WARNING

The court hearing this matter directs that the following notice should be attached to the file:

This is a case under Part V of the Child, Youth and Family Services Act, 2017, (being Schedule 1 to the Supporting Children, Youth and Families Act, 2017, S.O. 2017, c. 14), and is subject to subsections 87(7), 87(8) and 87(9) of the Act. These subsections and subsection 142(3) of the Act, which deals with the consequences of failure to comply, read as follows:

87.— (7) Order excluding media representatives or prohibiting publication. — Where the court is of the opinion that the presence of the media representative or representatives or the publication of the report, as the case may be, would cause emotional harm to a child who is a witness at or a participant in the hearing or is the subject of the proceeding, the court may make an order,

( c ) prohibiting the publication of a report of the hearing or a specified part of the hearing.

(8) Prohibition re identifying child. — No person shall publish or make public information that has the effect of identifying a child who is a witness at or a participant in a hearing or the subject of a proceeding, or the child’s parent or foster parent or a member of the child’s family.

(9) Prohibition re identifying person charged .— The court may make an order prohibiting the publication of information that has the effect of identifying a person charged with an offence under this Part.

142.— (3) Offences re publication. — A person who contravenes subsection 87(8) or 134(11) (publication of identifying information) or an order prohibiting publication made under clause 87(7)( c ) or subsection 87(9), and a director, officer or employee of a corporation who authorizes, permits or concurs in such a contravention by the corporation, is guilty of an offence and on conviction is liable to a fine of not more than $10,000 or to imprisonment for a term of not more than three years, or to both.

ONTARIO COURT OF JUSTICE

DATE: 2021 04 26 COURT FILE No.: Thunder Bay FO-19-209-00

BETWEEN:

Children’s Aid Society of the District of Thunder Bay Applicant,

— AND —

M.H. (deceased) P.V. Respondents

Before: Justice D.J. MacKinnon

Heard on: February 8, 2021 Reasons for Temporary Care and Custody released on: April 26, 2021

Counsel: M. Chambers, counsel for the applicant society M. Frangione, counsel for the respondent P.V.

MacKinnon, J.:

[1] This is my decision in regard to the temporary care and custody of S. born […], 2019. Her parents are M.H. (deceased) and P.V. The father M.H. was Guyanese Canadian and the mother P.V. is Metis from Northwestern Ontario. Unfortunately, M.H. passed away on January 5, 2021.

Background

[2] The child was apprehended shortly after birth at the Thunder Bay Regional Health Sciences Centre (TBRHSC) as a result of an alert generated from a child protection data base. S. has never been in the care of her parents.

[3] The alert was based on the prior apprehension of the first child of this couple, S.H., who is now in the care of her great grandparents.

[4] S. was born within the jurisdiction of the Children’s Aid Society of the District of Thunder Bay because her mother was at the TBRHSC with the father M.H. who had had a heart attack and was there for medical purposes. The parents ordinarily resided in Fort Frances Ontario, approximately 350 kilometres from Thunder Bay, where the mother still resides. S. is currently in a family placement with her half-sister S.S. and her husband in Thunder Bay.

[5] S.’s mother was induced at 38 weeks as a result of intrauterine growth restriction. She was given Fentanyl by the physicians. Otherwise there were no drugs in her system.

[6] S. has been in care pursuant to an interim interim without prejudice order since July 17, 2019. The parents were unable to retain counsel and had been representing themselves until May of 2020. They were, for some time, assisted by Andrew Johnson, an elder from the Seine River First Nation.

[7] Much of the time in this case was spent determining the jurisdiction of various child welfare agencies in the Fort Frances area, and the status of the child.

[8] The mother was unable to confirm her right to be registered with the Seine River First Nation. However, the evidence was clear and I found on September 15, 2020 that the mother P.V. and the child, S., were Metis, just as members of the maternal family were. Unfortunately, there is no Metis child welfare agency in the Fort Frances area, and the Indigenous child welfare agency there only serves its own bands and their members. This is a service gap in the child welfare system for Metis people.

