L.P. v. Catholic Children’s Aid Society of Toronto, 2016 CFSRB 11

L.P. v. Catholic Children’s Aid Society of Toronto

REASONS FOR DECISION

Date: April 7, 2016

Citation: 2016 CFSRB 11

Indexed as: L.P. v. Catholic Children’s Aid Society of Toronto

(CFSA s.68)

INTRODUCTION

1L. P. filed an application with the Child and Family Services Review Board (the “Board”) pursuant to subsection 68.1(4) 4 and 5 of the Child and Family Services Act, R.S.O. 1990, c.C.11, as amended (the “Act”), against the Catholic Children’s Aid Society (the “Society”) on January 22, 2016.

2The Application consisted of the following complaints under s.68.1(4)4 and 5 of the Act, as summarized in the Pre-Hearing Report dated March 4, 2016.

That the Society has not heard the Applicant’s service concerns or heard her when decisions were made and has not provided her with reasons for decisions that affected her interests, regarding the following concerns:

1. Her son’s repeated lateness for school;
2. Her son’s hygiene;
3. The delay in her son’s dental surgery for wisdom teeth and funding related to the surgery not being met; her son’s bunions not being attended to in a timely fashion;
4. Documents such as medical reports and school records, that she believes she is entitled to, are not being provided to her.

3The Board must decide whether or not the Applicant’s concerns were heard by the Society and whether or not the Society gave the Applicant reasons for its decisions. The hearing on the merits was held on March 21, 2016. The Board heard testimony from the Applicant and from the Society’s Child Worker (the “Worker”) at the hearing.

4For the reasons set out below the Board finds that the Society did hear the Applicant’s concerns as required by section 2(2)a of the Act, and that the Society did provide her with reasons for the decisions made in response to those concerns as required by section 68.1(4) 5 of the Act.

BACKGROUND

5The Applicant is the mother of the child [ ] (the “Child”), who will reach his 18th birthday on […], 2016.

6The Society has been involved with the family over two separate periods of time. From January 1998 through November 2000, the Society was involved in arranging for the Child’s placement with his maternal grandmother (the “Grandmother”). This placement was made under a supervision order from the court. The file was closed when the Grandmother received full custody of the Child.

7The second major involvement commenced on June 19, 2013, when the Child exhibited significant deterioration in his behaviour. He had been diagnosed with ADHD, but was not taking his medications. His behaviour was spiraling out of control, and became too challenging for the Grandmother to deal with. On June 24, 2013, the Child was apprehended, and placed in the residential facility of a local Children’s Mental Health Centre. On August 26, 2013, the Child was placed in a residential Group Home setting, in a community close to the Applicant’s home. Society wardship was obtained.

8The Society’s plan was to seek a Crown Wardship order from the court at the next hearing scheduled for April 25, 2016. This plan had the full support of the Child. This would have allowed the Society to continue to provide support to the Child, both emotional and financial, until age 21.

9A significant aspect of the Child’s situation and of the Society’s plan for Crown Wardship is that the Child was adamant that he did not want any contact with the Applicant. During his placement at the Group Home, he usually went to his Grandmother’s home on week-ends. Effectively, the Grandmother’s home was, for the Child, his “home”. The service plan of the Society, developed in conjunction with the Child and with the Grandmother, was based on the reality that the Child wanted no contact with his mother, that the Society was very willing to provide major support to the Child for the three years after his 18th birthday, and that the Grandmother would remain his “home”, even when the Child would leave the Group Home. The Society’s Plan of Care meetings did not involve the Applicant, in line with the Child’s wishes. The Child’s Grandmother was invited to those meetings, and usually attended.

ANALYSIS

10The relevant provisions of the Act are as follows:

2(2) Service providers shall ensure,

(a) that children and their parents have an opportunity where appropriate to be heard and represented when decisions affecting their interests are made and to be heard when they have concerns about the services they are receiving;

68.1(1) If a complaint in respect of a service sought or received from a society relates to a matter described in subsection (4), the person who sought or received the service may,

(a) decide not to make the complaint to the society under section 68 and make the complaint directly to the Board under this section;

68.1(4) The following matters may be reviewed by the Board under this section:

1. Allegations that the society has refused to proceed with a complaint made by the complainant under subsection 68(1) as required under subsection 68(2).

2. Allegations that the society has failed to respond to the complainant’s complaint within the timeframe required by regulation.

3. Allegations that the society has failed to comply with the complaint review procedure or with any other procedural requirements under this Act relating to the review of complaints.

4. Allegations that the society has failed to comply with clause 2 (2) (a).

5. Allegations that the society has failed to provide the complainant with reasons for a decision that affects the complainant’s interests.

