Archive for August, 2018

MCFD Decision-making via Renee Miller

August 18, 2018


MCFD Decision-making via Renee Miller fb page, Against MCFD- Parents fighting for second chances

The Law Society lists as:

“Parents, some important news and updates from the Supreme Court about the judicial review of MCFD decision-making. I am a defence lawyer on Vancouver Island. I am not taking any new clients, but I know this information is valuable to you and so I share it with you here. The Supreme Court weighed in on an important issue yesterday (July 25, 2018) about the judicial review of MCFD decisions which has not been made previously available to parents.

Currently, any child, young adult, parent, or representative of any of those three may at any time request an administrative review of any decision, act or failure to act of the MCFD (social worker) that relates to a service to a child, young person, young adult or family member under s. 15 of the Child Family and Community Service Regulations. When you request this form of administrative review under s. 15 of the Regulations, the MCFD has 30 days to complete their report. The request for an administrative review can be made to your social worker directly (although I don’t recommend that option because the social workers may not be aware of their statutory obligations and delays beyond the 30 days can occur), or through the complaints line at 1-877-387-7027.

You do not need a lawyer in order to engage with this part of the MCFD administrative review. The complaints specialist on the other end of the phone is a social worker in another jurisdiction who will review the decision of the MCFD. The complaint specialist will ask you if you want a resolution or an administrative review. If you chose the resolution, you will not have exhausted your internal administrative review remedies and you will not be able to proceed to Supreme Court on a judicial review. I am not suggesting that a resolution may not be appropriate, and you are welcome to try that option first and if the outcome is unsatisfactory then follow-up again and ask for the administrative review under s. 15 of the CFCS Regulations.

I have requested administrative reviews for the following kinds of MCFD decisions: removal of a child from a non-consenting parent pursuant to a safety plan, the decision to remove First Nations children from their First Nations school and put them in public school absent the cultural consultation that was agreed to at mediation, the MCFD refusal to provide a second mediation to a client when the second mediation was promised in writing to that parent, imposition of a safety plan that resulted in the removal of a parent from the home when the MCFD had only a suspicion of possible future domestic violence, causing that family financial stress. Complaints could equally be made about MCFD decisions to move children between foster homes.

The MCFD Complaints Process brochure that is available at the Justice Access Centre and the MCFD offices tells parents that ineligible complaints include “a complaint about any matter that is currently before the court.” THIS IS NOT TRUE. All of the above examples I provided were for clients who had matters currently before the provincial court. The Supreme Court asked the MCFD to amend this publicly available information so that parents are aware of both their rights of administrative review, and then the option of judicial review in Supreme Court of MCFD decisions.

Parents will always receive a letter from the MCFD following the completion of an administrative review. In that letter the MCFD will suggest to you that if you don’t believe the MCFD has followed a fair process that you can request an external review through the Ombudsperson. This is misleading. The Ombudsperson has no authority to review decisions of the MCFD until your judicial review options in Supreme Court have been exhausted (see s. 11(1)(a) of the Ombudsperson Act.) Also, don’t try to get the Representative of Children and Youth to help you, they can’t review decisions of the MCFD absent critical injury or the death of a child (see s. 6(1)(c) of the Representative of Children and Youth Act).

Parents, when you are unhappy about the outcome of an administrative report, your next step is a judicial review of the original MCFD decision in Supreme Court. It will be nearly impossible for you to take this next step without assistance from counsel. In order to have the MCFD judicially reviewed in Supreme Court you will have to first ask for the Supreme Court to waive your $200.00 filling fees (the people I represent in criminal law never have to pay a filling fee to have the Supreme Court review their bail/sentence or conviction). I personally believe that it is a s. 7 Charter violation to ask a parent to have to pay a $200.00 filling fee to attempt to hold the MCFD accountable for their decision making.

The “Order to Waive Fees Package” is available on the Supreme Court website under Supreme Court Information Packages. You can take this information with you to the Justice Access Centre and a lawyer there can help you fill out the paperwork. You can fill in by hand the financial statement, the educational and employment history and work place skills portions. You will need to type out the Order to Waive fees portion (for the Court), and you will also need to attach a draft petition to your request to waive fees.

I will make sure that the Justice Access Centre has precedents to help you. If your lawyers need copies of any of those precedents please ask them to email me. The petition engages the involvement of the Attorney General, who then replaces the local Director counsel who normally represents the MCFD in provincial court. You submit the application to Waive Fees to the Registry and the Master will review your paperwork. It usually takes about two weeks for the Court to decide whether your fees will be waived. The registry will charge you $40.00 to notarize your affidavits, so I strongly encourage you to use the local Justice Access Centre offices. Legal Aid is in the process of starting specialized Child Apprehension offices on the island, and lawyers there will also be able to help you. The lawyers have been hired and those resources should be available to you soon.