[9] In the fall of 2020, the child suffered a catastrophic medical event which required her to be taken to Southern Ontario for medical care. She has since returned to Thunder Bay but continues to suffer neurologically. This will be discussed further.

Protection Concerns

[10] The grounds of protection claimed by the agency are:

s.74 (2)(b)(i) there is a risk that the child is likely to suffer physical harm inflicted by the person having charge of the child or caused by or resulting from that person’s,

(i) failure to adequately care for, provide for, supervise or protect the child;

and

s.74 (2)(h) there is a risk that the child is likely to suffer emotional harm of the kind described in subclause (f) (i), (ii), (iii), (iv) or (v) resulting from the actions, failure to act or pattern of neglect on the part of the child ’s parent or the person having charge of the child ;

f) the child has suffered emotional harm, demonstrated by serious,

(i) anxiety, (ii) depression, (iii) withdrawal, (iv) self-destructive or aggressive behaviour, or (v) delayed development.

and there are reasonable grounds to believe that the emotional harm suffered by the child results from the actions, failure to act or pattern of neglect on the part of the child’s parent or the person having charge of the child.

Temporary Care Hearings

[11] The test on a Temporary Care Hearing is set out in subsections 94 (2), (4) and (5) of the Child, Youth and Family Services Act, 2017 (the Act) that read as follows:

94 (2) Where a hearing is adjourned, the court shall make a temporary order for care and custody providing that the child,

(a) remain in or be returned to the care and custody of the person who had charge of the child immediately before intervention under this Part;

b) remain in or be returned to the care and custody of the person referred to in clause (a), subject to the society’s supervision and on such reasonable terms and conditions as the court considers appropriate;

(c) be placed in the care and custody of a person other than the person referred to in clause (a), with the consent of that other person, subject to the society’s supervision and on such reasonable terms and conditions as the court considers appropriate; or

(d) remain or be placed in the care and custody of the society, but not be placed in a place of temporary detention, of open or of secure custody.

Criteria

(4) The court shall not make an order under clause (2) (c) or (d) unless the court is satisfied that there are reasonable grounds to believe that there is a risk that the child is likely to suffer harm and that the child cannot be protected adequately by an order under clause (2) (a) or (b).

Placement with relative, etc.

(5) Before making a temporary order for care and custody under clause (2) (d), the court shall consider whether it is in the child’s best interests to make an order under clause (2) (c) to place the child in the care and custody of a person who is a relative of the child or a member of the child’s extended family or community.

[12] The onus is on the agency to prove that there are reasonable grounds to believe that S. is likely to suffer harm and cannot be protected by a return to the parent, or a return with supervisory terms.

Issues

[13] Has the Applicant agency proven that there are reasonable grounds to believe that S. is in need of protection?

[14] Has the Applicant agency proven that the only disposition can be that the child remain in care on a temporary basis?

Evidence of the Agency

[15] The parents met a couple of years prior to the birth of their first child in September of 2015. There was a 46 year age difference. P.V. had been a sex trade worker. M.H. had previously been a police officer and militia member in his birth country, but worked mainly in security in Canada. He had acquired a criminal record in Canada. He was prescribed marijuana and used it daily. He had become a spiritual adviser.

[16] The main evidence on which the agency relies is a parenting assessment report used in the first court proceeding dealing with S.H., the older child of this couple. The report writer says that the older child was apprehended from the hospital because the “mother was diagnosed with schizophrenia and has not been on her medication for approximately one year,” her extreme mood swings and her inability to care for the child“. As an example, the assessor says, “The baby did not latch properly and P. became upset and was very agitated and demanded formula for the baby”. She also cites the criminal activity of the father and an inability by either to parent.

[17] The agency also claims that the parents have been unable to work cooperatively with the agency. The father was often angry, threatening and difficult to deal with. The mother was more cooperative and was capable of discussing matters with agency staff, but the agency believes that the assessor was correct in her assessment that the mother has cognitive deficits, mental health issues and that there were domestic imbalances which rendered her ineffective. The assessor recommended that the older child not be placed with her parents. She did not observe the parents with the child.

