group will report by Christmas or early in the new year with some ideas.

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We have been providing services, and we've also been trying to do the work. I don't know that we have all the answers. We're seized with the fact that there is a terrible problem in aboriginal communities.

Ms. Carol Skelton: Are these trained suicide prevention teams you've sent into the communities?

Mr. Ian Potter: Yes, they are.

Ms. Carol Skelton: Second, can we have the results of your studies and everything when they come out?

Mr. Ian Potter: This is part of the advisory group. Yes, I am sure that the minister would be pleased to share that with you.

Ms. Carol Skelton: Thank you very much.

The Chair: Thank you.

We'll do it through the clerk of the committee, then.

Madam Guay.

[Translation]

Ms. Monique Guay (Laurentides, BQ): Thank you, Mr. Chairman.

Thank you very much for being here today. The information that you have given us is of great importance, because it is the foundation for relations with Aboriginal persons, with children, with people.

You say that there are seven regions. Would it be possible to give us a description of the investments by program and by region so that we can have an idea, based on real figures, of how this is done? Please send the information through our clerk. My colleague is from the Manitoba region and I am from Quebec. That would enable us to visualize what is done and how much money is involved.

Secondly, I note that your programs are quite recent, dating back to 1994, and 1996. So these are programs that you have put in place quite recently. Do you have any statistics on the results or the effects of these programs? Have any adjustments been made over time? Representatives from Statistics Canada met with us, and the statistics they provided dated back to some time ago, to 1996. It is now 2001, it has been five years. They did not have new ideas or new statistics for us. Perhaps you have more recent information, with the programs that you have put in place. That would also be of interest to us.

Mr. Ian Potter: Thank you, Madam Guay.

First of all, we can put together the figures and the documents regarding the programs by province and by region. That will not be a problem.

As for your second question, I am going to ask Nicole Lafrenière-Davis, who is the director of this program, to discuss the evaluation. The programs are new, and I think that we are preparing to evaluate their impact. Nicole can explain that better than I can.

The Chair: Ms. Lafrenière-Davis, please introduce yourself.

Ms. Nicole Lafrenière-Davis (Acting Director, Childhood and Adolescence Division, Department of Health): Of course. My name is Nicole Lafrenière-Davis, and I am the Acting Director of the Childhood and Adolescence Division at Health Canada.

What I can do is tell you about research. The most advanced evaluation is the one on the Canada Prenatal Nutrition Program. As this is an off-reserve and Inuit program, Debra can tell you about the people under the program on-reserve.

There are five parts to the Prenatal Nutrition Program evaluation. The first assessment deals primarily with the project itself. Each year, people involved in these projects must fill out a rather comprehensive questionnaire on management, governance and partnerships that are established in the communities. That gives us an overview of the project itself.

After that, we also have an impact evaluation as soon as women enter the program. So when entering the program, each mother must fill out a questionnaire and she fills out another one when she leaves the program. It covers all kinds of data on the mother's experience during this period.

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For the third component of the evaluation, we created a base-line. We have, with some difficulty, identified a group of at-risk mothers who did not have access to the Prenatal Nutrition Program, and we also had them fill out a questionnaire to try and understand their reality. At this time, we are currently comparing the base-line data and all of the other data I mentioned that we collect from the mothers.

Another component of the evaluation is a qualitative evaluation. We have identified several ways of seeing what is happening in the program itself thanks, for example, to case studies, which, more and more, is the methodology we use to understand the realities of these programs. These studies are highly detailed and give us a good understanding. We have completed one case study; three others remain.

The final component of the evaluation deals with the relationship between program costs and benefits. Since there are very few cost-benefit evaluations in Canada, we are very eager to see what the results will be, but, naturally, it will involve a more long-term evaluation of the mothers.

Ms. Monique Guay: Thank you, Ms. Lafrenière. We are also eager to see these evaluations, because it will be very interesting to see the results.

Now I have a question on the programs that Health Canada has set up. Do you run programs jointly with the provinces that are interested or that are already working with Aboriginal people? Are efforts being made to save money? If programs already exist in the provinces and you work in conjunction with them, it is obviously a lot less costly.

