The Child and Family Services System in Manitoba

This Thursday, I met with members of the External Review of Manitoba's Child and Family Services to provide them a summary of what I have heard from many, many people around Manitoba. I have championed the need for improvements to our approach to children in Manitoba in the Legislature. As a result many people have come to me with issues and concerns. A summary of what I have heard is provided in the document below. I welcome your input and comments. If you would like to provide suggestions please email to me at jgerrard@leg.gov.mb.ca.
If you would like to meet with me to provide your comments in person, please call my executive assistant Georgina Sabesky at 204-945-5194 to make the arrangements.



Manitoba Liberal Caucus Briefing Document

for the

External Review into Child and Family Services



Submitted to:

Billie Schibler,
Children’s Advocate for the Province of Manitoba

Irene Hamilton
Ombudsman for the Province of Manitoba

Michael Hardy
Executive Director, Tikinagan Child and Family Services
(Sioux Lookout, ON)



June 28, 2006





Manitoba Liberal Party Caucus
Room 169, Legislative Building
Winnipeg, MB R3C 0V8
Ph. (204) 945-5194 Fax. (204) 945-3220
jgerrard@leg.gov.mb.ca

Liberal Caucus Briefing Document
to the External Review into Child and Family Services


I. Introduction

The numerous deaths over the past seven years of children in the care of Manitoba’s Child and Family Services (CFS) system, or shortly after leaving the care of that system, is a matter of great concern for all Manitobans. In particular, there is justifiable outrage at the shocking number of homicides among children involved with CFS. Alongside the general public, Liberal MLAs demand answers as to why and how Manitoba’s child protection system has failed so many children in Manitoba.

Although our first preference is to have a fully open and transparent investigation into the ongoing crisis within CFS by way of a judicial inquiry (with the power to summon witnesses and receive testimony under oath), the Liberal Caucus will nonetheless make use of the current external review into Manitoba’s child welfare system to provide knowledge we have received as MLAs about CFS practices. While we are disappointed that no clear terms of reference for this review has ever been provided, and that this has created unnecessary confusion, we are prepared to do our best in providing input to the review.

Many times over the past seven years, our caucus has raised in the Legislature issues related to the operation of Manitoba’s CFS system. Our caucus has heard from children, from parents, from foster parents, and from a variety of other individuals with concerns about our province’s child welfare system. We have reviewed various reports on the operation of the system, including:

the report of Mirwaldt, Perron, & Thomas on Emergency Assessment Placement Department(EAPD) Shelter System, (Office of the Children’s Advocate, March 2004)

multiple Annual Reviews of the Office of the Chief Medical Examiner; and

various Inquest Reports into the deaths of children involved with CFS.

Additionally, members of our caucus have visited the Knowles Centre and have spoken with a number of individuals with varied roles within the system, both past and present.

Our caucus takes as face value the scope of the external review into CFS announced by the Minister and we will therefore address a broad range of issues within that scope:

1) the standards, processes and protocols for the opening and closure of child and family services cases,

2) the standards, processes and protocols for the transfer of child and family services cases between child and family services authorities,

3) the excessive workloads managed by front line social workers in the child and family services system, and

4) other issues relevant to Manitoba’s child welfare system.

The Liberal Caucus hopes that the government’s external review into CFS will consider carefully the information below in making its recommendations.


II. Core principles which Manitoba’s child welfare system has failed to live up to

1) Jordan’s Principle: In every decision, the needs of the child must take precedence.

This is the most obvious principle for any child welfare system, but it is one that CFS has been unable to live up to.

Considerable attention has been paid to the case of young Jordan. Jordan was an aboriginal child who was removed from his community and placed in a hospital at birth because of major medical problems. At age two, Jordan was ready to go back home to his community but was unable to do so due to bureaucratic in-fighting between the provincial and federal governments over the cost-sharing of his medical treatment. Because government put young Jordan’s needs second to those of finance officials, Jordan died at the age of four in a distant hospital without ever having the opportunity to live in a warm, caring home within his community. This tragic case illustrates clearly that the provincial government does not take seriously enough the basic principle that the needs of the child must take precedence over other concerns.