The petition in Supreme Court challenges the ORIGINAL decision of the MCFD. It doesn’t matter how bad the administrative report may be, the Supreme Court presently believes that the review authority is immune from judicial review because the review authority can only make recommendations. The original MCFD decision itself is not a recommendation, and as long as your legal rights as a parent have been breached you will have a cause of action for judicial review against the MCFD in Supreme Court under the Judicial Review Procedures Act. In order for the Supreme Court to review the MCFD, you must have first completed the administrative review process under s. 15 of the CFCS Regulations. The Supreme Court will want to review the recommendations in that report.

I believe that judicial reviews of MCFD decision making are half the work of child protection law. Legal aid, however, believes that judicial review of MCFD decision making is currently beyond their funding mandate. That mandate may well change with the advent of the specialized CFCSA clinics that are due on the Island. I tell my clients that I will gladly pursue a review of the MCFD, but that the hours I have been given on the legal aid referral will be used entirely on the Supreme Court matter and you may or may not qualify to receive a second referral for the on-going provincial court CFCSA issues.

I hope this is a helpful overview of the full MCFD review process. Please know I am never on Facebook and if I don’t reply to you it is not because my heart does not go out to you for the sheer enormity of the task ahead of you. I believe that legal reform must happen to permit parents an easier avenue of judicial review of MCFD decisions. The provincial court is a statutory court with limited ability to review most day-to-day decisions of the MCFD. Only the Supreme Court currently holds that jurisdiction. There is a great deal the government can and should do to help parents review the decisions of the MCFD. This information is province specific, but no doubt the principles are the same in other provinces.”

‪First Biomarker Evidence Autism Is Linked to DDT via @medscape‬

August 17, 2018

First Biomarker Evidence Autism Is Linked to DDT via @medscape

First Biomarker Evidence Autism Is Linked to DDT

Megan Brooks


August 16, 2018

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Elevated levels of a dichlorodiphenyltrichloroethane (DDT) metabolite in pregnant women provide the first biomarker evidence that the banned insecticide is implicated in autism in children, new research shows.

Dr Alan Brown

“This study provides the first evidence, using a marker of an insecticide in the blood, that a pregnant mother’s exposure to this organic pollutant is related to an increased risk of autism in her offspring. Previous studies were based, for example, on proximity to sites that were contaminated with these pollutants,” lead investigator Alan S. Brown, MD, MPH, professor of epidemiology at Columbia University’s Mailman School of Public Health and of psychiatry at Columbia University Medical Center in New York City, told Medscape Medical News.

“The study,” he said, “offers potential implications for understanding a pathway regarding how autism might develop from a prenatal exposure and could have policy implications for public health regarding testing for, and minimizing exposure to, environmental pollutants.”

The study was published online August 16 in the American Journal of Psychiatry.

Autism Trigger?

DDT and other organic pollutants were widely banned in many countries decades ago, but they persist in the food chain, leading to continuous exposure among populations. The chemicals transfer across the placenta, resulting in potential prenatal exposure.

Using the Finnish Prenatal Study of Autism, a national birth cohort study, the researchers identified 778 children with autism born between 1987 and 2005 and a matched control group. Maternal serum specimens from early pregnancy were assayed for levels DDE (p,p’-dichlorodiphenyl dichloroethylene), a breakdown product of DDT.

The odds of autism were nearly one third higher among offspring of mother’s with DDE levels that were in the highest 75th percentile, after adjusting for maternal age, parity, and history of psychiatric disorders (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.02 – 1.71; P = .03).

The odds of autism with intellectual disability were increased by greater than twofold with maternal DDE levels higher than this threshold (OR, 2.21; 95% CI, 1.32 – 3.69; P = .002). There was no association between total maternal levels of polychlorinated biphenyls (PCBs) and autism.

Along with genetic and other environmental factors, our findings suggest that prenatal exposure to the DDT toxin may be a trigger for autism. Dr Alan Brown

These findings “provide the first biomarker-based evidence that maternal exposure to insecticides is associated with autism among offspring,” the investigators write.

“We think of these chemicals in the past tense, relegated to a long-gone era of dangerous twentieth-century toxins. Unfortunately, they are still present in the environment and are in our blood and tissues. In pregnant women, they are passed along to the developing fetus. Along with genetic and other environmental factors, our findings suggest that prenatal exposure to the DDT toxin may be a trigger for autism,” Brown said in a news release.

Important Study, Concerning Findings

Commenting on the findings for Medscape Medical News, Benjamin Yerys, PhD, of the Department of Child and Adolescent Psychiatry and Behavioral Sciences and the Center for Autism Research, Children’s Hospital of Philadelphia, said this study is important because it addresses the question of whether a specific insecticide chemical increases the risk that a child will have autism.