I would like to hear your comments on that, Mr. Potter.

Mr. Ian Potter: Perhaps Ms. Lafrenière-Davis can add a few remarks as well.

Off-reserve programs in the provinces are managed in conjunction with the provinces. In Quebec, for example, the situation is one of the best. The provincial and federal programs are well integrated. Perhaps Nicole can explain how the provincial and federal programs are integrated in Quebec.

Ms. Nicole Lafrenière-Davis: For the CAPC Program, the Community Action Program for Children, and the Prenatal Nutrition Program that I just described, services are delivered through the CLSCs. We realize that this is an excellent way of doing things. We occasionally benefit from investments by the Quebec government, which increases our funds and is an added advantage.

Ms. Monique Guay: It would be good if that were done elsewhere, if all of the provinces could benefit from that. As you know, the CLSCs just keep getting better.

I have one final question, Mr. Chairman. One thing worries me and greatly concerns me, and I am talking about children with special needs. When we talk about special needs, at least in French, we tend to think about handicapped children, about children experiencing difficulties.

• 1615

I would like you to explain what these children's special needs are and I would like you to elaborate a bit on that. Are you talking about children who are living in difficult family environments or children who have personal health problems or integration problems? Could you elaborate a bit on that, please?

Mr. Ian Potter: My colleague can perhaps explain the meaning of this terminology.

Ms. Monique Guay: Thank you.

Mr. Richard Budgell: There is not really a simple answer, because we are talking about a wide range of possible special needs.

The Chair: You do not mean at risk—

Mr. Richard Budgell: No, these are special needs. It may be a matter of delays, language problems or developmental delays, or specific physical problems. I believe that the special aid program for Aboriginal people covers every type of special need that exists.

We have data that indicate that there are delays with respect to language development, cases of FAS/FAE, delays with respect to behaviour, development, visual problems, the brain, and autism.

Based on the data that we have, we are trying to do our best to evaluate what these special needs are to determine what we can do to help these children.

Ms. Monique Guay: [Editor's Note: Inaudible].

The Chair: It is called FAS/FAE.

Mr. Ian Potter: It is fetal alcohol syndrome.

Ms. Monique Guay: Yes.

[English]

The Chair: Mr. Tonks, did I see you indicate a desire to participate, way back there?

Mr. Alan Tonks (York South—Weston, Lib.): I am interested in the statistics on parental involvement. You indicate that to a large extent programs on early childhood problems, particularly for children with special needs, are dependent on treatment of the family, in particular sole-support mothers. Part of the recommendation is to have more home visiting, to try to develop a broader strategy to help children in early childhood programs.

Is there anything else you are doing? I read the material through, and except for that comment I didn't find anything else. It seems to me it's very important to have other support mechanisms in the strategy. Maybe you'd like to elaborate a little bit on that.

Mr. Richard Budgell: I think it's one of the areas where our sites are working the most intensely, albeit sometimes they report to us they don't feel they necessarily have adequate resources to do the full job they would like to do.

Many sites, for instance, would like to have full-time parental involvement workers. They would work at bringing parents into the sites or doing home visiting with parents. Quite often now, one of the other workers in the sites—the director or teacher—squeezes in that kind of thing, in the midst of their other responsibilities.

• 1620

As a basic principle, I think what works is if parents find that the site is doing things that are useful to them. It could be providing them with some training, which can be in a whole range of things. Sometimes parenting training is provided to people through our sites, or sometimes it can be things like organization of a collective kitchen among parents participating in a site. So there's a very wide range of strategies for doing it, working in a concentrated way to involve parents.

As I've said to you, sites have consistently reported to us that this is an area of real challenges for them. That has something to do with the fact that we know.... For instance, in Aboriginal Head Start off reserve, 34% or 36% of our parents are single mothers. Those are people quite often struggling to make a living and with other children. It's not easy to try to bring someone like that out to a parent council meeting in the middle of the week when they've been working and they have kids to take care of and they're really struggling to stay afloat. That's not an atypical situation for parents in our program. We know that if we don't reach the parents, we work less effectively with the family and with the child.