The Manitoba Liberal Party strongly supports making Jordan’s Principle the foundational principle for all decisions within CFS and the provincial government. As illustrated above, it is a principle that is not universally reflected in the decisions of the provincial government and its agencies. The provincial government must act to ensure that, where there are debates over issues of who pays costs, it is the provincial government that steps forward in best interests of the child and subsequently takes appropriate action to settle and recover costs.

2) Family Support Principle: No child should be placed in care simply because of a lack of basic parental supports to the family.

Our caucus heard of a mother who went to Manitoba’s child welfare system to ask for some assistance at a time when she was having difficulties coping as a parent. Shortly after meeting with representatives within the system, the mother had her child taken away from her and placed into care despite no readily apparent or imminent threat to the safety of the child.

The long-run emotional cost to the child and parents (as well as the long-run financial cost to our child welfare system) is simply far too high to have children taken away from parents when all that is needed is better support for parents facing short-term difficulties. When parents fear their children may be taken away, they are reluctant to ask for help which in turn can actually increase the longer-run risk to the child.

It is the view of our caucus that it makes much greater sense to have a child welfare system that provides empowering and nurturing support for parents looking after their child rather than seizing children from families experiencing short-term, non-threatening difficulties.

3) Safety in Care Principle: Children in the care of child and family services agencies should be placed in model, loving and caring homes.

Time and time again, our caucus has heard of children who report having had very difficult and disturbing experiences (including physical, emotional and sexual abuse) while supposedly in the “care” of the province. The numerous reports of children dying by way of homicide while in care speak volumes regarding the dangers experienced by children in CFS care. In the last six years alone, some 31 children have been reported to have died, by homicide, while in care, or shortly after leaving care.

The Manitoba Liberal Caucus condemns the provincial government for allowing conditions within our child welfare system get to such a point on its watch.


III. Major concerns with conditions and practices within CFS and Manitoba’s child welfare system

1) Case overload due to inappropriate utilization of the child welfare system

A major concern the Liberal Caucus has with the current child welfare system is that there are children being placed into care when they do not necessarily need to be in care. Putting a child in care should be a last resort, used only when there is a clear and apprehended threat to the safety of the child. Too often, we are seeing cases where CFS is using removal of children from the home (with accompanying emotional consequences on child and family) in place of more appropriate forms of assistance and support to parents.

We believe that the child welfare system is in desperate need of better intermediate and preventative supports that can be provided to children and their families in cases where there is a far smaller risk to the child’s safety. An approach is needed that provides better support for children inside the home and decreases the need or likelihood of a child being placed in care in the first place. We see no obvious need to use the most invasive form of child welfare response – apprehension – in every case where assistance is required. In fact, filling a high risk case system with lower risk cases only overloads the system.

Standards, processes, and protocols for placing children in care must therefore be reviewed right alongside a full investigation of the family support system needed to ensure children who do not have to be put into care will not be put into care. The West Region of Manitoba has had some success in this area and its efforts need to be extended to other areas of the province.



2) Children in care often do not receive optimal care

We have heard a number of horror stories from adults who have been in care of Manitoba’s Child and Family Service system who are only now willing to talk about their experiences. These include children who were exposed to physical and sexual abuse while in care, and children who were placed in environments where they started taking drugs or joining gangs.

It is the view of our caucus that there is a clear and pressing need to open up the CFS system to investigation and to listen to the stories and experiences of those who have been in care. Only by shining the full light of public scrutiny on CFS can we ensure that the mistakes of the past will not be repeated.