In addition, he said the study was meticulous.

“The investigators measured the chemical directly from blood given by mothers when they were pregnant, and they controlled for other risk factors that increase risk for autism, including parents’ age and their own history of having a psychiatric illness. This has never been done before at such a large scale (~1500 people),” said Yerys.

“The findings raise concern that specific chemicals that were used in insecticides over 30 years ago may still exist in our food chain today and they may add risk for a child to develop autism,” said Yerys.

He noted that other studies using slightly different methods to measure the insecticide exposure in mothers and smaller samples have had different results.

“These mixed findings suggest we still have much to learn about how the insecticide exposure is adding risk, and if it adds risk for all people or only some people. We also do not have a great understanding of what mothers can do to reduce or prevent the risk that is added from insecticide exposure. Therefore, it is too early to make recommendations about how to change prenatal care or screening,” said Yerys.

“We do not know if a mother must have a specific genetic or biological makeup that makes her body more susceptible or resilient to the insecticide toxin. So this insecticide toxin may add risk for a specific set of women but not others,” he added.

The study was supported by the National Institute of Environmental Health Sciences. The authors and Dr Yerys have disclosed no relevant financial relationships.

Am J Psychiatry. Published online August 16, 2018. Abstract

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The Evolution of Safe Transport Systems for Infants, Children and Maternal Patients in Canada- A Journey to Excellence

August 2, 2018

The Evolution of Safe Transport Systems for Infants, Children and Maternal Patients in Canada- A Journey to Excellence

Submitted by: 

Dr. Allan de Caen, Pediatric Intensive Care Consultant and Clinical Professor of Pediatrics at the Stollery Children’s Hospital / University of Alberta

Kate Mahon, Executive Director of the Trauma Association of Canada

Not all Canadian infants and children have immediate access to tertiary level care, due in part to Canada’s regionalization of pediatric-subspecialty care in the last 40 years and how regional health care is resourced. This means that efficient transfer of critically ill and injured infants and children over the long distances between referral hospitals and accepting tertiary care pediatric centers has become more and more necessary.

Many medically-fragile infants and children are often transported by health care teams that are expert in adult transport services but are often limited in their training and experience in neonatal and pediatric acute care. Challenges have existed for these health care teams in providing a consistent and adequate level of neonatal and pediatric acute care to those infants and children being moved between Canadian health care facilities.

The challenges are amplified when the tools and vehicles to safely transport these patients are few and far between.

Kate Mahon, Executive Director of the Trauma Association of Canada, paints a vivid picture as she recounts working as a PICU nurse at the IWK Health Centre in Halifax, Nova Scotia in 1982.

If a critically ill child needed to be transported to the IWK, our first call would be to the Canadian Armed Forces Air Search and Rescue Squadron (located in Greenwood, NS or Summerside, PEI). If available, a Sea King Helicopter or C-130 Hercules aircraft would be dispatched with the caveat, “if we get a call of a ship in distress you will be diverted with us in that Mission”. In such a large aircraft, our neonatal team would be harnessed in, so they would not fall over in flight as we tended to our patients.

In a scenario where neither of these aircraft were available, we had to “shop around” to find a private ambulance service or even private transport helicopters shuttling workers to and from oil rigs to assist in the transport. Given that most of these private services had no specialized pediatric critical care experience, an extra stop would be made to pick up a member of our team to ensure appropriate care was delivered to the paediatric patient on-route.

These challenges and barriers continued to plague the neonatal and paediatric transport field for years.

At a national symposium entitled “Transport Systems: Moving our Children across Systems – Challenges, Barriers and Enablers,” held at CAPHC’s 2008 Annual Conference in Edmonton, delegates identified the need to develop national standards for the inter-facility transport of critically ill newborns, children and youth. At the time there were no Canadian standards to guide the safe and competent care of infants and children during transport.

As a result of that session, CAPHC, later that year established a National Transport Systems Steering Committee comprised of multidisciplinary experts from across the country that began to address this issue. Determined to raise the bar, work by this group resulted in the establishment of a tool that would drive the education standards for health care providers involved in the interfacility transport – Competencies Profile-Interfacility Critical Care Transport of Maternal, Neonatal, and Paediatric Patients.

The group also lobbied Accreditation Canada to revise their EMS standards to incorporate the minimum standard of care that one should expect for the transport of acutely ill infants and children when being moved between Canadian health care facilities, citing the CAPHC work as a reference. The result was “Accreditation Canada EMS and Interfacility Transport Standards” which outlines the minimum standard for air and ground ambulance and interfacility (emergent and non-emergent) transport of infants, children (and adults).

Today, this national working group continues to work together to resolve educational and equipment challenges that are faced by transport teams while willingly sharing solutions and innovations in moving acutely ill infants and children (and maternal patients) between health care facilities across Canada.