The Parenting Assessment Report

[18] The main evidence on which the agency relies is the report by Dr. Soulange Lavack dated April 9, 2017. As M.H. is deceased, I would not, in any event, consider any of the conclusions in the report relating to him.

[19] Should the court accept this as an expert report? The report makes many conclusions about the capabilities of P.V. and her mental health. It speculates on her ability to focus on and parent S.H., the older child, when that child had also never been in the care of the parents. The report was arrived at without any observation of the parents and child together by the writer.

[20] I recognize that the courts relied on this report in the previous proceeding dealing with the older child. The provision of this report in this proceeding, and following on the Motherisk Report, raises some concerns for the court.

[21] In Regulation 155/18 of the Child, Youth and Family Services Act, a court-ordered assessment is required to meet certain criteria. While it is unknown if this assessment was ordered by the court in the previous case, the criteria are, in my estimation, relevant. They are:

1. A resumé of the person performing the assessment outlining, i. the assessor’s academic and professional qualifications and credentials, including any publications relevant to the questions being addressed, and ii. information regarding the type and number of assessments previously conducted by the assessor.

2. A schedule setting out, i. a summary of the instructions received, whether written or oral, ii. a list of the questions upon which an opinion is sought, and iii. a list of the materials provided and considered.

3. A schedule setting out the methodology used in carrying out the assessment, including the interviews, observations, measurements, examinations and tests, and whether or not they were conducted or carried out under the assessor’s supervision.

4. The reasons and factual basis for any conclusions drawn by the assessor.

5. A direct response to the questions presented to the assessor in the assessment order, or an explanation of why these questions could not be addressed.

6. Recommendations where these were required of the assessor, or an explanation of why recommendations could not be made.

[22] The above list seems to be a good starting point. I find, however, that the agency has failed to provide almost all of the information required.

[23] A resume or curriculum vitae of the writer is not provided. Educational qualifications are not provided. There is no indication of prior expert testimony before courts in Manitoba or Ontario. This is particularly concerning as counsel for the mother raised the issue that the writer of the report, while listed as a member of the Manitoba Association of Psychologists, has no similar membership in Ontario.

[24] It appears that, in Manitoba, a psychologist can self report his or her expertise. Dr. Lavack self-reports expertise in 50 categories. There is no clear delineation of her actual areas of expertise which have been vetted by a professional body.

[25] In Children’s Aid Society Region of Halton v. J.B. 2018 ONCJ 884, [2018] O.J. No 6760, the report of a school psychologist was not admitted by the court as a result of an exaggeration of her expertise. The testimony in that case by the Registrar of the College of Psychologists of Ontario, included the following, as summarized by Justice Penny Jones:

To be registered in one of the eight categories an applicant would have to demonstrate to the College’s satisfaction that enough of the applicant’s coursework and training would put him or her into one of the College’s eight categories of practice. Then there would be a period of supervision by a primary and a secondary supervisor pre-approved by the College, followed by written testing and an oral exam...It is professional misconduct to intentionally make public statements that are misleading or fraudulent as to a member’s area of authorized practice…

[26] The court has not been provided with a resume of Dr. Lavack or proof of qualifications to conduct a parenting assessment in the Province of Ontario.

[27] The questions given to the writer are not set out. The conditions for the tests administered are not specified. The methodology for the investigation, and the reasons for conducting the assessment in a certain way, are not described. The list of interviewees and collaterals is not set out.

[28] One area of the report deals with the cognitive abilities of P.V. The Wechsler Adult Intelligence test was administered. Dr. Lavack found that the mother’s score was extremely low for her age. I do not know that the writer of the report was qualified to administer the test and to analyze the results as that information has not been provided to me.

[29] I chose this particular aspect of the report because, having had P.V. before the court representing herself much of the past two years, the conclusion of the writer of the report seems at odds with my observations of P.V. in the courtroom, where she has been able to intelligently express the position of herself and her husband.