6. Such other matters as may be prescribed.

68.1(5) Upon receipt of a complaint under this section, the Board shall conduct a review of the matter.

68.1(7) After reviewing the complaint, the Board may,

(a) order the society to proceed with the complaint made by the complainant in accordance with the complaint review procedure established by regulation;

(b) order the society to provide a response to the complainant within a period specified by the Board;

(c) order the society to comply with the complaint review procedure established by regulation or with any other requirements under this Act;

(d) order the society to provide written reasons for a decision to a complainant;

(e) dismiss the complaint; or

(f) make such other order as may be prescribed.

11In P.O. v. Family and Children’s Services Niagara, 2012 CFSRB 33 at paragraphs 13-14, the Board described the purpose of s.68.1(4) and (5) as follows:

The obligations under s. 68.1(4)4 and 5 reflect the importance of active participation for parents, providing them with the opportunity to have some degree of influence in the process. This is facilitated through genuine communication, giving applicants the opportunity to have input into decision making and to have enough information to make informed responses to, or accept decisions.

To be heard involves active listening, discussions, the society’s taking steps to address the Applicant’s concerns and communicating this to her so that she feels that her concerns are taken seriously and dealt with thoroughly.

12To meet the statutory obligation reasons must be timely and detailed and the Applicant must be given sufficient information to understand what factors were considered in making a decision and why.

13The Board examined in detail the four issues listed in the Pre-Hearing Report, as follows.

14In response to the Applicant’s complaints to the Board, the Society submitted a lengthy letter, dated February 8, 2016, to the Applicant and to the Board, detailing the Society’s explanations and reasons for its actions on the four issues that are the subject of this hearing. As well, the Society provided extensive evidence at the hearing by the Child Protection Worker [ ].

Issue 1: Her son’s repeated lateness for school.

15The Applicant in her complaint alleged that the Child had a very high number of late arrivals at his school. He is taking courses at various grade levels. In report cards submitted in evidence, the teacher’s comments are generally positive. However, the question is raised by the school: “What is reasoning [sic] to [name] showing up late so many times?” The Applicant testified that, when the Child returns to live with his Grandmother, he will be enrolled at a different special program in the downtown area.

16The Worker testified that this issue of school lateness had not been brought to his attention until early this year, when the Grandmother called him about it. The Applicant did not call the Worker on this issue. The Worker spoke with the Group Home supervisor to learn more about the practices in the Group Home around school attendance, and what might be the circumstances leading to the late arrivals at school.

17The Society did not dispute this fact of his numerous late arrivals at school. The Society explained that this situation occurred for the following reason. When the Child was living in the Group Home, he and a number of other residents were driven to the school together in a Group Home vehicle. Group Home residents are often dealing with issues that are problematic, and school attendance is frequently one of these issues. Whenever any one of the residents travelling with the group had difficulties getting ready for school, for any one of a number possible reasons, it would result in a delay for the Group Home’s vehicle departure for the school. The Worker testified that the Group Home is aware of this problem, and is working at resolving this issue.

18The Worker also put a perspective on the lateness issue, which mitigates some of the negative consequences of a late school arrival. The consequence would be much more serious if a resident was attending regular classes, which always start at a given time. Most of the residents, including the Child, did not attend regular classes, but were enrolled in a “Section” program. These Section programs provide for highly-individualized small-group programming for each student, and the impact of a late arrival does not carry the same consequence as arriving late to an already-started regular class.

19The Worker testified that he responded to the Grandmother, who had made the complaint, by calling her and giving the reasons for the lateness at school.

20The Board finds that the Society did give reasons and an explanation for the issue of the Child’s repeated lateness at school.

Issue 2: Her son’s hygiene.

21The Applicant stated that the Child had very bad hygiene habits while in the Group Home over the last few years. She testified that he would not shower, that he was not getting haircuts, and that he was reluctant to use the shared facilities at the Group Home. She indicated, in contrast, when he visited on week-ends at his Grandmother, that his grooming habits improved substantially. She also indicated that he could not get haircuts while in the Group Home, because the staff did not supply money for such activities. She complained that the family ended up having to pay for the cost of haircuts.

22The Worker testified that this issue was raised with him by the Grandmother, and not by the Applicant.

23The Society expressed its position on this issue both in its February 8, 2016 letter to the Applicant and to the Board, and through the testimony of the Worker. He testified at the Hearing that his understanding is that the Child’s hygiene habits have been good at the Group Home. He has visited the Child regularly at the Group Home, and has discussed this issue with the Group Home staff, who reported to him that the Child’s hygiene habits are good, that he showers daily, and the Group Home staff expressed the concern that the Child does not follow through with his good hygiene practices when he visits at his Grandmother on the week-ends. The Group Home staff also indicated that the Child struggles with cleaning his bedroom on a regular basis.