3) Inadequate transitioning assistance for children leaving care

A third major concern is that when children leave care they are inadequately followed up and inadequately transitioned. The transition out of CFS care into a new and unfamiliar situation is obviously a high risk period for any child and there needs to be close attention paid on each of these cases. While some children in care have had substantial and positive transition experiences (in some cases, with children staying with their foster parent after they turn eighteen), there are other cases where children are literally dumped on the street when they leave care.

It is our view that there is an urgent need for CFS to provide a more consistent and successful transition process for children leaving care. There also needs to be a shift to a child welfare system that does a much better job at promoting adoption and providing the transitional support necessary for those who adopt children into their families.

4) Insufficient management of the CFS workplace environment and work standards

The Liberal Caucus has major concerns about the work environment of CFS employees and case workers. We hear regularly that average case loads in the system remain well above professionally-accepted case load maximums for child safety. We also hear on a regular basis that overburdened case workers are simply unable to provide the level of support necessary for case families. While we have heard of wonderful CFS workers doing incredible work on behalf of the children they watch over, we have also heard sadly of workers not adequately performing their duties.

It is our view that a serious effort has to be made to bring the average case load of CFS workers down throughout the system, while at the same time, implementing the practice of requiring a formal signature and short report signed off by both the parent and the worker at the time of a visit as part of an enhanced accountability process.

5) Failure or refusal by the provincial government to comply with numerous existing recommendations to improve CFS

The Liberal Caucus is extremely critical with regard to the accountability of the provincial government in following up on red flags, warnings, and clear instructions from both within and outside the child welfare system. In multiple inquest reports, reports from the Office of the Chief Medical Examiner, and in a report by the Child Advocate, there have been literally hundreds of recommendations made to improve Manitoba’s child and family services system in the past six or so years – many if not most – of which remain unimplemented. The record of the current NDP government has been particularly atrocious in this respect, and logically, there is great skepticism about whether effective change will be achieved even if good recommendations are made by this external review.

Therefore, we believe that this external review must also look at developing a more effective mechanism for holding the provincial government to account for its consistently inadequate implementation of CFS recommendations.

6) The use of ADHD and anti-depressant medications in children in care

A worrisome aspect we have heard time and time again is concern that there may be excessive treatment of children in care using drugs for Attention Deficit and Hyperactivity Disorder (ADHD) such as Ritalin and an associated use of antidepressant drugs.

Manitoba has the highest per capita use of Ritalin and anti-depressants of all provinces. From 1999 to 2004, per capita use of ADHD medications in Manitoba increased by more than 100% from 7.6 to 15.8 for ages 4-17. In contrast, per capita use of ADHD medications in Saskatchewan was reduced by 12% during the same period. An examination is needed to determine why there has been such a dramatic increase in ADHD drug use in Manitoba.

We were unable to get specific statistics on the use of ADHD drugs in children in care in Manitoba. We are therefore quite concerned about the anecdotal evidence provided which suggests overuse of these drugs for children in care.

It is quite worrisome that (as the Minister of Health himself admitted during estimates in the Legislature) Manitoba has no standards for the use of Ritalin for children in care. Standards for the use of Ritalin and other ADHD drugs by children in care need to be set and more research needs to be done in this area.

A further concern is the accumulating evidence that the overuse of these prescription drugs many in fact act as a gateway for more harmful non-prescription drugs such as crystal meth. One ADHD drug, Dexedrine (dextroamphetamine), is closely chemically related to methamphetamine (crystal meth), and others like Ritalin are chemically related.

It is the Liberal Caucus’ view that a review of the use of Ritalin and other ADHD drugs for children in care must take place in order to put in place standards for such use and to reduce overall drug use among children in care where possible. We believe this external review into CFS needs to take as serious look into the issue of over-medicating children while in care and the longer term consequences to the child of being exposed to drugs within the CFS system.



7) Insufficient action on preventing Fetal Alcohol Spectrum Disorders (FASD)

The Liberal Caucus has consistently heard from individuals involved with Manitoba’s child welfare system that too little attention is paid by the provincial government when it comes to preventing FASD. By failing to take a harder line on FASD prevention, the current government is turning a specific and identifiable public health problem (reducing alcohol consumption during pregnancy) into a complex, resource-heavy, socio-medical CFS problem (the complex behavioural consequences of FASD).