[30] P.V. admits a learning disability and that she left school at an early age. How was this accounted for in the administration of any tests? In addition, P.V. is Metis. How was this considered in the administration of the tests?

[31] In regard to the maternal grandmother, the report describes her as unable or unwilling to support P.V., largely because of her own dysfunctions and alcohol issues. This contrasts with her affidavit filed in this proceeding, which is uncontested, in which she describes her work as a supervising nurse at the hospital in Fort Frances. Was the original assessment of her incorrect? Has the situation changed?

[32] The general atmosphere in which the assessment was conducted is worrisome. The parents had a forty-six year age difference between them. Each of the parents had a troubling history. M.H. was a man of colour originally from another country. P.V. was a Metis woman. They were poor and not people of middle class means. They were involved in Indigenous medicine. Racial, cultural and discriminatory factors, if not recognized, could impact the fairness of such evaluations. There is no indication how these factors were accounted for.

[33] P.V. raises some issues about the fairness and even-handedness of Dr. Lavack. For example, P.V. wanted to show some documents to the doctor regarding the work of the parents. According to P.V., the doctor refused to accept the items, stating that all the information she needed was provided to her in the agency file. This is an unfairness in not allowing the parents to submit their own materials, and to consider their evidence.

[34] Further, when P.V. indicated that they were attending with a traditional healer for assistance, she says that the doctor told her, “cut the hoodoo voodoo shit out”. If this is true, how qualified was Dr. Lavack to provide an assessment related to Indigenous people, especially in Northwestern Ontario where many Indigenous and non-Indigenous people use traditional medicine?

[35] It is also reported by P.V. that she was being bullied by the assessor who was hostile to her throughout the process, especially when she cried.

[36] A parenting assessment can be relevant to the parenting issues which arise in a case before the court. In addition, on a temporary care motion, the court is entitled to consider any evidence which is “credible and trustworthy” in accordance with s. 94(10) of the Child, Youth and Family Services Act.

[37] I cannot admit and rely upon the report related to S.H. dated April 9, 2017 and written by Dr. Lavack. No evidence has been provided to me to verify the qualifications of Dr. Lavack to conduct such an enquiry in Ontario, nor any evidence to assure me that the circumstances of the assessment fell within the expertise of the writer, or that the methodology was appropriate for the issues in that case. I am very concerned about elements of bias and unfairness related to this couple and to P.V. in this report, and I do not have confidence in the report to rely on the conclusions as the assessor.

[38] The report was also written at another time with another child. While it may be relevant, I do not find it credible or trustworthy.

The Mother’s Abilities

[39] P.V. does not have schizophrenia as originally claimed in the first case, but has admitted that she has Borderline Personality Disorder (BPD). Her physician prescribed Dialectical Behavioural Therapy which she has completed. This has given her techniques to use when emotional. She also continues with a low level of Lorazepam as prescribed by her physician.

[40] P.V. attends counselling at the Fort Frances Tribal Area Health Services. She has earned her Grade 12 through the Adult Learning program at the Friendship Centre in Fort Frances. Alcohol and drugs have not been part of her life since before her children were born.

[41] P.V. suffers from an autoimmune disorder called Hashimoto’s disease. This affects the thyroid gland and her hormones and emotions. It appears that this issue is being dealt with by the mother and her physician.

[42] The mother has indicated that she has been willing to sign consents for the agency to access information about her from these sources and to accept the terms and conditions of a supervision order.

[43] The Applicant agency in this matter have provided information to the medical professionals involved with S. I note that the reports of the doctors suggest the following information:

i. Note: October 12, 2020 – Hamid M.D. This 13 month-old child was adopted at the age of 6 months. Her adopted mother knew her from the first day. The child was brought to me by her adoptive parents and the adopted mother had the following concerns; ii Note: October 19, 2020 – Chiu M.D. Mom had a history of substance use during pregnancy; iii Note: November 26, 2020(date of printing, no signature page)(Tab 12) – As per the half-sister, S.’s biological mother also had a history of hepatitis C, syphilis and HSV although it is not clear if any were treated and when this may have occurred…As per her sister, S.’s biological mother is 27 years old and has a history of bipolar disorder, as well as Hashimoto’s and is an IV drug user.