Mr. Alan Tonks: When you talk about sites and programs, are you talking about...? Excuse my lack of information on this. The Aboriginal Head Start program has 305 sites on reserve. In a site, do you have a sort of holistic capability of drawing on other programs, for example, such as CAPC, the prenatal nutrition program, the fetal alcohol syndrome program, and any other programs? Do you have any capacity to draw on other resources in order to do what you just said, in terms of providing linkages on your sites?

Mr. Richard Budgell: As Ian has said, the context is a bit different on and off reserve, but in both cases, there's an onus on the projects and an onus on the departments that are funding the activities to do everything we can to work with anybody else in the field. On reserve, that primarily means other federally funded initiatives. Off reserve, quite often that means services or programs coming from provincial governments, or even municipal governments sometimes.

I know from urban and northern sites that I've seen across the country—and I've seen about 60 of them at this point—that they are very frequently working in a way where they are blending and working with other existing programs. For instance, in Quebec, we have sites that are integrated and co-located with the provincial government's child care program. They're called centres de la petite enfance. They're integrated with that in the case of two sites in southern Quebec. Then in northern Quebec, all the sites have integrated programming, with child care and head start.

We have a lot of sites located in community centres. They are not aboriginal community centres, but just community centres, where they're working with the other programming in that community centre. In some cases, they're located in an aboriginal multi-purpose child and youth location. I was just in one in Saskatoon a few weeks ago, and it's a multi-purpose child and youth service centre. It has funding from 20 different sources. Aboriginal Head Start and Health Canada are just two of those; they have funding from 20 different sources: federal, provincial, municipal, health system, and education system.

• 1625

In that particular location they're also operating an alternate school for aboriginal kids who have dropped out of the standard school system. Of course, their funding for that comes from the public school system in Saskatchewan. We have more work to do on that, but the direction is very clear and I think we're doing a pretty good job.

Mr. Alan Tonks: I guess that's where I was hoping you would go. Having been in Winnipeg a few weeks ago as part of the urban task force, we were told there were 80,000 off-reservation first nations people. It's a huge problem. There are all the kinds of problems you've described—the full spectrum of a family.

The criticism was there were just a number of programs, and everyone was scrambling to try to get the right mix. Some were very knowledgeable and able to do it; some others were falling through the cracks. There was a difference, if I can put it that way, between the treatment of those 80,000 off reservation and programs that were being offered on reservation. There was a huge difference of opinion between the chiefs and community-based organizations that were trying to help mothers who were unemployed and falling prey to all kinds of problems.

I guess the thrust of where I'm going is that an aboriginal person in need.... A child in need is a child in need, regardless of program qualification and so on.

In your evaluation, will you be coming out with more holistic and sort of strategic—maybe that's not the word, but coordinated...? On your site, will the evaluation be coming forward with recommendations? I think you said it will be attempting to move in that direction.

Mr. Richard Budgell: One of the things the evaluations always ask is how are you linked to other services and programs in your community? So we're already collecting information about how sites are linked to other programs and services in their own communities.

In terms of the impact evaluation, it's a really interesting question. It would be a really interesting thing to test out in an impact evaluation. You could ask, for instance, if there were a difference in child and family impacts between sites that were sort of more multi-purpose and comprehensive, and sites that were more unique or—

Mr. Alan Tonks: Specific.

Mr. Richard Budgell: Yes. It would be a very interesting question. We're just in the process of designing our impact evaluation now, so it would be an interesting area for investigation.

The Chair: Mr. Potter, do you want to add something?

Mr. Ian Potter: Yes.

Mr. Tonks, the issue you raised is a fundamental one, with respect to the longer term development of our programs. As the chairman of this committee remarked, prior to taking on the responsibilities of managing the services for first nations on reserve, I was the assistant deputy minister responsible for the other part of Health Canada. In that capacity I was co-chair representing the federal government on the early childhood development initiative.

That initiative, which was endorsed by first ministers in September 2000, set out a framework on the goals governments would work toward. It also set out reporting requirements. We did that partly because we recognized that to be successful we had to find ways of integrating a variety of different programs from many different sectors—education, health, social—for many different levels of government, and from different sources of funding.