24The Worker explained that the Grandmother was the “point person” for the Society, since she had cared for the Child for most of his life and since the Child had effectively broken off contact with the Applicant, until mid-December 2015. The Worker also reminded the Board that it was the Grandmother, and not the Applicant, who regularly attended the Plan of Care meetings at the Society.

25The Board finds that the Society did give reasons and an explanation for the issues relating to the Child’s hygiene.

Issue 3: The delay in her son’s dental surgery for wisdom teeth and funding related to the surgery not being met; her son’s bunions not being attended to in a timely fashion.

26The Applicant testified that she believes that the Society has unduly delayed the dental work on the Child. In fact, she alleges that this delay has caused him pain, and, most recently, an infection for which the Child needed to take a 14-day regimen of antibiotics. When asked if she had been given reasons by the Worker for the delays, she responded that she has not been able to reach him, and that “he is always on holidays”.

27A major part of the Applicant’s complaint dealt with the issue of the costs of the required dental work. She stated that she and her family have now become burdened with the costs of the required dental work.

28The Worker testified that on this issue, the Grandmother was the contact point for the Society and for the Worker. He related that, for a week or two in May 2015, there was some low-key contact between the Child and the Applicant. However, the Child very quickly complained about the Applicant’s texting to him, and the Child again took the position that he wanted no more contact with the Applicant. Thus, the contacts relating to the dental issue were between the Worker and the Grandmother, until the Applicant became involved again in mid-December 2015. Since that date, the Applicant has also been contacting the Worker, who has been responding to both the Grandmother and the Applicant.

29In essence, the complaint focusses on the delays in obtaining the necessary dental work, and the fact that the family has paid for most of the dental work. The Child has complained about pain at various times during the periods of delay.

30The Worker has explained to both the Grandmother and to the Applicant the circumstances of the delays. The Child’s dentist was prepared, at various times, to proceed with the required dental work. This, however, was not accepted by the family. The Applicant was insisting, because of the extent of the dental surgery required, that the work had to be done in a hospital setting. The dentist did not agree that a hospital setting was required for the work that was planned. The family rejected the dentist’s professional opinion, and continued to insist on the need for a hospital setting.

31The Worker explained to the family that there were two principal reasons for the delay, namely the disagreement about the appropriate venue for the dental work to be performed, and the fact that a referral to a hospital cannot be made directly by a parent, but such referral must come from a dentist or physician. Thus, the Grandmother did not have standing to refer the situation to a hospital, as such a referral required that it come from a dentist, and the dentist who was to perform the work did not believe that a hospital was needed, yet he was the only professional familiar with the case who could make such referral.

32With regards to the payment of the costs of the dental surgery, the Worker testified that the Society’s dental insurance card was sent to the dentist. This would have resulted in the Society paying the full cost of the work, if done by the dentist. It had been pointed out that the Society was committed to paying for any work that would not have been covered by the Society’s insurance plan. The Worker testified that the Grandmother had told him that it was the Applicant’s firm position that she wanted the costs of the dental work to be paid for by the insurance plan available at her husband’s place of employment. The Grandmother added that somehow the Applicant did not trust the Society to come through with the payment for the dental services. It was the Worker’s opinion that the issue of the payment being made by the Society or by the Applicant’s spouse’s insurance plan was not a factor in the delay in getting the work done. The Worker on a number of occasions in his testimony gave as the reasons for the delay the disagreement between the family and the dentist as to the need for hospitalization.

33These reasons for the delay in the dental work and the timeline of changed dates were also documented by the Society in an e-mail dated January 5, 2016 from the Society staff [ ], submitted in evidence by the Applicant. The e-mail repeats the reasons for the delays as being the insistence on a hospital setting for the dental work. The e-mail also confirms the Worker’s stated reasons behind the issue of the costs: “The Society dental card was faxed to the said dentist but [Grandmother] insisted that she use [the Child’s] step-Dad’s dental benefit.”

34The dental work did get done in January 2016 by the dentist at the emergency dental clinic, and the Child’s four wisdom teeth were extracted in three separate visits.

35The concerns about the bunion were raised not by the Applicant but by the Grandmother, in 2014. The perception of the family is that nothing was done on this issue, and that it continues to be a problem for the Child.

36With regards to the bunions on the Child’s feet, the same allegation is made that the Society caused undue and repeated delays. The Applicant submitted into evidence a report dated June 28, 2013 (less than one week after the Child’s apprehension) from a local hospital clinic, which confirmed that he had a bunionette on his foot, and which suggested it may be related to inappropriate footwear. The report recommended that surgery not be performed, but rather recommended trying an orthotic for the next year or so.