[44] These allegations are not true. How did this information get to the doctors or the sister? Even if the parenting assessment contained some of these erroneous claims, how did the information get to the doctors and the sister without a breach of privacy rules? What is the impact of these claims on the overall opinions of the doctors?

Claims of the Agency

[45] Based on the information produced, and despite the determination by the agency to continue with the position taken at the outset of this matter, I do not find that there are reasonable grounds to consider that S. is in need of protection from the mental health, cognitive abilities or parenting of her mother as there is no evidence supporting that these issues are barriers to her ability to parent nor are there reasonable grounds for believing that these issues will impact on parenting.

[46] It would have been likely that S. would have been returned to her parents if the temporary care motion had been heard earlier.

[47] In this situation, I remove from my consideration, two factors.

[48] I do not consider the evidence related to M.H. He had his own history and personality, but the claims made by the agency in regard to him are no longer relevant to the issue of parenting.

[49] The length of time that S. has been in the care of her sister will not be considered by me. The existing order was made on an interim interim without prejudice basis, and was allowed to remain this way until the first scheduled argument of this motion in October of 2020.

[50] However, in the fall of 2020, S. suffered a serious and debilitating medical situation which changed her circumstances and raised new issues related to the temporary care order. It caused the adjournment of the motion.

Medical Condition of S.

[51] On October 12, 2020, the sister /caregiver of S. took her to the Thunder Bay Regional Health Sciences Centre (TBRHSC) as the child appeared unwell, was not eating well and had difficulty with balance and hand-eye coordination. The child received medication but her condition continued to deteriorate and she was transferred to the Children’s Hospital in London Ontario. At that time, the position of the agency was that the mother required more time to build supports, address protection concerns and work with the agency to ensure that the child would be safe, secure and properly cared for.

[52] S. was diagnosed with Opsoclonus-Myoclonus Ataxia Syndrome. This is an autoimmune reaction in the cerebellum of the child, which coordinates movement. The symptoms observed in the child include loss of the ability to sit up, to hold her head up, to walk, to feed herself and obvious tremors in her extremities. The syndrome appears to be initiated by an infection. Part of the treatment has been IVIG (intravenous immunoglobulin) which is a blood product given by transfusion and Rituximab.

[53] Following application of this treatment, the child seemed to improve by January of 2021. While she was able to begin walking again, she continued to have tremors and a lack of coordination and balance.

[54] Even prior to the death of M.H., the relationship between these parents and D.S., the husband of S.S. was very concerning. P.V. reports that he made comments (set out in the affidavit of October 3, 2020 of P.V.) which were very aggressive, saying, in regard to the children, “They are going to call me daddy.” And to P.V., “You’re nothing but a drug addict.” and “You think this is abuse, its only going to get worse.” These comments, if true, are inappropriate for a temporary caregiver.

[55] During the adjournments following the hearing of this interim motion, the situation of the child has fluctuated with some regression. The agency suggests that the child should not be in the care of her mother because:

1. The child should not be moved from Thunder Bay where medical services are available;
2. The child should not be moved from Thunder Bay due to Covid 19;
3. There may not be any IVIG or the ability to administer it in Fort Frances;
4. The mother may not be able to respond to this medical situation; and
5. There should be no change of caregiver during this time.

[56] The actual medical needs of the child appear to be:

1. A monthly appointment at the Thunder Bay Regional Health Sciences Centre;
2. Daily administration of steroids, which may be being weaned;
3. Monthly transfusions of IVIG and/or Rituximab if necessary;
4. Appointments virtually or in person as agreed with Dr. Warkentin and Dr. Noor.

[57] The mother has indicated an ability to meet these requirements. Meanwhile, the maternal grandmother, L.P., a qualified nurse of twenty years, has offered her assistance in meeting the needs of the child in Fort Frances. S.’s sister and other maternal family members live there.