The conclusion was that there was no easy way of doing this, and to command and control a system was probably not going to be effective. We should set out an agreement on what the goals were and a commitment to work together to share the information, and try to build methods of communicating and working together at the community level. Over time the pressures of those would push us into more integrated program delivery focused on the individual needs of the community and the families.

• 1630

So it is a really important issue. It's something we're working to try to address, but I don't think there are any easy answers on how you can integrate the capacity of all these different sectors.

Mr. Alan Tonks: On that, the issue of the social union framework agreement has come up from time to time. To my understanding, that was an attempt to delineate some edges around strategic partnerships that would cut across those kinds of institutional, governmental, and administrative areas.

It seems to me you're working within that framework and that sort of spirit. I hope you'll be successful because it's a subset of the larger issues in education, post-secondary education, and a whole variety of capacity-building areas. We need to have some guidelines. This has been raised previously at this committee, and I appreciate that this is very much in keeping with that.

The Chair: This committee, along with another subcommittee of HRD that deals with disability, sees itself as a horizontal committee. Though we are technically part of the HRD committee, you're here because we're interested in the way these programs cut across.

It's evident, from both the social union framework agreement accountability regime and its reflection in the ECDI accord, that there are three different measures. The first is relatively easy. It's the baseline accounting, to which we're all subject for September 2001. The second, which is a little less easy, deals with accessibility to the programs listed and how you monitor the growth. The third, which is by far the toughest, is the comparable indicator framework that deals with outcomes. Of course, the more complex the number of factors being woven together, the more difficult it is to ascribe success to this item versus that item. Integration itself may be a cause of success.

I'm interested in the kind of evaluative piece here. My first question deals with the second issue. We're talking about a universe of 337,000 children on and off reserve. For the Aboriginal Head Start initiative, the Canada prenatal nutrition program, and maybe the off-reserve section of CAPC, what percentage of at-risk children, as you would define them, are currently covered by programs?

When Health Canada talks about prenatal nutrition generally across the country, they will say in the one instance, which is prenatal nutrition, that with the new money they hope to basically target half of all children at risk. So they obviously have some sense of what 100% of that looks like. But what percentage of the 337,000 children out there, aged three, four, and five, for Aboriginal Head Start are you hitting? What percentage does 11,000 represent? In other words what would it take to get to as many as you can identify?

What percentage of off-reserve aboriginal kids are you hitting with CAPC—we can't talk about on-reserve, you don't have it—and then the same for prenatal nutrition? Is that stuff you have? It would give us some idea of what it would take to get to 100%.

That's my first order of questions.

Mr. Ian Potter: Nicole, do you know the data?

The Chair: Even orders of magnitude would be fine.

Mr. Ian Potter: Maybe we can start with Debra Gillis.

Ms. Debra Gillis: With respect to the head start program on reserve, we serve about 7,700 children. According to our estimates, the majority of children on reserve are at risk, and we are reaching about 25% of the children at risk.

• 1635

The Chair: About 25%, you say?

Ms. Debra Gillis: Yes. It's about 25% through their head start on reserve.

The Chair: How about off reserve?

Mr. Richard Budgell: On reserve, we're reaching 3,500 out of 42,000 three- to five-year-old kids.

The Chair: But is that the total universe of three- to five-year-old off-reserve kids, or the ones at risk?

Mr. Richard Budgell: That's all aboriginal kids.

The Chair: Okay, an estimate.

Mr. Richard Budgell: It's 42,000, and I would go with my colleague's definition that our estimate is that the overwhelming majority of those kids could qualify as vulnerable or at risk.

The Chair: So we're talking about a lesser percentage. In other words, what...? I can't do the math here, but—

Mr. Richard Budgell: It's 7%. We're reaching 7% of the total population.

The Chair: That's 7% for the off reserve, is it?

Mr. Richard Budgell: Yes.

The Chair: So this tells us we have a way to go.

What are your estimates for the prenatal nutrition program?

Ms. Nicole Lafrenière-Davis: For the off reserve, we look at about 350,000 births in a year. We're trying to reach, we estimate, around 10% of at-risk mothers. We're reaching 26,000 now.

The Chair: That's 26,000 off-reserve aboriginal people.