37The Applicant submitted into evidence a Consultation Report from the local hospital, dated June 28, 2013 (less than one week after the Child’s apprehension). This report confirms that the Child “. . . has had a bunionette for the past few years.” The report also states “We would not wish for him to have surgery unless it is quite bothersome to him. Surgery is often painful and then also leads to recurrence. [. . .] We will follow him on a p.r.n. basis.” The report is clear that the Child had the bunionette a few years before his apprehension, and that subsequently there was a medical recommendation against surgery. The Society acted in accordance with medical advice on this issue, and that was the reason for its decision to not plan for more intrusive intervention on this issue.

38The Worker in his testimony explained that when concerns were expressed over the bunion, a referral was made to a physician for a consultation and remedy as needed. On at least two occasions, when a medical appointment had been set up, the Child would tell the physician that the bunion did not hurt him. This led to the physician not prescribing a surgical intervention, but rather suggesting better footwear and orthotics.

39The worker explained to the Grandmother, and very recently to the Applicant, that the reason for no active intervention being performed on the bunion was that the Child indicated that he was not suffering any pain from the bunion each time he saw medical personnel. As things now stand, there is another referral for an appointment that has been made to again have the situation assessed medically.

40The Board finds that the Society did give reasons and an explanation for the issues relating to both the delay in the dental work and the issues surrounding the Child’s bunion.

Issue 4: Documents such as medical reports and school records, that she believes she is entitled to, are not being provided to her.

41At the hearing, the Applicant withdrew the portion of issue 4 dealing with the school records.

42The Applicant complained that, since the Child was admitted into the care of the Society, she has received only very infrequent and sparse medical reports. She did receive a report at one time when he was taken to the family doctor, but substantially she has not received medical reports on a regular basis.

43She specifically referred the Child to a psychiatrist, [ ], who saw him last year, but she has never received a report of that medical contact.

44The Worker had previously explained to both the Grandmother and to the Applicant that, with children over the age of 16, medical information is not routinely shared with parents or guardians, as a child at that age gains the right to confidentiality over his medical issues. The Child always has the option of sharing information or reports with a parent or guardian, but that is his or her choice.

45The Applicant in the recent past, and also in her evidence at the hearing, had requested that the Society provide her with a copy of the full medical records. The Worker indicated that this would not be done, for the reason of confidentiality of the Child over his medical records. At discharge from the Society’s wardship, the Applicant will be given a full copy of his medical records. It will be the Child’s decision as to what if any part of his medical record he wants to share with his Grandmother or with the Applicant. The Worker explained that these reasons apply to any situation of an older child leaving the care of the Society.

46The Board finds that the Society did give reasons and an explanation for the issues relating to access to the Child’s medical records by persons other than the Child.

CONCLUSION

47The Board recognizes the following dilemma: the Applicant is the person who made the complaints to the Board in her January 22, 2016 application, yet most of the issues as they became relevant had been brought to the Society’s attention by the Grandmother, in whose home the Child grew up.

48The Society regularly discussed with the Grandmother issues as they arose, and gave her its reasons and explanation when decisions were made. The Board also recognizes that the Child’s choice was to not have any significant interaction with the Applicant over the last couple of years, until mid-December 2015. While the Worker has heard the Applicant and given reasons to her since she became involved, the Board recognizes that it is with the Grandmother that most of the discussions and explanations have occurred. During the relevant time frame, the Grandmother was acting as the parent to the Child. The Grandmother was heard by the Society, and was given reasons, in the absence of significant contact with the Applicant during the time period in question.

49When the Applicant became involved after mid-December 2015, the Society’s reasons were given to the Applicant. Having recently become more involved with the Child, she filed her application to the Board on January 22, 2016. In response to the application, the Society’s detailed letter dated February 8, 2016 was addressed to the Applicant, and not to the Grandmother. Through this letter and through the Worker’s testimony at the hearing, the Society did provide her with reasons on its various decisions relating to the four issues in question.

50The Board finds that the Society met its obligations to both hear the concerns expressed and to give reasons for the decisions that the Society has made. The Society has met its obligations as required by the Act, and the Board dismisses the application.

CONFIDENTIALITY ORDER

51The hearing was conducted in private and was not open to the public. Pursuant to Rules 30.1 and 30.2 of the Board’s Rules of Procedure parties and their representatives must not use, share, discuss or disclose any Board documents or decisions or any other documents or information provided or used in this application with anyone including through the media or on-line. The Board prohibits the use of any of this information for any purpose outside of the Board’s proceedings.

JOHN F. SPEKKENS

_____________________

John F. Spekkens Presiding Member