[58] Fort Frances is a community of about 10,000 people in Northwestern Ontario and is one of its larger communities. It has the LaVerendrye Hospital. The child’s pediatrician says that he is uncertain if there are IVIG supplies at the hospital or the ability to administer it, even though it is a transfusion. The physician of the mother in Fort Frances, Dr. Meyer, says that she is willing to be trained and educated in regard to the child’s syndrome in order to provide care to the child and to assist the mother.

[59] I note that the IVIG and Rituximab are administered on a schedule which is developed when needed.

[60] Throughout the medical emergency related to S., her mother engaged as much as possible given the illness of her husband and the lockdown and the position of the agency not to allow in person visits. She worked cooperatively with the agency to determine the medical steps and did not fail to consent to or support the recommendations of the medical professionals.

[61] The question for the court is whether there are reasonable grounds to believe that the life of the child would be at risk of physical harm if returned to the mother.

[62] There is no evidence that such harm is likely in the mother’s care. However, risk is an issue with a child who has such a difficult disease because the mother is untested, having never had either of her children in her care. The lack of experience of the mother is not the result of her actions, but this apprehension and court case.

[63] I reject the concept that children should be in the care of a child welfare agency because the medical care they need is not available in their own community. The provincial government, which establishes hospitals in the province and resources to them, is the same body that operates the child welfare system. If that reasoning was acceptable, S. would be in London Ontario near the Children’s Hospital there.

[64] Significantly, the Child, Youth and Family Services Act provides that children are only in need of protection regarding their health in certain circumstances. While the agency has not claimed those grounds of protection, they would be the following:

s.74 (2) (e) the child requires treatment to cure, prevent or alleviate physical harm or suffering and the child’s parent or the person having charge of the child does not provide the treatment or access to the treatment , or, where the child is incapable of consenting to the treatment under the Health Care Consent Act, 1996 and the parent is a substitute decision-maker for the child, the parent refuses or is unavailable or unable to consent to the treatment on the child’s behalf;

and

s.74(2)(j) the child suffers from a mental, emotional or developmental condition that, if not remedied, could seriously impair the child’s development and the child’s parent or the person having charge of the child does not provide treatment or access to treatment, or where the child is incapable of consenting to treatment under the Health Care Consent Act, 1996, refuses or is unavailable or unable to consent to the treatment to remedy or alleviate the condition ;

[65] There is no evidence that P.V. has ever refused treatment or made herself unavailable to consent to treatment or is unable to do so. There is no evidence that she does not provide treatment or access to treatment or is intending to refuse to address the medical issues of the child. I am not prepared to anticipate that the parent will fail to provide the child for treatment when there is no history or evidence to support this contention.

[66] Notably, the legislation does not find a child in need of protection when medical services are not available in his or her community. The reason is obvious. It would be reprehensible if children were removed from otherwise good parents in Northwestern Ontario solely for the purpose of receiving medical care in an urban area. The public has not seen fit to pass legislation requiring this to occur. Indigenous and rural families would be disproportionately affected.

[67] Any decision under the Child, Youth and Family Services Act must consider the best interests of a child as set out in s.74 (3) including:

s.74 (3)(c)(v) “the importance for the child’s development of a positive relationship with a parent and a secure place as a member of a family”,

s.74(3)(c)(vii) “the importance of continuity in the child’s care and the possible effect on the child of disruption of that continuity” and s.74(3)(c)(x), “the risk that the child may suffer harm through being removed from, kept away from, returned to or allowed to remain in the care of a parent”.

[68] In my view the agency has not worked in regard to the importance of S. to be in the care of her mother and maternal family which includes her sister S.H.

[69] The best interests of S. include growing up with her parent if possible and within the context of a loving family, which includes her full sister.

[70] A change of residence of S. will break the continuity of the child’s care with her sister, S.S. and her husband D.S. This was, however, the agreement when she was placed with them, that her parents would continue to attempt to ger her into their custody and that was a real possibility.