Ms. Nicole Lafrenière-Davis: No, that's for CPNP, the whole program. I'm not differentiating between aboriginal and non-aboriginal.

The Chair: Do you have figures on the off-reserve aboriginal population? In other words, are we reaching 10%...? No, it's better than that. Help me.

Ms. Nicole Lafrenière-Davis: It's the whole population. The 26,000 are all the Canadian women we're reaching, aboriginal and non-aboriginal.

The Chair: I'd just be curious to know whether you're reaching a higher percentage of at-risk off-reserve aboriginal women. Do you see what I'm getting at? Don't worry about it.

Ms. Nicole Lafrenière-Davis: No, I don't have the breakdown for aboriginal women. We have the number of on-reserve women, which is around 6,000.

The Chair: What would that percentage be?

Ms. Debra Gillis: The on-reserve CPNP program is a universal program available on reserve, and there are about 10,000 births a year to women on reserve. The program reaches around 6,000 of those women, so it's around 60%. It's quite a large reach of that program.

The Chair: Now, if I may turn to the evaluation part, let me continue with the Canada prenatal nutrition program. If I heard Madam Lafrenière-Davis correctly, there were five elements that were being measured. The one I would have thought you might have measured but didn't hear you talk about was birth weight. I would have assumed that was an indicator, some kind of healthy outcome indicator. That would be my first question on that.

Then I also wanted to know about the linkage between the prenatal nutrition program and our preventive efforts in FAS/FAE. I would have assumed there was a connection between those two as well, and I wondered if we had some way of measuring whether, through all our programs on FAS/FAE, we're doing better with the women who go through those programs than we are with some control group.

So there are two sets of questions.

Ms. Nicole Lafrenière-Davis: On the first question, in the five evaluation components I mentioned we are indeed looking at birth weight, because some of the objectives of the program are a healthy birth weight, an increase in breast feeding, and healthier moms and infants. What we're beginning to see in the area of birth weight is a slight reduction in the rate of low birth weights.

Again, I'm not talking specifically about aboriginal women; I'm talking about all women who go through CPNP. We're beginning to see a slight reduction in low birth weights. The goal of high birth weight is still very much of a challenge for aboriginal women, and we're capturing low birth weight and high birth weight in our data centre.

The Chair: You are capturing it specifically for the aboriginal population, are you?

• 1640

Ms. Nicole Lafrenière-Davis: Yes, we are, and the other area where we've really seen a lot of success is in the area of breast feeding, where in CPNP the rate of breast-feeding moms is almost equal to that of the normative population.

The Chair: Do you have a “before” figure and an “after” figure? In other words, you've got it up to.... What is the control group? What rate of breast feeding is there in that group?

Ms. Nicole Lafrenière-Davis: I think it's 78% of women who breast-feed.

The Chair: I'm asking about a control group of at-risk women, ones who are not going through the program. In other words, I would assume that to be a lesser figure.

Ms. Nicole Lafrenière-Davis: I don't know what the figure is.

The Chair: Is that knowable?

Ms. Nicole Lafrenière-Davis: I don't know. I can certainly find out that figure.

Mr. Ian Potter: I'm sure we've asked that figure in establishing the baseline or control group to know what the comparison is.

The Chair: The other question I have right now before I turn it over to others has to do with Aboriginal Head Start and evaluation methods. It was stated that one of the objectives was to improve readiness for school. Is one of the evaluation tools for both the on-reserve and off-reserve groups the readiness-to-learn measure or the early development instrument or whatever it is? Again, I would assume there's a control group or an equivalent socio-economic group because you've indicated that's one of your objectives. I assume that has to be one of your tests.

Mr. Richard Budgell: We've looked at both of those, and we're not sure that we're going to use either of those measures—and I'm just talking about the urban and northern program.

We found an instrument we will be using—or will be pilot-testing, at least—called the “work sampling system”. It's called a “portfolio management system”, and it collects the child's work over a period of three years, if the child is in the program two years, and then into the school system at least one year. It tracks their cognitive development, development of mathematical skills, and development of social skills relating to school readiness, and there are a couple of other domains. There are in fact seven domains this work-sampling system works on for the child.