Therefore, we recommend the external CFS review look more closely at the deeper causes of the current child welfare crisis in Manitoba. There needs to be significant improvement across government in preventing FASD through better training and integrated public health approaches. An FASD screening program must be implemented so that the incidence of FASD is known and the effects of interventions designed to reduce FASD can be properly measured. All children in CFS care must be screened for FASD and foster parents with children with FASD need to have received training in raising children with FASD. Finally, improved research is needed into the extent of FASD and management practices around these disorders.

8) Over-reliance on warehousing children in institutional environments instead of placing them in foster homes

The shelter system within Child and Family Services in Manitoba has significant issues that need to be addressed. Within CFS, there is an over-reliance on placing children into institutions or even group homes rather than in high quality foster homes. While children are being essentially warehoused in institutional environments, they appear to be at greater risk for learning bad habits and inappropriate behaviours from other children. We have regularly heard of youth becoming involved with drugs and gangs in such places, and we question whether enough effort is being made to place children in foster homes.

The excellent report by Mirwaldt, Perron, & Thomas on Emergency Assessment Placement Department (EAPD) Shelter System, (Office of the Children’s Advocate, March 2004) provides many solid recommendations which have never been implemented. On page five of their report, mention is made of the “lack of community resources” to care for high needs children and youth with the result that children end up in shelters where staff are “ill-equipped and or supported to meet these needs.”

Our caucus therefore would like to see the external review examine the shelter practices within CFS to determine if enough emphasis us being put on placing children in care into secure and nurturing foster homes instead of warehousing children in institutional environments.


IV. Concluding Comments

Aside from the most important goal of ensuring the immediate safety of Manitoba’s most vulnerable children through a properly-run and administered child welfare system, Manitoba’s Child and Family Services system must also be used as a vital resource for preventative measures that will protect the lives of vulnerable children in the future.

Providing good homes and proper care for children in advance can mean huge cost savings to the provincial government down the road. As one example, studies in Alberta, Ontario and Nova Scotia have revealed that over half of the children in the custody of the justice system have had past or present child welfare status.[1] As Green and Healy further point out, experience in Saskatchewan shows that too many young people end up in custody of the justice system because of poor quality of care in the child welfare system or in the mental health system.[2] From what our caucus has been told by individuals involved in child welfare in Manitoba, the situation is similar in our province. A dramatically improved child and family services system in Manitoba will yield significant savings in the justice system. Again, from what we have been told in our experience as MLAs, there are also considerable savings to be made in the education system from an improved CFS system.

At its core, what we suggest to you is that the way in which human and financial resources have been utilized needs to be done much better than it has been in the past. For instance, it appears that too much money is spent on drugs like Ritalin and anti-depressants for children in care while at the same time too little money is spent on ensuring an appropriate ratio of CFS workers to children in care.

The Liberal Caucus believes that the most direct problem that exists within Manitoba’s CFS system is the lack of action and accountability by the Minister responsible for Child and Family Services. Hundreds of important and helpful recommendations have not been implemented by her government. The inadequate performance of the present government and its ministers is making the jobs of dedicated and hard-working child family services workers next to impossible.

[1] Geigen-Miller, M. “Policy Implications and Implementation Strategies for Section 35 of the Youth Criminal Justice Act,” (Ottawa, National Youth in Care Network, 2002) quoted in Green, Ross Gordon and Kealy, Kearney F. Tough on Kids: Rethinking Approaches to Youth Justice. (Purich Publishing Limited, Saskatoon, 2003). p 59.

[2] Green, Ross Gordon, Kealy, Kearney F. Tough on Kids: Rethinking Approaches to Youth Justice. (Purich Publishing Limited, Saskatoon, 2003). p 55.