[71] Is there a risk that S. could suffer harm by being returned to or in the care of her mother? It can be said that there is a risk of a medical emergency taking the life of S. because, if she resided with her mother, she would be residing further from the care that a specialized infant intensive care unit can provide.

[72] I take judicial notice that air ambulance is available in Northwestern Ontario to bring people to the TBRHSC but it also requires time which individuals in medical emergencies do not always have. This is, however, the same situation faced by any parent of a child with medical needs in Northwestern Ontario.

[73] I recognize that there is some risk as a result of her medical situation if the child was to be returned to her mother’s care in Fort Frances. Risk management is always an issue when a child is returned to a parent. Risk needs to be addressed and planned for in order to be reduced.

[74] In this case, however, the medical emergency of the child to date did not arise immediately. There were, in the past, signs of dysfunction preceding the admission of the child to the hospital, then treatment given in Thunder Bay and then delivery of the child to better medical facilities in Southern Ontario. In regard to the use of IVIG, there is nothing to prevent the transfusion to occur in LaVerendrye Hospital or in Thunder Bay, but it is expected that the agency will assist with this if they wish it to happen in Thunder Bay

[75] There is nothing to suggest that Dr. Meyer, who has agreed to be S.’s doctor in Fort Frances, would not recognize the need for the child to move to the bigger medical facility in Thunder Bay or those in Southern Ontario when necessary. In addition, P.V.’s mother has agreed to assist in regard to the medical issues. The plan put forth by the mother satisfies me that she has focused on this issue and that the basics of her plan are satisfactory to meet the needs of S.

Decision

[76] The onus is on the agency to satisfy the court that the child should remain in the care of the agency or others under s.94(2) of the Child, Youth and Family Services Act.

[77] I am not satisfied that there are reasonable grounds to believe that the mother is unable to parent this child, nor that the child should have been apprehended from her. While P.V. and M.H. might have been difficult and uncooperative at the outset, it seems as though the agency relied heavily on the alert and the Lavack report.

[78] The current medical situation of the child is very serious and a central focus of everyone in this case. I am, in this order, giving a period of time for all parties to work together to ensure the best coverage for the child’s needs in Fort Frances and the reduction of risk. There must be consideration for the fact that the child could suffer an emergency in Fort Frances. This order will be fashioned to consider those factors.

[79] I order as follows:

i. P.V. shall have temporary care of S. born […], 2019 subject to terms of supervision; ii The residence of the child will be changed to the mother’s residence within 30 days of the end of the current provincial lock down, and no later. iii During this period, the Children’s Aid Society of the District of Thunder Bay shall: a. Provide training to P.V. and her mother in regard to the medical needs of the child; b. Facilitate the sharing of information and planning between the medical personnel engaged with the child in Thunder Bay, Toronto and in Fort Frances; c. Ensure access by the mother and grandmother sufficient to allow for training in regard to the day to day care of the child; d. Continue to monitor the medical situation of the child; e. Engage the medical establishment and the mother and her family to develop an emergency protocol regarding any medical crisis of the child while in Fort Frances; f. Develop any other supports for the mother or protocols necessary in the circumstances; g. Support the mother with transportation and accommodation as much as possible when medical appointments are necessary in Thunder Bay; h. Support medical contact virtually whenever possible. iv The child will be in the care of her mother subject to the following terms of supervision. The mother shall; a. Have decision-making authority in regard to any medical needs of the child; b. Engage in and complete any training provided by the agency or physicians in regard to the care of the child; c. Continue with counselling and any therapy for herself recommended by her physician; d. Work with her mother, L.P., the agency and S.’s medical team to develop an emergency protocol for any medical emergency arising in Fort Frances; e. Sign any consents requested by the agency in regard to the medical and other needs of the child; f. Allow regular agency visits to her home to assess the condition of the child; g. Attend medical appointments set up by Dr. Meyer, Dr. Warkentin or Dr. Noor, and attend virtually when agreed. h. Comply with public health regulations regarding Covid 19.

[80] The matter will be adjourned to May 18, 2021 to be spoken to.

Released: April 26, 2021 Signed: Justice D.J. MacKinnon