We haven't made a final decision yet about whether we would use either of those instruments that you refer to.

The Chair: They're actually the same instrument. The EDI is just the new version of it as developed.

Are you going to be tracking these kids in all these programs in some kind of longitudinal fashion? All the literature, the whole rationale for the original Ypsilanti study, was that over 30 years you began seeing effects. How are you going to track those?

Mr. Richard Budgell: So far within our program, what we feel we're able to do is to follow the kids into grade two as a specific part of an evaluation. We think that a longitudinal research study would be a wonderful thing. However, it would entail the investment of considerable resources, so there are no plans at the moment to do a long-term longitudinal study as part of our evaluation—a couple of years into the school system, but not necessarily beyond.

The Chair: We'll have an off-line conversation about that.

Mr. Richard Budgell: It certainly doesn't mean that we're not convinced of the virtues of that kind of study. In fact, I'm certainly convinced of the virtues of that kind of study.

The Chair: Ms. Skelton.

Ms. Carol Skelton: We've heard over the years that community-based services and supports are the most effective tools to help children and families. How are you working, let's say, with the Federation of Saskatchewan Indian Nations to implement your programs in Saskatchewan?

• 1645

Ms. Debra Gillis: Actually, the FSIN and all other regional first nations' organizations are really quite involved in the development and implementation of the programs. For example, a person employed by the FSIN participates very closely with Health Canada employees in the development of the head start program and sits on the national advisory committee. So it's a very collaborative partnership. Over the years, more and more of that has happened with all first nations' organizations across the country. They are involved right from the very beginning when the program is being developed right through to selection and implementation, and also to evaluation.

Ms. Carol Skelton: So our Minister of Health for FSIN would more than likely be the person sitting on the board, then, since they have ministers in different portfolios?

Ms. Debra Gillis: Generally, it's not the health portfolio holder or the chief, it's a usually a staff member who represents the Health and Social Development Commission.

Ms. Carol Skelton: Thank you very much.

I have one other question about the suicide prevention teams you send in. Do you use a lot of elders on those? Whom are they made up of?

Ms. Debra Gillis: The suicide prevention teams vary. They can be quite different from each other, depending upon the community. But you're quite right, elders are often part of the whole picture in working with families and individuals.

Generally, they tend to be psychologists, counsellors, specialized trained workers who can work with the children or the individuals in the families. They may include social workers or physicians. It depends upon the area. But elders definitely play a large role. Often they will bring together the communities and the people in the community who can also help and assist.

Ms. Carol Skelton: Okay. I have one other question—very small. What assurance do we have that the funds intended for children and families will get to those children and families where it's needed to be? Do you have controls in place?

Mr. Ian Potter: I could maybe address that. Yes, we do have controls in place. The programs are delivered by community organizations: either aboriginal organizations outside the reserves or the band councils on reserves. They are funded through contribution agreements. The contribution agreements are quite specific with respect to reporting on the program activity, financial reporting, and audit requirements. We have within the department a fairly extensive system where the contribution agreements are vetted and developed. They're vetted by a number of different parties to assure that the budgets are appropriate for the number of people they're serving and that there is efficient use of the funds.

Ms. Carol Skelton: Thank you very much.

[Translation]

The Chair: Ms. Guay, you have the floor.

Ms. Monique Guay: Thank you, Mr. Chairman. I have two short questions. They will not take very long.

Are the on-reserve programs administered and carried out by Aboriginal people or are departmental officials responsible for them? How does that work? It would be interesting to know if they are people from the department. I will wait for your answer and I will go back to that.

Mr. Ian Potter: In most cases, the programs are managed by the Aboriginal persons themselves. The Indian Band Council is responsible for program management. Normally, it sets up a committee that is responsible for organizing the programs. The link between the department and this committee is part of a contribution—

Ms. Monique Guay: These people must have a certain amount of training on the new programs they receive. You want to achieve results and you want the target client to have access to the programs, whether it be a specific age group or a group of children. Does the department provide training for these people?

• 1650

Mr. Ian Potter: The programs that are prepared contain guidelines that outline what must be put in place to ensure that the human resources are qualified to offer the various programs. Everything is done in accordance with the organizations.

Ms. Monique Guay: I imagine that it is easier for the Aboriginal persons living on-reserve to deliver the various programs than for people from outside to try and implement these programs. It would be much more difficult for people from outside the community to do so, because they are not necessarily familiar with Aboriginal customs and lifestyle. That is interesting.

I will ask my last question and then I will give the floor to someone else.

We have met with other departments, including the Department of Indian Affairs. We will undoubtedly meet with others as well. My question has been put to the people from the various departments. I will ask you the same thing.

Is there a problem with administering your programs in light of what is already in place at the Department of Indian Affairs or in other departments? Do you end up in situations where there is overlap? Are there any adjustments that need to be made? We have been told that this problem exists in other departments. Do you have the same problem? In your opinion, are there any short- or medium-term solutions that could help solve this problem?

Mr. Ian Potter: In general, it is possible to integrate each organization's programs on-reserve. As Mr. Budgell said, it is possible to have a situation where 22 organizations subsidize the same program. That is possible. But it is also true that in some cases, some programs are not linked to other programs. For example, the child care program is independent of the Aboriginal Head Start Initiative Program.

The departments are grappling with this situation. We have tried to make sure that there is more integrated management. At present, we are developing a program in Alberta where there are a number of links among the departments, that aims to bring education programs, social programs, the health program, the child care program and human resources under a single organization so that it can all be managed more effectively.

Ms. Monique Guay: That way, it is easier to manage and it saves you a substantial amount of money.

Mr. Ian Potter: Yes, that is true.

[English]

The Chair: Mr. Tonks.

Mr. Alan Tonks: Yes, Mr. Chairman, thank you.

My colleague and I are from the Toronto and the Niagara area, and I noticed that there are aboriginal head start programs in the Montreal area, the Ottawa area, and most urban areas, but there are no head start programs in that part of the country. Is there an explanation for that?

The Chair: It's plain discrimination.

Mr. Ian Potter: Yes, there is, Mr. Tonks, and it's that we may have failed to provide a map of the other head start services offered there, but we don't have....

The Chair: I think we have one.

Mr. Ian Potter: Do you have one?

What I believe you're looking at is a map of what's called the first nations head start program.

A voice: Right.

Mr. Ian Potter: This is the on-reserve program, and it's the absence of reserves in your area—

Mr. Alan Tonks: Oh, I see.

Mr. Ian Potter: —that I think might account for the lack of programming. But there may be another map.

Richard, could you...?

Mr. Richard Budgell: The yellow pamphlet that's in front of you is the off-reserve map. On the off-reserve map you'll see we have three sites in Toronto and sites in Hamilton, London....

Mr. Alan Tonks: All right, that makes me feel better.

• 1655

Ms. Monique Guay: That's how well we can see you can cover it now.

Mr. Alan Tonks: What was the question I had?

The Chair: Now that you've ceased to be offended, you mean.

Mr. Alan Tonks: I wasn't greatly offended, but I appreciate the programs.

I'll have to wait for a minute, Mr. Chairman. I've forgotten my question.

The Chair: While he's doing that, I was curious as I looked at this map.... I was looking at Saskatchewan. It's really more of an organizational question about why, when you look at the Prince Albert Grand Council on the map, it seems to be both north and south and all over the place. How does this work?

Ms. Carol Skelton: [Inaudible—Editor].

The Chair: That's the answer, is it? All right, fine.

Mr. Potter said in his introduction to the Aboriginal Head Start program that he really was looking to assess three kinds of things: how the kids were doing, how the parents were doing, and how the community was doing. One has a first glimpse of it in the third chart Mr. Budgell was referring to.

I don't know whether this can be captured in more than anecdotal fashion, whether it can be done as a focus group or whatever, but I've heard anecdotal evidence to the effect that some of the benefits—and I would think this would be at the community level as much as at the parental level—are in the people who are actually undertaking the work. We're now empowering and bringing along a whole new group of folks who may not have been doing this sort of work before. I daresay there is now not only a growth in competence but there are a lot of collateral benefits. It's almost a social cohesion argument—some unintended and positive consequences are taking place.

You've laid these out, Mr. Potter, as completely noble objectives. I'm wondering whether there's a way of capturing in story form—I know it's in part of the literature—a way of monitoring how this goes in a way that gets beyond the anecdotal but still captures the flavour of it and gives us some sense of best practices.

Ms. Nicole Lafrenière-Davis: I'd like to speak a bit on this and give you an example.

In the Atlantic provinces, which have CAPC and CPNP programs, CPNP involves aboriginals, but it's not typically for aboriginal people. We have realized with the evolution of the program that there appear to be certain things that matter, which were not those things we were necessarily measuring—the number of times they come to the program, how long they stay. This had to do much more with the supportiveness of the environment created and with the level of involvement and participation in the community. Sometimes they would describe it as being empowered to take some kind of social action, social action defined as making the rights of their children known to their children's school.

When we're looking at performance measures—evaluation methodologies—little research exists to give us indicators for this kind of social cohesion involvement. In the Atlantic region we have some interesting research happening right now and we're putting some research dollars in so we can begin to develop the indicators that would permit us to measure those elements of community life that appear to be making a much greater difference than the traditional things we've been measuring.

We feel this will be a very important contribution to the whole of the early childhood development initiatives and evaluation processes.

The Chair: When will you have at least some preliminary results?

Ms. Nicole Lafrenière-Davis: Probably by the end of next year we'll at least have some indicators in place that we can then begin substituting for the more traditional kinds of questions and measures we have in the different instruments I've talked to you about.

• 1700

The Chair: The last question—for me anyway—is a very tough one; it's a sort of cost-benefit analysis of your various programs. I understand the head start program is probably the most expensive because it's the most labour-intensive. But the prenatal nutrition and the FAS/FAE may be the most crucial, because if you don't get it right in the beginning you're going to be dealing with the effects and the costs over a lifetime.

Dare I ask how you make those calculations when you petition the likes of us for money? How do you weigh all of this? Obviously they're all very much worth while, but....

Mr. Ian Potter: If I could, Mr. Chair, at the moment we look to the literature and the research that has been done. In most of our programs we have evaluation frameworks in place. We're collecting data. We will be able to have outcome indicators on the kind of information you want on cost-benefit in the long run.

We're actually encouraging dialogue with the research community, to engage them. As Mr. Budgell has said, we don't have all the resources to do this, but we have many areas researchers could be interested in. The recent initiatives with the Canadian Institutes of Health Research are focused on trying to relate the researchers to the needs of the policy community. This is an area we're trying to explore to encourage this.

At the moment we look to what is there, often in other countries where they've done longitudinal work. The existence of the national longitudinal survey of children and adolescents in Canada and is providing both researchers and us with a base from which to look at a number of effects. Over time we will start to see the impacts of some programs where the size is such as to be able to be measured.

The literature tells us there is definitely a cost-benefit advantage to these investments in early childhood: the younger the population you invest in, the longer the payback, the greater the benefit to society. Our advice to our ministers and departments is usually, using this data from other research sources and focusing on the fact that success in the first years—the formative years, zero to five—that it's likely to pay off enormously in later years in a whole variety of areas, both economic and social.

The Chair: Thank you very much. We've had a very good afternoon and we're encouraged. These programs are on the ground and starting to show some results that seem to be positive. They are very preliminary and there is much we don't know and much we should know.

Thank you for coming and thank you also for the work you do, because it's obviously making a difference.

Mr. Alan Tonks: Mr. Chairman, I echo those sentiments. I remember what my question was.

The Chair: Right.

Mr. Alan Tonks: It wasn't a question; that's why I forgot it. It was actually a request.

As you know, the Prime Minister has a task force taking a general look at the future of cities and the role they play. If there's anything you think relevant to the early childhood program as it relates to first nations people in an urban context, and any recommendations that may come out of your survey and your findings, please feel free to flow those through to the task force. They would be very helpful to us in putting our report together as it focuses on aboriginal issues.

A voice: Excellent.

Mr. Ian Potter: Thank you very much.

The Chair: Thank you all.

• 1705

Next week the Department of Justice will be here. Justice will be done.

The meeting is adjourned.